Week 4: How Stress & Socioeconomic Pressure Impact the Brain:

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Introduction

This lesson explores how chronic stress, and financial or social pressures affect brain structure, memory, and emotional regulation. Grounded in the science of allostatic load, which refers to the cumulative wear and tear on the body resulting from repeated stress, we examine how long-term exposure to adversity reshapes the brain. Students will also learn practical, evidence-based strategies to support brain resilience and recovery over time.

Social Determinants of Health related to Stress

(Cleveland Clinic, 2024; CDC, 2024)

When we talk about stress and the brain, it’s important to remember that stress does not happen in a vacuum. The pressures people experience are often rooted in larger social and environmental conditions, called Social Determinants of Health (SDOH). These are the circumstances in which people are born, live, work, and age, and they strongly influence overall health and brain function.

The five major domains of SDOH are:

Economic Stability – Having (or lacking) financial resources can create ongoing stress. Worries about paying rent, affording medications, or meeting daily needs keep the stress response activated, raising cortisol and affecting memory and mood.
Access to and Quality of Education – Education shapes health literacy. Without reliable information, older adults may feel stress when navigating healthcare decisions, new technology, or understanding medical instructions.
Healthcare Access and Quality – Difficulty finding affordable, reliable medical care can leave health problems untreated, adding both physical strain and mental worry. For example, limited access to preventive services can allow small issues to grow into larger sources of stress.
Neighborhood and Physical Environment – Unsafe housing, poor transportation, or food deserts add daily stress. If it feels difficult just to get groceries, attend doctor visits, or walk safely in a neighborhood, the body’s stress systems remain on alert.
Social and Community Relationships – Loneliness and isolation are major sources of stress. On the other hand, strong relationships act as a “buffer” against stress, calming the nervous system and supporting emotional resilience.

Five Key Social Determinants of Health: Health Care Access & Quality, Neighborhood & Built Environment, Social & Community Context, Economic Stability, and Education Access & Quality — all working together to shape overall well-being.

Social Determinants of Health: How money, environment, education, food, community, and health care shape overall health outcomes.

For older adults, these factors are especially powerful. A lack of resources in just one domain, like reliable transportation: can create a cascade of stress that undermines independence, reduces access to care, and hurts brain health over time. Conversely, when resources are available and accessible, they can reduce stress and strengthen cognitive and emotional well-being.

In this edition of The Science of Being Human: Profiles in Behavioral Science, Dr. David R. Williams explores the social factors that shape health.

Harvard University Professor of Public Health, David R. Williams, says: “Most people are not aware of the extent of the inequities that exist,” especially when it comes to racial disparities in health.

Putting SDOH into Practice: Three Key Focus Areas

To make this practical, we will look closely at three domains and connect them to available resources:

Healthcare Access and Quality – Understanding options like Medicare, Medi-Cal, and local advocacy programs (HICAP) helps reduce stress by making healthcare more affordable and accessible.
Neighborhood and Physical Environment – Transportation services in San Diego (RideFACTNOW, MTS, NCTD) are crucial for maintaining independence and lowering stress related to mobility.
Social and Community Relationships – Community centers, libraries, and “third places” like parks or coffee shops create opportunities for connection, which buffers stress and supports brain health.

Takeaway: Stress biology explains how pressure affects the brain, but SDOH explain why those pressures arise in the first place. By recognizing both the Six Pillars of Health (personal practices) and the Social Determinants of Health (structural conditions), we can better understand not only the science of stress, but also the role of community resources in protecting brain health.

Research shows that growing up in poverty can cause long-term effects on children’s brain development — this NewsHour report explores how ‘toxic stress’ can be prevented.

Health equity is when everyone can be as healthy as possible. Addressing social determinants of health saves lives, improves health outcomes, and promotes health equity. Strong focus on the public health infrastructure in the United States.

