The research findings over the past several decades all point to the pivotal role stress plays in our lives. We know that there's no way around stress and it comes from good things, such as weddings, promotions and births, as well as the trials and tribulations of living, e.g., divorce, death, or illness.

Stress attacks our immune system, leaving us less able to ward off diseases as simple as the common cold or, possibly, as debilitating and deadly as cancer and the myriad autoimmune disorders around us. Diabetes is only one of these immune disorders and stress plays a major role in its containment or ability to defeat us. Belief in our health is eroded by stress, resulting in decreased health and a concomitant decrease in our belief about our health and our future.

But now, we have new evidence that stress along with poverty and low socio-economic status play roles more devastating than we ever knew. One of these new discoveries links stress to increases or decreases in life expectancy.  

A recent report from an American Psychological Association working group on stress, indicated the importance of more research and more effective community outreaches, personal activities and clinician training with regard to stress, particularly among those who are in a minority or low-income population. 

The effects of stress and its negative tenacity in terms of our country's stress-related illnesses and injuries have been seen as significant.  The group has indicated that more than $300B a year can be attributed to stress-related accidents, absenteeism, employee turnover, lowered production, and associated costs in the area of medical, legal and insurance fees.  Stress and resulting burnout insinuates itself into every aspect of our lives and every career, even those in the medical profession. In medicine, in fact, it has become a major concern that is being vigorously addressed.

The impact that stress has, in its overreaching manner, on our total population, cannot be estimated because it is not possible to state in terms of a true dollar figure.  Stress not only endangers us and can lead to injury, but also injures our community in significant, unconscious ways and deprives us of the full promise of our populace's abilities. In this way, stress is a community problem that spreads across the entire country. We all suffer from the ill-effects of stress in our people.

Several factors which have been identified by the APA stress group included negative self-concept of those in low socioeconomic groups, low self-esteem, a distrust of the intentions of others and a worldview that is threatening, resulting in a diminished perception of life's meaning.  The conclusion, therefore, in the latter, can be one possible factor for high suicide rates we may see in particular populations or age groups within those in ethnic minority or low income groups. No one is immune to its effects.

Shortened lifespan is also one of the most disturbing effects of stress. Astoundingly, a 2016 analysis of men in the upper one percent of income in our country indicates that, on average, they live 15 years longer than those men in the bottom one percent. 

Women, similarly, in this low-income group, had 10 years less life than women in the upper one percent income group.  The value of life is, undoubtedly, associated with one's income level and the ability to avail oneself of not only healthcare opportunities but a higher sense of self-esteem and hope for the future. They do not find their core being slowly eaten away by daily stress.

What interventions might we begin to consider if we were to effectuate ways to help those in lower income or minority groups?  Some of the APA suggestions include:

1.  Mind-body interventions which can be taught locally, require no expenditure of funds and can help alleviate stress almost immediately as it provides life-affirming relief.

2.  Yoga or meditation exercises for these groups since these have shown efficacy with regard to both mental and physical health. Any age group can participate and it also provides access to group support.

3.  Communication education to enhance interactions between patients and caregivers or healthcare providers. Emotional health is heavily dependent on actively working toward self-management in terms of emotional responses to stressors.

4 Teaching parental skills to improve the interaction within families, which has an immediate impact on a child's mental health and educational efforts.

5. Any means to promote parent-child attachments which might include more interactions outside the family or within the home which offer quality time together and provide a sense of protection and support from parents.

In terms of community resources, we must consider both research and training for everyone in the mental health or healthcare fields.  Training programs have, over the years, become attuned to the need for multicultural training but we must now begin to reevaluate these programs for clinicians.  There is an evident inequality in both mental health and healthcare in general when it comes to assisting persons struggling with income inequality or cultural barriers due to their ethnicity.  Of course, there is also a need for an increased sensitivity to the disproportionate attention paid to gender when it comes to a variety of programs and opportunities for availing oneself of these programs.

American Psychological Association, APA Working Group on Stress and Health Disparities.

(2017). Stress and health disparities: Contexts, mechanisms, and interventions among

racial/ethnic minority and low-socioeconomic status populations. Retrieved from

http://www.apa.org/pi/health-disparities/resources/stress-report.aspx