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. 2012 Mar;7(2):135-58.
doi: 10.1177/1745691612436694.

"Shift-and-Persist" Strategies: Why Low Socioeconomic Status Isn't Always Bad for Health

Edith Chen  1 , Gregory E Miller  2
Affiliations

"Shift-and-Persist" Strategies: Why Low Socioeconomic Status Isn't Always Bad for Health

Edith Chen et al. Perspect Psychol Sci. 2012 Mar.

Abstract

Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES and poor health and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that, in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low-SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self through reappraisals) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low-SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.

Keywords: cardiovascular; health; resilience; socioeconomic status.

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Figures

Figure 1
Figure 1
Model of how “shift-and-persist” strategies lead to health benefits among low socioeconomic status (SES) individuals. The model depicts how low SES children are embedded within broader family and neighborhood contexts which entail exposure to recurrent, often uncontrollable stressors. Traditional models (middle row in model) state that thesestressors evoke a constellation of psychological responses, including cognitive threat appraisals, negative emotions, and coping behaviors, as well as health behaviors that can contribute to disease. These responses in turn elicit acute physiological activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, which if maintained over time, promote long-term pathogenic mechanisms that result in disease years later. However, in the midst of this adversity, some low SES children are able to find positive role models, who provide stable attachment relationships that promote positive beliefs about others and the world (e.g., trust and optimism), and who socialize children about appropriate emotion regulation behaviors. In turn, attachment and socialization of behaviors allows children to more easily shift themselves in the face of immediate stressors (reappraise stressors and regulate their emotional reactions), while at the same time, persisting with life by holding on to meaning and optimism. Together, this set of strategies makes low SES children less likely to acutely display negative psychological and physiological responses to stressors. Over a lifetime, these tendencies can offset the pathogenic processes for chronic diseases of aging that low SES normally sets into motion.
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References

    1. Adler NE, Boyce T, Chesney MA, Cohen S, Folkman S, Kahn RL, et al. Socioeconomic status and health: The challenge of the gradient. American Psychologist. 1994;49:15–24. - PubMed
    1. Adler NE, Boyce WT, Chesney MA, Folkman S, Syme SL. Socioeconomic inequalities in health: No easy solution. Journal of the American Medical Association. 1993;269:3140–3145. - PubMed
    1. Affleck G, Tennen H, Croog S, Levine S. Causal attribution, perceived benefits, and morbidity after a heart attack: an 8-year study. J Consult Clin Psychol. 1987;55(1):29–35. - PubMed
    1. Ahnert L, Gunnar MR, Lamb ME, Barthel M. Transition to child care: associations with infant-mother attachment, infant negative emotion, and cortisol elevations. Child Dev. 2004;75(3):639–650. - PubMed
    1. Allen JP, Hauser ST, Borman-Spurrell E. Attachment theory as a framework for understanding sequelae of severe adolescent psychopathology: an 11-year follow-up study. J Consult Clin Psychol. 1996;64(2):254–263. - PubMed