Explaining the Social Gradient in Health in Canada: Using the National Population Health Survey to Examine the Role of Stressors

Overview

Journal Int J Behav Med

Publisher Informa Healthcare

Date 2004 Oct 22

PMID 15496342

Citations 9

Authors

Heather M Orpana

Louise Lemyre

Affiliations

Soon will be listed here.

Abstract

Understanding the mechanisms that explain the pervasive association between socioeconomic status and health has been identified as an important area of research. Using the 1994-1995 National Population Health Survey, this study examines whether exposure to psychosocial stressors may be one mediating mechanism of the social gradient in health. Data were obtained including indicators of socioeconomic status (SES); exposure to recent life events and chronic stressors; and self-rated health status. Results showed a clear gradient in poor self-rated health with decreasing SES. Higher exposure to stressors across several domains was also observed with decreasing SES. Exposure to stressors was further associated with poor self-rated health, above and beyond adjusting for SES. Across income adequacy groups, exposure to stressors accounted for 16% to 26% of the relationship between income group and poor self-rated health among men and for 6% to 15% among women, suggesting that exposure to psychosocial stressors may be one of the mediators underlying the higher prevalence of poor self-rated health within lower socioeconomic groups.

Citing Articles

Changes in household debt due to COVID-19 and mental health concerns among adults in Ontario, Canada.

Nigatu Y, Elton-Marshall T, Hamilton H Int J Soc Psychiatry. 2022; 69(3):774-783.

PMID: 36373945 PMC: 9666416. DOI: 10.1177/00207640221136795.

Does "Rural" Always Mean the Same? Macrosocial Determinants of Rural Populations' Health in Poland.

Ucieklak-Jez P, Bem A Int J Environ Res Public Health. 2020; 17(2).

PMID: 31936149 PMC: 7013667. DOI: 10.3390/ijerph17020397.

Number of Chronic Medical Conditions Fully Mediates the Effects of Race on Mortality; 25-Year Follow-Up of a Nationally Representative Sample of Americans.

Assari S J Racial Ethn Health Disparities. 2016; 4(4):623-631.

PMID: 27440120 PMC: 6662183. DOI: 10.1007/s40615-016-0266-4.

Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? A cross-sectional study based on the West Jutland cohort study.

Glasscock D, Andersen J, Labriola M, Rasmussen K, Hansen C BMC Public Health. 2013; 13:532.

PMID: 23724872 PMC: 3679909. DOI: 10.1186/1471-2458-13-532.

Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways.

Schreier H, Chen E Psychol Bull. 2012; 139(3):606-54.

PMID: 22845752 PMC: 3500451. DOI: 10.1037/a0029416.

References

Hemingway H, Marmot M . Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999; 318(7196):1460-7. PMC: 1115843. DOI: 10.1136/bmj.318.7196.1460. View

Lynch J, Smith G, Kaplan G, House J . Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. BMJ. 2000; 320(7243):1200-4. PMC: 1127589. DOI: 10.1136/bmj.320.7243.1200. View

Adler N, Boyce T, Chesney M, Cohen S, Folkman S, Kahn R . Socioeconomic status and health. The challenge of the gradient. Am Psychol. 1994; 49(1):15-24. DOI: 10.1037//0003-066x.49.1.15. View

Pearlin L . The sociological study of stress. J Health Soc Behav. 1989; 30(3):241-56. View

Brunner E . Stress and the biology of inequality. BMJ. 1997; 314(7092):1472-6. PMC: 2126744. DOI: 10.1136/bmj.314.7092.1472. View

Lynch J, Kaplan G, Salonen J . Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc Sci Med. 1997; 44(6):809-19. DOI: 10.1016/s0277-9536(96)00191-8. View

Holmbeck G . Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: examples from the child-clinical and pediatric psychology literatures. J Consult Clin Psychol. 1997; 65(4):599-610. DOI: 10.1037//0022-006x.65.4.599. View

Stronks K, van de Mheen H, Looman C, Mackenbach J . The importance of psychosocial stressors for socio-economic inequalities in perceived health. Soc Sci Med. 1998; 46(4-5):611-23. DOI: 10.1016/s0277-9536(97)00206-2. View

WATSON D, Pennebaker J . Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychol Rev. 1989; 96(2):234-54. DOI: 10.1037/0033-295x.96.2.234. View

10.

Manor O, Matthews S, Power C . Self-rated health and limiting longstanding illness: inter-relationships with morbidity in early adulthood. Int J Epidemiol. 2001; 30(3):600-7. DOI: 10.1093/ije/30.3.600. View

11.

Pincus T, Callahan L, Burkhauser R . Most chronic diseases are reported more frequently by individuals with fewer than 12 years of formal education in the age 18-64 United States population. J Chronic Dis. 1987; 40(9):865-74. DOI: 10.1016/0021-9681(87)90186-x. View

12.

Marmot M, Shipley M, Rose G . Inequalities in death--specific explanations of a general pattern?. Lancet. 1984; 1(8384):1003-6. DOI: 10.1016/s0140-6736(84)92337-7. View

13.

Baum A, Posluszny D . Health psychology: mapping biobehavioral contributions to health and illness. Annu Rev Psychol. 1999; 50:137-63. DOI: 10.1146/annurev.psych.50.1.137. View

14.

McEwen B . Protective and damaging effects of stress mediators. N Engl J Med. 1998; 338(3):171-9. DOI: 10.1056/NEJM199801153380307. View

15.

Idler E, Benyamini Y . Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997; 38(1):21-37. View

16.

Schnall P, Landsbergis P, Baker D . Job strain and cardiovascular disease. Annu Rev Public Health. 1994; 15:381-411. DOI: 10.1146/annurev.pu.15.050194.002121. View

17.

Baum A, Garofalo J, Yali A . Socioeconomic status and chronic stress. Does stress account for SES effects on health?. Ann N Y Acad Sci. 2000; 896:131-44. DOI: 10.1111/j.1749-6632.1999.tb08111.x. View

18.

Tambay J, Catlin G . Sample design of the national population health survey. Health Rep. 1995; 7(1):29-38, 31-42. View

19.

Adler N, Epel E, Castellazzo G, Ickovics J . Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000; 19(6):586-92. DOI: 10.1037//0278-6133.19.6.586. View

20.

Baron R, Kenny D . The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51(6):1173-82. DOI: 10.1037//0022-3514.51.6.1173. View