• Eva N Woodward, Jennifer L Walsh, Theresa E Senn, and Michael P Carey.
• Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Brown University, Box G-BH, Providence, RI 02912, USA. Electronic address: eva.woodward2@va.gov.
• J Natl Med Assoc. 2018 Aug 1; 110 (4): 371377371-377.

BackgroundStress is associated with unhealthy behaviors and premature morbidity and mortality, especially among those of low socioeconomic status (SES). Clarifying the roles of stress-related risk and protective factors can guide interventions designed to reduce stress and improve health among socioeconomically disadvantaged populations.Purpose(1) Replicate prior research showing that lower SES is associated with higher stress in a predominantly racial minority, socioeconomically disadvantaged sample, and (2) test the hypothesis that different types of social support (a protective factor) mitigate the deleterious effects of SES on self-reported perceived stress.MethodsLow-income patients (N = 508, 54% male, 68% African American, Mage = 28) from a publicly-funded clinic provided demographic information and then completed measures of perceived stress and social support. Four types of social support were assessed (viz., affectionate, emotional/informational, positive social interaction, and tangible). Structural equation modeling tested the hypothesized associations among SES, social support, and stress.ResultsIndividuals of lower SES, β = -0.27 (0.08), p < 0.01, and lower overall social support, β = -0.47 (0.05), p < 0.001, reported higher stress. Social support moderated associations between SES and stress, with participants with lower SES benefitting the most from social support. Of the four types of social support that were measured, positive social interaction was the strongest moderator, β = 0.20 (0.08), p = 0.01.ConclusionsThe associations among SES, stress, and social support corroborate prior research. Positive social interaction was particularly important for decreasing stress among socioeconomically disadvantaged persons.Published by Elsevier Inc.

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