Low socioeconomic status (SES) is associated with a wide array of poor health outcomes. Nonetheless, some low-SES individuals maintain good physical health despite facing recurrent, severe adversities in life. This article describes a “shift-and-persist” model that explains why that is. The model states that in the midst of adversity, some low-SES children find role models who teach them to trust others, to better regulate their emotions, and to focus on their futures. Over a lifetime, these low-SES individuals may develop an approach to life that prioritizes shifting (accepting stress for what it is and adapting oneself to it) in combination with persisting (enduring life challenges by holding on to meaning and optimism). This combination of shifting and persisting strategies mitigates physiological responses to the barrage of stressors confronted by low-SES individuals and forestalls pathogenic sequelae that lead to chronic disease. Identifying health-relevant protective qualities that naturally occur in some low-SES individuals represents one important approach for improving the health of those who confront a lifetime of disadvantages.
AdlerN. E.BoyceW. T.ChesneyM. A.CohenS.FolkmanS.KahnR. L.SymeS. L. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49, 15–24.
2.
AdlerN. E.BoyceW. T.ChesneyM. A.FolkmanS.SymeS. L. (1993). Socioeconomic inequalities in health: No easy solution. Journal of the American Medical Association, 269, 3140–3145.
3.
AdlerN. E.RehkopfD. H. (2008). U.S. disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252. doi:10.1146/annurev.publhealth.29.020907.09085210.1146/annurev.publhealth.29.020907.090852
4.
BonannoG. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events?American Psychologist, 59, 20–28. doi:10.1037/0003-066X.59.1.2010.1037/0003-066X.59.1.20
5.
BravemanP. A.CubbinC.EgerterS.WilliamsD. R.PamukE. (2010). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100, S186–S196.
6.
BuekensP.NotzonF.KotelchuckM.WilcoxA. (2000). Why do Mexican Americans give birth to few low-birth-weight infants?American Journal of Epidemiology, 152, 347–351.
7.
ChenE.LeeW.CaveyL.HoA.MillerG. E. M. (2012). Role models and the psychological characteristics that buffer low socioeconomic status youth from cardiovascular risk. Manuscript submitted for publication.
8.
ChenE.MatthewsK. A.BoyceW. T. (2002). Socioeconomic differences in children’s health: How and why do these relationships change with age?Psychological Bulletin, 128, 295–329.
9.
ChenE.MillerG. E. (2012). “Shift-and-persist” strategies: Why being low in socioeconomic status isn’t always bad for health. Perspectives on Psychological Science, 7, 135–158.
10.
ChenE.MillerG. E.KoborM. S.ColeS. W. (2011). Maternal warmth buffers the effects of low early-life socioeconomic status on pro-inflammatory signaling in adulthood. Molecular Psychiatry, 16, 729–737. doi:10.1038/mp.2010.5310.1038/mp.2010.53
11.
ChenE.MillerG. E.LachmanM. E.GruenewaldT. L.SeemanT. E. (2012). Protective factors for adults from low childhood socioeconomic circumstances: The benefits of shift- and-persist for allostatic load. Psychosomatic Medicine, 74, 178–186.
12.
ChenE.StrunkR. C.TretheweyA.SchreierH. M.MaharajN.MillerG. E. (2011). Resilience in low-socioeconomic-status children with asthma: Adaptations to stress. Journal of Allergy and Clinical Immunology, 128, 970–976. doi:10.1016/j.jaci.2011.06.04010.1016/j.jaci.2011.06.040
13.
Diez RouxA. V.MairC. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186, 125–145. doi:10.1111/j.1749-6632.2009.05333.x10.1111/j.1749-6632.2009.05333.x
14.
EvansG. W. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92.
15.
EvansG. W.KimP.TingA. H.TesherH. B.ShannisD. (2007). Cumulative risk, maternal responsiveness, and allostatic load among young adolescents. Developmental Psychology, 43, 341–351.
