Gene H. Brody

Background Low socioeconomic status (SES) is a risk factor for poor outcomes across development. Recent evidence suggests that, although psychosocial resilience among youth living in low‐SES households is common, such expressions of resilience may not extend to physical health. Questions remain about when these diverging mental and physical health trajectories emerge. The current study hypothesized that skin‐deep resilience – a pattern wherein socioeconomic disadvantage is linked to better mental health but worse physical health for individuals with John Henryism high‐effort coping – is already present in childhood. Methods Analyses focus on 165 Black and Latinx children ( M age = 11.5) who were free of chronic disease and able to complete study procedures. Guardians provided information about their SES. Children reported on their John Henryism high‐effort coping behaviors. They also provided reports of their depressed and anxious mood, which were combined into a composite of internalizing symptoms. Children's cardiometabolic risk was captured as a composite reflecting high levels of systolic or diastolic blood pressure, waist circumference, HbA1c, triglycerides, and low high‐density lipoprotein cholesterol. Results Among youth who reported using John Henryism high‐effort coping, SES risk was unrelated to internalizing symptoms and was positively associated with cardiometabolic risk. In contrast, for youth who did not engage in high‐effort coping, SES risk was positively associated with internalizing symptoms and was unrelated to cardiometabolic risk. Conclusions For youth with high‐effort coping tendencies, socioeconomic disadvantage is linked to cardiometabolic risk. Public health efforts to support at‐risk youth must consider both mental and physical health consequences associated with striving in challenging contexts.