Association between socioeconomic status and metabolic syndrome in women: testing the reserve capacity model

OBJECTIVE: Low socioeconomic status (SES) environments may impede the development of a bank of resources, labeled reserve capacity, and may also be stressful, thereby depleting available reserves. In consequence, lower SES persons may experience more negative emotions, leading to adverse health consequences. The authors tested the reserve capacity model in relation to the metabolic syndrome. DESIGN: There were 401 initially healthy women who followed longitudinally for 12 years. Self-reported characteristics, stressors, and cardiovascular risk factors were measured repeatedly. Structural equation modeling was used to evaluate hypothesized relationships. MAIN OUTCOME MEASURE: Metabolic syndrome factor. RESULTS: Confirmatory factor analysis verified reserve capacity as the aggregate of optimism, self-esteem, and social support, and negative emotion as the aggregate of depressive symptoms, anger, and tension. Structural equation modeling showed two pathways to the metabolic syndrome factor, (chi2(59) = 111.729, p < .0001 chi2/df = 1.894; CFI = .956; RMSEA = .047): direct from low SES to the metabolic syndrome factor (B = -0.19, t = -3.24, p = .001); and indirect, from low SES to low reserve capacity to high negative emotions to the metabolic syndrome factor (B = -0.024, t = -2.05, p = .04). CONCLUSION: Low SES may increase risk for metabolic syndrome, in part, through reserve capacity and negative emotions.