The study also suggests that contrary to previous research, it may be that when it comes to handling stress associated with living in predominantly low-income communities, tangible aid like money, child care and transportation are more important than emotional support from friends and family.
While previous studies have shown that unsafe neighborhoods, money problems and lack of social support can affect general health, they often have looked only at one factor at a time. That approach does not fully capture the influence of chronic stress from the combined factors on health overall, says Barbara A. Israel, Dr.PH, of the University of Michigan School of Public Health, writing in the June issue of Health Education & Behavior.
The study included interviews with 679 black women, 18 and older, living in predominantly low-income neighborhoods on the east side of Detroit. All the women cared for children for at least five hours a week.
Women with the highest levels of chronic stress (e.g. money and family concerns) were more likely to report being in poor health than those with low stress. Additionally, women who indicated high levels of chronic stress worries also reported a greater likelihood of depressive symptoms.
The researchers found that while both emotional support and instrumental support are in and of themselves associated with health, that when both types of support are examined together, it is the tangible aid that is most important.
The study involved black women, the majority of whom are below the poverty level, who live in poor neighborhoods and for whom money problems are a major source of chronic stress, says Israel. “It therefore seems reasonable that the tangible supports provided by family and friends (such as child care, transportation, money) might be particularly strongly associated with better general health and fewer depressive symptoms.”
Israel adds, “These findings suggest the need for health education interventions and policy strategies that focus on strengthening both emotional and instrumental support, as well as aim at broadscale changes necessary to reduce chronic stressful conditions that exist in low-income urban communities.”
The study was based on surveys conducted by the East Side Village Health Worker Partnership, a community-based participatory research project of the Detroit Community-Academic Urban Research Center and funded by the Centers for Disease Control and Prevention.
Health Education & Behavior, a bimonthly peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. SOPHE is an international, non-profit professional organization that promotes the health of all people through education. For information about the journal, contact Elaine Auld at (202) 408-9804.