Neighborhood-level stressors, social support, and diurnal patterns of cortisol: The Chicago Community Adult Health Study

Abstract

Neighborhood disadvantage has consistently been linked to increased rates of morbidity and mortality, but the mechanisms through which neighborhood environments may get “under the skin” remain largely unknown. Differential exposure to chronic environmental stressors has been identified as a potential pathway linking neighborhood disadvantage and poor health, particularly through the dysregulation of stress-related biological pathways such as cortisol secretion, but the majority of existing observational studies on stress and neuroendocrine functioning have focused exclusively on individual-level stressors and psychosocial characteristics. This paper aims to fill that gap by examining the association between features of the neighborhood environment and the diurnal cortisol patterns of 308 individuals from Chicago, Illinois, USA. We found that respondents in neighborhoods with high levels of perceived and observed stressors or low levels of social support experienced a flatter rate of cortisol decline throughout the day. In addition, overall mean cortisol levels were found to be lower in higher stress, lower support neighborhoods. This study adds to the growing evidence of hypocortisolism among chronically stressed adult populations and suggests hypocortisolism rather than hypercortisolism as a potential mechanism linking social disadvantage to poor health.

Cancer-related fatigue shows a stable association with diurnal cortisol dysregulation in breast cancer patients

“…The altered decline in diurnal cortisol might also be a consequence of stress or disrupted rest/activity cycles induced by fatigue, since in other studies higher evening cortisol levels had been associated with work-related stress [40][41][42], sleep disturbances [43], disrupted rest/activity cycles [44], or lack of social support [42,45].…”

The association between psychosocial stress and mortality is mediated by lifestyle and chronic diseases: The Hoorn Study

“…Experimental studies report that behavioral and endocrine changes occur after an acute psychological stress test, including cigarette craving (Buchmann et al, 2010), decreased physical activity (Hamer, 2012;Rutters et al, 2009), increased alcohol intake (Pohorecky, 2010), HPA axis activation (Born et al, 2010;Strahler et al, 2010) and inflammatory responses (Carpenter et al, 2010). Furthermore, population-based and patient studies have shown associations between psychosocial stress, chronic HPA axis activation (Karb et al, 2012), disruption of the circadian rhythm (Dedert et al, 2012), sleep deprivation (Mezick et al, 2009), depression (Musselman et al, 1998), type 2 diabetes (Puustinen et al, 2011) and cardiovascular disease (Neylon et al, 2013). Up until now, none of the previous studies on stressful life events have studied mediating factors, therefore, the second aim of our study is to evaluate whether the suspected relationship between the number of stressful life events and mortality is mediated by behavioral factors and morbidities.…”

Distress, circadian rhythms, immunity, and survival in presurgical breast cancer patients.

“…Previous research has shown that individuals living in neighborhoods with increased levels of perceived stressors had an increase of cortisol throughout the day and evening, starting three hours after waking, and lower overall cortisol mean (Karb et al, 2012).…”

“…It is possible that neighborhood stress can influence disease through neuroendocrine pathways (Steptoe & Feldman, 2001). Flattened salivary cortisol rhythms have been observed in individuals who live in neighborhoods with high levels of both perceived (e.g., perceived violence) and observed (e.g., homicide rates) stressors (Karb, Elliott, Dowd, & Morenoff, 2012). Flattened diurnal slopes and flatter decline from 30 minutes post-awakening to about two hours post-awakening were associated with neighborhood poverty (Hajat et al, 2015).…”

“…However, these stressors were not socioeconomic in nature, as Karb and colleagues (2012) explored perceived neighborhood violence, safety, physical hazards, and quality of neighborhood service and observed homicides, robberies and burglaries, physical disorder and deterioration, vacant lots and houses, and stress conditions (Karb et al, 2012). Neighborhood violence has been shown to be associated with low waking cortisol, and a "weaker, less consistent" association with neighborhood poverty and cortisol slope (Do et al, 2011, p. 630).…”