Socioeconomic determinants of psychological well-being: the role of income, income change, and income sources during the course of 29 years.

BACKGROUND Considerable evidence indicates that income and other measures of socioeconomic position are associated with a wide variety of health outcomes. The authors of a few studies have prospectively examined the association between socioeconomic position over the course of decades and health outcomes. The present study, covering almost three decades of the life course, examined the cumulative impact of different income measures on psychological well-being among adults. METHODS We used data collected over the course of 29 years (1965-1994) from Alameda County Study participants to study the association between average income, income changes, profit and benefit incomes-and five scales of psychological well-being--Purpose in Life, Self-acceptance, Personal Growth, Environmental Mastery, and Autonomy. In age-adjusted models, the psychological well-being measures were each regressed on each of the income measures. Potential confounders (sex, education, race/ethnicity, social isolation, depression, and perceived health) were also examined. RESULTS Mean income over the course of almost three decades was strongly associated with all five scales of psychological well-being. Psychological well-being increased with the number of waves in which profit income was reported and with income increases over time. For all scales except Autonomy, psychological well-being decreased with the number of waves receiving need-based benefit and with decreasing income over time. CONCLUSIONS Psychological well-being may reflect the accumulation of socioeconomic advantage and disadvantage over decades.