Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-09T05:23:54.026Z Has data issue: false hasContentIssue false
  • English
  • Français

RACIAL DISPARITIES IN HEALTH

How Much Does Stress Really Matter?1

Published online by Cambridge University Press:  15 April 2011

Michelle J. Sternthal ,
Natalie Slopen  and
David R. Williams
Michelle J. Sternthal*
Affiliation:
Department of Environmental Health, Harvard School of Public Health
Natalie Slopen
Affiliation:
Center on the Developing Child, Harvard University
David R. Williams
Affiliation:
Department of Society, Human Development, and Health, Harvard School of Public Health; Departments of African and African American Studies and of Sociology, Harvard University
*
Michelle J. Sternthal, 1656 Park Road NW, Washington, DC 20010. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Despite the widespread assumption that racial differences in stress exist and that stress is a key mediator linking racial status to poor health, relatively few studies have explicitly examined this premise. We examine the distribution of stress across racial groups and the role of stress vulnerability and exposure in explaining racial differences in health in a community sample of Black, Hispanic, and White adults, employing a modeling strategy that accounts for the correlation between types of stressors and the accumulation of stressors in the prediction of health outcomes. We find significant racial differences in overall and cumulative exposure to eight stress domains. Blacks exhibit a higher prevalence and greater clustering of high stress scores than Whites. American-born Hispanics show prevalence rates and patterns of accumulation of stressors comparable to Blacks, while foreign-born Hispanics have stress profiles similar to Whites. Multiple stressors correlate with poor physical and mental health, with financial and relationship stressors exhibiting the largest and most consistent effects. Though we find no support for the stress-vulnerability hypothesis, the stress-exposure hypothesis does account for some racial health disparities. We discuss implications for future research and policy.

Keywords

RaceEthnicityStressHealthHealth InequalitiesCumulative Stress
Type
Moving Forward in Studying Racial Disparities in Health
Information
Du Bois Review: Social Science Research on Race , Volume 8 , Issue 1: Special Issue: Racial Inequality and Health , Spring 2011 , pp. 95 - 113
Copyright
Copyright © W.E.B. Du Bois Institute for African and African American Research 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

This study was in part supported by the National Institute of Child Health and Human Development grants HD38986 and HD050467. M. J. Sternthal was supported by grant T32-ES07069-29 and the Leaves of Grass Foundation.

