More Money, Better Heart Health? Not Always

Young people who pull themselves out of poverty may be no better off when it comes to their heart health, a new study suggests.

Researchers found that “upwardly mobile” U.S. adults tended to be less stressed and depressed than peers who spent their whole lives below the poverty line. Unfortunately, it did not make a difference in their cardiovascular health.

They were just as likely to have conditions like obesity and elevated blood pressure, blood sugar and cholesterol, the study found.

The results might sound surprising, said Dr. Nieca Goldberg, a cardiologist and volunteer expert with the American Heart Association. After all, both higher income and better mental health have been consistently linked with better physical health.

“But I can think of a few reasons for the findings,” said Goldberg, who was not involved in the study.

“When you consider it, these are people who work very hard,” she said. “They may be really focused on their jobs, at the expense of other things. They may have no time for exercise, or end up eating a lot of grab-and-go foods.”

Compared with people whose income stays low, Goldberg said, they may be less worried about money and security — and, therefore, in better mental shape. But that doesn’t necessarily mean their lifestyles are healthy.

Lead researcher Gregory Miller agreed that lack of time for exercise or “restorative activities” like vacations could be a factor. But he also pointed to the “direct physical toll” of constant striving for the proverbial American dream.

Upwardly mobile Americans did show less psychological distress. But measures used in the study might not have picked up subtler issues, according to Miller, a faculty fellow at Northwestern University’s Institute for Policy Research in Evanston, Ill.

“When you talk to people,” he said, “you hear things like, ‘I got to where I am due to great determination.’ And the attitude can be, ‘I don’t have time to be depressed, I don’t have time to be stressed. I have to keep going.'”

It can all start early, when a kid from a poor family “beats the odds” and gets into college, according to Miller. If earlier schooling left them less prepared, they may need to hit the books twice as hard as more-advantaged classmates.

The mindset of “I need to work twice as hard” can persist, especially for minorities facing racial discrimination, Miller said.

Other research has linked that type of striving to higher levels of stress hormones and signs of faster “aging” in blood cells, according to Miller’s team.

The current findings are based on data from two U.S. health studies begun in the 1990s. One involved a nationally representative sample of teens who were followed until their early 30s; the other included adults of all ages.

Participants were considered upwardly mobile if they grew up in families living below the poverty line or receiving welfare but their own incomes were higher.

Compared with their peers who remained in poverty, that group did report less “perceived stress” and depression symptoms, Miller’s team found. But they were just as likely to have metabolic syndrome — a collection of risk factors for heart disease that includes abdominal obesity, and elevated blood pressure, blood sugar and cholesterol.

Overall, 29% of upwardly mobile Americans had metabolic syndrome by age 29, and 44% had developed it by middle-age. That compared with 24% and 33%, respectively, among people who were more advantaged throughout life.

The findings were published online April 28 in the Journal of the American Heart Association.

According to Goldberg, higher earnings may protect upwardly mobile people from some major stressors their parents faced — like worrying about paying the rent or affording groceries. “But money can’t buy you health,” she said.

Goldberg encouraged hard-working people to remember to care for themselves, too. That, she said, can be as simple as taking walks with your family.

Beyond that, Miller pointed to the need for broader efforts.

At colleges, for example, students from disadvantaged backgrounds can often get academic help if they need it; but, Miller said, “we don’t do much to help them feel more included.”

It can be isolating, he noted, “when you don’t have enough money for the football game, let alone the weekend ski trip.”

More information

The American Heart Association has more on metabolic syndrome.