Small (but meaningful?) differences : the cumulative impact of gender on health for husbands and wives



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The cumulative risk model is used to explain the coexistence of small gender differences and large health disparities between husbands and wives. Specifically, the current model incorporates conflict (a risk factor), support (a protective factor), and coping (a moderator of the conflict-stress link) to predict cortisol slopes for newlywed husbands and wives. One hundred and seventy-two couples completed both global and daily measures of protective factors (empathy, responsiveness, and perceived support), risk factors (withdrawal, loyalty, self-silencing, and negativity), and coping (self-distraction, substance use, emotional support, and rumination). For the six days that participants provided daily reports of these constructs, participants also provided waking and evening saliva samples for later determination of salivary cortisol levels. I hypothesized that men would incur more protective factors than would women, and that these protective factors would be associated with steeper cortisol slopes (i.e., healthy cortisol slopes.) Further, I hypothesized that women would incur more cumulative risks than would men, and that these risks would be associated flatter cortisol slopes (i.e., unhealthy cortisol slopes). Finally, I hypothesized that the association between cumulative risk and cortisol slopes would be moderated by coping, such that theoretically-effective coping strategies would blunt the impact of cumulative risks whereas ineffective coping strategies would exacerbate the impact of cumulative risks. Support for these hypotheses was mixed. Women did incur fewer cumulative protective factors than did men; however, there were no gender differences in cumulative risks for this highly satisfied newlywed sample. The impact of both cumulative protection and cumulative risk on cortisol slopes differed for men and women. Coping moderated the impact of cumulative risk on daily cortisol slopes, but again these patterns were different for men and women. Future work must continue to isolate gender differences in relationship processes to understand resulting health implications. With further refinement, the proposed model can provide a more holistic explanation of gendered health disparities, and perhaps identify ways that women and men can experience more equivalent health benefits from romantic relationships.