Theoretical Framework for Neuroendocrine Dysregulation in Chronic Poverty-Related Stress: A Physiological Investigation in Rural Communities of Kebbi State

The physiological consequences of chronic poverty-related stress are conceptually understudied, particularly in the context of rural northern Nigerian communities where socioeconomic deprivation and neuroendocrine burden intersect in complex ways. This study developed and tested a theoretical framework linking chronic poverty-related psychosocial stress to hypothalamic-pituitary-adrenal axis dysregulation and cardiovascular risk in rural adults in Kebbi State, North West Nigeria. A mixed-methods longitudinal design enrolled 150 rural adults from subsistence farming communities over eighteen months. Salivary cortisol awakening response, diurnal cortisol slope, blood pressure, sympathovagal balance via heart rate variability, and inflammatory marker high-sensitivity C-reactive protein were assessed at three time points. Poverty severity was indexed using the Multidimensional Poverty Index. Structural equation modelling was applied to test hypothesised causal pathways. Results confirmed the proposed theoretical pathways: poverty severity predicted flattened cortisol awakening response at twelve months, which in turn mediated elevations in blood pressure and blunted heart rate variability at eighteen months. High-sensitivity C-reactive protein partially mediated the cortisol-cardiovascular relationship. Sex moderated the neuroendocrine-cardiovascular pathway, with women showing stronger cortisol-heart rate variability coupling. This study makes an original theoretical and empirical contribution to the physiology of poverty, a frontier area lacking grounded Nigerian data. Biopsychosocial intervention models targeting cortisol regulation in rural poverty contexts are proposed. Keywords: poverty stress, cortisol, neuroendocrine, cardiovascular risk, Kebbi State.