On the Intersection of Race, Stress, and Health.

Abstract

The challenge of eliminating racial and ethnic health disparities has been a daunting task. These disparities are highly multi-factorial in nature, and researchers have been unable to elucidate the exact mechanisms, and appropriate solutions, to adequately address these problems. The study of the stress process provides an opportunity to further examine the mechanisms that contribute to health disparities. The three studies in this dissertation build upon the current literature by exploring the interactions between race, stress, and health. The first paper theoretically explored the role of stress in current public health explanations of racial and ethnic health disparities. The second paper utilized data from the Americans’ Changing Lives longitudinal study and compared levels of chronic stress and negative life events between Black and White respondents. The final chapter examined the health of the two racial groups, and further investigated the relationship between race, health, and stress. Hierarchical linear modeling suggested that Black Americans reported higher levels of chronic stress over the four waves of data collection. There was not any evidence of a racial difference in the slope of the chronic stress measures over time. When measuring negative life events, however, there was no difference in the average amount of events reported over the study period, but Black respondents did report experiencing negative life events more rapid than their White counterparts, over the study period. When considering health outcomes, Blacks consistently reported worse functional health and self-rated health over the entire study period, as compared to Whites. There was further evaluation of these health differences, once stress was added to the model. There were no significant differences in the interaction between race and stress, between Black and White respondents. Taken together, these studies indicate that when examining a segment of the life course, Black respondents consistently report higher levels of chronic stress and negative life events, and worse health than their White counterparts. The observed differences in stress and health persisted after various sociodemographic variables were controlled. This study enforces the need for work that considers the stress process as a pathway in which health disparities are developed and maintained.