Stress

Stress is one of the most talked about psychosocial constructs in popular discourse. We invoke the language of stress when we want sympathy, to convey that we feel inundated by demands, responsibility, or worry. The harried young mother in a store, a student at exam time, and the busy corporate executive are all familiar images of the stressed individual. Less prominent in the popular imagination is the stress of the [Page 1003]impoverished, the unemployed, those facing discrimination, and outcasts at the margins of society. Stress is central to the study of health disparities because the disadvantaged members of society bear it in disproportion.

In its epidemiological sense, stress is a way to characterize those aspects of experiencing the social and physical environment that influence the wellbeing of individuals. A variety of definitions have been put forth, but a prevailing theme is that stress results either from socioenvironmental demands that strain the adaptive capacity of the individual or from the absence of means for the individual to obtain desired ends. Stress therefore is not strictly an attribute of the environment but arises from discrepancies between social conditions and characteristics of the individual. Similar to stress in engineering, psychosocial stress can be thought of as a force on a resisting body that flexes within, but may exceed, a normal range. Social stress research differs from engineering in that it treats the capacity to resist as a separate construct, that of coping. Epidemiologists also distinguish stressors from distress: Stressors refer to the environmental stimulus, while distress is the psychological or behavioral response to the stressor. This entry will describe the origin and development of stress concepts, the continuum of stress, stress as a process, and social patterns of stress exposure.