Social disadvantage and stress
Stress affects health when a perceived challenge exceeds a person's ability to cope. This is especially the case when the imbalance between stressful conditions and available coping resources is severe and/or chronic.
The effects are not always negative. For example, meeting and overcoming a challenge may actually have positive health effects by leading to growth, adaptation and learning that promote a person’s resilience and capacity for coping with future hardships. Health-damaging effects of stress are more likely to occur when a person experiences ongoing or chronic exposure to stressors in aspects of everyday life over which he or she has limited control—for example, trying to juggle both family and job commitments without a flexible work schedule or personal and sick leave. This type of chronic stress leads to negative behavioral, cognitive, physiologic and neurologic changes over time that increase vulnerability to poor health.
Striking differences in health and life expectancy have been repeatedly seen in the United States and other countries based on differences in educational attainment, occupational ranking, income and accumulated wealth. These differences follow a stepwise pattern: health improves incrementally with increasing levels of social and economic advantage.
People with greater socioeconomic advantage—with more education, higher incomes and/or greater wealth, for example—may be more likely to experience stress in ways that actually have beneficial effects on their health; this can occur when their own sense of being able to successfully meet and resolve the challenges they encounter is reinforced. In contrast, those with less education and lower incomes typically face more frequent and numerous stressors in many aspects of their lives, while at the same time having more limited social and material resources for coping.
The growing scientific knowledge about the links between stress and health has tremendous practical significance. Understanding these links is essential for raising awareness about the importance of policies and programs that can help make life less stressful, particularly for those who experience the most stress and are most vulnerable to its health-damaging effects. While much remains to be learned, current knowledge makes it clear that addressing the effects of stress—particularly chronic stress, and particularly among children—can play a critical role in realizing the health potential of all Americans.