The Impact of Stress, Trauma, and Violence on Well‐Being and Physical Health

This special issue on the impact of stress, trauma, and violence on well‐being and physical health, featured in Research in Nursing & Health, is particularly timely amid rising burdens for individuals, families, and communities worldwide. Recent societal shifts—driven by climate change, social unrest, systemic inequality, resource scarcity, and economic instability—heighten exposure to chronic stress, violence, and potentially traumatic events. Indeed, approximately 70% of people globally will experience at least one potentially traumatic event during their lifetime (World Health Organization ²⁰²⁴). Yet exposure to adversity—and access to resources that foster healing, recovery, and resilience—is not equitably distributed. Social, economic, environmental, and structural conditions shape who is most vulnerable to adversity, how its effects unfold and become embodied across the life course, and the opportunities available to promote health and well‐being after exposure.

Several articles in this special issue highlight childhood experiences as key determinants of mental and physical health. This focus reflects growing recognition that childhood is a sensitive developmental period during which exposure to adversity (including abuse, violence, neglect, and other potentially traumatic experiences) can have profound and enduring consequences for health and well‐being (Fan and Kang 2025). Understanding the pathways by which these experiences influence health is therefore critical. Drawing on Beck's Cognitive Theory of Depression, Ossipova et al. (2025) examined perceived everyday discrimination as a common stressor among youth and found that greater exposure to discrimination was associated with more dysfunctional attitudes and depressive symptoms. Dysfunctional attitudes were also linked to inflammation, suggesting that cognitive processes may provide one pathway through which exposure to social stressors and other forms of adversity contributes to both psychological and physical health outcomes.

While the preceding article focuses on the consequences of adversity, three subsequent studies shift attention to the relational and psychological resources that may mitigate its harmful effects and promote positive adaptation across the life course. Lopez et al. (2025) examined whether emotional support lessens the negative effects of adverse childhood experiences (ACEs) among Latina immigrant women. Similarly, Hemphill et al. (2026) explored ACE narratives among women experiencing houselessness and identified sources of support and protection that may promote safety, resilience, and well‐being. Complementing this focus on protective factors, Yu et al. (2025) investigated the mechanisms through which positive childhood experiences contribute to flourishing among Chinese young adults. Collectively, these studies highlight the importance of supportive relationships and positive developmental experiences in shaping health and well‐being, suggesting that such resources diminish the effects of childhood adversity, foster resilience, and promote positive trajectories across diverse populations.

While childhood experiences offer an important lens for examining health outcomes, other articles focus on a broader matrix of life events over time. Nursing scholarship has long recognized that human health fluctuates constantly over the course of a lifespan, influenced by broader family, community, and societal contexts (Meleis 2011). This perspective aligns with embodiment theory, which holds that lived experiences—including chronic stress, trauma, violence, and other forms of adversity—can become biologically embedded, influencing health across the life course and even across generations (Krieger 2021). Together, these frameworks provide a lens for understanding the next four articles in this issue, which examine violence, grief, and natural disasters as distinct yet interconnected forms of adversity that affect health through complex relational, biological, and structural pathways.

In their meta‐synthesis, Dao‐Tran et al. (2025) synthesized current evidence on the mental health impacts of natural disasters, showing that the consequences of disasters extend far beyond immediate injury, displacement, and material loss, affecting susceptibility to depression, anxiety, stress, and posttraumatic stress disorder. Importantly, the authors emphasize that vulnerability, adaptation, and recovery result not only from exposure to the disaster itself but also from the social, economic, and environmental conditions in which individuals and communities live.

Wuest et al. (2026) reached a similar conclusion regarding interpersonal violence. Their findings indicate that cumulative exposure to violence contributes to chronic pain disability through interconnected pathways involving injury, depression, and posttraumatic stress. The study also highlights the broader social context in which violence occurs, identifying housing instability, limited economic resources, substance use, and gendered expectations as important influences on health outcomes. Extending this focus on cumulative adversity, Sabri and Granger (2026) demonstrate how social discrimination, chronic stress, physiological dysregulation, and exposure to violence intersect to shape reproductive health among immigrant women.

