A Biopsychosocial Investigation of Women's Health at Midlife

Upchurch, Dawn; Greendale, Gail; Wildman, Rachel

Abstract

Midlife is a time of significant change in women's personal and professional lives. Moreover, health increasingly deteriorates, setting the stage for quality of life in later years. The purpose of the proposed research is to identify and investigate the longitudinal explanatory pathways that impact 3 important health outcomes. We target outcomes that are common and that have high personal and social costs: 1) Vasomotor Symptoms;2) Depressive Symptoms;and 3) Allostatic Load. A distinguishing feature of this research is its use of an innovative biopsychosocial model that incorporates multiple domains of women's lives and acknowledges the multidimensionality of women's health. Specifically, we investigate the impact of: 1) Social Stressors and Social Support;2) Psychological Factors;and 3) Lifestyle Behaviors on each health condition over a 10-year period using latent growth curve analysis, longitudinal structural equation models, and longitudinal random effects, as appropriate. In so doing, we will identify the specific pathways for both level and change over time for each woman for each health outcome. Because we propose that multiple aspects of health are linked in complex ways, we will also examine the interrelationships between the intervening variables, between the health outcomes, and investigate possible feedback between health outcomes and intervening variables. Data are from the Study of Women Across the Nation (SWAN) a community-based, 10-year longitudinal study of midlife women (aged 42-52 at baseline) designed to characterize the physiological and psychosocial changes that occur during the menopause transition. By emphasizing characteristics that are potentially modifiable, the proposed research will provide new information relevant to clinical and programmatic intervention that may serve to reduce health differentials and promote well-being among midlife women.

Public Health Relevance

Promoting health and well-being, especially as women enter into midlife and early old age is a key public heath priority. By better understanding how social, psychological, and lifestyle factors (many of which are modifiable) contribute to health during midlife, new information relevant to clinical and programmatic interventions will become available.