Stress related to discrimination and poverty is shortening lives in the United States. Here’s what experts say can be done about it.
Stress can take a toll not just mentally, but also physically and even financially. A new study finds that certain socioeconomic and ethnic groups in the United States face a high burden of systematic stressors, putting them at increased risk for a variety of health hazards and reducing their life expectancy.
In an extensive report released today by the American Psychological Association, mental health experts synthesized research on stress and health among certain socioeconomic, racial, and ethnic groups to show the long-term effects of stress.
Elizabeth Brondolo, PhD, a study co-author and chair of the Working Members Group, said the point of the report is to reveal the many ways stress can take a human toll.
“The problem with stress is that it’s such a big concept,” she told Healthline. “When people think about it, they often get overwhelmed or they’re not sure how to conceptualize it or how to measure it or how to think about really what the clinical implications are.”
She said the group wanted to break down the concept “to focus on stress in explaining disparities or contributing to disparities by race and or ethnicity or socioeconomic status.”
The results of stress from socioeconomic inequality can be found in curtailed life expectancy and lost income.
According to the report, men who make in the top 1 percent of income live almost 15 years longer than those in the bottom 1 percent.
For women, the difference is 10 years of longevity.
Stress not only affects a person’s mental health. It also takes a physical toll on the body. Inflammatory hormones are released when a person is stressed. This increases cardiovascular and cancer risk, among other issues.
As a result, the authors pointed out, stress results in “accidents, absenteeism, employee turnover, diminished productivity, and direct medical, legal, and insurance costs” that cost the United States $300 billion every year.
Brondolo pointed out that living in certain areas that are more violent and also segregated from surrounding communities can result in enough stress to affect a person’s way of thinking.
“If you live in a highly threatening environment and there’s few protections, you’re going to develop different ways of thinking and responding than you if you live in a more supportive environment,” she said.
Brondolo said the researchers’ goal was to highlight the lack of resources and help these groups have, as well as the increased stressors they face.
“It’s not that everybody doesn’t have stress in their life, but they have different kinds of stressors, and the gap between the demand and resources is particularly large for certain groups,” she said.
“One finding is that if you are, for example, a low-income white child, you are more likely to live in a neighborhood that’s middle class,” she said. “That means you have access to the social capital.”
She explained this can mean there’s more support if a low-income child doesn’t have something as basic as a calculator. Their neighbor or friend might have one they can borrow.
In addition, if parents are busy, other parents can pick children up from school.
Brondolo also explains how race can play a part in the risk of developing chronic stress.
Being discriminated against has clear impacts on health.
People who report being discriminated against are more likely to have higher blood pressure readings.
Some research has found this blood pressure increase lasts through the night, indicating people’s bodies aren’t able to repair from the stress-related damage caused by discrimination.
“Similarly, persistent discrimination has been associated with disruptions in the normal circadian rhythm,” the authors wrote.
A disrupted circadian rhythm or interrupted sleep can also put people at risk for a variety of health risks, including cardiovascular disease.
Long-term stress or “chronic” stress can actually change the way the brain works.
Normally once a stressful event is over, a person’s stress hormones will return to a baseline. But chronic stress affects this system, keeping a person from getting back to a baseline.
“These stress exposures may produce changes to gene expression that have widespread effects on neurobiological structures and processes,” the authors wrote.
Dr. Ramani Durvasula, a professor of psychology at California State University, Los Angeles, said this report should be a “wake-up call” for people in psychology, social work, and public health to take action.
“The structures are broken,” she told Healthline.
Durvasula pointed out that doctors can advise action for lessening stress, but these may not go far enough at the root of stress.
“In fact, people occupying these groups are often ‘blamed’ for their lack of resource, which lifts the blame off of making structural changes: affordable health care, income equality, fair taxation systems, higher quality education for all SES (socioeconomic) strata, better policies for working parents. The list is endless.”
Durvasula said without structural changes to lessen the stress burden on these groups and not stopping the narrative of blaming poor people for being poor, there’s little chance for meaningful change.
“That blame becomes one more stressor,” she said. “Stress impacts an individual in numerous ways — immune function, endocrine function, pain modulation, psychiatric symptomatology, cardiovascular function — and impacts cognitive elements of the person, such as perceptions of control, hopelessness, helplessness, and agency.”
Durvasula explained that this report shows how for many of the poorest Americans, the medical system doesn’t help relieve stress, but adds to it.
“Our healthcare systems are often quite punitive. Those who need them most… are often the ones who can’t get transport to appointments, are forced to make them months in advance and then hold jobs that don’t provide the flexibility to change hours, who can’t get child care, who face evictions or other residential instability that can make continuity of care difficult,” she said. “These folks are often charged cancellation fees, forced to wait months for another appointment, have longer wait times, and face byzantine insurance systems.”
Durvasula said public health, medical experts, and mental health experts all need to start working together to change systematic stressors to help those most at risk.
“As a psychologist, I can only say that we need to step out of our focus on the individual and start focusing on systems. Otherwise, we are engaging in a cruel hoax when working with these populations,” she said.