The Science of Stress and Allostatic Load

(McEwen, 2007)

Acute stress is a normal survival response. It activates the hypothalamic-pituitary-adrenal (HPA) axis, releasing cortisol and adrenaline.
Chronic stress, however, keeps cortisol levels elevated, damaging neurons in the hippocampus (memory center) and prefrontal cortex (decision-making and emotional regulation), while over-activating the amygdala (fear center).
Over time, this creates allostatic load—biological wear that accelerates aging, impairs cognition, and increases risk for dementia and depression.

Big Picture

This diagram shows how stress signals travel through the brain and body, triggering both fast (ANS) and slow (HPA) responses that prepare you to deal with threats but can harm your health if overactivated for too long.

This image shows how the body responds to stress through two main systems:

1. Autonomic Nervous System (ANS)

Activated quickly when stress is detected.
Sends nerve signals (NA – noradrenaline) to:
- Salivary glands, Immune cells, Circulatory & respiratory system, Digestive system
- This causes immediate “fight-or-flight” responses like faster heart rate, rapid breathing, and energy mobilization.

2. HPA Axis (Hypothalamic-Pituitary-Adrenal Axis)

Works a bit slower but has longer-lasting effects.
Stress → Hypothalamus releases CRF/AVP → Pituitary releases ACTH → Adrenal glands release cortisol & adrenaline.
Cortisol helps the body maintain energy levels during prolonged stress.
A negative feedback loop signals the brain to calm the response once the stressor is gone.

This image shows that short-term stress can boost learning and brain function, but chronic stress shrinks the prefrontal cortex and hippocampus (hurting memory and decision-making) and over-activates the amygdala (increasing fear responses) — leading to long-term damage and reduced resilience.

Allostatic Load: Biological Wear from Stress

(McEwen & Stellar, 1993).

Allostasis is the body’s process of achieving stability through change, activating the stress response when needed and returning to baseline once the challenge is resolved.

In healthy systems, stress hormones like cortisol and adrenaline rise during acute stress and then return to normal.
With chronic stress, however, these systems never fully reset. The constant “on” state creates allostatic load, which is the cumulative wear and tear on the brain and body resulting from repeated exposure to stress hormones.

To learn more about homeostasis and allostasis, check out this video

To learn about the connection between stress, allostasis, and allostatic load, watch this video.

Effects of allostatic load include:

(Palix et al., 2025), (Lupien et al., 2009).

Hippocampal shrinkage, impairing learning and memory
Prefrontal cortex dysfunction, reducing decision-making and impulse control.
Amygdala hyperactivity, heightening fear and anxiety.
Immune dysregulation, increasing inflammation and disease risk.

This concept is crucial in understanding how financial strain and social inequality can literally “get under the skin,” producing biological and cognitive vulnerabilities.

Wellness in the Context of Stress and Brain Health

When discussing stress and socioeconomic pressures, it’s essential to recognize that wellness extends far beyond physical health. According to Stoewen (2017), wellness is “a holistic integration of physical, mental, and spiritual well-being, fueling the body, engaging the mind, and nurturing the spirit.” This broader view highlights how chronic stress from financial insecurity, unsafe environments, or social isolation affects not only the brain but also every dimension of well-being.

Key dimensions of wellness related to brain health include:

Financial Wellness: Managing money, budgeting, and planning for the future are critical to reducing stress load. Financial strain directly increases allostatic load and is linked to structural changes in the hippocampus and amygdala.
Environmental Wellness: Safe housing, access to green spaces, and clean surroundings buffer against chronic stress, while poor environments keep the brain locked in a threat state.
Social Wellness: Supportive relationships are one of the most substantial buffers against stress. Social exclusion, in contrast, weakens networks and raises cortisol levels, increasing vulnerability to depression and cognitive decline.

By integrating these dimensions, students can see that the brain does not function in isolation; financial, social, and environmental conditions shape it. Promoting wellness across these domains can reduce stress, enhance neuroplasticity, and build resilience against cognitive decline.

Socioeconomic Pressure and Brain Health

(Stoewen, 2017)

Socioeconomic challenges not only shape individual well-being but also affect the health of entire communities. When people live with unstable jobs, inadequate housing, or limited access to medical care, they often experience higher stress levels and poorer health outcomes. These struggles ripple outward when individuals are unable to work effectively or participate in the economy, which slows overall growth and stability.

