University of Alabama, Tuscaloosa, Alabama, USA.
University of Alabama at Birmingham, Birmingham, Alabama, USA.
Stress Health. 2022 Apr;38(2):340-349. doi: 10.1002/smi.3095. Epub 2021 Sep 6.
Socioeconomic status (SES) is a well-established determinant of health. Disparities in stress are thought to partially account for SES-health disparities. We tested whether multiple indicators of SES show similar associations with psychological stress and whether race, sex, and geographic region moderate associations. Participants (n = 26,451) are from a well-characterized national cohort of Black and White US adults aged 45 years or older. Psychological stress was measured using the 4-item perceived stress scale. Income was assessed as annual household income and education as highest level of education completed. Occupation was assessed during a structured interview and subsequently coded hierarchically. For all sex-race-region groups, the largest SES-stress associations were for income and the smallest were for occupation. Race moderated SES-stress associations, such that income and education were more closely associated with stress in Black adults than White adults. Additionally, education was more strongly associated with stress in individuals living in the stroke belt region. Black Americans with lower income and education reported greater psychological stress and may be at higher risk for disease through stress-related pathways. Thus, which SES indicator is examined and for whom may alter the magnitude of the association between SES and psychological stress.
社会经济地位（SES）是健康的一个既定决定因素。压力方面的差异被认为部分解释了 SES 与健康差异之间的关系。我们测试了多个 SES 指标是否与心理压力有相似的关联，以及种族、性别和地理位置是否调节了这种关联。参与者（n=26451）来自一个具有代表性的美国黑人和白人成年人群体的全国队列，年龄在 45 岁或以上。心理压力通过 4 项感知压力量表进行测量。收入是根据家庭年收入评估的，而教育是根据完成的最高教育水平评估的。职业是在一次结构化访谈中评估的，并随后进行分层编码。对于所有性别-种族-地区群体，SES 与压力之间最大的关联是收入，最小的关联是职业。种族调节 SES 与压力之间的关联，例如，收入和教育与黑人成年人的压力更为密切相关，而不是与白人成年人。此外，在中风带地区生活的个体中，教育与压力的关联更为密切。收入和教育水平较低的美国黑人报告的心理压力更大，他们可能通过与压力相关的途径面临更高的疾病风险。因此，所检查的 SES 指标以及针对的人群可能会改变 SES 与心理压力之间的关联程度。
