SOCIAL STRESS AND HEALTH

SYO4400
MEDICAL SOCIOLOGY
A. Stress and Health
A HEIGHTENED MIND-BODY
REACTION TO STIMULI
INDUCING FEAR AND ANXIETY
Occur when people experience
information that goes against
their beliefs or desires.
Situations that people find
threatening or burdensome
STRESS REACTION
A physiological or emotional
arousal involving autonomic
and neuroendocrine
adaptations
The fight or flight pattern
of physiological change
(Cannon 1932)
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Biology of Stress: Cortisol (-4:50)
A stress hormone, made by the adrenal glands
Functions:
1.Helps the body use sugar (glucose) and fat for
energy (metabolism).
2.Helps the body manage stress (immunity).
The cortisol level in the blood can be affected by
certain conditions (e.g., physical or emotional stress,
strenuous activity, infection, or injury).
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The Model

(Social) Stress Health

Stressors Reaction disparities

Can differential life stress experiences contribute to health disparities?

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Factors Determining the Effects of Stress
1.The nature of the threat itself
2.The duration of the threat
3.The subjective definition of the threat by the individual
4.The psychological style (e.g., personality) of the
individual involved
5.The objective social environment within which the threat
appears
6.The social influences acting upon the individual (e.g.,
supports offered by group membership)
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Stress Adaptation (Mechanic 1962, 1978)
The extent of physiological damage depends on:
1)The importance of the situation to the individual and
the extent of his or her motivation
2)An individuals capacity to deal with the situation
(e.g., personal skills, past experiences)
3)The individuals preparation (e.g., schools, family) by
society to meet problems
4)The influence of societys approved modes of
behavior
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Stress Adaptation (contd)
Some stresses cannot be changed by an individual
simply changing his or her behavior
-e.g., a lower-class diabetic deciding to eat a healthier
diet

Social capital, i.e., an investment in social relations

that people can use as a buffer against stress and
depression (Lin 2001)

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B. Sociological Approaches
1. FUNCTIONALISM
Situations where people are
forced to respond to
conditions not of their own
choosing (Durkheim [1897]
1912; Suicide)
Norms, values, socialization,
conformity, etc.
2. SYMBOLIC INTERACTIONISM
The outcome depends on an
individuals definition of the
situation and how he or she
comes to terms with it
(Thomas 1951).
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Symbolic Interactionism (contd)
Stress from the failure of the other person to reflect a
self-image consistent with that intended by the
individual (Cooley 1902).

Stressful is the integrity of the self to be challenged

(Goffman 1959)
-Face-work (or impression management): Take actions
to make ones activities consistent with the face he or
she is projecting.

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C. Social Stress
Modern threats are symbolic, not physical.

Related more to a situation than to a specific person

or object
1.Social Stressors
2.Class Position (SES)
3.Racial Prejudice & Discrimination
4.Life Course
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1. Social Stressors (Pearlin 1989)
1)LIFE EVENTS -Change in financial status
Accumulation of several -Change in residence
events in a persons life -Taking a vacation
within a relatively short -Victimization by
period discriminatory practices
-Death of a spouse
EVENTS VARY:
-Divorce
-Positive or negative
-Marriage
-Speed
-Loss of job -Extent
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Social Stressors (contd)
2)CHRONIC STRAINS 3)DAILY HASSLES
Persistent demands that Mini-events that require small
require readjustments over a behavioral adjustments (e.g.,
prolonged period traffic jams)
-e.g., coping with poverty,
job/role-related overload,
conflicts, capacity, or
restructuring
Have a stronger effects on
health than life events.

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2. Social Class Position
BOTH NEGATIVE LIFE EVENTS SOCIAL STRESSORS ARE
AND CHRONIC STRAINS ARE THOUGHT TO BE FATE, LUCK,
GREATEST AT THE BOTTOM OF OR CHANCE
SOCIETY (THOITS 2010) Fatalism or powerlessness in
Embedded in class hierarchies the lower class (Mirowsky &
Ross 1989)

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Class Position (contd)
SOCIAL RANK AND THE SUPPORTIVE MICRO-
ABILITY TO HANDLE STRESS ENVIRONMENT (I.E.,
The higher ones position in a RELATIONS AT WORK AND
social hierarchy, the better HOME)
one deals with stressful Provide a buffer to stress.
situations and the effects of Facilitate its transformation
stress on the body (Evans et into a less harmful experience
al. 1994; Pearlin et al. 2005) (Evans et al. 1994).

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Job Loss (Gallo et al. 2006)
Health outcomes of 582 persons in a larger nationwide
sample for a decade who had experienced involuntary
job loss after the age of 50
-Twice the risk of stroke and heart disease compared
to others without this negative experience

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Economic Recession
Increased mental illness during economic recessions
(Brenner 1973)
1)Provocation Disrupt usual lifestyles, which causes
mental illness in vulnerable people
2)Uncovering Expose people with mental illnesses by
reducing the resources they used to cope.