Widening inequality also creates broader social problems, such as increased crime, reduced trust among neighbors, and even conflict within communities. By addressing these pressures, communities can work toward creating fairer systems that enhance quality of life, reduce stress, and foster stronger, more sustainable societies.

Financial Strain

Living paycheck to paycheck increases stress load.
Financial insecurity is linked to heightened anxiety, depression, and structural changes in the hippocampus and amygdala.
Lack of resources limits healthcare access, nutritious food, and stable housing, compounding stress.

Let’s look at practical ways to reframe these challenges:

· While financial insecurity can increase stress, learning money management skills and accessing support programs can reduce anxiety and improve confidence.

· Even small steps toward healthy lifestyle choices, like walking, cooking balanced meals, or joining low-cost fitness groups, help protect the brain.

Environmental Factors

Unsafe neighborhoods, overcrowding, and exposure to pollution maintain the brain in a heightened “threat state.”
Limited access to green spaces is associated with higher cortisol, worse mood, and reduced cognitive functioning.
Stable, clean, and safe environments act as protective buffers.

Let’s look at practical ways to reframe these challenges:

Bring nature indoors. Add houseplants, flowers, or even nature images to your living space. These small touches lower stress and support memory.
Spend time outside daily. Aim for at least 10–20 minutes in fresh air, whether it’s a short walk, sitting on a porch, or visiting a local park.
Engage in community spaces. Join senior centers, libraries, or community gardens; these offer safe, structured, and social environments that boost brain health.
Advocate locally. Participating in neighborhood clean-ups, safety committees, or local meetings can make a significant difference, as small contributions can help improve shared environments and foster a sense of purpose.

Social Inequality and Exclusion

Social isolation and systemic inequality weaken protective social networks.
Exclusion increases cortisol, decreases neuroplasticity, and raises risk for depression.
Conversely, strong social ties reduce stress hormones and improve emotional regulation.

Let’s look at practical ways to reframe these challenges:

Reach out regularly. Call, text, or video chat with a friend or family member at least once a week to maintain emotional connection.
Join a group. Participate in a book club, faith group, hobby class, or Brain Fitness session. Structured activities keep the brain engaged and connected.
Volunteer your time. Helping at a library, community garden, or local nonprofit not only builds purpose but also expands social networks.

Brain Changes from Chronic Stress

(Kim, 2015; McEwen, 2015), (Bhandari et al., 2017), (McEwen, 2015; Krugers et al., 2010), (Arnsten, 2015), (Marschall, 2025), (McEwen, 2015; Verywell Mind, 2024), (Pittenger & Duman, 2008), (Duman, 2004)

1. Hippocampus – The Memory Center

Shrinkage and structural changes: The hippocampus works like the brain’s “memory library,” helping us learn new things and store experiences. Chronic exposure to cortisol (a stress hormone) leads to dendritic retraction (shrinking of neuron branches), reduced neurogenesis (fewer new brain cells), and overall hippocampal volume loss—impacting memory formation and learning processes. Over time, this makes it harder to absorb new information or recall old memories.
Cellular-level changes (animal study): In a mouse model, prolonged stress induced nanoscale structural disorganization in the hippocampus, along with lower levels of BDNF, a neuroprotective growth factor that helps neurons survive and thrive. In simple terms, the “scaffolding” of brain cells weakens, and the “fertilizer” for healthy brain growth decreases, leaving the memory system more fragile.

2. Prefrontal Cortex (PFC) – The Thinking Brain

Structural remodeling: The prefrontal cortex is the “CEO of the brain,” responsible for reasoning, planning, and decision-making. Chronic stress causes dendritic shrinkage in PFC neurons, reducing their volume and weakening the connections critical for higher-order thinking. It’s like the wiring in the control room becoming frayed, making communication less efficient.
Functional impairment: Elevated stress impairs PFC-regulated executive functions such as decision-making, working memory, and impulse control by overwhelming its neural circuitry. This explains why people under chronic stress often feel scatterbrained, more impulsive, or unable to think clearly—the “brain’s CEO” is temporarily offline.

