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How Much Does Stress Really Matter?1

Published online by Cambridge University Press:  15 April 2011

Michelle J. Sternthal*
Department of Environmental Health, Harvard School of Public Health
Natalie Slopen
Center on the Developing Child, Harvard University
David R. Williams
Department of Society, Human Development, and Health, Harvard School of Public Health; Departments of African and African American Studies and of Sociology, Harvard University
Michelle J. Sternthal, 1656 Park Road NW, Washington, DC 20010. E-mail:


Despite the widespread assumption that racial differences in stress exist and that stress is a key mediator linking racial status to poor health, relatively few studies have explicitly examined this premise. We examine the distribution of stress across racial groups and the role of stress vulnerability and exposure in explaining racial differences in health in a community sample of Black, Hispanic, and White adults, employing a modeling strategy that accounts for the correlation between types of stressors and the accumulation of stressors in the prediction of health outcomes. We find significant racial differences in overall and cumulative exposure to eight stress domains. Blacks exhibit a higher prevalence and greater clustering of high stress scores than Whites. American-born Hispanics show prevalence rates and patterns of accumulation of stressors comparable to Blacks, while foreign-born Hispanics have stress profiles similar to Whites. Multiple stressors correlate with poor physical and mental health, with financial and relationship stressors exhibiting the largest and most consistent effects. Though we find no support for the stress-vulnerability hypothesis, the stress-exposure hypothesis does account for some racial health disparities. We discuss implications for future research and policy.

Moving Forward in Studying Racial Disparities in Health
Copyright © W.E.B. Du Bois Institute for African and African American Research 2011

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This study was in part supported by the National Institute of Child Health and Human Development grants HD38986 and HD050467. M. J. Sternthal was supported by grant T32-ES07069-29 and the Leaves of Grass Foundation.



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