264861 Residential segregation, everyday unfair treatment, and allostatic load: Examining cross-level interactions

Sunday, October 28, 2012

Dawn M. Richardson, DrPH, MPH , School of Public Health, University of Michigan, Ann Arbor, MI
Amy J. Schulz, PhD , School of Public Health, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Graciela B. Mentz, PhD , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Vicki Johnson-Lawrence, MS, PhD , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Carmen A. Stokes, MSN, FNP , Nursing, University of Detroit Mercy, Detroit, MI
Background: A growing literature has investigated the causal pathways linking social determinants and disease. Increasingly examined is the role of stress and the physiologic damage caused to the body due to chronic stress, through multiple biologic pathways that may accumulate across the lifespan. Stressful experiences trigger hormone release that is damaging to the body, particularly when stress is chronic. Discrimination and segregation conceptualized as chronic stressors have been linked to allostatic load. One area in need of further exploration is determining the conditions under which individuals are most vulnerable to the effects of chronic stress; thus, this study examines the joint effects of individual and neighborhood level stress on allostatic load. Methods: For this analysis, we used the 2002 Detroit Healthy Environments Partnership's two-stage random probability survey of 919 adults and the 2000 Census data for the corresponding 69 block groups. We tested the hypothesis that neighborhood characteristics (i.e., percent poverty and residential segregation) are associated with allostatic load, controlling for individual and neighborhood level covariates. We also tested whether these associations were mediated or moderated by everyday unfair treatment. Relationships were estimated using hierarchical linear modeling. Preliminary Findings: Preliminary findings show that neighborhood characteristics are associated with allostatic load in fully adjusted models. Unfair treatment does not mediate these relationships, but does modify the relationship between poverty and allostatic load. Discussion: The interaction between poverty and segregation may indicate that individuals in our sample experience higher levels of stress due to class-based (as opposed to race-based) discrimination.

Learning Areas:
Public health or related research

Learning Objectives:
1. Discuss the importance of neighborhood characteristics as chronic stressors impacting allostatic load. 2. Describe how stressors at the individual and neighborhood level interact to impact allostatic load. 3. Discuss potential program and policy implications for reducing chronic stress in ethnically diverse urban neighborhoods.

Keywords: Social Inequalities, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I conceptualized this work and conducted the data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.