16.
EwartC. K.JorgensenR. S. (2004). Agonistic interpersonal striving: Social-cognitive mechanism of cardiovascular risk in youth?Health Psychology, 23, 75–85.
17.
FisherP. A.GunnarM. R.ChamberlainP.ReidJ. B. (2000). Preventive intervention for maltreated preschool children: Impact on children’s behavior, neuroendocrine activity, and foster parent functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1356–1364.
18.
GrewenK.GirdlerS. S.WestS. G.BragdonE.CostelloN.LightK. C. (2000). Stable pessimistic attributions interact with socioeconomic status to influence blood pressure and vulnerability to hypertension. Journal of Women’s Health & Gender-Based Medicine, 9, 905–915. doi:10.1089/15246090075002094610.1089/152460900750020946
19.
GunnarM. R.DonzellaB. (2002). Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology, 27, 199–220.
20.
HeckhausenJ.WroschC.SchulzR. (2010). A motivational theory of life-span development. Psychological Review, 117, 32–60. doi:10.1037/a001766810.1037/a0017668
21.
JamesS. A.StrogatzD. S.WingS. B.RamseyD. L. (1987). Socioeconomic status, John Henryism, and hypertension in blacks and whites. American Journal of Epidemiology, 126, 664–673.
22.
LachmanM. E.WeaverS. L. (1998). The sense of control as a moderator of social class differences in health and well-being. Journal of Personality and Social Psychology, 74, 763–773.
23.
LutharS. S. (2006). Resilience in development: A synthesis of research across five decades. In CicchettiD.CohenD. J. (Eds.), Developmental psychopathology: Vol. 3. Risk, disorder, and adaptation (2nd ed., pp. 739–795). New York, NY: John Wiley.
24.
MarmotM. G.BosmaH.HemingwayH.BrunnerE.StansfeldS. (1997). Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet, 350, 235–239.
25.
MastenA. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56, 227–238.
26.
MastenA. S.GarmezyN.TellegenA.PellegriniD. S.LarkinK.LarsenA. (1988). Competence and stress in school children: The moderating effects of individual and family qualities. Journal of Child Psychiatry, 29, 745–764.
27.
MatthewsK. A.GalloL. C.TaylorS. E. (2010). Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future. Annals of the New York Academy of Sciences, 1186, 146–173. doi:10.1111/j.1749-6632.2009.05332.x10.1111/j.1749-6632.2009.05332.x
28.
MorozinkJ. A.FriedmanE. M.CoeC. L.RyffC. D. (2010). Socioeconomic and psychosocial predictors of interleukin-6 in the MIDUS national sample. Health Psychology, 29, 626–635. doi:10.1037/a002136010.1037/a0021360
29.
RepettiR. L.TaylorS. E.SeemanT. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128, 330–366.
30.
RutterM. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316–331.
31.
SchneidermanN.IronsonG.SiegelS. D. (2005). Stress and health: Psychological, behavioral, and biological determinants. Annual Review of Clinical Psychology, 1, 607–628. doi:10.1146/annurev.clinpsy.1.102803.14414110.1146/annurev.clinpsy.1.102803.144141
32.
TaylorS. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. American Psychologist, 38, 1161–1173.
33.
UpdegraffJ. A.SilverR. C.HolmanE. A. (2008). Searching for and finding meaning in collective trauma: Results from a national longitudinal study of the 9/11 terrorist attacks. Journal of Personality and Social Psychology, 95, 709–722. doi:10.1037/0022-3514.95.3.70910.1037/0022-3514.95.3.709
34.
WernerE. E. (1995). Resilience in development. Current Directions in Psychological Science, 4, 81–85.
35.
WrightR. J.SteinbachS. F. (2001). Violence: An unrecognized environmental exposure that may contribute to greater asthma morbidity in high risk inner-city populations. Environmental Health Perspectives, 109, 1085–1089.
