Social disadvantage and adolescent stress

Goodman, Elizabeth; McEwen, Bruce S.; Dolan, Lawrence M.; Schafer-Kalkhoff, Tara; Adler, Nancy E.

doi:10.1016/j.jadohealth.2004.11.126

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Volume 37, Issue 6 , Pages 484-492, December 2005

Social disadvantage and adolescent stress

Elizabeth Goodman, M.D.
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
- Address correspondence to: Dr. Elizabeth Goodman, Heller School for Social Policy and Management, Brandeis University MS 35, 415 South St., Waltham, MA 02453-9110.
Bruce S. McEwen, Ph.D.
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University, New York, New York
Lawrence M. Dolan, M.D.
- Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Tara Schafer-Kalkhoff, M.A.
- Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Nancy E. Adler, Ph.D.
- Department of Psychiatry, University of California School of Medicine, San Francisco, California

Received 19 August 2004; received in revised form 9 November 2004

Abstract

Purpose

Low socioeconomic status (SES) and minority race/ethnicity are both associated with chronic stress and co-vary in American society. As such, these factors are often used synonymously, without clear theoretical conceptualization of their roles in the development of stress-related health disparities. This study theorized that race/ethnicity and SES reflect social disadvantage, which is the underlying factor in the development of stress-related illness, and examined how social disadvantage, defined in terms of both race/ethnicity and SES, influences adolescents’ stress.

Methods

This is a cross-sectional school-based study of 1209 non-Hispanic black and white 7th–12th graders from a single Midwestern metropolitan public school district. Each student completed a questionnaire and a parent provided SES information. Race/ethnicity was obtained from school records. Linear regression analyses determined the influence of race/ethnicity and SES to stress. Race/ethnicity and presence or absence of at least one parent who graduated from college were used to define four subgroups for within-group analyses.

Results

Stress was higher among black students, those from lower SES families, and those with lower perceived SES. In subgroup analyses, neither race nor SES maintained their independent associations with stress among socially disadvantaged groups. Black race was not associated with stress among those without a college-educated parent, and parent education did not influence stress among black students. In contrast, among more socially advantaged groups, both SES and race explained variation in adolescents’ stress.

Conclusions

Social disadvantage is associated with increased stress, regardless of whether disadvantage is defined in terms of race or SES. This suggests that race and SES measure adversity in the social environment, and therefore, serve as risk markers, rather than risk factors. Future research should focus on the experience of adversity, which is reflected by these social characteristics, and the processes by which it operates.

Keywords: Race , Socioeconomic status , Disparities , Stress , Social disadvantage