This application is a competitive revision of POI AGO20166-07A2, "Integrative Pathways to Health and Illness." We seek funds to add 1,400 older respondents (aged 55-74) to the ongoing "Refresher" data collection for the MIDUS (Midlife in the U.S.) national study. Reviewers of our competitive renewal for the POI (2011-2016) strongly encouraged this submission. The expanded Refresher sample will parallel the size and age distribution of the MIDUS I sample, thus affording two rich datasets for investigating pathways to health, with baselines situated on either side of historic economic change occurring in the U.S. Newly recruited older adults will complete a phone interview, two questionnaires, and a telephone-based cognitive battery. In addition, randomly selected subsamples will participate in 8-day diary assessments (n = 400), accompanied by 4 days of salivary assessments (Cortisol, DHEA-S, alpha amylase) 4 times a day as well as a 2-day clinic visit for comprehensive biomarker assessments (n = 200), including a laboratory challenge protocol accompanied by on-line physiological measures.
Aim 1 is focused on age effects of the economic recession. We predict that younger Refresher respondents will exhibit greater vulnerability in income and wealth, whereas older adults will show vulnerability in retirement savings and difficulty finding new work following lay-off. Health concomitants of economic hardship are also predicted to vary by age.
Aim 2 is focused on period effects of the economic recession. Due to greater exposure, we predict that the post-recession Refresher sample will exhibit more compromised mental and physical health compared to the pre-recession MIDUS baseline sample (with respondents matched on age). Although aging brings increased risk for physical health problem, we predict that such effects will be most evident among the post-recession Refresher sample, particularly those with pre-existing vulnerability (low educational status).
Aim 3 is focused on psychosocial moderating effects of life course (aging) and socioeconomic (social inequalities) effects on health. Using combined Refresher and MIDUS samples, we hypothesize that adverse health effects of economic hardship will be amplified among those with higher levels of vulnerability moderators (work-family conflict, job stress, neuroticism). Alternatively, among those with high protective moderators (well-being, sense of control, cognitive abilities, mental cohesion, and social support) adverse health will not be evident. The expanded MIDUS Refresher will lay the foundation for future tracking how economic hardship is changing the life course of different cohorts of American adults.
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