Although there are many health-related advantages to higher socioeconomic position, the relationship between high job-strain, work-related stress, and psychosocial working conditions in midlife can complicate this relationship over the life course. Seminal work on the social determinants of health has highlighted that individuals in the most socio-economically deprived individuals are likely to have the poorest health outcomes. Conversely, individuals in the upper ends of the socioeconomic spectrum are more likely to enjoy greater health, wealth, and longevity than their disadvantantaged counterparts. With that said, indicators of higher socioeconomic position, such as housing tenure, income, and occupation, may also be associated with occupations that have greater work-related stress, less perceived control, and lower levels of happiness than individuals in lower socioeconomic positions. For example, recent reviews have highlighted that work-related stress in the banking sector is associated with deleterious effects on mental and physical health. Consequently, working long hours in demanding occupations may have long term implications for health and wellbeing in later life. In order to mitigate the potentially negative impact of mid-life stressors on the long-term health and wellbeing of older adults, better outcomes may be facilitated by empowering individuals to adapt more successully to their current circumstances through the fostering of resilience resources.
Individuals that experience more positive outcomes than would be expected given the level of adversity demonstrate what is known as “resilience”. With roots in developmental psychology, examining the trajectories of the children of parents with alcoholism, the field of resilience has expanded to examine the full spectrum of the lifecourse, particularly in later life. The elements that constitute resilience may vary depending on the particular context, but in every circumstance there must be some sort of adversity that is linked to some sort of positive outcome. The exact nature of these components can be any combination of physiological or psychological variables, for example: life satisfaction whilst living with a chronic disease or quality of life after the loss of a spouse. Resilience has been described as both a trait as well part of a more dynamic, modifiable process. A fundamental attribute of traits is that they are relatively stable across the life course, making this a poor target for interventions: trait resilience refers to a type of resilience that is largely immutable that some individuals are born with, and others are not. For dynamic conceptualizations of resilience, modifiable aspects of lifestyle may facilitate greater levels of resilience, which is more suited to developing targeted interventions.
Resilience fostering factors may have an impact both during and years after one experiences adversity; therefore, if one is able to foster greater resilience earlier in life it may be possible to offset the long-term negative implications. For example, using the British 1946 Birth Cohort Study, we examined the association between psychosocial trauma on adolescents and the mental health of these individuals five decades later, observing that individuals who experienced greater psychosocial adversity in early life had much poorer mental health outcomes in later life. Further, we identified social support as mediating this relationship, i.e. the negative implications of early life adversity could be offset by integrating resilience fostering factors into one's life.
Alongside social support, other resilience resources associated with better physical and mental health outcomes include modifiable lifestyle behaviors such as physical exercise, mindfulness, coping strategies. An advantage of incorporating these behaviors into one’s life is that they are associated with both proximal and distal positive impacts; individuals may be able to improve their current circumstances as well as foster better long-term outcomes.
Oftentimes individuals are unaware of increases in their level of stress and/or that they have reduced activities previously used to offset this stress. The boiling frog fable comes to mind: a frog placed into a pot of boiling water immediately jumps out of the pot, but when the frog is put into a pot of cold water and the temperature is slowly increased, the frog is boiled and dies. Similarly individuals that have increasingly demanding stressors may not realize the degree to which their stress has increased, nor the negative implications for their health and wellbeing.
Capturing a variety of biomarkers that are able to quantify, track, or indicate one’s level of health and wellbeing may be useful in developing strategies for resilience. If individuals are able to monitor their health and wellbeing earlier in the life course and integrate resilience fostering behaviors, there are short and long-term implications for the improvement of individuals’ health outcomes. Complementing traditional clinical assessment, the movement towards mHealth innovations that track individuals’ health and health related behaviors has gained traction amongst the general public as well as within organizations. If an organization is built on fostering circumstances in which they have the most productive employees for the longest period of time possible, the integration of mHealth technologies alongside traditional clinical interventions that can facilitate these outcomes is critical. To this end, companies such as The Harper Institute work with employers who have employees in high-stress circumstances, developing in-person and digital platforms that monitor the health and wellbeing of employees in order to foster better long-term outcomes for both the individuals and the company as a whole. Through the integration of platforms such as these, it may be possible to offset negative health outcomes long before the initial symptoms develop. By tracking and monitoring individuals’ health, it may be possible to foster greater resilience in the short-term as well as develop resilience resources that foster better long-term outcomes for older adults.
Although there are many benefits afforded by higher socioeconomic position, there are instances in which individual health may be adversely affected by stressful work environments. In order to offset the impact of these stressors, identifying resilience resources may mitigate some of these negative outcomes in later life. By improving one’s capacity to address adversity in the short and long-term, it may be possible to foster greater health and wellbeing across the lifecourse.
About the Author
Theodore D Cosco joined the Oxford Institute of Population Ageing in 2016 as a Research Fellow. Dr. Cosco is a Chartered Psychologist (British Psychological Society) trained in applied social research methods (MSc 2011, Trinity College Dublin) and epidemiology (PhD 2015, University of Cambridge), and Assistant Professor of Mental Health and Aging in the Department of Gerontology, Simon Fraser University. His research interests include resilience, mental health, and the interface between technology and healthy ageing.
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