Mastery moderates the association between cumulative socioeconomic status risk and accelerated biological aging among middle-aged Black American women

Abstract Objectives This study examines how exposure to cumulative socioeconomic status (SES) risk in midlife shapes subsequent biological aging among Black American women and tests whether a sense of mastery moderates these associations. Methods Using longitudinal data from 334 middle-aged Black American women in the Family and Community Health Study (FACHS), we used hierarchical regression models to test our hypotheses and probed the interaction by estimating conditional differences between high and low mastery across levels of cumulative SES risk. Results Cumulative SES risk was significantly associated with accelerated aging. After accounting for key environmental, psychosocial, behavioral, and biological confounders, each additional risk factor was associated with an increase in GrimAgeAccel of approximately 0.53 years (6.4 months). Among women with lower mastery, cumulative SES risk was positively and significantly associated with accelerated biological aging, with each additional SES risk factor associated with an increase of approximately 0.59 years (7.1 months) in GrimAge acceleration. Cumulative SES risk was not associated with accelerated aging among women with higher mastery. Discussion Consistent with stress process theory, higher mastery was associated with a weaker association between cumulative socioeconomic disadvantage and accelerated aging among middle-aged Black American women. Persistent SES-related disparities in biological aging indicate that upstream sociostructural determinants impose a chronic physiological burden that cannot be addressed by individual coping resources alone. Simultaneously bolstering psychosocial resources and addressing the structural conditions that necessitate such high levels of individual coping may be critical for promoting sustained, population-level improvements in healthy aging.