Psychosocial Consequences of Body Weight and Obesity

The body weight of U.S. adults and children has risen markedly over the past three decades. The physical health consequences of obesity are widely documented, and emerging research from the Midlife in the United States study and other large-scale surveys reveals the harmful impact of obesity on adults’ psychosocial and interpersonal well-being. This chapter synthesizes recent research on the psychosocial implications of body weight, with attention to explanatory mechanisms and subgroup differences in these patterns. A brief statistical portrait of body weight is provided, documenting rates and correlates of obesity, with a focus on race, gender, and socioeconomic status disparities. The consequences of body weight for three main outcomes are described: institutional and everyday discrimination, interpersonal relationships, and psychological well-being. The chapter concludes with a discussion of the ways that recent integrative health research on the psychosocial consequences of overweight and obesity inform our understanding of population health.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

Weight Identity Among Older Adults in the United States: Genetic and Environmental Influences

This chapter uses twin pairs from the Midlife in the United States study to investigate the genetic and environmental influences on perceived weight status for midlife adults. The inquiry builds on previous work investigating the same phenomenon in adolescents, and it shows that perceived weight status is not only heritable, but also heritable beyond objective weight. Subjective assessment of physical weight is independent of one’s physical weight and described as “weight identity.” Importantly, significant differences are shown in the heritability of weight identity among men and women. The chapter ends by discussing the potential relevance of these findings for broader social identity research.

Disparities in Health Between Black and White Americans: Current Knowledge and Directions for Future Research

Conceptual frameworks for racial/ethnic health disparities are abundant, but many have received insufficient empirical attention. As a result, there are substantial gaps in scientific knowledge and a range of untested hypotheses. Particularly lacking is specificity in behavioral and biological mechanisms for such disparities and their underlying social determinants. Alongside lack of political will and public investment, insufficient clarity in mechanisms has stymied efforts to address racial health disparities. Capitalizing on emergent findings from the Midlife in the United States (MIDUS) study and other longitudinal studies of aging, this chapter evaluates research on health disparities between black and white US adults. Attention is given to candidate behavioral and biological mechanisms as precursors to group differences in morbidity and mortality and to environmental and sociocultural factors that may underlie these mechanisms. Future research topics are discussed, emphasizing those that offer promise with respect to illuminating practical solutions to racial/ethnic health disparities.

The Roles of Twin Studies and Modern Genomic Technologies in Integrative Health Science

This chapter focuses on genetically informative research design and strategy in integrative health science (IHS). A feature of IHS is studying individual differences in health outcomes together and in a multidisciplinary manner. The chapter focuses on the advantages of using genetically informative research strategies for IHS. Genetically informative strategies are tools to enrich inferences within the IHS paradigm. They help parse the meaning of observed associations between exposures and outcomes. Two strategies are considered for the Midlife in the United States study : (1) Gene × Environment interactions and (2) correlations between education and allostatic load. A strategy likely to be employed in IHS research involves using segments of RNA to understand mechanisms underlying health and illness, focusing on the conserved transcriptional response to adversity (CTRA). The conclusion is that IHS and genetically informative research strategies are natural allies in understanding origins of health and illness in the population at large.

Intimate Partner Relationships and Health

The linkages between intimate relationships and superior physical and mental health are well documented. Contemporary scholars explore under what conditions, for which outcomes, for whom, and through which pathways marriage and other intimate partnerships affect health. The chapter summarizes conceptual frameworks for understanding marriage and health, and contemporary empirical studies yielding four main discoveries: Relationship status is powerfully linked to health in cross-sectional studies, yet weaker associations are found in longitudinal studies that account for social selection; the protective effects of romantic partnerships vary based on characteristics of the union; the marriage–health nexus varies based on gender, race, and age; and (d) integrative science approaches have advanced understanding of the pathways linking social relationships to health. The review draws on population-based longitudinal studies, notably the Midlife in the United States (MIDUS) study. Implications of contemporary research on marriage and health for policy and practice are highlighted.

Perceived Discrimination and Health: Integrative Findings

The Midlife in the United States (MIDUS) study was the first national health study to include a comprehensive battery to measure both major acute and chronic experiences of discrimination. Studies using MIDUS data have made significant contributions to the growing area of research on discrimination and health. This chapter provides an overview of research on discrimination and health, giving special attention to how findings from the MIDUS study have contributed to this literature. It provides a description of the discrimination instruments in MIDUS and summarizes key MIDUS findings that have examined discrimination in relation to health outcomes. This chapter outlines priority areas for future research. With growing recognition of the need to better understand the conditions under which specific aspects of discrimination are pathogenic for particular social groups, this chapter highlights the importance of using MIDUS to reach these goals.

Psychosocial Resources and Physiological Dysregulation

Psychosocial resources refer to individual personality and social relationship factors that tend to cluster together and contribute to psychological and physical health and well-being. Growing evidence demonstrates robust relations between psychosocial resources and health. Physiological dysregulation represents one key mechanism that may help to explain the link between psychosocial resources and health. The current chapter focuses on the relations of psychosocial resources with physiology, drawing on findings from the Midlife in the United States (MIDUS) study and other large, epidemiological studies. The focus is on the relations of psychosocial resources with allostatic load, a composite index of multisystem physiological dysregulation, while also highlighting select findings for individual biomarkers. The summary of evidence examines psychosocial resources as both a direct and a moderating factor on biological outcomes. The chapter concludes with suggestions for future research.

Daily Positive Experiences and Health: Biobehavioral Pathways and Resilience to Daily Stress

Positive emotions and minor positive events are more likely to occur in people’s daily lives than negative emotions and stressors. This chapter provides an overview of theoretical perspectives and previous research linking positive experiences with stress and health. A conceptual framework is proposed that describes constructs within the realm of “daily positive experiences.” The framework posits that daily positive experiences contribute to health through biological, behavioral, and stress-buffering pathways. The sociodemographic patterning of daily positive experiences by age, gender, race, and socioeconomic status is described. Multidisciplinary work is presented linking between-person differences and within-person (day-to-day) variations in daily positive experiences to stressor reactivity, inflammation, and diurnal cortisol rhythms. The chapter concludes with a discussion of unanswered questions and key areas for future discovery and innovation. The study of everyday positive experiences provides insights into health and well-being that go beyond what can be learned from focusing solely on negative experiences.

Social Inequalities, Psychological Risk and Resilience, and Health

Epidemiological evidence from the Midlife in the United States and other studies shows robust socioeconomic disparities in mental and physical health outcomes. Considerable heterogeneity exists in health within socioeconomic strata; not all socioeconomically disadvantaged individuals exhibit poor health. Evidence is presented supporting an integrative conceptual framework wherein psychological factors moderate the association between socioeconomic status and health, illuminating unique risk and resilience profiles. Regarding protective factors, distinctions between hedonic well-being and eudaimonic well-being are highlighted. Regarding psychological risk factors, the focus is on the experience and expression of anger. Several pathways through which socioeconomic and psychological factors may affect health, including health behaviors, emotion regulation, and physiological responses to stress are considered. The chapter concludes with directions for future research, including efforts to integrate psychological strengths and risk factors and the need for longitudinal and intervention approaches to address the public health issue of health disparities from a biopsychosocial perspective.