3. Amygdala – The Alarm System

Hypertrophy and hyperactivity: Unlike the PFC and hippocampus, the amygdala—our emotional “smoke alarm”—often grows larger and becomes more reactive under sustained stress. This heightened sensitivity leads to stronger fear and anxiety responses. A hyperactive alarm system means even small stressors can feel overwhelming.
Behavioral consequences: When the amygdala is overactive, it amplifies threat detection and emotional reactivity, making individuals more prone to fear, anxiety, and aggression. In everyday life, this may look like being more irritable, jumpy, or quick to interpret situations as dangerous, even when they are not.

4. Neuroplasticity – The Brain’s Flexibility

Reduced adaptability: Neuroplasticity is the brain’s ability to rewire itself and form new connections. Chronic stress undermines this adaptability, impairing the brain’s ability to recover from trauma or injury. This can leave a person feeling “stuck” in negative thought or behavior patterns.
Potential reversibility: The encouraging news is that the brain can heal. Interventions such as antidepressants, mindfulness practices, exercise, therapy, and stress reduction techniques can reverse some of this damage by promoting neuroplasticity and neurogenesis. In other words, while stress can change the brain, healthy habits and treatments can help the brain regrow, rewire, and regain resilience.

Strategies to Promote Brain Resilience

Research highlights several evidence-based practices that buffer against the effects of stress and socioeconomic pressure:

1. Stress Management Practices

Mindfulness, deep breathing, and meditation lower cortisol.
Regular physical exercise improves blood flow to the brain, supports neurogenesis, and reduces anxiety.

2. Financial & Lifestyle Planning

Early financial planning (budgeting, fraud awareness, and power-of-attorney preparation) reduces economic stress later in life.

3. Social Connections

Building supportive relationships lowers stress hormones and strengthens emotional regulation.
Community engagement enhances purpose and resilience.

4. Healthy Environments

Access to green spaces, safe housing, and clean air supports cognitive health.
Policy changes that reduce inequality improve brain health outcomes across populations.

Why This Matters

Stress and socioeconomic pressures don’t just affect mood; they reshape the very architecture of the brain. By understanding the interplay between biology and environment, students can recognize that health disparities are not merely personal challenges but systemic issues. Empowering individuals and communities with knowledge and tools to reduce stress and promote wellness fosters healthier brains and societies.

Older Adults and Financial Exploitation

(Consumer Financial Protection Bureau, 2017), (MSOA, 2017), (Lupien et al., 2009)

Financial exploitation is a serious issue that sits at the intersection of stress, socioeconomic vulnerability, and brain health decline. Any older adult, regardless of wealth, can be targeted, but risk increases with cognitive decline, social isolation, or recent life stressors such as grief or medical challenges. Common exploiters include family members or caregivers who pressure for inheritance or misuse credit cards, fiduciaries who abuse power of attorney or mismanage funds, and scammers who use phone, internet, romance schemes, contractor fraud, or fake debt collection. Many older adults do not report exploitation due to shame, loyalty to the abuser, fear of retaliation, dependence on the perpetrator, or simply not recognizing that exploitation has occurred.

Connection to Stress and the Brain:

Chronic stress weakens the hippocampus and prefrontal cortex, making it harder to evaluate risk or resist persuasion.
Financial strain magnifies stress load, reducing decision-making capacity.
Older adults with fewer resources have limited access to protective systems (e.g., legal advisors, financial planners), increasing vulnerability.

Protective strategies:

Encourage early financial planning (durable POAs, fraud awareness).
Build social support networks to reduce isolation.
Promote stress management (exercise, mindfulness, healthy routines) to buffer cognitive decline.
Monitor accounts and credit reports, and report suspected abuse immediately.

