Midlife Family Economic Hardship and Later Life Cardiometabolic Health: The Protective Role of Marital Integration.

Background and Objectives: The current study assesses the unique influences of family economic hardship (FEH) in early and late midlife on husbands' and wives' body mass index (BMI) and the influence of BMI on the onset of cardiometabolic (CM) disease in later adulthood. The protective role of marital integration is also considered in relation to the stress-response link between FEH and BMI.

Research Design and Methods: Analyses were performed using structural equation modeling with prospective data from 257 husbands and wives in enduring marriages over a period of 25 years beginning when they were approximately 40 years old. A multigroup analysis tested the moderating role of marital integration.

Results: The distal influence of FEH in early midlife on BMI in later adulthood remained statistically significant even after controlling for proximal FEH. Proximal FEH in later midlife was influential for wives', but not husbands', BMI. BMI in later midlife was related to the onset of CM disease in their later life. Moderation analysis showed that FEH and subsequent BMI were associated for couples with below average levels of behavioral integration but not for couples with above average levels of integration.

Discussion and Implications: Taken together, these findings suggest a family-health process stemming from early FEH and operating cumulatively over the life course. FEH in early midlife is a persistent determinant of physiological dysregulation as reflected by BMI. Findings identify BMI as a modifiable leverage point for the long-term reduction of CM disease risk and highlight the role of spouses as a buffer against the detrimental stress-health association.