Abstract
Background:
Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans.
Methods:
We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress.
Results:
Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns.
Discussion:
Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.
Keywords: coping, race/ethnicity, stress
INTRODUCTION AND BACKGROUND
The substantial detrimental effects of stress on health disproportionately impact individuals from minority racial/ethnic groups in the United States (1-4). The generalized minority stress model (5) posits that enhanced stress burdens for stigmatized groups are largely attributable to disproportionate exposure to economic disadvantage, discrimination, acculturation, negative life events, and unhealthy residential environments. On the other hand, “paradoxes” exist wherein immigrants, Hispanics, and African Americans report better mental health than White Americans (6-10). These paradoxes reflect a range of possible explanations including sample selection, cultural differences in survey item interpretation, stress desensitization due to overexposure, differences in social support, or as posited by well-established stress models (11) —more effective coping behaviors.
Active versus Avoidant Coping
Healthy coping behaviors reduce stress (11,12) and may function as a form of “psychological activism” to promote resilience, particularly among racial/ethnic minorities (13,14). Coping behaviors that may promote health include “active” coping, which involves problem-solving and use of social support (15). Religious-based coping is also a form of “active coping” that may be particularly prevalent and effective among cultural groups with high rates of religiosity—such as Hispanics and African Americans (16). Racial/ethnic minorities might be particularly likely to develop active coping styles as a form of resistance to higher exposure to discrimination (12). However, active coping as a form of resistance to unequal conditions may also exhaust psychological resources, enhance stress, and contribute to reduced health in a phenomenon known as “John Henryism” (17). In contrast to healthy active coping behaviors, “avoidant coping” behaviors include substance use, denial, and sometimes humor—all of which can exacerbate stress (14,15).
Environmental Riskscapes
Patterns of active and avoidant coping as well as their impact on stress levels may differ not only by race, ethnicity, and immigrant status (1,12)–but also residential context. For example, racial/ethnic patterns of coping and stress may be particularly pronounced in physical environments that are unhealthy—such as environmental riskscapes. Environmental riskscapes are residential areas with high levels of disorder and/or that contain environmental hazards (e.g., pollution). Immigrants and racial/ethnic minorities are disproportionately more likely to reside in these environments and be exposed to the associated stressors, and the experience of being a minority race/ethnicity living in a particularly unhealthy or stressful environment may create “double jeopardy” of stressor exposure (18).
However, the active and avoidant coping and stress experiences of racial/ethnic minorities and immigrants (especially in environmental riskscapes) are surprisingly understudied in the literature. In fact, we are unable to identify any empirical work on this topic. Below, we summarize three crucial gaps in existing research.
Gaps in Existing Literature
First, existing studies of coping and stress by race/ethnicity compare only one or two racial/ethnic groups, and nearly all studies focus non-Hispanic Black populations only (19,20) or non-Hispanic Blacks versus White populations (21-23). We located one study that focused on Japanese immigrant populations (24). We were unable to locate any studies that examined coping behaviors and psychological distress by both race/ethnicity and immigrant status among multiple groups.
Second, nearly all studies are based on small sample sizes ranging from N=34 (25) to N=462 (20), which provides little data on comparisons across racial/ethnic groups. We were able to locate three studies on coping, stress, and race/ethnicity that analyzed samples of 1000 respondents or more, but all three compare only Black and White respondents and do not include Hispanics or immigrant groups (23,26).
Third, most studies on coping and stress by race/ethnicity focus on a single form of coping (e.g., religiosity (27); Afro-centered coping (20,28)) or a single source of stress (racial/ethnic discrimination (23), immigration and acculturation (22), specific health conditions (25,29,30), caregiver burden (31), domestic violence (24), or athletic competition (21). These studies are unable to compare active versus avoidant coping and cannot consider overlapping forms of stress, such as the potential “double jeopardy” of being a racial/ethnic minority and/or immigrant residing in an environmental riskscape. In fact, we were unable to locate any studies that compare different forms of coping across multiple racial/ethnic groups (including immigrants) residing in environmental riskscapes.
Taken together, these existing studies provide limited and inconsistent evidence about coping patterns by race/ethnicity. Some find that African Americans and immigrants are more likely to use avoidant coping (20-25,30), while others find higher levels of active coping among minority groups (19,32). Studies of specific coping behaviors find that compared to Whites, minority racial/ethnic groups have lower rates of substance misuse (avoidant coping) (26,32) and higher rates of religious (active) coping (28,31). Non-Hispanic African Americans are more likely than Hispanics or Whites to exhibit John Henryism (30) (potentially non-sustainable active coping), while Whites are more likely to use humor-based coping (can be active or avoidant) than minorities (29). Furthermore, despite well-known linkages between residential environmental stressors and stress—particularly for minority groups—there is a lack of empirical data on the impact of environmental riskscapes on coping and stress of people from minority races/ethnicities—especially immigrant populations.
