RACIAL DISPARITIES IN HEALTH: How Much Does Stress Really Matter?
- Authors
- Sternthal, Michelle J; Slopen, Natalie; Williams, David R
- Year
- 2011
- Journal
- Du Bois review : social science research on race
- PMID
- 29887911
- DOI
- 10.1017/S1742058X11000087
- PMCID
- PMC5993442
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.
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| Perceived Neighborhood Racial Composition and Depressive Symptoms Among Black Americans Across Adulthood: Evaluating the Role of Psychosocial Risks and Resources. | Thomas Tobin CS et al. | β | 2023 | β |
| Prevalence and correlates of major depressive disorder among a national sample of middle-aged and older adults in India. | Pengpid S et al. | β | 2023 | β |
| Prevalence and determinants of depression, anxiety, and stress symptoms among Black individuals in Canada in the context of the COVID-19 pandemic. | CΓ©nat JM et al. | β | 2023 | β |
| Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1). | Sifunda S et al. | β | 2023 | β |
| Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada. | Turner BJ et al. | β | 2023 | β |
| Race and Ethnicity, Racism, and Population Health in the United States: The Straightforward, the Complex, Innovations, and the Future. | Hummer RA | β | 2023 | β |
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| Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults. | Batayeh B et al. | β | 2023 | β |
| Racial/Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors. | Erbetta K et al. | β | 2023 | β |
| Racialized Health Inequities: Quantifying Socioeconomic and Stress Pathways Using Moderated Mediation. | Brown TH et al. | β | 2023 | β |
| Racism as a Source of Pain. | Schubiner H et al. | β | 2023 | β |
| Revisiting the Black-White Mental Health Paradox During the Coronavirus Pandemic. | LaMotte ME et al. | β | 2023 | β |
| Social Isolation: An Unequally Distributed Health Hazard. | Umberson D et al. | β | 2023 | β |
| Societal Adaptation to Aging and Prevalence of Depression Among Older Adults: Evidence From 20 Countries. | Richardson RA et al. | β | 2023 | β |
| Sociocultural factors associated with persistent prescription opioid use (PPOU) among Puerto Rican adults in Massachusetts. | Essien-Aleksi IE et al. | β | 2023 | β |
| Study protocol for the Mindful Moms Study: A randomized controlled trial evaluating a mindful movement intervention for marginalized pregnant people experiencing depression. | Kinser PA et al. | β | 2023 | β |
| Survival of epithelial ovarian cancer in Black women: a society to cell approach in the African American cancer epidemiology study (AACES). | Schildkraut JM et al. | β | 2023 | β |
| The associations of everyday and major discrimination exposure with violence and poor mental health outcomes during the COVID-19 pandemic. | Raj A et al. | β | 2023 | β |
| The effects of contemporary redlining on the mental health of Black residents. | Pearson AL et al. | β | 2023 | β |
| The Effects of Suicide Exposure on Mental Health Outcomes Among Post-9/11 Veterans: Protocol for an Explanatory, Sequential, Mixed Methods Study. | Sayer NA et al. | β | 2023 | β |
| The heart of Detroit study: a window into urban middle-aged and older African Americans' daily lives to understand psychosocial determinants of cardiovascular disease risk. | Davis KM et al. | β | 2023 | β |
| The Relationship Between Intersectional Oppression and Affirmation and Latino Sexual Minority Men's Mental Health. | Mayo D et al. | β | 2023 | β |
| The role of discrimination and adverse childhood experiences in disordered eating. | Nelson JD et al. | β | 2023 | β |
| Vaccine mistrust among Black individuals in Canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system. | CΓ©nat JM et al. | β | 2023 | β |
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| Association of COVID-19 and Endemic Systemic Racism With Postpartum Anxiety and Depression Among Black Birthing Individuals. | Njoroge WFM et al. | β | 2022 | β |
| A systematic review and meta-analysis of the Everyday Discrimination Scale and biomarker outcomes. | Lawrence JA et al. | β | 2022 | β |
| Black Canadians' Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities. | Husbands W et al. | β | 2022 | β |
