{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:09:42Z","timestamp":1789708182226,"version":"4.0.1"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Cancer Institute of the National Institutes of Health","award":["R00CA245900"],"award-info":[{"award-number":["R00CA245900"]}]},{"name":"Dean\u00e2\u20ac\u2122s Office of Weill Cornell Medicine","award":["Ritu Banga Healthcare Disparities Research Award"],"award-info":[{"award-number":["Ritu Banga Healthcare Disparities Research Award"]}]},{"name":"Sandra and Edward Meyer Cancer Center"},{"name":"Sandra and Edward Meyer Cancer Center"},{"name":"Sandra and Edward Meyer Cancer Center"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The rising prevalence of individuals reporting extreme stress has major public health implications as it increases vulnerability to accelerated premature biological aging, thus increasing risk of chronic disease. To examine the impact of stress on premature biological aging, we assessed the association between exposure to increased stress, quantified by the Perceived Stress Scale, and odds of high allostatic load (AL). To illuminate previously unexplored socio-contextual factors, we controlled for self-reported individual and neighborhood social determinants of health that included discrimination, loneliness, food insecurity, neighborhood disorder, and neighborhood social cohesion. We utilized a cross-sectional design to examine the association between perceived stress and AL among 7,415 participants ages 18\u201365 in the <jats:italic><jats:italic>All of Us<\/jats:italic><\/jats:italic> Research Program, who enrolled from 2017\u20132022. We used logistic regression to evaluate the association between stress and high AL, controlling for sociodemographic factors and self-reported social determinants of health. Participants who were younger, receiving Medicaid, or Hispanic had increased prevalence of high stress. High stress was associated with elevated odds of high AL in age and sex-adjusted models (OR=2.18, 95%CI\u2009=\u20091.78, 2.66, high stress vs. low), an association which remained significant after adjusting for social determinants of health (OR=1.29, 95%CI\u2009=\u20091.01, 1.65). Using restricted cubic splines, high stress was significantly associated with increased odds of high AL, even after controlling for upstream individual and neighborhood-level determinants of health. While individuals living below the medium poverty-to-income ratio demonstrated little appreciable association between high stress and increased odds of high allostatic load, those living above the median poverty-to-income ratio reporting increased stress appeared to have increased odds of high allostatic load. Through addressing the upstream factors causing undue burdens of stress, which particularly affect marginalized communities and younger generations, we can begin to address premature biological aging and the comorbid conditions it accompanies.<\/jats:p>","DOI":"10.1371\/journal.pone.0330106","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T17:46:03Z","timestamp":1754675163000},"page":"e0330106","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Perceived stress and allostatic load: Results from the All of Us Research Program"],"prefix":"10.1371","volume":"20","author":[{"given":"Faith","family":"Morley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Mount","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjile","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulla M.","family":"Tamimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7515-7270","authenticated-orcid":true,"given":"Kevin H.","family":"Kensler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"pone.0330106.ref001","year":"2023"},{"issue":"12","key":"pone.0330106.ref002","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1016\/j.socscimed.2010.02.024","article-title":"Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study","volume":"70","author":"J Mattei","year":"2010","journal-title":"Soc Sci Med"},{"issue":"10","key":"pone.0330106.ref003","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1080\/13607863.2021.2010183","article-title":"With age comes well-being: older age associated with lower stress, negative affect, and depression throughout the COVID-19 pandemic","volume":"26","author":"EC Fields","year":"2022","journal-title":"Aging Ment Health"},{"issue":"1","key":"pone.0330106.ref004","doi-asserted-by":"crossref","first-page":"3576","DOI":"10.1186\/s12889-024-20961-4","article-title":"Continuous worsening of population emotional stress globally: universality and variations","volume":"24","author":"X Piao","year":"2024","journal-title":"BMC Public Health"},{"key":"pone.0330106.ref005","doi-asserted-by":"crossref","first-page":"106111","DOI":"10.1016\/j.psyneuen.2023.106111","article-title":"Adult age differences in the psychophysiological response to acute stress","volume":"153","author":"G Mikneviciute","year":"2023","journal-title":"Psychoneuroendocrinology"},{"key":"pone.0330106.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ynstr.2014.09.001","article-title":"Recognizing Resilience: Learning from the Effects of Stress on the Brain","volume":"1","author":"BS McEwen","year":"2015","journal-title":"Neurobiol Stress"},{"issue":"3","key":"pone.0330106.ref007","first-page":"105","article-title":"Allostatic Load Biomarker Associations with Depressive Symptoms Vary among US Black and White Women and Men","volume":"6","author":"GS Bey","year":"2018","journal-title":"Healthcare (Basel)"},{"key":"pone.0330106.ref008","doi-asserted-by":"crossref","first-page":"111050","DOI":"10.1016\/j.jpsychores.2022.111050","article-title":"Measuring allostatic load: Approaches and limitations to algorithm creation","volume":"163","author":"JT Carbone","year":"2022","journal-title":"J Psychosom Res"},{"issue":"1","key":"pone.0330106.ref009","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000510696","article-title":"Allostatic Load and Its Impact on Health: A Systematic Review","volume":"90","author":"J Guidi","year":"2021","journal-title":"Psychother Psychosom"},{"issue":"5","key":"pone.0330106.ref010","doi-asserted-by":"crossref","first-page":"826","DOI":"10.2105\/AJPH.2004.060749","article-title":"\u201cWeathering\u201d and age patterns of allostatic load scores among blacks and whites in the United States","volume":"96","author":"AT Geronimus","year":"2006","journal-title":"Am J Public Health"},{"issue":"18","key":"pone.0330106.ref011","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1001\/archinte.1993.00410180039004","article-title":"Stress and the individual. 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