Job loss doesn't just affect individuals. It impacts families and even whole communities. Stress, uncertainty, and lost income affect children in various ways.

As Dr. Donald Warne explains, there is a direct biochemical connection between living in poverty and blood sugar levels. The stress of being poor and of having family members die young creates a complicated web of cultural values and beliefs that make controlling diabetes more difficult. Add to that the lack of availability of healthy food and it's no wonder diabetes rates are high.

De Graaf compellingly makes the case for federally guaranteed paid time off for all employees by laying out the links between vacation, productivity, child-rearing, and health.

In this original interview, Dr. Jack Shonkoff, director of the Center on the Developing Child at Harvard University, discusses the importance of early childhood experiences on life-long health, learning, and success. He describes the effect of toxic stress on brain development, and asserts that we have a moral and economic incentive to provide the best environments for all children or pay the price later in the form of reduced productivity and the burden of chronic disease.

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In this original interview, Dr. Jack Shonkoff, director of the Center on the Developing Child at Harvard University, discusses the importance of early childhood experiences on life-long health, learning, and success. He describes the effect of toxic stress on brain development, and asserts that we have a moral and economic incentive to provide the best environments for all children or pay the price later in the form of reduced productivity and the burden of chronic disease.

A seminal article linking stress and high demand / low control work to heart disease and other health problems.

The purpose of this site is to bring together, for public dissemination, information about and related to Job Strain (specifically) and Work Stress (in general).

The second in a series of in-depth articles about New Yorkers living with diabetes, this article describes the epidemic of diabetes in low-income neighborhoods like East Harlem.

Dise Langrus is one of many Marshallese who were relocated from their home islands 40 years ago after U.S. nuclear testing rendered it uninhabitable. Others were moved to make room for the construction of the U.S. military base on Kwajalein Island. Today, the Marshallese confront the worst of the "developing" and urbanized worlds: infectious disease running rampant because of poverty and squalid conditions and chronic illnesses resulting in part from the stress of dislocation and cultural loss.

Maybe it affects your every move. Maybe you never notice it.

Walk a mile in someone else’s shoes by watching and listening to four slideshows. You may be surprised to learn how great a role race plays in your own life.

In this audio podcast, excerpted from an interview conducted for UNNATURAL CAUSES, Nancy Krieger of the Harvard School of Public Health talks about the political economy of health, how racial and place-based inequities impact health, and how public health and social justice are inextricably intertwined. ENHANCED PODCAST (m4a)

This paper, co-authored by Drs. Jack P. Shonkoff, W. Thomas Boyce, and Bruce S. McEwen, illustrates that the origins of many adult diseases can be traced to negative experiences early in life, so confronting the causes of adversity before and shortly after birth may be a promising way to improve adult health and reduce premature deaths.
Summary of Essential Findings (pdf)
Q&A (pdf)

Americans now work more hours than the citizens any other country, including Japan. According to a poll by Take Back Your Time, 52 percent of working Americans received less than a week of paid vacation in the past year – more than half of those received none – while 65 percent of workers received less than two paid weeks off. Pushing for guaranteed paid vacation could have major positive impacts on the nation's mental and physical health.

"Think for a moment of poverty as a disease, thwarting growth and development, robbing children of the healthy, happy futures they might otherwise expect. In the exam room, we try to mitigate the pain and suffering that are its pernicious symptoms. But our patients’ well-being depends on more, on public health measures and prevention that lift the darkness so all children can grow toward the light."

Extensive research has shown that high demand-low control jobs are a recipe for chronic stress. Globalization and changes in the labor market over the past 30 years have resulted in a dramatic transformation in the nature and conditions of work – complicating our picture of the sources and types of stressors that workers face, as well as subsequent health outcomes and remedies.

Dr. Braveman made this presentation, fully titled "The Unsolved Mystery of Racial Disparities in Birth Outcomes: Is Racism-Related Stress a Missing Part of the Puzzle?" at the NIH Summit on Health Disparities in December 2008. It provides an excellent summary of the logic and evidence that points to structural racism as a key factor in explaining the Black / white gap in infant mortality and low birth weight. Includes considerations of neighborhood, employment, social factors, the life-course model, and the "immigrant paradox."

Public Health Advocacy Curriculum: This ten-lesson curriculum combines classroom- and community-based activities to teach students about the upstream or root causes of health, and to encourage them to become health advocates.

The chronic stress of racism and the social inequality it engenders may be underlying social determinants of persistent racial disparities in health, including infant mortality, preterm delivery, and low birth weight. This article describes the problem of racial disparities in adverse birth outcomes; outlines the multidimensional nature of racism and the pathways by which it may adversely affect health; and discusses the implications for clinical practice.

This background paper examines the impact of stress and stress mediators on pregnancy outcomes for African American women. The report also examines social support and other relational experiences, and makes recommedations for related changes in public policy and maternal and child health practices.

Alan Zaslavsky put out a request for studies on racism and stress in April 2010 on the Spirit of 1848 listserv.  This bibliography is a list of the studies suggested to him.

In profiling researcher Arline Geronimus and the development of her weathering hypothesis, this article lays out evidence for the relevance of racism and other social factors for understanding population health, particularly in the example of teen pregnancies in low-income Black communities. Could serve as an introduction to the topic for those new to health equity ideas.

Advancing health equity to ensure all Americans have the opportunity to lead healthy lives should be a priority. We have an opportunity to do so in a way that alleviates pressure on the health system and saves money. This memo was developed in January '09 to provide background and recommendations for developing a comprehensive, prevention-oriented strategy for acheiving health equity.

This key study finds that job strain increases blood pressure in men not only at work, but at home and while sleeping. It also finds that regular use of alcohol further raises daytime blood pressure, but only among those in high-strain jobs.

Research has conclusively demonstrated a correlation between socio-economic status (SES) and health outcomes, but traditional explanations based on health care access and the incidence of dangerous or harmful lifestyles do not fully account for this relationship. Recent studies highlight the relevance of psychosocial stress: perceiving a lack of control and predictive information regarding stressors, having few outlets for frustration, perceiving a worsening of one’s situation, and lacking social support structures. Other controversial research indicates that high inequality levels within a given community worsen health outcomes for all individuals, suggesting that one’s perception of her poverty is as important as her absolute poverty level.

NOTE: This article is only available via subscription or paid download.

In this audio podcast, excerpted from an interview conducted during the making of UNNATURAL CAUSES, Sir Michael Marmot of University College, London, discusses the social gradient in health, his pioneering Whitehall Studies and why he's optimistic about improving health outcomes.

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