Sternthal Michelle J, Slopen Natalie, Williams David R
Department of Environmental Health, Harvard School of Public Health.
Center on the Developing Child, Harvard University.
Du Bois Rev. 2011 Spring;8(1):95-113. doi: 10.1017/S1742058X11000087. Epub 2011 Apr 15.
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.
尽管人们普遍认为压力存在种族差异,且压力是将种族地位与健康状况不佳联系起来的关键中介因素,但相对较少的研究明确检验过这一前提。我们在一个由黑人、西班牙裔和白人成年人组成的社区样本中,研究了压力在不同种族群体中的分布情况,以及压力易感性和压力暴露在解释健康方面种族差异中的作用,采用了一种建模策略,该策略考虑了压力源类型之间的相关性以及压力源在健康结果预测中的累积情况。我们发现,在八个压力领域的总体和累积暴露方面存在显著的种族差异。黑人比白人表现出更高的高压力得分患病率和更大的聚集性。美国出生的西班牙裔的压力源患病率和累积模式与黑人相当,而外国出生的西班牙裔的压力状况与白人相似。多种压力源与身心健康不佳相关,其中财务和人际关系压力源的影响最大且最为一致。尽管我们没有找到支持压力易感性假设的证据,但压力暴露假设确实解释了一些种族健康差异。我们讨论了对未来研究和政策的启示。