May 2004

Wake Forest University Baptist Medical Center

Less educated people have lower stress, but more health effects

WINSTON-SALEM, N.C. – While less educated people report fewer stressful days than those with more education, their stress is more severe and has a larger impact on their health, reports a researcher from Wake Forest University Baptist Medical Center and his colleagues in the current issue of the Journal of Health and Social Behavior.

Joseph G. Grzywacz, Ph.D., an assistant professor in the Department of Family and Community Medicine, said studies on stress typically overlook daily stressors or hassles, which are different from chronic or acute stressors, such as major illnesses or loss of a loved one.

"What makes this study unique is that we asked people what happened to them each day of the study, and it was done with a national sample," Grzywacz said.

The main finding is that daily stressors are not random – where you are in society determines the kinds of stressors that you have each day, Grzywacz said. And while those with more education have more days of stress, they are not as affected by it.

A lot of attention has been given to inequalities in health, he said. There is a well-documented disparity between the advantaged and disadvantaged based on studies of death rates and rates of disease. Grzywacz's study used education as a measure of socioecomonic status.

"Less advantaged people are less healthy on a daily basis and are more likely to have downward turns in their health," Grzywacz said. "The downward turns in health were connected with daily stressors, and the effect of daily stressors on their health is much more devastating for the less advantaged."

Different people can look at the same stressors in very different ways, he said. For one person, a rainy day might seem a little gloomy or have no impact at all. But for an outside laborer, it could mean no work, therefore, no money, which means very high stress. Another example is a wealthier individual who reports as stressful that his daughter would not practice the viola. A poorer person might not even be able to afford such a musical instrument, so it is not an issue.

Future research might measure the impact of all three types of stressors – acute, chronic and daily – Grzywacz said. "Is the whole greater than the sum?" Another question to pursue is why less advantaged people report less daily stress, when previous research indicates they experience more acute and chronic stress. "If something happens every day, maybe it's not seen as a stressor – maybe it is just life?"

For this study, a total of 1,031 adults were interviewed daily for eight days. Each day, they were asked, "Since we last talked, has anything stressful happened….tell me about that." The adults gave each stressor a rank from low to high severity. Their responses were rated by trained coders to indicate how severe the stressors were.

People with less than a high school degree reported experiencing stressors on 30 percent of the study days. Those with a high school degree and/or some college reported stress on 38 percent of days, and those with a college degree reported stress on 44 percent of days.

The research was supported by grants from the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Aging, and the John D. and Catherine T. MacArthur Foundation.

In addition to Grzywacz, others participating in the research include David M. Almeida, associate professor in the Department of Human Development and Family Studies at Pennsylvania State University, Susan Ettner, associate professor in the Division of General Internal Medicine and Health Services Research at the University of California at Los Angeles, and Shevaun D. Neupert, M.S., a post-doctoral fellow at Brandeis University in the Department of Psychology.



Contacts: Karen Richardson, [email protected]; Shannon Koontz, [email protected]; at 336-716-4587.

About Wake Forest University Baptist Medical Center: Wake Forest Baptist is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University School of Medicine. It is licensed to operate 1,282 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of "America's Best Hospitals" by U.S. News & World Report.


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