Current Study
This study addresses limitations of previous research by focusing on a sizable sample of non-Hispanic Black (N=257), non-Hispanic White (N=304), and US-born (N=689) and foreign-born (N=749) of Mexican origin individuals who resided in Texas City, Texas. This urban area borders a large complex of petrochemical plants (33-36) and is the site of several large-scale oil refinery explosions over the years (Texas City Disaster of 1947, Texas City Refinery Explosion of 2005)—and is thus considered to be an environmental riskscape (18,36). The population of this area also is majority racial/ethnic minority, particularly of Mexican origin (foreign-born and US-born).
With this context of racial/ethnic diversity within an environmental riskscape, we seek to: 1) investigate patterns of active and avoidant coping by racial/ethnic group, 2) test associations between these two forms of coping and perceived stress, and 3) assess if associations are similar or variant across racial/ethnic groups (i.e., test the moderating effect of race/ethnicity).
METHODS
Participants & Data Collection
Data on Texas City are drawn from the Texas City Stress and Health Study, which was designed to assess sociobiological stress and health among a cross-sectional and racially/ethnically diverse sample of Texas City, Texas. Residents of Texas City were surveyed in-person from 2004 to 2006 in three stages using US Census Bureau Current Population Survey methods for listing, enumeration, and interviewing, which yielded an 80 percent response rate from three strata: 1) 1/8 of all non-Hispanic households in Texas City, 2) a majority of Hispanic households with a respondent aged 25-64, and 3) a full Census of Hispanics aged 65 and older. Of the approximately 50,000 residents of Texas City during the study period, data were collected for 2,706 respondents. Consistent with previous studies analyzing this dataset (35), we excluded from our analytic sample the 7.4% of respondents who were Hispanic from non-Mexican origin (a wide range of nations, N=173) and respondents who marked “other” race/ethnicity (N=28) to enhance clarity in interpretation and racial/ethnic classification. Furthermore, 51 of the remaining 2,505 respondents had missing data on our outcome of interest (perceived stress) and were also excluded, yielding a sample size of N = 2454 prior to listwise deletion. Listwise deletion reduced the sample size to N = 1995, largely due to income (N = 260), neighborhood quality assessments (N = 51), life events (N = 58), active coping (N = 66), and avoidant coping (N=52). We conducted multiple imputation in SAS (proc mi) to generate N=10 imputed datasets, yielding a non-imputed listwise deleted (N = 1995) and imputed (N = 2454) versions of the working dataset. The institutional review board at University of Texas Medical Branch approved the study protocol, and informed consent was obtained from all participants.
Measures
Perceived Stress.
The outcome measure of perceived stress is assessed through a 10-item Perceived Stress Scale (37), which is validated as an indicator of perceived psychological distress across diverse racial/ethnic groups, including Spanish-speakers and non-Hispanic Blacks. Responses to these items were summed to create a scale of perceived stress ranging from 0 to 40 (alpha=0.88).
Coping Behaviors.
Coping is measured with the 28-item Brief COPE Scale (38), with item responses ranging from 0 (“I do not do this at all”) to 3 (“I do this a lot”). Exploratory factor analysis of all items in the Brief COPE for the total sample and for subsamples by race/ethnicity revealed consistency across race/ethnicity and two factors with Eigenvalues of greater than 1.5. Items clustered around behaviors conceptually reflecting “active” and “avoidant” forms. Three items were removed (“make fun of the situation,” “make jokes about it,” and “express your negative feelings”) because their factor loadings did not clearly align with either “active” or “avoidant” coping. The 25 remaining items were summed to create two scales of coping behaviors (correlated at r=0.04), including “active” (16 items, alpha=0.85) and “avoidant” (9 items, alpha=0.75).
Race/Ethnicity.
Race/ethnicity was self-reported and is measured with four dummy variables representing non-Hispanic Black, non-Hispanic White, as well as US-born of Mexican origin and foreign-born of Mexican origin. Non-Hispanic Black respondents were the reference group, which prioritized comparisons between Black and Mexican respondents rather than comparing all minority racial/ethnic groups to White respondents.
Stressors and Appraisal.
Sources of stress include three domains that capture personal and environmental factors, including: 1) stressful life events (30 items summed of the number of events occurring within the past year to the respondent/respondents’ spouse/partner, children, or relatives/close friends, including accidents, injuries, illnesses, and occupational and domestic disruptions(39)), 2) neighborhood quality (average score from 0 to 4 for respondents who answered at least 75% of 28 items assessing satisfaction, social embeddedness, sense of community, and level of crime; alpha=0.91(40)), and 3) geographic proximity to the petrochemical plants (distance in kilometers assessed from the respondents’ home address and the boundary of the petrochemical complex). A fourth predictor captures appraisal of the environmental riskscape as a stressor (41): 4) concern over the health risks caused by the petrochemical complex (a 4-item summation scale asking respondents about concerns over pollution, accidents, stored waste, health problems as well as knowledge about risk and perceived control over risk; alpha=0.98(41)).
