My dissertation examines particular psychosocial pathways--subjective social status, daily hassles, and daily interpersonal stressors--underlying health disparities. Subjective social status, a measure of stressful social comparisons, constitutes an important, yet understudied mechanism linking socioeconomic status and health. Few studies have examined the effects of subjective social status among U.S. Latinos, the nation's largest and one of its fastest growing ethnic-minority groups.
Stress research has focused on major events and chronic stress, largely overlooking the effects of daily hassles, particularly among African Americans--a group disproportionately burdened by high levels of stress and poverty. A majority of daily hassles involve interpersonal conflict. Individuals experiencing chronic pain may be especially susceptible to the effects of interpersonal conflict as arguments with significant others could result in increased emotional reactivity and compromised symptom management. Prior studies have relied on an aggregate
measure of interpersonal stress, potentially obscuring important variability in health effects. Thus, my research, through three studies, investigates whether subjective social status, daily hassles, and interpersonal stress serve as health determinants and potential mediators of the status-health relationship among racial/ethnic minorities and chronic pain populations.
The first study among U.S. Latinos found a strong inverse relationship between
subjective social status and poor health, especially among immigrant Latinos. This finding supports the prevailing notion that stressful social comparisons robustly influence health and partially account for the status-health relationship. The second study among whites and African Americans, found that daily hassles do not mediate the status-health relationship. Rather, traumatic events are more closely tied to status and have the greatest impact on health. The third study among rheumatoid arthritis patients found a positive association between status and
exposure to spouse/partner conflicts, a result that substantially nuances existing literature documenting a general inverse status-stress relationship. This study also found that increases in negative interpersonal spouse/partner events result in a significant rise in emotional reactivity.
Future socioeconomic health disparities research should account for relative status, a meaningful measure for examining how social disadvantage causes stress. These investigations should also focus on the effects of interpersonal spouse/partner conflicts and strategies to reduce their frequency and incidence. Researchers may wish to incorporate multiple stressors, paying attention to the effects of early life challenges and their particular implications in forming the
context for experiencing and responding to chronic stressors and daily hassles. This research furthers our understanding of the intermediate, psychosocial chain of events that lead to poor health.