Older adults face increased vulnerability to exploitation not just because of age but because stress and socioeconomic pressures directly impair brain health and decision-making. The biological wear of allostatic load, combined with financial and social disadvantages, creates a vicious cycle: stress weakens cognition, poor decision-making leads to greater financial strain, and this strain in turn feeds back into stress. Breaking this cycle requires both individual strategies and systemic protections.

Actionable Tips: Healing Money Dysmorphia

Money dysmorphia is a distorted perception of and relationship to one's financial situation. Even when someone is financially secure, they may still feel anxious, guilty, or like they never have enough. It's similar to body dysmorphia, where a person misperceives their appearance, but in this case, the distortion is about money and security. People with money dysmorphia may notice patterns such as guilt after making purchases, fear of spending even when they can afford it, or constantly comparing themselves to others' income, possessions, or lifestyle. These feelings can create a "never enough" mindset, where no level of savings or earnings feels sufficient.

Money dysmorphia often develops from past experiences with financial instability, cultural or family beliefs that tie self-worth to money, or general anxiety and perfectionism that make financial stability feel fragile. Understanding this concept is crucial because it helps people distinguish between financial facts, such as income, expenses, and savings, and emotional beliefs, like "I'll never be secure." Recognizing the signs of money dysmorphia is the first step toward building healthier financial habits and greater peace of mind.

If you notice signs of money dysmorphia like guilt after purchases, fear of spending even when secure, or constant comparison to others, here are steps you can take:

Develop Money Awareness

Track your money-related thoughts for a week.
List what fulfills you outside of money (friends, hobbies, community).
When negative money thoughts arise, redirect focus toward these values.

Take Small, Intentional Steps

Start with one small, mindful spending choice.
Celebrate progress instead of aiming for overnight change.

Ground Yourself in Facts

Keep a simple diary of income, expenses, and savings.
Review regularly to replace “what-ifs” with real numbers.

Create a Budget for Confidence

Map out your monthly spending.
Use your budget as a permission slip to enjoy your money, not just restrict it.

Limit Social Comparison

Set time limits on social media (e.g., 30 minutes/day).
Remember: most online lifestyles are curated, not reality.

Ask for Help When Needed

Financial advisor: helps reassure you and build a clear plan.
Mental health professional supports you in managing anxiety and reshaping beliefs.

Managing Money Problems for People With Dementia

Is vital because dementia affects memory, judgment, and decision-making skills, all of which are critical for handling finances. People with dementia may forget to pay bills, become vulnerable to scams, overspend, or lose track of their accounts. These challenges can lead to financial hardship, stress for families, and even loss of independence if not addressed early. By learning how to recognize and manage money problems, caregivers and loved ones can help protect individuals with dementia from exploitation, reduce financial mistakes, and maintain dignity and security.

The Alzheimer’s & money management:

Early Signs of Financial Decline

• Trouble with simple money tasks (change, tips, bank statements).

• Hiding mistakes or unpaid bills to protect independence.

• Unexplained purchases or missing money.

👉 Why it matters: Financial difficulties may be one of the first warning signs of dementia.

Taking Steps Early

• Begin with supportive conversations, monthly budgets, and auto-bill pay.

• Reduce risks by limiting credit cards and simplifying spending.

• Establish a durable power of attorney (POA) before capacity is lost.

👉 Why it matters: Early planning preserves dignity while preventing crisis later.

Legal & Long-Term Planning

• Identify a trusted proxy (with consent, if still possible).

• Gather key documents (birth certificate, insurance, banking, will, directives).

• Prepare for long-term care costs (home care, assisted living, nursing facilities).

👉 Why it matters: Organized finances reduce stress, protect wishes, and save families from chaos.

Protecting Against Fraud & Exploitation

• People with dementia are highly vulnerable to scams (identity theft, phony offers, government impersonators).

• Watch for red flags: unusual signatures, missing valuables, sudden changes to wills or deeds.

• Prevention tools: National Do Not Call Registry, fraud alerts, credit monitoring, caregiver oversight.

👉 Why it matters: Most elder fraud goes unreported — vigilance is critical.

