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The Perception of Stress and its Impact on Health in Poor Communities

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Abstract

With the increased understanding of the relationship between stress and disease, the role of stress in explaining persistent disparities in health outcomes has received growing attention. One body of research has focused on allostatic load—the “wear and tear” that results from chronic or excessive activation of the stress response. Other research has looked at the link between stress and health behaviors. In this study, we conducted 7 focus groups with a total of 56 people to understand how people living in Highbridge, South Bronx, New York, a low income community with poor health outcomes, perceive stress and its relationship to health. Focus group participants described a direct causal pathway between stress and poor health as well as an indirect pathway through health behaviors, including uncontrolled eating, sleep deprivation, substance abuse, smoking, violence and aggression, and withdrawal and inactivity. Participants articulated a number of theories about why stress leads to these unhealthy behaviors, including self-medication, adaptive behavior, discounting the future, depletion of willpower, and competing priorities. Their nuanced understanding of the link between stress and health elucidates the mechanisms and pathways by which stress may result in disparities in health outcomes and create challenges in changing health behaviors in poor communities like the South Bronx.

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Acknowledgments

This work was made possible by a grant from the United Hospital Fund of New York with additional support from Bronx Health REACH/Center for Excellence in the Elimination of Disparities through a Legacy Grant from the Centers for Disease Control and Prevention. Significant assistance was provided by the Highbridge Community Life Center, Project Samaritan, Highbridge Voices, and the Bronx District Public Health Office of the New York City Department of Health and Mental Hygiene, and colleagues Beth Weitzman (NYU) and Maxine Golub and Charmaine Ruddock (Institute for Family Health).

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Authors and Affiliations

  1. Department of Population Health, New York University School of Medicine, 550 First Avenue, VZ30 6th Floor, 625, New York, NY, 10016, USA

    Sue A. Kaplan

  2. The Robert F. Wagner Graduate School of Public Service, New York University, 295 Lafayette Street, 2nd Floor, New York, NY, 10012, USA

    Sue A. Kaplan & Todor Mijanovich

  3. The Highbridge Community Life Center, 797 Ogden Avenue, Bronx, NY, 10452, USA

    Vivienne Patricia Madden & Ellenrita Purcaro

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  1. Sue A. Kaplan
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  2. Vivienne Patricia Madden
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  4. Ellenrita Purcaro
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Correspondence to Sue A. Kaplan.

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Kaplan, S.A., Madden, V.P., Mijanovich, T. et al. The Perception of Stress and its Impact on Health in Poor Communities. J Community Health 38, 142–149 (2013). https://doi.org/10.1007/s10900-012-9593-5

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