Covariates:
Control variables include sex (1 = female), age (years), education (1 = has high school degree), income (low: less than $25,000, middle: $25,000-49,000, and high: $50,000 or more), social support (average score from 0 to 4 for respondents who answered at least 75% of the 19-item scale, alpha=0.97(42)), marital status (1 = married), exercise behaviors (1 = exercised 3+ days over the last week), general health (average score of any 5 items assessing “general” mental and physical health from the Short Form-36 (SF-36)), ranging from 0 to 100 with higher values indicating better health(43).
Analysis
Descriptive and bivariate analyses were performed on the listwise deleted dataset (N = 1995) and multivariate analysis used the imputed dataset (N = 2454; results combined from 10 imputations). Table 1 includes descriptive univariate statistics for the total sample and by racial/ethnic subsample. Table 2 summarizes the results of paired t-tests comparing each coping item by each racial/ethnic group combination, Table 3 displays results of multivariate OLS regression analysis with interactions by coping and race/ethnicity. Statistically significant interactions are illustrated in Figure 1.
Table 1.
Descriptive Statistics by Race/Ethnicity (N=1999, listwise deleted)
| TOTAL | White (Non-Hispanic) |
Black (Non-Hispanic) |
Mexican (US-Born) |
Mexican (Foreign-Born) |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mean/% | (Min, Max)/(N=) | Mean/% | (S.D.)/(N=) | Mean/% | (S.D.)/(N=) | Mean/% | (S.D.)/(N=) | Mean/% | (S.D.)/(N=) | |
| Perceived Stress | 13.283 | (0, 39) | 13.159 | (7.103) | 14.809 | (7.325) | 13.075 | (7.291) | 12.770 | (6.123) |
| Race/Ethnicity | ||||||||||
| Black (Non-Hispanic) | 12.856% | (N=257) | ||||||||
| Mexican (Foreign-Born) | 15.208% | (N=304) | ||||||||
| Mexican (US-Born) | 34.467% | (N=689) | ||||||||
| White (Non-Hispanic) | 37.469% | (N=749) | ||||||||
| Coping Behaviors | ||||||||||
| Active | 33.404 | (0, 48) | 34.709 | (7.746) | 33.949 | (8.097) | 32.909 | (8.703) | 30.849 | (9.518) |
| Avoidant | 6.574 | (0, 24) | 6.870 | (4.554) | 7.856 | (5.017) | 6.282 | (4.604) | 5.424 | (4.342) |
| Stressors & Appraisal | ||||||||||
| Negative Life Events | 2.065 | (0, 15) | 2.146 | (2.351) | 2.350 | (2.413) | 2.144 | (2.445) | 1.444 | (1.941) |
| Neighborhood Quality | 2.744 | (0, 4) | 2.854 | (0.665) | 2.477 | (0.773) | 2.750 | (0.751) | 2.687 | (0.619) |
| Distance from Plants (km/1000) | 5.899 | (0.13, 15.57) | 6.802 | (3.342) | 5.029 | (3.205) | 5.948 | (3.394) | 4.298 | (2.632) |
| Concern about Health Risk | 10.295 | (0, 16) | 9.043 | (5.397) | 11.268 | (5.295) | 10.373 | (5.109) | 12.378 | (4.725) |
| Covariates | ||||||||||
| Female | 57.629% | (N=1152) | 55.941% | (N=419) | 69.261% | (N=178) | 55.443% | (N=382) | 56.908% | (N=173) |
| Age | 47.879 | (25, 90) | 51.764 | (16.206) | 47.347 | (15.032) | 46.424 | (14.669) | 42.057 | (13.288) |
| High School Degree | 0.642 | (N=1283) | 78.905% | (N=591) | 73.541% | (N=189) | 60.523% | (N=417) | 28.289% | (N=86) |
| Income (Low) | 38.319% | (N=766) | 27.770% | (N=208) | 50.973% | (N=131) | 33.237% | (N=229) | 65.132% | (N=198) |
| Income (Middle) | 16.158% | (N=323) | 14.686% | (N=110) | 18.288% | (N=47) | 17.126% | (N=118) | 15.789% | (N=48) |
| Income (High) | 45.523% | (N=910) | 57.543% | (N=431) | 30.739% | (N=79) | 49.637% | (N=342) | 19.079% | (N=58) |
| Social Support | 3.420 | (0, 4) | 3.365 | (0.794) | 3.258 | (0.815) | 3.505 | (0.696) | 3.498 | (0.735) |
| Married | 58.679% | (N=1173) | 59.413% | (N=445) | 36.187% | (N=93) | 59.361% | (N=409) | 74.342% | (N=226) |
| General Health | 62.794 | (0, 100) | 60.622 | (23.897) | 57.427 | (24.514) | 65.174 | (22.643) | 67.289 | (21.669) |
| Exercises (3+ days/wk) | 41.221% | (N=824) | 47.263% | (N=354) | 34.241% | (N=88) | 39.768% | (N=274) | 35.526% | (N=108) |
Table 2.