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3. Racial Prejudice (Sawyer et al. 2012)
Experiment to test the link between the anticipation of
prejudice and increased psychological and CV stress
1)Latina college students (participants) and white females
(confederates) paired
2)Filled attitude forms that included questions on racial
stereotypes
3)Each Latina student prepared a 3-minute speech on what I
am like as a work partner for their white partner.
4)The speakers hooked up to blood pressure cuffs and sensors
to measure other CV data
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Racial Prejudice (contd)
Results An increased sympathetic response ("fight or
flight response higher blood pressure, a faster heart
rate, and shorter pre-ejection periods)
Findings Merely the anticipation of racism, and not
necessarily the act, is enough to trigger a stress
response.

Source: Sawyer et al. 2012. Discrimination and the Stress Response: Psychological and
Physiological Consequences of Anticipating Prejudice in Interethnic Interactions. The
American Journal of Public Health 102(5):1020-1026. (More in Silverstein, Jason 2013.
How Racism is Bad for Our Bodies. The Atlantic. 3/12/2013)

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4. Life Course A Lifelong Impact of Childhood
Stress on Health (Winning et al. 2015)
Data The 1958 British Birth Cohort Study (N=6,714)
Findings
1.Childhood stress increases the risk of developing heart disease
and metabolic disorders (e.g., diabetes).
-Early-life stress Biological change Chronic illness
2.Even the adults who had lower distress levels were at higher
risk of chronic illness if they had experienced higher levels of
distress during childhood.
Source: Aubrey, Allison. 2015. Childhood Stress May Prime Pump For Chronic
Disease Later. NPR. 9/29/2015.
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Health Disparities Anchored to Earlier
Circumstances of Life Course (Pearlin et al. 2005)
Assumption Health disparities at mid- and late life, may
be anchored to earlier circumstances of the life course.
Findings:
1.People with the least privileged statuses having the
greatest chances of exposure to health-related stressors
2.Enduring economic strain and discriminatory experiences
-The stressors closely linked to status and status
attainment
-The stressors that continue or are repeated across
the life course
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 Life Course (contd)
3.Circumstances of stress proliferation, a process that
places people exposed to a serious adversity at risk for
later exposure to additional adversities

Implications Effective effort to close the systemic health

gaps must recognize their structural underpinnings.

Source: Pearlin, Leonard I. et al. 2005. Stress, Health, and the Life Course:
Some Conceptual Perspectives. Journal of Health and Social Behavior 46(2):
205-219.
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D. Health Outcomes (House 2002; Siegrist
2010; Wright 2014)
WEAKER DEFENSES AGAINST Cardiovascular complications
DISEASES Hypertension
Peptic ulcers
MORE SUSCEPTIBILITY TO
Compulsive vomiting
ILLNESSES
Muscular pain
Asthma
Migraine
Other physical ailments

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Wright (2014): Stress & Asthma
Findings High asthma hospitalization rates in the low
SES communities

Factors Psychological distress, pollution, SES, etc.

Mechanisms Neuroendocrine-Immune (mind-body)

interactions

Source: Wright, Rosalind, 2014. Health Disparities, Social Stress, and Asthma.
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Supplementary Readings
Cleveland Clinic. Social Media Causes Relationship Stress.
Mirowsky, John and Catherine E. Ross. 1989. Social Causes
of Psychological Distress. NY: Aldine de Gruyter.
Pearlin, Leonard I. et al. 2005. Stress, Health, and the
Life Course: Some Conceptual Perspectives. Journal of
Health and Social Behavior 46(2):205-219.
Siegrist, Johannes. 2010. Stress in the Workplace. The
New Blackwell Companion to Medical Sociology. Edited by
William C. Cockerham. Wiley-Blackwell.
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Supplementary (contd)
Thoits, Peggy A. 2010. Stress and Health: Major Findings
and Policy Implications. Journal of Health and Social
Behavior 51(1):S41-S53.
Velasquez-Manoff, Moises. Status and Stress. NYT.
7/27/2013.

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Web Resources
AsapSCIENCE. 2013. Can Stress Actually Kill You?
Aubrey, Allison. Childhood Stress May Prime Pump For Chronic
Disease Later. NPR. 9/29/2015.
MBL Wellness Club. 2008. The Long Term Effects of Chronic
Stress.
Silverstein, Jason 2013. How Racism is Bad for Our Bodies.
The Atlantic. 3/12/2013.

VIDEO:
-Wright, Rosalind, 2014. Health Disparities, Social Stress, and
Asthma.
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