| Comparing multidimensional facets of stress with social, emotional, and physical well-being using ecological momentary assessment among a Hispanic sample. | Zawadzki MJ et al. | β | 2022 | β |
| Compassion, Discrimination, and Prosocial Behaviors: Young Diasporic Chinese During the COVID-19 Pandemic. | Chen Y et al. | β | 2022 | β |
| Developing the Florida Academic Cancer Center Alliance Health Disparities Common Measure: The Florida Health and Ancestry Survey. | Dyal BW et al. | β | 2022 | β |
| Disparities across Sexual Orientation in Obstructive Airway Disease among U.S. Adults. | Nagata JM et al. | β | 2022 | β |
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| Epigenetic Determinants of Racial Disparity in Breast Cancer: Looking beyond Genetic Alterations. | Joshi S et al. | β | 2022 | β |
| Establishing a Framework for Gathering Structural and Social Determinants of Health in Alzheimer's Disease Research Centers. | Stites SD et al. | β | 2022 | β |
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| Experiences of Discrimination, Institutional Responses to Seminal Race Events, and Depressive Symptoms in Black U.S. Medical Students. | Milam AJ et al. | β | 2022 | β |
| Factors Associated with Depression and Anxiety Symptoms among Migrant Population in Spain during the COVID-19 Pandemic. | Bayes-Marin I et al. | β | 2022 | β |
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| Race, Ethnicity, and Clinical Features of Alcohol Use Disorder Among US Military Veterans: Results From the National Health and Resilience in Veterans Study. | Carr MM et al. | β | 2021 | β |
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| Social Stressors, Arboviral Infection, and Immune Dysregulation in the Coastal Lowland Region of Ecuador: A Mixed Methods Approach in Ecological Perspective. | Vega Ocasio D et al. | β | 2021 | β |
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| The Differential Contribution of Adverse Childhood Experiences and Perceived Discrimination on Substance Use among Hispanic Emerging Adults. | Espinosa A et al. | β | 2021 | β |
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| The psychological impacts of COVID-19 related stressors on Syrian refugees in Turkey: The role of resource loss, discrimination, and social support. | Kurt G et al. | β | 2021 | β |
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| Internalizing Profiles of Homeless Adults: Investigating Links Between Perceived Ostracism and Need-Threat. | Van Zalk N et al. | β | 2019 | β |
| Light Privilege? Skin Tone Stratification in Health among African Americans. | Hargrove TW | β | 2019 | β |
| Longer-but Harder-Lives?: The Hispanic Health Paradox and the Social Determinants of Racial, Ethnic, and Immigrant-Native Health Disparities from Midlife through Late Life. | Boen CE et al. | β | 2019 | β |
| Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study. | Jochman JC et al. | β | 2019 | β |
| Perceived discrimination and mental health among older African Americans: the role of psychological well-being. | Yoon E et al. | β | 2019 | β |
| Perceived discrimination, trust in physicians, and prolonged symptom duration before ovarian cancer diagnosis in the African American Cancer Epidemiology Study. | Mullins MA et al. | β | 2019 | β |
| Placing prostate cancer disparities within a psychosocial context: challenges and opportunities for future research. | Cuevas AG et al. | β | 2019 | β |
| Psychosocial Stress and Overweight and Obesity: Findings From the Chicago Community Adult Health Study. | Cuevas AG et al. | β | 2019 | β |
| Racism and Health: Evidence and Needed Research. | Williams DR et al. | β | 2019 | β |
| Religiosity and health: A global comparative study. | Zimmer Z et al. | β | 2019 | β |
| Role of stress management for cardiovascular disease prevention. | Chinnaiyan KM | β | 2019 | β |
| Stressor landscapes, birth weight, and prematurity at the intersection of race and income: Elucidating birth contexts through patterned life events. | Koning SM et al. | β | 2019 | β |
| Stressors in Midlife and Risk of Dementia: The Role of Race and Education. | Gilsanz P et al. | β | 2019 | β |