Summary of Results of Coping Item T-Tests by Race/Ethnicity (N=1995, listwise deleted)
| Reference Group |
(A)
White (Non-Hispanic) |
(B)
Black (Non-Hispanic) |
(C)
Mexican (US-Born) |
|||
|---|---|---|---|---|---|---|
| Coping Behaviors | Black (Non-Hispanic) |
Mexican (Foreign-Born) |
Mexican (US-born) |
Mexican (Foreign-Born) |
Mexican (US-born) |
Mexican (Foreign-Born) |
| Active | ||||||
| 1. Turn to work or other activities to take your mind off things. | ||||||
| 2. Concentrate your efforts on doing something about the situation… | ↓*** | ↓*** | ↓*** | |||
| 3. Get emotional support from others. | ↓* | ↓*** | ↓* | ↓** | ||
| 4. Take action to try to make the situation better. | ↓* | ↓*** | ↓* | |||
| 5. Get help and advice from other people. | ↓* | ↓*** | ↓** | ↓* | ||
| 6. Try to see it in a different light, to make it seem more positive. | ↓** | |||||
| 7. Try to come up with a strategy about what to do. | ↓** | ↓*** | ↓*** | ↓*** | ↓*** | |
| 8. Receive comfort and understanding from someone. | ↓*** | ↓** | ↓*** | |||
| 9. Look for something good in what is happening. | ↓*** | ↓* | ↓** | ↓** | ||
| 10. Do something to think about it less, such as… | ||||||
| 11. Accept the reality of the fact that it has happened. | ↓*** | ↓*** | ↓*** | |||
| 12. Try to find comfort in your religion or spiritual beliefs. | ↑*** | ↓** | ↓*** | ↓*** | ↓** | |
| 13. Try to get advice or help from other people about what to do. | ↓* | |||||
| 14. Learn to live with it. | ↓** | ↓** | ||||
| 15. Think hard about what steps to take. | ↓* | ↓*** | ↓*** | ↓*** | ↓*** | |
| 16. Pray or meditate. | ↑*** | ↓*** | ↓*** | |||
| Avoidant | ||||||
| 1. Say to yourself "this isn't real." | ↑*** | ↑* | ↓*** | ↓*** | ||
| 2. Use alcohol or other drugs to make yourself feel better. | ↓*** | ↓** | ||||
| 3. Give up trying to deal with it. | ↑*** | ↓*** | ↓*** | |||
| 4. Refuse to believe that it has happened. | ↑*** | ↓*** | ↓*** | |||
| 5. Say things to let your bad feelings escape. | ↓*** | ↓*** | ↓*** | ↓* | ↓*** | |
| 6. Use alcohol or other drugs to help you get through it. | ↓*** | ↓* | ↓** | |||
| 7. Criticize yourself. | ↓*** | ↓*** | ↓*** | |||
| 8. Give up the attempt to cope. | ↑*** | ↑*** | ↑* | ↓*** | ↑** | |
| 9. Blame yourself for things that happened. | ↓*** | ↓** | ↓*** | ↓*** | ||
Note: Comparing mean item scores of group in bold to group in italics, downward arrows (↓) indicate lower, upward (↑) indicate higher
p≤0.05
p≤0.01
p≤0.001
Table 3.
