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Study finds reasons for higher accumulated stress levels among African-American and Latina women vs. Caucasian women more complicated than thought

Toronto, November 17, 2016

By Leslie Shepherd

Dr. Pat O’Campo
Dr. Pat O’Campo

African-American and Latina women have a higher accumulated stress level than Caucasian women, but a new study found that less than half the differences could be explained by expected factors such as poverty, neighbourhoods, stress and support systems.

Study author Dr. Pat O’Campo, a researcher with the Centre for Urban Health Solutions of St. Michael’s Hospital, said there was growing interest in the impact of stress on women’s health, including lifetime accumulated stress and the psychological toll of having to repeatedly respond to stress.

In a study published today in the journal Social Science & Medicine, Dr. O’Campo compared the “allostatic load” of African-American, Latina and Caucasian women enrolled in a large longitudinal health disparities study in the United States.

“Allostatic load” is an emerging concept that refers to the biological “wear and tear on the body,” which grows over time as a person is exposed to repeated or chronic stress.

Dr. O’Campo’s team developed a list of 10 biomarkers to determine the “allostatic load” of each of the 1,766 women in the study: Body Mass Index, waist-hip ratio, systolic and diastolic blood pressure, pulse, high-sensitivity C-reactive protein (a protein that increases in the blood with inflammation and may play a role in predicting the risk of developing cardiovascular disease), blood sugar levels over time (HbA1c), levels of “good” cholesterol, total cholesterol and levels of the stress hormone cortisol. Women who fell outside the clinical cutoffs for each biomarker were given one point, up to a maximum of 10.

The average allostatic load scores were 4.65 for African-Americans, 4.57 for Latina and 3.86 for Caucasians.

Dr. O’ Campo said researchers then adjusted the numbers to account for what they assumed were the factors behind the discrepancies: household poverty, neighbourhoods, self-reported stress and resilience to stress. But that explained only 36 per cent of the high AL for African-American women compared to Caucasian women and only 42 per cent of the excess risk for Latinas compared to Caucasians.

“There remained a significant unexplained inequality between African-American and Latina women as compared to Caucasians even after adjustment for this set of variables,” said Dr. O’Campo, who has a PhD in social epidemiology.

One explanation could be that this study looked at the women’s current economic and health situation rather than their lifetime income levels, for example, she said. Another explanation could be that more social determinants of health need to be studied such as employment and housing status.

Dr. O’Campo noted that while there has been considerable research on women’s health prior to and during pregnancy, this study focused on women at least one year after giving birth who were not pregnant again.

“Women’s health during the childbearing years is important for reproductive health,” Dr. O’Campo said. “But postpartum health status can promote or hinder healthy aging.”

The women in this study were part of the Community Child Health Research Network developed to examine how community-, family-, and individual- level stressors may influence and interact with biological factors to affect maternal and child health. It was conducted in three urban sites (Washington, D.C., Baltimore and Los Angeles County), one suburban site (Lake County, Il.) and one rural site (seven counties in eastern North Carolina).


This paper is an example of how St. Michael's Hospital is making Ontario Healthier, Wealthier, Smarter.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

Media contacts

For more information or to arrange an interview with Dr. O'Campo, please contact:

Leslie Shepherd
Manager, Media Strategy, St. Michael's Hospital
416-864-6094
shepherdl@smh.ca