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Community stress, demoralization, and body mass index

Columbia University, New York, New York, United States
Social Science & Medicine (Impact Factor: 2.56). 07/2003; 56(12):2467-78. DOI: 10.1016/S0277-9536(02)00282-4
Source: PubMed

ABSTRACT Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Center in the USA, and given an initial questionnaire that included all 27 questions of the Dohrenwend demoralization instrument, as well as questions about household economics and health. An index of chronic community stress (ICCS) was compiled for each of the health areas of the study zone by standardizing and weighting each stressor significantly associated with low birthweight rate and summing the standardized, weighted values. Health areas were divided into ICCS quintiles. The graph of the quintile weighted averages of the index vs. the quintile averages of the demoralization score was an asymmetric inverted 'U' shape that fitted well to a stochastic resonance signal transduction model (adjusted R2=0.73). On average, the women in the worst three quintiles were much heavier than those of the two best quintiles. Women reporting household economic deprivations were significantly more demoralized than the others. Median health area rents were strongly negatively associated with the ICCS. The worst average demoralization score occurred in the middle quintile, a state of coping with both poor community conditions and an economically strained household. Rents bridge community conditions and household economics.

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Available from: Deborah Wallace, Aug 30, 2015
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    • "The instrument has been applied to US ethnically diverse samples containing not only white participants, but also participants of African and Latin American descent (Vernon & Roberts, 1981; Page & Cole, 1992; Reyes et al. 2011; Wallace et al. 2003) and has also been used in Poland (Perera et al. 2013), Israel (Feldman et al. 1995; Ritsner et al. 1996), and Germany (Fichter et al. 1993; Fichter & Quadflieg, 2001). It has never been validated in non-Western populations. "
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