OLS Regression Predicting Perceived Stress for Total Sample (N=2454, imputed)
| 1 | 2 | 3 | 4 | 5 | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Intercept | 14.756 (0.404) |
*** | 18.476 (0.692) |
*** | 13.696 (0.763) |
*** | 19.017 (1.015) |
*** | 22.503 (1.538) |
*** |
| Race/Ethnicity | ||||||||||
| White (Non-Hispanic) | −1.694 (0.468) |
*** | −0.172 (0.436) |
0.206 (0.382) |
0.558 (0.366) |
−1.752 (1.518) |
||||
| Mexican (Foreign-Born) | −1.860 (0.471) |
*** | −0.803 (0.432) |
−0.131 (0.380) |
0.296 (0.368) |
−4.895 (1.448) |
*** | |||
| Mexican (US-Born) | −1.858 (0.549) |
*** | −0.852 (0.504) |
−0.124 (0.444) |
−0.121 (0.451) |
−4.748 (1.600) |
** | |||
| Stressors & Appraisal | ||||||||||
| Negative Life Events | 0.791 (0.058) |
*** | 0.718 (0.052) |
*** | 0.608 (0.051) |
*** | 0.609 (0.050) |
*** | ||
| Neighborhood Quality | −2.681 (0.196) |
*** | −1.320 (0.180) |
*** | −0.570 (0.181) |
** | −0.561 (0.181) |
** | ||
| Distance from Plants (km) | −0.063 (0.041) |
−0.088 (0.036) |
* | −0.062 (0.035) |
−0.059 (0.035) |
|||||
| Concern about Health Risk | 0.135 (0.026) |
*** | 0.185 (0.022) |
*** | 0.123 (0.022) |
*** | 0.121 (0.022) |
*** | ||
| Coping Behaviors | ||||||||||
| Active | −0.124 (0.014) |
*** | −0.108 (0.014) |
*** | −0.216 (0.037) |
*** | ||||
| Avoidant | 0.682 (0.026) |
*** | 0.594 (0.025) |
*** | 0.589 (0.025) |
*** | ||||
| Covariates | ||||||||||
| Female | 1.939 (0.231) |
*** | 1.932 (0.231) |
*** | ||||||
| Age | −0.050 (0.008) |
*** | −0.049 (0.008) |
*** | ||||||
| High School Degree | −0.350 (0.256) |
−0.370 (0.256) |
||||||||
| Low Income | 0.781 (0.306) |
* | 0.800 (0.306) |
** | ||||||
| Middle Income | −0.200 (0.354) |
−0.168 (0.356) |
||||||||
| Social Support | −0.608 (0.163) |
** | −0.561 (0.163) |
*** | ||||||
| Married | 0.406 (0.244) |
0.425 (0.243) |
||||||||
| General Health | −0.059 | *** | −0.059 | *** | ||||||
| (0.005) | (0.005) | |||||||||
| Exercises (3+ days/wk) | −0.421 (0.230) |
−0.418 (0.229) |
||||||||
| Interaction (Coping * Race/Ethnicity) | ||||||||||
| Active*White (Non-Hispanic) | 0.068 (0.043) |
|||||||||
| Active*Mexican (Foreign-Born) | 0.139 (0.047) |
** | ||||||||
| Active*Mexican (US-born) | 0.155 (0.042) |
*** | ||||||||
| Adjusted R Sq. | 0.006 | 0.187 | 0.382 | 0.447 | 0.455 | |||||
Note: Unstandardized regressions shown with standard errors in parentheses;
p≤0.05
p≤0.01
p≤0.001
Figure 1.
Association between Active Coping and Perceived Stress by Racial/Ethnic Group
Results
Descriptive and Bivariate
Descriptive results of all variables are displayed in Table 1. Non-Hispanic Black respondents reported statistically significantly higher stress (14.8) compared to all other groups, while White (13.2), US-born Mexican American (13.1), and foreign-born Mexican American (12.8) had similar levels of stress. We found similar levels of active coping among non-Hispanic White (34.7) and Black respondents (34.0), and slightly lower levels for US-born (32.9) and foreign-born (30.9) Mexican Americans. Non-Hispanic Black respondents had the highest levels of avoidant coping (7.9) and foreign-born Mexican Americans the lowest (5.4).
In terms of stressors and stressor appraisal, non-Hispanic Black respondents reported the highest average negative life events and the lowest neighborhood quality. Foreign-born Mexican Americans lived the closest to the petrochemical complex, followed by non-Hispanic Black respondents. Both of these groups also reported the highest concern about the health risks posed by the petrochemical plants—especially foreign-born Mexican Americans.
A closer examination of coping items by race/ethnicity is presented in Table 2. Active coping items followed a gradient wherein non-Hispanic Whites score higher than all other groups on multiple items, followed by non-Hispanic Black respondents, US-born Mexican American respondents, and then foreign-born Mexican American respondents. Avoidant coping followed a slightly different and less consistent pattern. Non-Hispanic Black respondents scored higher than White and Mexican American respondents on multiple avoidant coping items (Columns A and B). Cronbach’s alphas for the coping scales were relatively strong and consistent across groups, varying from 0.83 (White) to 0.86 (Black and foreign-born Mexican American) for active coping and 0.73 (White) to 0.78 (Black) for avoidant coping.
Multivariable
In Table 3, non-Hispanic Black respondents (reference group) had the highest levels of perceived stress, but race/ethnicity explained less than 1% of the variation in perceived stress (Model 1, R2=0.006). Initial associations between race/ethnicity and perceived stress were mediated by the addition of stressor sources and stressor appraisal to the model, which explain nearly 19% of the variation (Model 2, R2=.187). Respondents who reported more negative life events, lower quality neighborhoods, and greater concern about petrochemical health risk also reported higher perceived stress. Overall, race/ethnicity, stressor sources, stressor appraisal, and coping explained 38% of the variation in perceived stress (Model 3, R2=.382). Active coping was associated with lower perceived stress and avoidant with higher. Covariates explained 45% of the variation in perceived stress (Model 4, R2=.447).
