Higher Stress of Minorities & Poor May Lead to Health Disparities

The heavy burden of stress found among both low-income populations and racial/ethnic minorities is associated with a much greater risk of developing mental and physical health issues that ultimately affect life expectancy, according to a new report from the American Psychological Association (APA).

“Good health is not equally distributed. Socioeconomic status, race, and ethnicity affect health status and are associated with substantial disparities in health outcomes across the lifespan,” said Elizabeth Brondolo, Ph.D., chair of an APA working group that wrote the report. “And stress is one of the top 10 social determinants of health inequities.”

Individuals with lower socioeconomic status report more severe (but not more frequent) stress as well as a greater number of traumatic events in their childhood, according to the report. In addition, African-Americans and U.S.-born Hispanics report more stress than their non-Hispanic white counterparts, partially stemming from exposure to discrimination and a tendency to experience more violent traumatic events.

Research has shown that high levels of stress can lead to mental and physical health problems.

“Stress affects how we perceive and react to the outside world,” Brondolo said. “Low socioeconomic status has been associated with negative thinking about oneself and the outside world, including low self-esteem, distrust of the intentions of others, and the perceptions that the world is a threatening place and life has little meaning. Stress is also known to contribute to depression.”

Stress may also play a role in physical health problems by the way it affects behavior. High levels of stress have been consistently linked to a wide variety of negative health behaviors, including smoking, drinking, drug use, and physical inactivity.

These behaviors and their outcomes (e.g., obesity) are closely associated with the development of many diseases, including diabetes, cancer, cardiovascular disease, and cognitive decline later in life, according to the report.

A 2016 analysis shows that men whose income is in the top one percent live almost 15 years longer than those in the bottom one percent, according to the report. For women, that difference is nearly 10 years.

The report identifies several types of interventions at the individual, family, health care provider, and community levels that can be useful in helping reduce the negative effects of stress on low-income and minority populations and potentially address some of the health disparities.

For example, at the individual level, mind-body interventions, such as yoga or meditation, were found to be accepted by disadvantaged groups and effective at improving mental and physical health outcomes.

Other interventions reported include improving the quality of communication between patients and their health care providers and teaching parenting skills to promote positive parent-child attachments.

The report calls for additional multidisciplinary research on the interrelationship of barriers to health experienced by disadvantaged individuals. It also recommends improving psychology training programs to make sure health care workers are able to adequately discuss and address the effects of inequality on individual health.

Finally, the report suggests the importance of raising awareness among policymakers and the public on the stress-inducing implications of persistent exposure to subtle biases and microaggressions.

“Disparities in both stress and health may not be visible to those who have more advantages or who have relatively limited direct contact with those affected,” said Brondolo. “A well-informed community is critical to improving the health of racial/ethnic and poor communities.”

Source: American Psychological Association

Posted by Patricia Adams