| The Association Between Perceived Discrimination and Allostatic Load in the Boston Puerto Rican Health Study. | Cuevas AG et al. | β | 2019 | β |
| The Mind-Body Study: study design and reproducibility and interrelationships of psychosocial factors in the Nurses' Health Study II. | Huang T et al. | β | 2019 | β |
| The moderating role of race/ethnicity and nativity in the relationship between perceived discrimination and overweight and obesity: results from the National Epidemiologic Survey on Alcohol and Related Conditions. | Cuevas AG et al. | β | 2019 | β |
| The Prevalence and Health Impacts of Frequent Work Discrimination and Harassment among Women Firefighters in the US Fire Service. | Jahnke SA et al. | β | 2019 | β |
| The weathering hypothesis as an explanation for racial disparities in health: a systematic review. | Forde AT et al. | β | 2019 | β |
| When richer doesn't mean thinner: Ethnicity, socioeconomic position, and the risk of child obesity in the United Kingdom. | Goisis A et al. | β | 2019 | β |
| A multi-group path analysis of the relationship between perceived racial discrimination and self-rated stress: how does it vary across racial/ethnic groups? | Yang TC et al. | β | 2018 | β |
| Behaviors and Risks for Cardiovascular Disease Among Muslim Women in the United States. | Budhwani H et al. | β | 2018 | β |
| Discrimination and Health Among Taxi Drivers in New York and Toronto. | Mirpuri S et al. | β | 2018 | β |
| Everyday Discrimination among African American Men: The Impact of Criminal Justice Contact. | Taylor RJ et al. | β | 2018 | β |
| High rates of posttraumatic stress symptoms in women living with HIV in Canada. | Wagner AC et al. | β | 2018 | β |
| Intersecting Social Inequalities and Body Mass Index Trajectories from Adolescence to Early Adulthood. | Hargrove TW | β | 2018 | β |
| Measuring Emergency Care Survival: The Implications of Risk Adjusting for Race and Poverty. | Ioannides KLH et al. | β | 2018 | β |
| Perceived Unfair Treatment by Police, Race, and Telomere Length: A Nashville Community-based Sample of Black and White Men. | McFarland MJ et al. | β | 2018 | β |
| Physical-psychiatric comorbidity: patterns and explanations for ethnic group differences. | Erving CL | β | 2018 | β |
| Psychosocial Mechanisms Underlying Older Black Men's Health. | Brown TH et al. | β | 2018 | β |
| Psychosocial Stress Over the Lifespan, Psychological Factors, and Cardiometabolic Risk in the Community. | Gebreab SZ et al. | β | 2018 | β |
| Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination. | Colen CG et al. | β | 2018 | β |
| Racial/Ethnic Inequities in Low Birth Weight and Preterm Birth: The Role of Multiple Forms of Stress. | Almeida J et al. | β | 2018 | β |
| Right back like we left something: examining the commodification of Blackness in social services to address racial disparities - the case of Hartford. | Searcy Y | β | 2018 | β |
| Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study. | Brewer LC et al. | β | 2018 | β |
| Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. | Williams DR | β | 2018 | β |
| The association of perceived discrimination and depressive symptoms among Chinese, Korean, and Vietnamese Americans. | Chau V et al. | β | 2018 | β |
| The effects of whiteness on the health of whites in the USA. | Malat J et al. | β | 2018 | β |
| Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions. | Nguyen TT et al. | β | 2018 | β |
| Weighed down by discriminatory policing: Perceived unfair treatment and black-white disparities in waist circumference. | McFarland MJ et al. | β | 2018 | β |
| When anger expression might be beneficial for African Americans: The moderating role of chronic discrimination. | Park J et al. | β | 2018 | β |
| Associations between race, discrimination and risk for chronic disease in a population-based sample from Canada. | Siddiqi A et al. | β | 2017 | β |
| Cumulative psychological stress and cardiovascular disease risk in middle aged and older women: Rationale, design, and baseline characteristics. | Albert MA et al. | β | 2017 | β |
| Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator? | Butler AM et al. | β | 2017 | β |
| Discrimination and symptoms of obsessive-compulsive disorder among African Americans. | Williams MT et al. | β | 2017 | β |
