“Good health is not equally distributed. Socio-economic status, race and ethnicity affect health status and are associated with substantial disparities in health outcomes across the lifespan,” said Elizabeth Brondolo, PhD, chair of an APA working group that wrote the report. “And stress is one of the top 10 social determinants of health inequities.”
Stress-related illnesses and injuries are estimated to cost the United States more than $300 billion per year from accidents, absenteeism, employee turnover, lowered productivity and direct medical, legal and insurance costs, according to the report.
People with lower incomes report more severe (but not more frequent) stress and having had more traumatic events in their childhood, said the report. African-Americans and U.S.-born Hispanics also report more stress than their non-Hispanic white counterparts, stemming in part from exposure to discrimination and a tendency to experience more violent traumatic events.
And all that stress can lead to mental and physical health problems.
“Stress affects how we perceive and react to the outside world,” Brondolo said. “Low socio-economic status has been associated with negative thinking about oneself and the outside world, including low self-esteem, distrust of the intentions of others and the perceptions that the world is a threatening place and life has little meaning. Stress is also known to contribute to depression.”
Stress may also play a role in physical health disparities by affecting behavior. High levels of stress have been consistently associated with a wide variety of negative health behaviors, including smoking, drinking, drug use and physical inactivity. These behaviors and their outcomes (e.g., obesity) are closely linked to the onset and course of many diseases, including diabetes, cancer, cardiovascular disease and cognitive decline later in life, according to the report.
