The Unequal Loop: Socioeconomic Status and the Dynamic Bidirectional Relationship between Physical and Mental Health

This study draws on longitudinal data from the Health and Retirement Study (2008-2020) to investigate the dynamic bidirectional relationship between physical and mental health, focusing on socioeconomic disparities. Dynamic panel models reveal significant bidirectional associations between measures of physical and mental health for both positive and negative health indicators, but the magnitude varies by education and wealth. Specifically, the interconnection between indicators of negative physical and mental health (i.e., functional limitations and depression symptoms) is stronger among the socioeconomically disadvantaged, whereas the relationship between indicators of positive physical and mental health (i.e., physical activity and positive affect) is stronger at higher levels of wealth (although not education). By disentangling the bidirectional association between physical and mental health, these results imply an important process of the reproduction and perpetuation of health inequalities.