Shifting attention to experiences of loss, Dsouza et al. (2026) examined prolonged grief among ethnoracially minoritized caregivers through a qualitative study of cultural interpretations of bereavement. Participants described grief as a deeply relational, culturally situated experience, emphasizing trust, meaning‐making, and family dynamics as central to understanding and navigating loss.

Together, these studies illustrate that experiences of violence, grief, and catastrophe reverberate beyond immediate encounters. Collectively, they demonstrate how adversity becomes embodied over time and how context shapes vulnerability, adaptation, and recovery. In doing so, they challenge reductive explanations of health and underscore the need for ongoing research and critical reflection on how nursing and related disciplines conceptualize adversity, resilience, and well‐being.

As this special issue explores at length, adversity is not randomly distributed across populations. More than two decades after the publication of the landmark report Unequal Treatment (Institute of Medicine ²⁰⁰³), substantial racial and ethnic inequities in health and healthcare persist, particularly among Black populations and Black women. These inequities reflect not only differences in access to resources and opportunities but also the cumulative effects of social and structural conditions that shape health across the life course.

Flaskerud and Winslow's (1998) Vulnerable Populations Conceptual Framework (VPCF) offers a useful lens for understanding these processes. The framework posits that limited access to resources—including human capital, societal power, and healthcare—increases the relative risk of adverse health outcomes. Subsequent research has shown that these inequities often heighten exposure to discrimination and lead to chronic stress, resulting in poorer mental and physical health.

Several articles build on this work by examining how discrimination, minority stress, and adverse healthcare experiences shape health outcomes among Black populations. Sherman et al. (2026) report elevated depressive symptom severity among Black transgender women, including feelings of worthlessness and appetite changes. Importantly, these symptoms may also signal increased risk of suicidality, underscoring the need for early screening and sustained intervention in marginalized communities. A notable strength of the study is its community‐based participatory research approach, which engaged Black transgender women as advisory board members throughout the research process.

Similarly, Burton, and Ezemenaka (2026) examined how gendered racial microaggressions affect stress and depression among Black female college students. Their findings show a significant association between the frequency of microaggression experiences and reported depressive symptoms. Building on the VPCF, the authors incorporate constructs from the Minority Stress Model (Meyer 2003) and conceptualize environmental stressors, such as discrimination and structural inequities, as core social determinants of health.

Further research indicates that perceived racial and sex‐based discrimination extends into healthcare settings, including maternity care. Black women in the United States continue to experience disproportionately high rates of pregnancy‐related morbidity and mortality and are about three times more likely than White women to die from pregnancy‐related causes (U.S. Centers for Disease Control and Prevention ²⁰²⁴). Against this backdrop, the next two studies in this issue use qualitative and quantitative methods to deepen understanding of how stress and adverse healthcare experiences affect Black women during the perinatal period.

Using qualitative methods, Jaynes et al. (2025) examined the experiences of Black women with high‐risk pregnancies. Participants reported symptoms consistent with posttraumatic stress, including intrusive thoughts, avoidance behaviors, negative changes in mood and cognition, and heightened arousal, such as hypervigilance. Many also described ongoing strategizing and vigilance stemming from mistrust of healthcare systems.

Complementing these findings, Britt et al. (2026) examined associations between posttraumatic stress disorder (PTSD) and perinatal outcomes among 238 pregnant Black individuals. Their findings showed significant associations between PTSD diagnosis and symptom severity with prolonged labor and labor dysfunction. This study is among the first to link PTSD symptomatology to labor outcomes, extending prior research that focused more broadly on trauma exposure in labor and maternal health outcomes. This work provides important insights into potential pathways linking psychological distress and birth outcomes.

Taken together, these studies of maternal and infant health among Black populations advance the foundational work on the Weathering Hypothesis by Geronimus (1992) and others, which holds that chronic stress and discrimination contribute to adverse health outcomes.

