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Peer-reviewedCC BYPsychoneuroendocrinology

Biological sex, socioeconomic position, and stress physiology among Native Americans: Findings from the Oklahoma Study of Native American Pain Risk III

  • Jamie L. Rhudy1,2,3
  • Travis S. Lowe4
  • Kayla N. Trevino1
  • Parker A. Kell1,3,5
  • Taylor V. Brown1,3
  • Claudia N. Vore1,3
  • Brandon W. Jones1,3
  • Aleiyah Fields1,3
  • William R. Lovallo6
  • Joanna O. Shadlow7
7 affiliations
  1. 1TSET Health Promotion Research Center, The University of Oklahoma Health Sciences, 4502 E. 41st Street, Tulsa, OK, 74135, USA
  2. 2Department of Health Promotion Sciences, The University of Oklahoma Health Sciences, 4502 E. 41st Street, Tulsa, OK, 74135, USA
  3. 3Department of Psychology, The University of Tulsa, 800 S. Tucker Drive, Tulsa, OK, 74104, USA
  4. 4Department of Anthropology and Sociology, The University of Tulsa, 800 S. Tucker Drive, Tulsa, OK, 74104, USA
  5. 5Department of Anesthesiology, Washington University in St. Louis School of Medicine, 4925 Children’s Place, St. Louis, MO, 63110, USA
  6. 6University of Oklahoma Health Sciences and VA Medical Center, 921 NE 13th Street, Oklahoma City, OK, 73104, USA
  7. 7Department of Psychology, Oklahoma State University, 700 North Greenwood Avenue, Tulsa, OK, 74106, USA
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Abstract

Native Americans (NAs) experience disproportionate exposure to chronic sociocultural stressors that may shape physiological stress systems and contribute to health disparities. Yet, little research has examined acute stress reactivity, stress recovery, and their predictors in NAs. The present study investigated the independent and joint effects of sex and socioeconomic position (SEP) on sympathetic-adrenomedullary (SAM), hypothalamic-pituitary-adrenal (HPA), and negative affective responses to the Trier Social Stress Test (TSST) in 120 healthy NA adults (74 women). SEP was assessed using objective (household income) and subjective (subjective social status) indicators. SAM (skin conductance level, heart rate, blood pressure), HPA (cortisol), and negative affect were measured during baseline, stress, and recovery. Men displayed robust stress responding across all measures, whereas women showed robust SAM and affective responses but blunted cortisol reactivity. Exploratory analyses suggested this difference was not likely explained by hormonal contraceptive use. Lower income was associated with heart rate blunting in both sexes and cortisol blunting among men. By contrast, cortisol blunting was consistent across the income gradient among women. Lower income was associated with poorer cortisol recovery in both sexes. Subjective social status was unrelated to stress outcomes. These findings suggest that sex and SEP jointly shape stress physiology among NAs and support an intersectionality-informed understanding of stress-system functioning. Future research is needed to further understand how sociocultural and structural stressors become biologically embedded in NA populations and contribute to stress-related health disparities, but to also identify sources of resilience.

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Cite

BibTeXRIS
BibTeX
@article{rhudy2026biological,
  title = {{Biological sex, socioeconomic position, and stress physiology among Native Americans: Findings from the Oklahoma Study of Native American Pain Risk III}},
  author = {Jamie L. Rhudy and Travis S. Lowe and Kayla N. Trevino and Parker A. Kell and Taylor V. Brown and Claudia N. Vore and Brandon W. Jones and Aleiyah Fields and William R. Lovallo and Joanna O. Shadlow},
  journal = {Psychoneuroendocrinology},
  year = {2026},
  month = sep,
  doi = {10.1016/j.psyneuen.2026.108027},
  url = {https://europepmc.org/article/PMC/PMC13726897},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Biological sex, socioeconomic position, and stress physiology among Native Americans: Findings from the Oklahoma Study of Native American Pain Risk III
AU  - Jamie L. Rhudy
AU  - Travis S. Lowe
AU  - Kayla N. Trevino
AU  - Parker A. Kell
AU  - Taylor V. Brown
AU  - Claudia N. Vore
AU  - Brandon W. Jones
AU  - Aleiyah Fields
AU  - William R. Lovallo
AU  - Joanna O. Shadlow
PY  - 2026
DA  - 2026/09/30
JO  - Psychoneuroendocrinology
DO  - 10.1016/j.psyneuen.2026.108027
UR  - https://europepmc.org/article/PMC/PMC13726897
AB  - Native Americans (NAs) experience disproportionate exposure to chronic sociocultural stressors that may shape physiological stress systems and contribute to health disparities. Yet, little research has examined acute stress reactivity, stress recovery, and their predictors in NAs. The present study investigated the independent and joint effects of sex and socioeconomic position (SEP) on sympathetic-adrenomedullary (SAM), hypothalamic-pituitary-adrenal (HPA), and negative affective responses to the Trier Social Stress Test (TSST) in 120 healthy NA adults (74 women). SEP was assessed using objective (household income) and subjective (subjective social status) indicators. SAM (skin conductance level, heart rate, blood pressure), HPA (cortisol), and negative affect were measured during baseline, stress, and recovery. Men displayed robust stress responding across all measures, whereas women showed robust SAM and affective responses but blunted cortisol reactivity. Exploratory analyses suggested this difference was not likely explained by hormonal contraceptive use. Lower income was associated with heart rate blunting in both sexes and cortisol blunting among men. By contrast, cortisol blunting was consistent across the income gradient among women. Lower income was associated with poorer cortisol recovery in both sexes. Subjective social status was unrelated to stress outcomes. These findings suggest that sex and SEP jointly shape stress physiology among NAs and support an intersectionality-informed understanding of stress-system functioning. Future research is needed to further understand how sociocultural and structural stressors become biologically embedded in NA populations and contribute to stress-related health disparities, but to also identify sources of resilience.
SN  - 0306-4530
SN  - 1873-3360
ER  -