The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3033.0: Monday, November 17, 2003 - 8:30 AM

Abstract #54752

Stress, life events and socioeconomic disparities in health

Paula M. Lantz, PhD1, James S. House, PhD2, David Williams, PhD3, and Richard Mero, MA3. (1) School of Public Health, University of Michigan, 109 Observatory, Room M3116, Ann Arbor, MI 48109-2029, 734-763-9902,, (2) Department of Sociology, University of Michigan, Institute for Social Research, Survey Research Center, Ann Arbor, MI 48109, (3) Institute for Social Research, University of Michigan, 426 Thompson St. Rm 2230, Ann Arbor, MI 48106-1248

Background: To investigate the impact of exposure to a set of social stressors/negative life events on a range of physical health outcomes, and to assess the degree to which stress/negative life events explain socioeconomic disparities in these outcomes.

Methods: Data from the Americans' Changing Lives longitudinal study (a nationally-representative sample of 3,617 U.S. adults age 25 and older) were analyzed using Cox proportional hazard models and multinomial logistic regression. Analyses investigated the predictive relationship between socioeconomic indicators (income and education) and five measures of stress and negative life events at baseline in 1986 with the health outcomes of mortality, functional impairment, and self-rated health in 1994.

Results: There was a significant socioeconomic gradient in the major life events and stressors considered in this study. The number of negative lifetime events, financial stress, marital stress and parental stress in 1986 were predictive of subsequent poor health outcomes in models that controlled for age, sex, race and baseline health status. For example, the mortality hazard rate ratio for a count of negative lifetime events was 1.25 (95% CI 1.1, 1.4). However, many of the relationships observed between stressors and health outcomes did not remain significant when controls for income and education were included, nor did the life events/stress variables serve to explain much of the effects of income and education on health.

Conclusions: Although the experience of negative life events and other types of stressors are clearly related to socioeconomic position, they offer only limited power in explaining socioeconomic disparities in mortality or general measures of health status in the Americans' Changing Lives sample.

Learning Objectives:

Keywords: Social Inequalities, Stress

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Behavior, Lifestyle and Social Determinants of Health: Session I

The 131st Annual Meeting (November 15-19, 2003) of APHA