Finally, we tested interaction terms of coping and race/ethnicity (Model 5) and found statistically significant differences in the “effect” (slope) of active coping. We plotted these coefficient estimates in Figure 1, which illustrates that active coping was associated with lower stress for non-Hispanic Black and White respondents but had very little to no association with stress for US-born or foreign-born Mexican Americans. Although Black and White respondents did not differ statistically in their slopes, Black respondents had the highest levels of stress and the steepest reduction in stress associated with use of active coping.
Discussion
In our racially/ethnically diverse sample residing an environmental riskscape, we observed that active and avoidant coping levels are relatively low among Mexican Americans and high among non-Hispanic Black and White respondents. Black respondents and foreign-born Mexican Americans reported the highest stressor exposure and stressor appraisal. While Black respondents reported the highest levels of perceived stress, foreign-born Mexican Americans reported the lowest. Associations between active coping and perceived stress appeared to differ by race/ethnicity. Mexican American respondents (foreign-born and US-born) exhibited little to no association between active coping and perceived stress, while Black respondents had a strong association.
Complex Patterns of Stressor Burden, Coping, and Stress among Black Respondents
Black respondents had the highest levels of stressor exposure and stressor appraisal across all indicators (negative life events, neighborhood quality, distance from plants, and concern about health risk), engaged in high levels of both active and avoidant coping, reported the highest levels of perceived stress, yet had the strongest association between active coping and reduced stress. Although all racial/ethnic groups can experience psychological exhaustion, this experience may be particularly potent for Black respondents (e.g., John Henryism), and therefore Black respondents might employ high levels of both forms of coping. High levels of avoidant coping might also exacerbate stress. Although we are unable to observe adverse early life circumstances and experiences, a lifetime of stressor exposure can negatively affect the development of coping resources and processes (44). Active coping is particularly effective for Black respondents, but it may not offset high stressor burden.
Foreign-Born Mexican Americans’ Paradox
Foreign-born Mexican Americans lived the closest to the petrochemical complex and expressed the greatest amount of concern about living in this riskscape. Yet, they also reported the lowest levels of both active and avoidant coping, the lowest stress, and the weakest association between active coping and reduced stress. These results are consistent with the immigrant health paradox (10) and underscore several important areas for future work on the mental health of Mexican immigrants. For foreign-born Mexican Americans especially, high stressor burden and stressor appraisal of the environmental riskscape did not translate into high levels of stress, and active coping did not explain their low levels of stress. As this is the first study to compare coping behaviors by race/ethnicity with a sizable sample of Mexican Americans, more work that examines cultural variation in coping and perceived stress is needed for this population—especially given their higher likelihood of residing in riskscapes as well as exposure to discrimination, poorer quality neighborhoods, immigration-related stressors, and low SES.
Limitations
This study is limited by its use of cross-sectional data from a specific geographic location (Texas City, Texas) and our inability to account for other key components of the stress process such as personality and sense of mastery, previous life experiences, cultural interpretations, and stigmas about stress and coping. Furthermore, although we conceptualize perceived stress as a potential risk factor for poorer health, associations between stress and health are variable and these concepts should not be conflated. Finally, this uniquely racially/ethnically diverse sample from an environmental riskscape was collected from 2004-2006.
New Contribution to the Literature
This study addressed several critical gaps in the literature and reveals new areas for future work. First, our study included a relatively large sample of multiple racial/ethnic groups, especially foreign-born Mexican Americans—a group that is highly exposed to stressors, yet continues to be overlooked in studies of racial/ethnic variation in coping and stress. Second, we focused on multiple sources of stressor exposure and stressor appraisal, including those specific to environmental riskscapes, where Black Americans and foreign-born Mexican Americans are particularly likely to reside. Third, our study revealed crucial differences in stress and coping between the two most vulnerable groups in our sample—Black Americans and foreign-born Mexican Americans. Black respondents in our sample have high levels of active coping that is particularly effective in reducing stress, yet perceived stress also remains high among this group, underscoring the possible risk of continued exhaustion from unequal exposure to multiple sources of stress. For Mexican Americans, the lack of association between exposure to stress, coping, and perceived stress is unique and, therefore, more research on stress and coping among Mexican Americans (especially foreign-born) is needed to evaluate how culture and the experience of immigration shape coping behaviors and perceived stress. Indeed, theories and models of coping and stress may eventually need to be revised to include more explicit attention to ethnic and immigrant groups' life circumstances and experiences.
Funding:
This work was supported by Grant P50 CA10563 from the National Cancer Institute, which funded the UTMB Center for Population Health and Health Disparities as well as the Texas City Stress and Health Study.