| Hypertension in Blacks: Unanswered Questions and Future Directions for the JHS (Jackson Heart Study). | Muntner P et al. | β | 2017 | β |
| Muslim Women's Experiences with Stigma, Abuse, and Depression: Results of a Sample Study Conducted in the United States. | Budhwani H et al. | β | 2017 | β |
| Political gender inequality and infant mortality in the United States, 1990-2012. | Homan P | β | 2017 | β |
| Psychosocial Factors and Hypertension: A Review of the Literature. | Cuevas AG et al. | β | 2017 | β |
| Race differences in depression vulnerability following Hurricane Katrina. | Ali JS et al. | β | 2017 | β |
| Racial Differences in Posttraumatic Stress Disorder Vulnerability Following Hurricane Katrina Among a Sample of Adult Cigarette Smokers from New Orleans. | Alexander AC et al. | β | 2017 | β |
| Review: Genetic research on alcohol use outcomes in African American populations: A review of the literature, associated challenges, and implications. | Dick DM et al. | β | 2017 | β |
| A clinical trial to examine disparities in quitting between African-American and White adult smokers: Design, accrual, and baseline characteristics. | Nollen NL et al. | β | 2016 | β |
| Adult Cigarette Smokers at Highest Risk for Concurrent Alternative Tobacco Product Use Among a Racially/Ethnically and Socioeconomically Diverse Sample. | Nollen NL et al. | β | 2016 | β |
| Air Pollution, Cardiovascular Outcomes, and Social Disadvantage: The Multi-ethnic Study of Atherosclerosis. | Hicken MT et al. | β | 2016 | β |
| A lost tribe in the city: health status and needs of African asylum seekers and refugees in Hong Kong. | Wong WC et al. | β | 2016 | β |
| Childhood adversity and adult health: Evaluating intervening mechanisms. | Turner RJ et al. | β | 2016 | β |
| Childhood Adversity and Men's Relationships in Adulthood: Life Course Processes and Racial Disadvantage. | Umberson D et al. | β | 2016 | β |
| Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample. | Hatch SL et al. | β | 2016 | β |
| Life Course Pathways to Racial Disparities in Cognitive Impairment among Older Americans. | Zhang Z et al. | β | 2016 | β |
| Life Stress, Race, and Abnormal Glucose Metabolism in Postmenopausal Women. | Dormire SL | β | 2016 | β |
| Race and Skin Color in Latino Health: An Analytic Review. | Cuevas AG et al. | β | 2016 | β |
| Racial and Ethnic Differences in Self-Reported Periodontal Disease in the Multi-Ethnic Study of Atherosclerosis (MESA). | Weatherspoon DJ et al. | β | 2016 | β |
| Relationships of cognitive load on eating and weight-related behaviors of young adults. | Byrd-Bredbenner C et al. | β | 2016 | β |
| The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study. | Johnson DA et al. | β | 2016 | β |
| Understanding and effectively addressing breast cancer in African American women: Unpacking the social context. | Williams DR et al. | β | 2016 | β |
| Understanding associations among race, socioeconomic status, and health: Patterns and prospects. | Williams DR et al. | β | 2016 | β |
| Workplace Discrimination Is Associated With Alcohol Abuse Among Ethnically Diverse Hospital Staff. | Thrasher AD et al. | β | 2016 | β |
| A Comparison of Birth Outcomes Among Black, Hispanic, and Black Hispanic Women. | Bediako PT et al. | β | 2015 | β |
| Discrimination and Cumulative Disease Damage Among African American Women With Systemic Lupus Erythematosus. | Chae DH et al. | β | 2015 | β |
| Ethnic Differences in Cardiovascular Disease Risk Factors: A Systematic Review of North American Evidence. | Gasevic D et al. | β | 2015 | β |
| RACE AS LIVED EXPERIENCE: The Impact of Multi-Dimensional Measures of Race/Ethnicity on the Self-Reported Health Status of Latinos. | Garcia JA et al. | β | 2015 | β |
| Racial/Ethnic Disparities in Men's Health: Examining Psychosocial Mechanisms. | Brown TH et al. | β | 2015 | β |
| Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues. | Lewis TT et al. | β | 2015 | β |
| The mental health of US Black women: the roles of social context and severe intimate partner violence. | Lacey KK et al. | β | 2015 | β |
| Unintended birth among Hispanic women in Texas: a descriptive analysis. | Vasquez D et al. | β | 2015 | β |
