Race and gender matter: A multidimensional approach to conceptualizing and measuring stress in African American women.

Abstract

Based on prior research and theory, the authors constructed a multidimensional model of stress in African American women comprised of race-related, gender-related, and generic stress. Exposure to and appraisal of these three types of stress were combined into a higher-order global stress factor. Using structural equation modeling, the fit of this stress factor and its ability to predict distress symptoms were examined in 189 socioeconomically diverse African American women aged 21 to 78. Results support the multidimensional conceptualization and operationalization of stress. Racerelated, gender-related, and generic stress contributed equally to the global stress factor, and global stress predicted a significant amount of variance in distress symptoms and intensity. This model exhibited better fit than a model without a global stress factor, in which each stress component predicted distress directly. Furthermore, race-related, gender-related, and generic stress did not contribute to distress beyond their representation in the global stress factor. These findings illustrate that stress related to central elements of identity, namely race and gender, cohere with generic stress to define the stress experience of African American women. Keywords stress; women; African American; gender; racism African American women experience a disproportionately high rate of stress-related health problems, including cardiovascular disease, cerebrovascular disease, and adverse birth outcomes (Office on Women 's Health, 2006). Despite evidence establishing a relationship between stress and health in other populations (e.g., Cohen, Tyrrell, & Smith, 1991; KiecoltGlaser, Glaser, Gravenstein, Malarkey, & Sheridan, 1996), effects of stress on health in African American women remain inadequately examined. One likely reason is the challenge of defining stress in African American women.Stress has been defined as a stimulus, a response, and as an interaction between stimuli and responses (Lobel & Dunkel-Schetter, 1990). According to the widely accepted transactional model, stress is a subjectively perceived discrepancy between environmental demands and biological, psychological, or social resources (Lazarus & Folkman, 1984). An important element of this definition is the perception of environmental demands or threats and perceived Correspondence concerning this article should be addressed to Cheryl L. Woods-Giscombé, School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460. E-mail: cheryl.giscombe@unc.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript ability to meet these demands, labeled stress appraisal (Lazarus & Folkman, 1984). "Stressors" are environmental demands, events, threats, or stimuli to which an individual is exposed. "Distress" is an aversive state evidenced by physical or psychological symptoms such as worry, tension, headaches, or weakness. Distress is an outcome of stress, resulting from exposure to stressors in the context of intra...

Coping Strategies as Moderators of the Relation Between Individual Race-Related Stress and Mental Health Symptoms for African American Women

“…Many African American women report daily microaggressions that are related to race and/or gender (e.g., Krieger, Rowley, Herman, Avery, & Phillips, 1993;Szymanski & Owens, 2009). In general, African American women may perceive exposure to racism at the individual level as highly stressful because negative race-related interpersonal interactions occur within the context of gender and likely intersect with emotional responses to other daily psychosocial challenges (Essed, 1991;Woods-Giscombé & Lobel, 2008). The overall findings of Greer et al's study suggest that high levels of individual race-related stress are related to poor psychological health for African American women.…”

Sojourner Syndrome and Health Disparities in African American Women

“…Examining race, gender, class, and age as independent or interaction variables also have substantial shortcomings in adequately describing the wide range of chronic and acute stressors experienced by African American women, because these experiences are not easily classified and do not fit neatly into one category. 9,12,13 Other research documents differential patterns of access, quality, and medical practice behaviors; however, these, too, fail to fully explain the widening gap in health disparities.…”

“…[5][6][7] Research indicates that African American women experience various types of acute and chronic stress throughout life that takes its toll by creating health disadvantages through a process described as weathering, or the physiologic wear and tear that provokes the early onset of disease and disability. 8,9 Particularly pernicious sources of stress include discrimination due to race, gender, class, and age. Although the existence of various types of discrimination and their effects on physical and mental health is well documented, there is little research on their combined effects on African American women's health [9][10][11] and differentiating the independent effects of each of these on health outcomes can be nearly impossible.…”

“…8,9 Particularly pernicious sources of stress include discrimination due to race, gender, class, and age. Although the existence of various types of discrimination and their effects on physical and mental health is well documented, there is little research on their combined effects on African American women's health [9][10][11] and differentiating the independent effects of each of these on health outcomes can be nearly impossible. 12 It is at the intersection of these categories that the heterogeneity and complexity of the lived experience of African American women can be described and where sources of health inequalities can be discovered.…”

Factors Influencing Female Caregivers' Appraisals of Their Preschoolers' Behaviors

“…Some authors have suggested that powerlessness, defined as the inability of the African American woman to access and obtain adequate income, education, and employment status, may result in an internal sense of helplessness and emotional distress while others have suggested that racism and gender issues play significant roles in global stress perceived by the African American woman (Ajrouch, Reisine, Lim, Sohn, & Ismail, 2010;Thomas & Gonzalez-Prendes, 2009;Woods-Giscombe & Lobel, 2008). These could be occurring in the participants in this study as one-third were recently laid-off from their jobs or currently looking to find work, only 28.7% had higher than a high school education, and half (51.3%) had a total family yearly income of less than $25,000.…”