Nowhere is the influence of SES on the body clearer than in the cardiovascular system.
less capable than those with more, but rather that the psychological toll of being low income can impact the way the brain functions. For example, research by Sendhil Mullainathan and Eldar Shafir, discussed in their book, Scarcity: Why Having Too Little Means So Much , has shown that cognitive performance varies with current financial resources, even within the same person. In a fascinating study on farmers in India, researchers found that immediately following harvest time, when the farmers were comparatively rich, they performed well on challenging tasks designed to test their executive functioning, specifically their ability to plan, maintain, and manipulate information (analogous to “thinking on your feet”). Be fore the harvest, when the farmers had fewer financial resources, they performed worse. These findings suggest that cognitive ability is not simply a trait that operates at the same level regardless of circumstances, but rather that our financial situation at any given time can influence how well we perform. In other words, it’s unlikely that people with fewer years of education or who make less money are inherently less capable than those with more, but rather, that the stress of not having enough financial resources and needing to constantly juggle what little money we have can take a toll on our cognitive performance. productivity and school performance; for people living paycheck to paycheck or reliant on student loans, their work or academic performance may suffer during times of the month or year in which they have less money, because the lack of resources is preventing them from functioning at their peak. It’s not difficult to imagine the implications this has for work
often refer to this process as “emotion regulation,” or our ability to turn off our negative emotional responses with different coping strategies. The ability to successfully turn down emotions is facilitated by activity in prefrontal regions of the brain, which, via their connections to other regions like the amygdala, can help down-regulate our initial emotional responses. To date, only two known studies have asked if SES influences neural responses during emotion regulation. Both of these studies found that people from lower SES backgrounds showed lower levels of activity in the prefrontal cortex when they attempted to regulate their emotional responses to negative images, like a picture of a gruesome car crash. Interestingly, one of these studies found that higher levels of chronic stress among people from lower SES backgrounds was a major contributor to this association between SES and lower prefrontal cortex activity, once again pointing to stress as a critical pathway through which SES may influence the brain and, ultimately, health. It’s important to pause here and point out that studying associations between SES and brain function raises challenging physiological questions. For example, do people from lower SES environments have brains that are “wired differently” based on something inherent in them (like genetics), or are factors related to the socioeconomic between the rich and the poor? In other words, if there are differences in brain functioning between people who have less and those who have more, is that due to “nature” or “nurture”? Interestingly, research suggests that people with less money or fewer years of education are not inherently climate the drivers of observed differences in brain functioning
Taking Social Class to (the) Heart It is now clear from the past decade of neuroimaging research that one’s socioeconomic status influences how the brain is functioning, particularly activity in the amygdala and the prefrontal cortex, both of which are critical for how we react to and recover from stress. But how does that brain activity translate into physiological changes that can influence health? Nowhere is the influence of SES on the body clearer than in the cardiovascular system. Hundreds of studies have shown that individuals from lower SES backgrounds have higher blood pressure and greater arterial plaque buildup, and ultimately suffer heart attack and stroke at higher rates, than those of higher status. Unhealthy behaviors undoubtedly contribute to this link: tobacco companies are more likely to advertise in and offer discounts at shops in low SES neighborhoods, contributing to greater cigarette smoking; many lower SES communities are “food deserts,” with an abundance of fast food restaurants and convenience stores and a lack of healthy, affordable food options (like grocery stores and farmers markets); and lower SES neighborhoods are less likely to have parks and other green spaces where people can safely exercise and spend time outdoors. Over time, these limited opportunities for healthy eating, physical activity, and smoke-free living can take a toll on the heart and arteries, increasing risk for heart disease and major cardiovascular events like stroke and heart attack. Beyond these behavioral pathways linking SES and cardiovascular risk, research suggests that cardiovascular responses to stress represent another way in which social hierarchies can impact the heart. So many studies have investigated this question that a
16 DANA FOUNDATION CEREBRUM | WINTER 2020
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