References
- 1.Pearlin LI. The Stress Process Revisited. In: Aneshensel CS, Phelan JC, editors. Handbook of the sociology of mental health. New York: Kluwer Academic/Plenum Publishers; 1999. p. 395–415. (Handbooks of sociology and social research). [Google Scholar]
- 2.Thoits PA. Stress and Health: Major Findings and Policy Implications. J Health Soc Behav. 2010. Mar 1;51(1_suppl):S41–53. [DOI] [PubMed] [Google Scholar]
- 3.Turner RJ, Avison WR. Status Variations in Stress Exposure: Implications for the Interpretation of Research on Race, Socioeconomic Status, and Gender. J Health Soc Behav. 2003;44(4):488–505. [PubMed] [Google Scholar]
- 4.Williams DR, Sternthal M. Understanding Racial-ethnic Disparities in Health: Sociological Contributions. J Health Soc Behav. 2010. Mar 1;51(1_suppl):S15–27. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Forrester SN, Gallo JJ, Whitfield KE, Thorpe RJ Jr. A Framework of Minority Stress: From Physiological Manifestations to Cognitive Outcomes. The Gerontologist. 2019. Nov 16;59(6):1017–23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Barnes DM, Bates LM. Do racial patterns in psychological distress shed light on the Black–White depression paradox? A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2017. Aug;52(8):913–28. [DOI] [PubMed] [Google Scholar]
- 7.Mouzon DM. Can Family Relationships Explain the Race Paradox in Mental Health? J Marriage Fam. 2013. Apr 1;75(2):470–85. [Google Scholar]
- 8.Mouzon DM. Relationships of choice: Can friendships or fictive kinships explain the race paradox in mental health? Soc Sci Res. 2014. Mar 1;44:32–43. [DOI] [PubMed] [Google Scholar]
- 9.Mouzon DM. Religious Involvement and the Black–White Paradox in Mental Health. Race Soc Probl. 2017. Mar;9(1):63–78. [Google Scholar]
- 10.Teruya SA, Bazargan-Hejazi S. The Immigrant and Hispanic Paradoxes: A Systematic Review of Their Predictions and Effects. Hisp J Behav Sci. 2013. Sep 5;35(4):486–509. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Lazarus RS, Folkman S. Stress, Appraisal, and Coping. In: Gentry WD, editor. Handbook of Behavioral Medicine. New York: Guilford Press; 1984. p. 189–217. [Google Scholar]
- 12.Kuo BCH. Coping, acculturation, and psychological adaptation among migrants: a theoretical and empirical review and synthesis of the literature. Health Psychol Behav Med. 2014. Jan;2(1):16–33. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Thoits PA. Stressors and Problem-Solving: The Individual as Psychological Activist. J Health Soc Behav. 1994;35(2):143–60. [PubMed] [Google Scholar]
- 14.Thoits PA. Personal Agency in the Stress Process. J Health Soc Behav. 2006. Dec 1;47(4):309–23. [DOI] [PubMed] [Google Scholar]
- 15.Carver CS, Connor-Smith J. Personality and Coping. Annu Rev Psychol. 2010. Feb;61(1):679–704. [DOI] [PubMed] [Google Scholar]
- 16.Cox K, Diamant J. Black men less religious than black women, but more religious than white women, men [Internet]. Pew Research Center. 2018. [cited 2022 Dec 14]. Available from: https://www.pewresearch.org/fact-tank/2018/09/26/black-men-are-less-religious-than-black-women-but-more-religious-than-white-women-and-men/ [Google Scholar]
- 17.James SA. John Henryism and the health of African-Americans. Cult Med Psychiatry. 1994. Jun;18(2):163. [DOI] [PubMed] [Google Scholar]
- 18.Mair CA, Cutchin MP, Kristen Peek M. Allostatic load in an environmental riskscape: The role of stressors and gender. Health Place. 2011. Jul 1;17(4):978–87. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Stevens-Watkins D, Knighton JS, Allen K, Fisher S, Crowell C, Mahaffey C, et al. John Henryism Active Coping as a Cultural Correlate of Substance Abuse Treatment Participation Among African American Women. J Subst Abuse Treat. 2016. Apr 1;63:54–60. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Utsey SO, Ponterotto JG, Reynolds AL, Cancelli AA. Racial Discrimination, Coping, Life Satisfaction, and Self-Esteem Among African Americans. J Couns Dev. 2000. Winter;78(1):72–80. [Google Scholar]
- 21.Anshel MH, Kang M, Miesner M. The approach-avoidance framework for identifying athletes’ coping style as a function of gender and race. Scand J Psychol. 2010. Aug;51(4):341–9. [DOI] [PubMed] [Google Scholar]
- 22.Knight BG, Silverstein M, McCallum TJ, Fox LS. A Sociocultural Stress and Coping Model for Mental Health Outcomes Among African American Caregivers in Southern California. J Gerontol Ser B. 2000. May 1;55(3):P142–50. [DOI] [PubMed] [Google Scholar]
