Cited by 351Stress Responses and CortisolHealth disparities and outcomesEmployment and Welfare Studies

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Psychobiological mechanisms of socioeconomic differences in health

Kristenson, M, Eriksen, H.R, Sluiter, J.K, Starke, D, Ursin, H·2004·Social Science & Medicine

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Abstract

The association between low socioeconomic status and poor health is well established. Empirical studies suggest that psychosocial factors are important mediators for these effects, and that the effects are mediated by psychobiological mechanisms related to stress physiology. The objective of this paper is to explore these psychobiological mechanisms. Psychobiological responses to environmental challenges depend on acquired expectancies (learning) of the relations between responses and stimuli. The stress response occurs whenever an individual is faced with a challenge. It is an essential element in the total adaptive system of the body, and necessary for adaptation, performance and survival. However, a period of recovery is necessary to rebalance and to manage new demands. Individuals with low social status report more environmental challenges and less psychosocial resources. This may lead to vicious circles of learning to expect negative outcomes, loss of coping ability, strain, hopelessness and chronic stress. This type of learning may interfere with the recovery processes, leading to sustained psychobiological activation and loss of dynamic capacity to respond to new challenges. Psychobiological responses and health effects in humans and animals depend on combinations of demands and expected outcomes (coping, control). In studies of humans with chronic psychosocial stress, and low SES, cortisol baseline levels were raised, and the cortisol response to acute stress attenuated. Low job control was associated with insufficient recovery of catecholamines and cortisol, and a range of negative health effects. Biological effects of choice of lifestyle, which also depends on the acquired outcome expectancies, reinforce these direct psychobiological effects on health. The paper concludes that sustained activation and loss of capacity to respond to a novel stressor could be a cause of the higher risk of illness and disease found among people with lower SES.

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Authors: Kristenson, M., Eriksen, H. R., Sluiter, J. K., Starke, D., & Ursin, H.
Affiliations: Linköping University (SE)
University of Bergen (NO)
Amsterdam UMC Location University of Amsterdam (NL)
Heinrich Heine University Düsseldorf (DE)
Corresponding author: Kristenson, M
ORCID: Kristenson, M
Eriksen, H.R
Starke, D
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2004-04
Volume: 58
Issue: 8
Pages: 1511-1522
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/s0277-9536(03)00353-8
OpenAlex: W2074544938
Cited by: 351
References: 149
Citations by year: 2026: 4 · 2025: 8 · 2024: 9 · 2023: 19 · 2022: 12 · 2021: 11 · 2020: 8 · 2019: 11 · 2018: 5 · 2017: 17 · 2016: 18 · 2015: 15 · 2014: 23 · 2013: 10 · 2012: 20
FWCI: 1.89
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
Keywords: socioeconomic status, health disparities, psychosocial stress, stress physiology, cortisol, job control, coping, outcome expectations, chronic stress, catecholamines, lifestyle choices, psychobiological mechanisms, social status and health
MeSH terms: Adaptation, Psychological, Health Status Indicators, Humans, Life Style, Social Class, Socioeconomic Factors, Stress, Psychological, Time

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Psychobiological mechanisms of socioeconomic differences in health

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