References

REFERENCES

Aneshensel, C. (1992). Social Stress: Theory and Research. Annual Review of Sociology, 18(1): 15–38.Google Scholar
Aneshensel, C. S. (2009). Toward Explaining Mental Health Disparities. Journal of Health and Social Behavior, 50(4): 377–394.CrossRefGoogle ScholarPubMed
Bobo, L. and Suh, S. A. (2000). Surveying Racial Discrimination: Analyses from a Multiethnic Labor Market. In Bobo, Lawrence, Oliver, Melvin, Johnson, J. H., and Valenzuela, A. (Eds.), Prismatic Metropolis: Inequality in Los Angeles, pp. 527–564. New York: Russell Sage Foundation.Google Scholar
Finch, B., Frank, R., and Vega, W. (2004). Acculturation and Acculturation Stress: A Social-Epidemiological Approach to Mexican Migrant Farmworkers' Health. International Migration Review, 38(1): 236–262.CrossRefGoogle Scholar
Franko, D. L., Striegel-Moore, R. H., Brown, K. M., Barton, B. A., McMahon, R. P., Schreiber, G. B., Crawford, P. B., and Daniels, S. R. (2004). Expanding Our Understanding of the Relationship between Negative Life Events and Depressive Symptoms in Black and White Adolescent Girls. Psychological Medicine, 34(07): 1319–1330.CrossRefGoogle ScholarPubMed
Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., and Kessler, R. C. (2010). Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication I: Associations with First Onset of DSM-IV Disorders. Archives of General Psychiatry, 67(2): 113.CrossRefGoogle ScholarPubMed
Hatch, S. L. and Dohrenwend, B. P. (2007). Distribution of Traumatic and Other Stressful Life Events by Race/Ethnicity, Gender, Ses and Age: A Review of the Research. American Journal of Community Psychology, 40(3): 313–332.Google Scholar
House, J. S., Lepkowski, James M., Kinney, Ann M., Mero, Richard P., Kessler, Ronald C., Herzog, A. Regula (1994). The Social Stratification of Aging and Health. Journal of Health and Social Behavior, 35: 213–234.CrossRefGoogle ScholarPubMed
Idler, E. L. (1992). Self-Assessed Health and Mortality: A Review of Studies. In Maes, S., Leventhal, H., and Johnston, M. (Eds.) International Review of Health Psychology, pp. 33–54. New York: John Wiley & Sons.Google Scholar
Karasek, R. A. and Theorell, T. (1990). Healthy Work, Stress, Productivity and the Reconstruction of Working Life. New York: Wiley.Google Scholar
Kessler, R. C. (1979). A Strategy for Studying Differential Vulnerability to the Psychological Consequences of Stress. Journal of Health and Social Behavior, 20(2): 100–108.Google Scholar
Lantz, P. M., House, J. S., Mero, R. P., and Williams, D. R. (2005). Stress, Life Events, and Socioeconomic Disparities in Health: Results from the Americans' Changing Lives Study. Journal of Health and Social Behavior, 46(3): 274–288.CrossRefGoogle ScholarPubMed
McEwen, B (1998). Protective and Damaging Effects of Stress Mediators. New England Journal of Medicine, 338: 171–179.Google Scholar
McNeilly, M., Anderson, N., Armstead, C., Clark, R., Corbett, M., Robinson, E., Pieper, C., and Lepisto, E. (1996). The Perceived Racism Scale: A Multidimensional Assessment of the Experience of White Racism among African Americans. Ethnicity and Disease, 6(1-2): 154.Google Scholar
Morenoff, J. D., House, J. S., Hansen, B. B., Williams, D. R., Kaplan, G. A., and Hunte, H. E. (2007). Understanding Social Disparities in Hypertension Prevalence, Awareness, Treatment, and Control: The Role of Neighborhood Context. Social Science and Medicine, 65(9): 1853–1866.CrossRefGoogle ScholarPubMed
Myers, H. (2009). Ethnicity-and Socio-Economic Status-Related Stresses in Context: An Integrative Review and Conceptual Model. Journal of Behavioral Medicine, 32(1): 9–19.Google Scholar
Paradies, Y. (2006). A Review of Psychosocial Stress and Chronic Disease for 4th World Indigenous Peoples and African Americans. Ethnicity and Disease, 16(1): 295–308.Google ScholarPubMed
Pearlin, L. I. (1989). The Sociological Study of Stress. Journal of Health and Social Behavior, 30(3): 241–256.CrossRefGoogle ScholarPubMed
Pearlin, L. and Schooler, C. (1978). The Structure of Coping. Journal of Health and Social Behavior, 19(1): 2–21.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1975). Sex Differences in Depression. Sex Roles, 1(3): 249–265.CrossRefGoogle Scholar
Rosow, I. and Breslau, N. (1966). A Guttman Health Scale for the Aged. Journal of Gerontology, 21: 556–559.CrossRefGoogle ScholarPubMed
Sampson, R. J., Raudenbush, S. W., and Earls, F. (1997). Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy. Science, 277(5328): 918–924.Google Scholar
Thoits, P. (2010). Stress and Health: Major Findings and Policy Implications. Journal of Health and Social Behavior, 51: S41–S53.CrossRefGoogle ScholarPubMed
Tillman, K. and Weiss, U. (2009). Nativity Status and Depressive Symptoms among Hispanic Young Adults: The Role of Stress Exposure. Social Science Quarterly, 90(5): 1228–1250.CrossRefGoogle ScholarPubMed
Turner, R. J., Lloyd, D. A., and Taylor, J. (2006). Stress Burden, Drug Dependence and the Nativity Paradox among US Hispanics. Drug and Alcohol Dependence, 83(1): 79–89.CrossRefGoogle ScholarPubMed
Turner, R. J., Wheaton, B., and Lloyd, D. A. (1995). The Epidemiology of Social Stress. American Sociological Review, 60(1): 104–125.CrossRefGoogle Scholar
Viruell-Fuentes, E. A. (2007). Beyond Acculturation: Immigration, Discrimination, and Health Research among Mexicans in the United States. Social Science and Medicine, 65(7): 1524–1535.CrossRefGoogle ScholarPubMed
Viruell-Fuentes, E. A., Morenoff, J. D., Williams, D. R., House, J. S. (Forthcoming). Su Salud Es … ∖?Regular?: Language of Interview, Self-Rated Health, and the Other Latino Health Puzzle. American Journal Of Public Health.Google Scholar
Williams, D. R. and Mohammed, S. A. (2009). Discrimination and Racial Disparities in Health: Evidence and Needed Research. Journal of Behavioral Medicine, 32(1): 20–47.Google Scholar
Williams, D. R., Mohammed, S. A., Leavell, J., and Collins, C. (2010). Race, Socioeconomic Status, and Health: Complexities, Ongoing Challenges, and Research Opportunities. Annals of the New York Academy of Sciences, 1186: 69–101.CrossRefGoogle ScholarPubMed
Williams, D. R., Yu, Y., Jackson, J. S., and Anderson, N. B. (1997). Racial Differences in Physical and Mental Health: Socio-Economic Status, Stress and Discrimination. Journal of Health Psychology, 2(3): 335.CrossRefGoogle ScholarPubMed