January 31, 2017

How success may make you sick

Daily Briefing

Editor's note: This popular story from the Daily Briefing's archives was republished on Aug. 15, 2018.

Some resilient people—those who strive for success and find it despite setbacks—may be more likely to get sick, according to research, James Hamblin writes for the New York Times' "Sunday Review."

The 4 foundational cracks that are undermining your nurses’ resilience

Experts say resilience seems like a desirable trait to many people. Gene Brody, a professor at the University of Georgia who has studied the effects that perseverance in the face of adversity has on health, said resilient strivers "cultivate persistence, set goals and work diligently toward them, navigate setbacks, focus on the long term, and resist temptations that might knock them off course."

And given health and lifespans in the United States can in part be attributed to socioeconomic status, "it seems natural to assume" that upward mobility could help to improve a person's health, Hamblin writes. But years of research suggest the opposite, he says.

Why success might make you sick

Research shows that "when resilient people work hard within a system that has not afforded them the same opportunities as others, their physical health deteriorates," Hamblin writes.

Hamblin points to the "John Henryism" scale, developed in the 1980s by a researcher named Sherman James to identify those who use "high-effort coping" to manage certain challenges. At the time he developed the scale, James found that high scores on the scale correlated with worse health outcomes among low-income black individuals—while white individuals seemed largely "unaffected by this phenomenon," Hamblin writes.

And other, more recent research seems to confirm the correlation.

For instance, in one analysis, Brody and colleagues examined the socioeconomic backgrounds and personalities of the participants in a study that sought to determine why some people get more colds than others. In the original study, participants were exposed to the rhinovirus—known to cause the common cold—and monitored for symptoms over five days.

Brody's analysis of the study found that those who were "more diligent and tended to strive for success" were more likely to get sick. The findings suggested that the immune systems suffered among those who succeeded despite facing adversity.

And in another study, published in 2015, Brody and three colleagues found that the white blood cells in so-called "strivers" were prematurely aged, compared with those of their peers. And in December 2016, they published a study that found an "unrelenting determination to succeed" was linked to a higher risk of diabetes among black adolescents.

Brody in other research has also found that DNA methylation patterns—which are indicators of how genes are translated—seem to vary as a product of socioeconomic status. Further, Brody and his colleagues have found that "strivers" from a young age tend to have elevated levels of cortisol, a stress hormone, and adrenaline. "Constantly bathing cells in stress hormones, the science would suggest, could sponsor more inflammatory responses," Brody said, which can potentially lead to autoimmune disorders such as diabetes.

Hamblin notes much of the research in this field has shown black individuals, more than white individuals, suffer negative health effects from "relentless striving." But new research suggests that effects can be seen across demographics.

The effects may branch beyond race, ethnicity

Last month, Mahasin Mujahid, a public health researcher at the University of California, Berkeley published a study—in collaboration with Sherman James—based on residents of Finland, most of whom were white. In the study, Mujahid and James found that lower-income individuals had more heart attacks—but the effect was most noticeable among those who scored highest on the John Henrysim scale.

Mujahid said, "The items that speak to John Henryism don't speak to gender or race or socioeconomic status." She pointed out that the scale is designed to measure repetitive, high-effort coping—and because black individuals typically encounter more discrimination and barriers to overcome, she said "the combination of adversity and high-effort coping is what's having health consequences."

Reflecting on his 1980s research, James said, "Because African-Americans experience so much more exclusion and degradation—something that working-class whites didn't experience at the time—that probably created conditions that were ripe for us to only see the effects in blacks." But now, he added, "we're seeing other groups begin to be exposed to ... very powerful forces of dislocation," such as technologically induced unemployment.

Ultimately, "what we want is for people who overcome so much to achieve the American dream to have the health to enjoy the fruits of their efforts," Brody said. "Right now that doesn't seem to be happening" (Hamblin, "Sunday Review," New York Times, 1/27).

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