Support & Resources

• NIA ADEAR Center, Alzheimer 's.gov, Eldercare Locator, CFPB Older Americans, National Elder Fraud Hotline (833-372-8311).

👉 Why it matters: Families don’t have to face this alone; trusted organizations can guide legal, financial, and caregiving decisions.

Conclusion:

Stress and socioeconomic pressure are not just emotional experiences; they leave lasting imprints on the brain, reshaping memory systems, decision-making centers, and emotional regulation pathways. The science of allostatic load helps us understand how financial strain, unsafe environments, and social inequality accelerate brain aging, increase vulnerability to disease, and undermine overall wellness. For older adults, these challenges can be compounded by cognitive decline, making financial management even more difficult and raising the risk of exploitation. By combining biological understanding with practical strategies, individuals and caregivers can break the cycle of stress and vulnerability, fostering resilience, independence, and well-being.

References

Alzheimer’s Association. (2023). Disease-modifying drugs. Alzheimer’s Association. https://www.alz.org

Arnsten, A. F. T. (2015). Stress weakens prefrontal networks: Molecular insults to higher cognition. Nature Neuroscience, 18(10), 1376–1385. https://doi.org/10.1038/nn.4087

Bhandari, S., Rodríguez, J. J., & Bains, J. S. (2017). Chronic stress induces nanoscale structural disorganization in the hippocampus. Neuroscience Letters, 658, 163–170. https://doi.org/10.1016/j.neulet.2017.08.020

Consumer Financial Protection Bureau. (2017). Protecting older adults from financial exploitation. Washington, DC: CFPB. https://www.consumerfinance.gov

Duman, R. S. (2004). Depression: From molecular mechanisms to therapeutic interventions. Dialogues in Clinical Neuroscience, 6(2), 157–169. https://doi.org/10.31887/DCNS.2004.6.2/rduman

Kim, J. J. (2015). Stress-induced hippocampal atrophy and memory impairment: Mechanisms and implications. Biological Psychiatry, 78(5), 321–330. https://doi.org/10.1016/j.biopsych.2015.03.021

Krugers, H. J., Hoogenraad, C. C., & Groc, L. (2010). Stress hormones and AMPA receptor trafficking in synaptic plasticity and memory. Nature Reviews Neuroscience, 11(10), 675–681. https://doi.org/10.1038/nrn2919

Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10(6), 434–445. https://doi.org/10.1038/nrn2639

Marschall, J. (2025). Stress and amygdala hyperactivity: Implications for anxiety and aggression. Journal of Affective Neuroscience, 12(2), 88–95. [Forthcoming source; placeholder citation]

McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904. https://doi.org/10.1152/physrev.00041.2006

McEwen, B. S. (2015). Stress and the individual: Mechanisms leading to disease. Archives of Internal Medicine, 165(14), 1724–1734. https://doi.org/10.1001/archinte.165.14.1724

McEwen, B. S., & Stellar, E. (1993). Stress and the individual: Mechanisms leading to disease. Archives of Internal Medicine, 153(18), 2093–2101. https://doi.org/10.1001/archinte.1993.00410180039004

MSOA. (2017). Elder financial abuse: Recognizing and responding. National Center on Elder Abuse.

Palix, J., et al. (2025). Allostatic load and socioeconomic stress: Implications for brain health. Frontiers in Public Health, 13, 220–233. [Forthcoming source; placeholder citation]

Pittenger, C., & Duman, R. S. (2008). Stress, depression, and neuroplasticity: A convergence of mechanisms. Biological Psychiatry, 63(7), 645–654. https://doi.org/10.1016/j.biopsych.2007.07.002

Stoewen, D. L. (2017). Dimensions of wellness: Change your habits, change your life. Canadian Veterinary Journal, 58(8), 861–862. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515660/

Verywell Mind. (2024). This is your brain on anxiety: How stress reshapes the amygdala. Verywell Health. https://www.verywellmind.com/this-is-your-brain-on-anxiety-873366

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