Relevantly, several studies on this issue identify trauma‐informed care (TIC) as a promising intervention for reproductive‐age individuals. In the United States, more than half of these individuals report exposure to childhood adversity (Hurley et al. 2022). These experiences, in turn, are linked to adverse perinatal outcomes, including preterm birth, postpartum depression, and challenges with maternal‐infant bonding (Mamun et al. 2023). Given the prevalence and consequences of trauma exposure, perinatal care settings offer a critical opportunity to identify, address, and mitigate the effects of adversity. Yet the articles in this special issue reveal a persistent gap between growing recognition of trauma's impact on health and the successful implementation of TIC in clinical practice.

Collectively, these studies suggest that barriers to TIC are largely structural rather than individual. Goldstein et al. (2026) demonstrate that implementation challenges stem from system‐level constraints, including insufficient infrastructure, a lack of standardized processes, and limited organizational resources. Their findings highlight a central tension in contemporary healthcare systems: although trauma‐informed approaches can improve outcomes and prevent downstream harms, prevailing volume‐driven models of care often leave little time or support for the relational, trust‐building work that TIC requires. These findings illustrate the need for healthcare reimbursement and care delivery models that better align with the realities of trauma‐informed practice.

Abdulqader et al. (2025) further emphasize that TIC cannot be the sole responsibility of individual clinicians. Rather, TIC must serve as a shared framework that guides interactions across the entire healthcare team. When trauma‐informed principles are applied inconsistently, opportunities for healing may be undermined, and patients may remain vulnerable to re‐traumatization. Their findings emphasize the importance of coordinated, system‐wide approaches that embed trauma‐informed principles across disciplines and care settings.

Koenig et al. (2026) extend this discussion by examining the experiences of clinicians who routinely care for trauma‐affected populations. Participants described coping mechanisms such as setting work‐life boundaries, seeking therapeutic support, and engaging in advocacy as a means of self‐preservation. While these approaches reflect acts of resilience and professional commitment, the findings also raise important questions about institutional responsibility. Healthcare systems must recognize the cumulative impact of secondary trauma and emotional labor on the workforce and invest in structural changes—policies, resources, and supports—that promote clinician well‐being.

Despite existing challenges, the studies also identify promising pathways forward. Clinicians described applying universal trauma precautions, individualizing care, and drawing on patient strengths (Goldstein et al. 2026). Across these articles, interprofessional collaboration, co‐located services, and organizational support were identified as facilitators, highlighting the need for a fundamentally different model of care. Approaches such as group‐based models (e.g., Centering Pregnancy) and expanded integration of doulas into care teams may offer additional opportunities to strengthen social support and continuity of care for individuals affected by trauma. Realizing the promise of TIC, however, will require more than increased awareness or training. It will require structural transformation—in healthcare systems, policies, and reimbursement structures—that incentivizes the time, training, team‐based approaches, and organizational commitment necessary to translate trauma‐informed principles into routine practice.

Experiences of adversity exert a profound influence across the life course. Collectively, the studies in this issue illuminate the complex relational, biological, and structural pathways through which adversity becomes embodied and informs health trajectories over time. They further reveal that vulnerability, resilience, adaptation, and recovery are deeply shaped by the social, environmental, economic, and healthcare contexts in which people live. Taken together, the findings challenge narrow, individual‐focused explanations of health and call for approaches that address the broader conditions that produce and sustain inequities. For nursing and related disciplines, this work reinforces the importance of integrating life‐course, trauma‐informed, and structurally focused perspectives into research, practice, education, and policy. Advancing health equity will require both individual‐and systems‐level action. This includes supporting individuals and families affected by adversity while also transforming the systems, institutions, and social conditions that facilitate health and wellness.

Author Contributions

Jada L. Brooks: writing – original draft (lead). Carmen Alvarez: writing – original draft (supporting). Sara F. Jacoby: writing – original draft (supporting). Elizabeth G. NeSmith: writing – original draft (supporting).

Data Availability Statement

Data sharing not applicable to this article, as no datasets were generated or analyzed during the current study.