Expert Commentary

Racial disparities in health: How much does stress really matter?

2011 study from Harvard University published in the DuBois Review exploring the interaction between stress and public health outcomes, along racial lines.

Stress (iStock)

Significant research supports the notion that there are acute disparities in health outcomes along racial and socioeconomic lines in the United States. Studies have also documented the negative health effects associated with stress. While higher levels of stress among people of color are sometimes cited as a potential factor driving poorer health outcomes, few studies have produced conclusive insights about this dynamic.

A 2011 study from Harvard University published in the journal Du Bois Review: Social Science Research on Race, “Racial Disparities in Health: How Much Does Stress Really Matter?” used a sample of 3,105 adults from the Chicago Community Adult Health study to investigate the relationship between stress and physical and mental health. The sample is separated into four groups: Blacks, Whites, American-born Hispanics and foreign-born Hispanics. The authors categorize stress into eight domains, including employment stressors, financial stressors and early life stressors, among others; and the study uses four indicators of health status: poor self-rated health, depressive symptoms, chronic illness and functional limitations. The measures of both stress and health were self-reported by the study participants.

The study findings include:

  • Blacks had the worst outcomes on all health indicators except for self-rated health.
  • Overall stress levels were the highest for Blacks. America-born Hispanics had similar stress levels to African-Americans, and foreign-born Hispanics had similar stress levels to Whites. Additionally, among study participants that reported experiencing any stressors, African-Americans were more likely to report multiple stressors than Whites.
  • A “graded association” was found between stress indicators and health outcomes, with “each additional stressor associated with worse outcomes.”
  • Blacks and American-born Hispanics reported a higher prevalence of financial and relationship stress and had a higher rate of multiple stressors, suggesting that both occurrences “may be especially important factors in understanding minorities’ relatively worse health profiles.”
  • The amount of stress reported by Blacks was found to explain a “substantial portion of the health differential,” regardless of socioeconomic status or the specific type of stress experienced.

While the study sought to eliminate compounding factors by controlling for such factors as age, education and income, the authors concede that the research has several other limitations, including both its Chicago-centric survey sample and the fact that it did not account for “gender-specific stressors such as miscarriages and rape.” Still, the authors note that the research “highlights the value of including a broad range of stressors to develop a more comprehensive understanding of the role of stressors in lives of social groups.”

Tags: African-American, poverty, race, Hispanic, Latino, mental health

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