Abstract Body (Do not enter title and authors here): Background: Chronic stress and low socioeconomic status (SES) are established risk factors for poor cardiometabolic health, yet little is known about how these associations vary by sex and age, particularly among Hispanic/Latino populations.

Objective: To examine associations between chronic stress, SES, and metabolic health and body mass phenotypes (MHBMPs), and whether associations differ by sex and age.

Methods: Cross-sectional data from 4,712 Hispanic/Latino adults enrolled in the Visit 1 HCHS/SOL Sociocultural Ancillary Study were analyzed. Chronic stress was measured via the Chronic Burden Scale; SES was categorized based on household income and education. MHBMPs were defined using BMI, blood pressure, lipid levels, and glucose. Polytomous logistic regression models were stratified by sex (male/female) and age group (18–44, 45–65+ years) and adjusted for covariates.

Results: Among women, low SES was strongly associated with metabolically unhealthy obesity (MUOB; aOR=3.31, 95% CI: 1.76–6.20), overweight (MUOW; aOR=2.19, 95% CI: 1.13–4.25), and normal weight (MUNW; aOR=1.66, 95% CI: 0.90–3.08). In men, associations were weaker, though moderate SES was inversely associated with metabolically healthy obesity (MHOB; aOR=0.32, 95% CI: 0.11–0.96). Among younger adults, low SES predicted MUOB (aOR=2.48) and MUOW (aOR=1.92); in older adults, both low and moderate SES were linked to MUOB (aORs=2.45 and 2.27, respectively). For chronic stress, women showed positive associations with MUOB and MUOW, though attenuated in adjusted models. In men, stress was inversely associated with MHOW (aOR=0.73) and MUNW (aOR=0.80). Among older adults, higher stress predicted MHOB (aOR=1.27), with no clear associations in younger adults.

Conclusion: Chronic stress and SES impact cardiometabolic risk in sex- and age-specific ways. Findings suggest that cumulative stress exposure and socioeconomic disadvantage may play mechanistic roles in the development of metabolically unhealthy obesity, particularly among women and those with low SES. These patterns highlight the importance of addressing social determinants in efforts to understand and reduce cardiometabolic disparities in Hispanic/Latino populations.