The stress literature has also recognized macro-stressors as one component of stressor exposure. These are large-scale system-related stressors such as economic recessions or natural disasters. They provide indirect exposure to stressors, that can have “collateral effects” on individuals (Yehuda et al. 2005). Research reveals that events such as earthquakes, terrorist attacks and the onset of war can trigger increases in acute symptoms of heart disease, increased hospital admissions and heart disease mortality (Bhattacharyya and Steptoe 2007). Highly publicized race-related traumatic events, such as extreme examples of police brutality could have similar effects. Some of the items on the Index of Race-Related Stress (such as references to racial abuses of the Jim Crow era) capture aspects of macro-stressors (Utsey and Ponterotto 1996) but comprehensively assessing the potential contribution of large-scale, race-related traumatic events will require researchers to capitalize on emergent opportunities to assess the health consequences of macro-stressors. Such efforts could utilize some of the strategies used in the larger stress literature such as creatively using hospital admissions and vital statistics data. Future research needs to identify the extent to which
