By Aric A. Prather: For More Info, Go Here…
Good health is not evenly distributed in the United States. Racial and ethnic minorities and those who live in socioeconomically disadvantaged circumstances are more likely to suffer from poor health compared to socioeconomically advantaged and white counterparts. How and why these disparities emerge and persist is complex and multifaceted. However, it is clear that the social conditions in which people live are fundamental in shaping health trajectories, and that the stress created through these social conditions serves as an important pathway driving poor health and furthering health disparities (for a more extensive discussion, see Stress and Health Disparities from the American Psychological Association).
The term “stress” has become so incorporated into our culture and language that some have suggested the term itself should be abandoned entirely due to its lack of precision. However, others, including myself, still find stress a meaningful process for understanding variation in disease risk. But how do we define stress? The traditional psychology definition for stress comes from Stress and Coping Theory, where stress is experienced when the demands of a situation outweigh one’s resources to meet or mitigate those demands. Therefore, people can experience stress when they are exposed to high-intensity, threatening demands, particularly when those demands are unpredictable or uncontrollable, and when demands are relatively minor, often called daily hassles, if the individual perceives a lack of resources to cope with these demands.
The links between stress and health are well documented, and as anyone who has experienced an illness knows, the connections between these two things are bidirectional. That is, while much of the research has focused on the influence of stress exposures on the development and progression of disease, health problems themselves, particularly those that are threatening and uncertain, can serve as stressors.
The literature on stress as a predictor of disease is vast and heterogeneous; however, there are several health outcomes that are reliably tied to stressful experiences, including many of the illnesses responsible for a large proportion of comorbidities and deaths worldwide, such as depression and cardiovascular disease. Indeed, prospective studies show that the experience of major stressful life events often precedes and predicts the clinical onset of depression and its subsequent reoccurrence. Moreover, among those who are depressed, the subsequent experience of a stressful life event is associated with worsening depression and a longer duration of illness. The link between stress and cardiovascular disease is also fairly robust. This is not surprising given that stress is associated with many of the early risk factors for cardiovascular disease, including hypertension, elevated inflammation of the immune system, dysregulation of lipid and glucose levels, and central adiposity. Chronic stress exposure has prospectively been linked to the development of clinical cardiovascular disease as well as more aggressive progression and increased cardiovascular-related mortality. Moreover, acute stress exposure (for example, experiencing a natural disaster) has been shown to trigger heart attacks among individuals with preexisting heart disease.
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