For decades, research upheld a common assumption: Wealth equals health. Because higher income is linked with fewer health problems, it's typically assumed that if a person's financial status improves, so will their health.
But according to new research, there is a hidden trade-off to ascending the socioeconomic ladder.
In a study published Tuesday in the Journal of the American Heart Association, scientists found that while wealth can improve mental health it does not always improve cardiometabolic health. Cardiometabolic health relates to one's chance of developing diabetes, heart disease, or stroke.
This paper adds to growing evidence that there are unique stressors on people who "buck the odds" and improve their financial status.
Tracking how wealth affects health — While climbing the socioeconomic ladder is part of the "American dream", the process of climbing that ladder comes with other costs, co-author Greg Miller, a psychologist at Northwestern University, tells Inverse.
"There's a lot of struggle and stressors associated with climbing the ladder," Miller says.
To study the relationship between upward mobility, stress, depressed mood, and cardiometabolic health, Miller and his team analyzed the data of 9,419 people who participated in two multi-decade studies.
The participants entered the studies sometime between ages 11 and 20 and stayed in the study until they were between the ages of 24 and 32. The participants were grouped into one of four categories based on their family income during childhood and adulthood: consistently advantaged, consistently disadvantaged, those who experienced upward mobility, and those who experienced downward mobility.
To distinguish where participants fell, the team took note of the participant's parent's education level, and whether the family received welfare during the participants' childhood or adolescence. Later in life, the team measured the participants' socioeconomic status based on whether they made more or less than $15,000 annually.
The researchers compared the participants' financial situations to measures of cardiometabolic health. These signs include abdominal fat, high blood pressure, elevated cholesterol levels, and high blood glucose, which can indicate metabolic syndrome.
"There's a lot of struggle and stressors associated with climbing the ladder."
Ultimately, the team observed a strange trade-off. As expected, upwardly mobile participants reported substantially less psychological distress than consistently disadvantaged individuals. In fact, most reported similar distress levels to those who were consistently advantaged.
But at the same time, upwardly mobile participants had a higher risk of metabolic syndrome compared to those who were always advantaged. In this case, this group more closely resembled individuals with consistent disadvantage.
Together, this suggests upward mobility doesn't always improve cardiometabolic health, even if it improves economic standing and mental health.
"We've known for a long time that when people have higher socioeconomic status, whether you define that by education or income or wealth, they generally have better health and in particular, cardiovascular health," Miller explains. "But these findings show that that the health benefits that you get from that status depend somewhat on how you got there."
For now, researchers are still untangling the web of social, behavioral, and environmental factors that drive this trade-off. This team speculates that lower-socioeconomic students face a long line of stressors, which then forces them to work double-time to catch up to their more advantaged peers.
Becoming upwardly mobile today, Miller points out, is harder than it used to be. Indeed, two-thirds of Americans born in the forties and fifties attained a higher socioeconomic status than their parents, while fewer than half the children born in the seventies and eighties were able to do the same.
To deal with the hurdles that make it difficult to move financially upward, young people have to employ traits like tenacity and self-control. But these traits, Miller says, may act like a "double-edged sword." They likely make it easier to deal with certain stressors, which boosts mental health. But they can't eliminate the stressors.
It may be that these stressors still affect cardiometabolic health, even if a person isn't processing them emotionally.
These results suggest that workplaces and universities need to be mindful of this complicated cause-and-effect, and create environments where individuals can feel supported physically and mentally at all times — not just because they've reached a certain status or not.
"There's a tendency for people to think 'Okay, you've made it to a high-status position — you're a doctor, lawyer, journalist, finance person, or an engineer — [so] you've 'made it,'" Miller says.
"But the life you live once you get there is still quite dependent on where you came from."
Background: To the extent they are higher in socioeconomic status (SES), people generally enjoy better cardiovascular health across the lifecourse. However, recent studies of upward mobility, where a child goes on to achieve higher SES relative to his/her parents, suggest that it entails a tradeoff between better psychological well-being and worse cardiometabolic health. Here, we consider further evidence for this tradeoff in two multi-decade studies, asking how upward income mobility relates to subsequent perceived stress, depressive symptoms, and metabolic syndrome. We ask parallel questions about downward mobility. Finally, given shifting patterns of mobility in recent generations, we also consider whether mobility’s association with health outcomes differs for individuals born in the middle and later parts of the 20th century.
Methods and Results: We analyzed prospective data from the National Longitudinal Study of Adolescent Health (N=7542) and the Midlife in the United States (N=1877) Study. In both studies, evidence of the tradeoff was observed. Upward mobility presaged lower perceived stress and fewer depressive symptoms, in combination with higher metabolic syndrome rates. Downward mobility, by contrast, presaged worse outcomes on all health indicators. The magnitude of the mobility- health associations was similar across cohorts.
Conclusions: These findings provide evidence that upward income mobility is associated with a tradeoff between well-being and cardiometabolic health. The similarity of the findings across cohorts suggests this tradeoff a generalized consequence of ascending the socioeconomic hierarchy, at least for Americans born in the middle and later parts of the 20th century.