| Associations between self-reported discrimination and diurnal cortisol rhythms among young adults: The moderating role of racial-ethnic minority status. | Zeiders KH et al. | β | 2014 | β |
| Childhood adversity, adult neighborhood context, and cumulative biological risk for chronic diseases in adulthood. | Slopen N et al. | β | 2014 | β |
| Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. | Slopen N et al. | β | 2014 | β |
| Everyday discrimination is associated with nicotine dependence among African American, Latino, and White smokers. | Kendzor DE et al. | β | 2014 | β |
| Fine particulate matter air pollution and blood pressure: the modifying role of psychosocial stress. | Hicken MT et al. | β | 2014 | β |
| Impact of Arizona's SB 1070 immigration law on utilization of health care and public assistance among Mexican-origin adolescent mothers and their mother figures. | Toomey RB et al. | β | 2014 | β |
| Intervening within and across levels: a multilevel approach to stigma and public health. | Cook JE et al. | β | 2014 | β |
| Racial disparities in self-rated health: trends, explanatory factors, and the changing role of socio-demographics. | Beck AN et al. | β | 2014 | β |
| Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress. | Hicken MT et al. | β | 2014 | β |
| The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities. | Woods-GiscombΓ© CL et al. | β | 2014 | β |
| The effects of food advertising and cognitive load on food choices. | Zimmerman FJ et al. | β | 2014 | β |
| Black-white blood pressure disparities: depressive symptoms and differential vulnerability to blood lead. | Hicken MT et al. | β | 2013 | β |
| Erratum to: Interpersonal discrimination and health-related quality of life among black and white men and women in the United States. | Sellers SL et al. | β | 2013 | β |
| "Every shut eye, ain't sleep": The role of racism-related vigilance in racial/ethnic disparities in sleep difficulty. | Hicken MT et al. | β | 2013 | β |
| Intergroup relations and health disparities: a social psychological perspective. | Major B et al. | β | 2013 | β |
| Interpersonal discrimination and health-related quality of life among black and white men and women in the United States. | Sellers S et al. | β | 2013 | β |
| Race differences in age-trends of autonomic nervous system functioning. | Fuller-Rowell TE et al. | β | 2013 | β |
| Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US). | Krieger N et al. | β | 2013 | β |
| Racism and Health I: Pathways and Scientific Evidence. | Williams DR et al. | β | 2013 | β |
| Stigma and racial/ethnic HIV disparities: moving toward resilience. | Earnshaw VA et al. | β | 2013 | β |
| The social group influences of US health journalists and their impact on the newsmaking process. | McCauley MP et al. | β | 2013 | β |
| Transgenerational Consequences of Racial Discrimination for African American Health. | Goosby BJ et al. | β | 2013 | β |
| "White Box" Epidemiology and the Social Neuroscience of Health Behaviors: The Environmental Affordances Model. | Mezuk B et al. | β | 2013 | β |
| Allostatic load burden and racial disparities in mortality. | Duru OK et al. | β | 2012 | β |
| Ethnic Differences in Family Stress Processes Among African-Americans and Black Caribbeans. | Goosby BJ et al. | β | 2012 | β |
| Investigating the Relationship between Perceived Discrimination, Social Status, and Mental Health. | Lee H et al. | β | 2012 | β |
| Miles to go before we sleep: racial inequities in health. | Williams DR | β | 2012 | β |
| Psychosocial stressors and cigarette smoking among African American adults in midlife. | Slopen N et al. | β | 2012 | β |
| Theory-guided selection of discrimination measures for racial/ ethnic health disparities research among older adults. | Thrasher AD et al. | β | 2012 | β |
| The social context of cardiovascular disease: challenges and opportunities for the Jackson Heart Study. | Williams DR et al. | β | 2012 | β |
| Community development efforts offer a major opportunity to advance Americans' health. | Williams DR et al. | β | 2011 | β |
| Exposing racial discrimination: implicit & explicit measures--the My Body, My Story study of 1005 US-born black & white community health center members. | Krieger N et al. | β | 2011 | β |