- 23.Vassillière CT, Holahan CJ, Holahan CK. Race, Perceived Discrimination, and Emotion-Focused Coping. J Community Psychol. 2016. May;44(4):524–30. [Google Scholar]
- 24.Yoshihama M. Battered Women’s Coping Strategies and Psychological Distress: Differences by Immigration Status. Am J Community Psychol. 2002. Jun 1;30(3):429–52. [DOI] [PubMed] [Google Scholar]
- 25.DeCoster V a., Cummings S. Coping with type 2 diabetes: do race and gender matter? Soc Work Health Care. 2004;40(2):37–53. [DOI] [PubMed] [Google Scholar]
- 26.Keyes KM, Barnes DM, Bates LM. Stress, coping, and depression: Testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks. Soc Sci Med. 2011. Mar 1;72(5):650–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Sternthal MJ, Williams DR, Musick MA, Buck AC. Depression, Anxiety, and Religious Life: A Search for Mediators. J Health Soc Behav. 2010. Sep 1;51(3):343–59. [DOI] [PubMed] [Google Scholar]
- 28.Blackmon SM, Coyle LD, Davenport S, Owens AC, Sparrow C. Linking Racial-Ethnic Socialization to Culture and Race-Specific Coping Among African American College Students. J Black Psychol. 2016. Dec 1;42(6):549–76. [Google Scholar]
- 29.Culver JL, Arena PL, Antoni MH, Carver CS. Coping and distress among women under treatment for early stage breast cancer: comparing african americans, hispanics and non-hispanic whites. Psychooncology. 2002. Dec 11;11(6):495–504. [DOI] [PubMed] [Google Scholar]
- 30.Kiecolt KJ, Hughes M, Keith VM. Can a High Sense of Control and John Henryism Be Bad for Mental Health? Sociol Q. 2009. Oct 1;50(4):693–714. [Google Scholar]
- 31.Haley WE, Gitlin LN, Wisniewski SR, Mahoney DF, Coon DW, Winter L, et al. Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: findings from the REACH study. Aging Ment Health. 2004. Jul;8(4):316–29. [DOI] [PubMed] [Google Scholar]
- 32.Farley T, Galves A, Dickinson LM, de Jesus Diaz Perez M. Stress, Coping, and Health: A Comparison of Mexican Immigrants, Mexican-Americans, and Non-Hispanic Whites. J Immigr Health. 2005. Jul;7(3):213–20. [DOI] [PubMed] [Google Scholar]
- 33.Cutchin MP. The need for the “new health geography” in epidemiologic studies of environment and health. Health Place. 2007. Jan 1;13(3):725–42. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Cutchin MP, Eschbach K, Mair CA, Ju H, Goodwin JS. The socio-spatial neighborhood estimation method: An approach to operationalizing the neighborhood concept. Health Place. 2011. Sep 1;17(5):1113–21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Peek MK, Cutchin MP, Salinas JJ, Sheffield KM, Eschbach K, Stowe RP, et al. Allostatic Load Among Non-Hispanic Whites, Non-Hispanic Blacks, and People of Mexican Origin: Effects of Ethnicity, Nativity, and Acculturation. Am J Public Health. 2010. May;100(5):940–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Hussaini M, Howell JL, Peek MK, Stowe RP, Zawadzki MJ. Psychosocial stressors predict lower cardiovascular disease risk among Mexican- American adults living in a high-risk community: Findings from the Texas City Stress and Health Study. PLoS One [Internet]. 2021. Oct [cited 2022 Sep 7];16(10 October). Available from: http://www.scopus.com/inward/record.url?scp=85117040084&partnerID=8YFLogxK [DOI] [PMC free article] [PubMed] [Google Scholar]
- 37.Cohen S, Williamson. Perceived Stress in a Probability Sample of the US. In: Spacapan S, Oskamp S, editors. The Social Psychology of Health. Newbury Park, CA: Sage Publications; 1988. p. 31–67. [Google Scholar]
- 38.Carver CS. You want to Measure Coping But Your Protocol’s Too Long: Consider the Brief COPE. Int J Behav Med. 1997. Jan;4(1):92. [DOI] [PubMed] [Google Scholar]
- 39.Turner RJ, Wheaton B, Lloyd DA. The Epidemiology of Social Stress. Am Sociol Rev. 1995. Feb 1;60(1):104–25. [Google Scholar]
- 40.Martinez ML, Black M, Starr RH. Factorial structure of the Perceived Neighborhood Scale (PNS): A test of longitudinal invariance. J Community Psychol. 2002. Jan;30(1):23–43. [Google Scholar]
- 41.Cutchin MP, Martin KR, Owen SV, Goodwin JS. Concern About Petrochemical Health Risk Before and After a Refinery Explosion. Risk Anal Int J. 2008. Jun;28(3):589–601. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 42.Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991. Jan 1;32(6):705–14. [DOI] [PubMed] [Google Scholar]
- 43.Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med -Hels-. 2001. Jan 1;33(5):350–7. [DOI] [PubMed] [Google Scholar]
- 44.Compas et al. Coping Models of Stress and Resilience. In: Harkness KL, Hayden EP, editors. The Oxford Handbook of Stress and Mental Health. Oxford: Oxford University Press; 2018. p. 585–600. [Google Scholar]