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Linking Perceived Unfairness to Physical Health: The Perceived Unfairness Model

March 2006
Review of General Psychology 10(1):21-40

DOI:10.1037/1089-2680.10.1.21

Authors:

Laura D Kubzansky

Harvard T.H. Chan School of Public Health

Rosalind Wright

Icahn School of Medicine at Mount Sinai

Can perceiving unfairness influence physical health? To address this question the authors propose the Perceived Unfairness Model, synthesized from psychological and epidemiological research. The model starts from the premise that perceiving unfairness, directed at beings to which the perceiver is emotionally attached, activates a cascade of psychological and physical processes. This cascade may be experienced by low or high status group members, and by the target or observer of the perceived unfairness. With repeated episodes, the effects of perceiving unfairness may accumulate and compromise physical health. Whether perceiving unfairness is potentially toxic or benign is a function of two key components of social location: identity relevance and helplessness to redress the unfairness. The authors conclude by discussing directions for developing the model. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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Linking Perceived Unfairness to Physical Health:

The Perceived Unfairness Model

Benita Jackson

Smith College

Laura D. Kubzansky

Harvard School of Public Health

Rosalind J. Wright

Brigham and Women’s Hospital/Harvard Medical School, and Harvard School of Public Health

Can perceiving unfairness inﬂuence physical health? To address this question the

authors propose the Perceived Unfairness Model, synthesized from psychological and

epidemiological research. The model starts from the premise that perceiving unfairness,

directed at beings to which the perceiver is emotionally attached, activates a cascade of

psychological and physical processes. This cascade may be experienced by low or high

status group members, and by the target or observer of the perceived unfairness. With

repeated episodes, the effects of perceiving unfairness may accumulate and compro-

mise physical health. Whether perceiving unfairness is potentially toxic or benign is a

function of two key components of social location: identity relevance and helplessness

to redress the unfairness. The authors conclude by discussing directions for developing

the model.

Health outcomes are increasingly recognized

as socially patterned. In 2001–2002, the leading

three causes of death in the United States were

heart disease, cancer, and stroke (Anderson &

Smith, 2005). Disproportionate rates of these

and other major diseases have been documented

in African Americans relative to other groups,

as well as among those with low versus higher

socioeconomic status (Adler & Ostrove, 1999).

The concept of weathering has been proposed as

one explanation for these disparities. Weather-

ing is the “the cumulative impact of repeated

experience with social, economic, or political

exclusion” and has been linked to premature

health decline in particular social groups

(Geronimus, 2001, p. 133). Material inequities

in access to nutritional food and good health

care, exposure to pollution and violence, and

unsafe neighborhoods account for some of these

disparities (Berkman & Kawachi, 2000b; Kawa-

chi, 2002). Psychological mechanisms related to

weathering undoubtedly play a role, too, but are

yet to be well explicated.

Recent scholarship has focused on under-

standing how social environments “get under

the skin” to inﬂuence health, and suggests that

psychological factors do play a fundamental

role (Taylor, Repetti, & Seeman, 1997). Per-

ceiving unfairness may be a critical psycholog-

ical variable that is socially patterned and also

inﬂuences physical health. The mere perception

of unfairness can have psychological conse-

quences: for example, powerlessness, anger,

guilt, and avoidance. Further, one’s social loca-

Benita Jackson, Department of Psychology, Smith Col-

lege; Laura D. Kubzansky, Department of Society, Human

Development, and Health, Harvard School of Public Health;

and Rosalind J. Wright, Channing Laboratory, Department

of Medicine, Brigham and Women’s Hospital/Harvard

Medical School, and Harvard School of Public Health.

During the preparation of this article, the authors were

supported by grants from the National Heart, Lung, and

Blood Institute (NHLBI) and Environmental and Health

Sciences (ES). Prior to her afﬁliation at Smith College,

Jackson was a post-doctoral fellow at Channing Laboratory,

supported by training grant HL07427; Kubzansky was sup-

ported by ES10932; and Wright was supported by K08

HL04187 and ES10932. Thanks to Eileen Zurbriggen, Jean

Twenge, and the reviewers for helpful comments on earlier

versions of this article. Earlier portions of this article were

presented at the annual meeting of the International Society

of Political Psychology in Boston (July 2003) and the Third

Annual Diversity Challenge Conference sponsored by the

Institute for the Study and Promotion of Race and Culture at

Boston College (October 2003).

Correspondence concerning this article should be addressed

to Benita Jackson, Department of Psychology, Clark Science

Center, 44 College Lane, Smith College, Northampton, MA,

01063. E-mail: bjackson@email.smith.edu

2006, Vol. 10, No. 1, 21– 40 1089-2680/06/$12.00 DOI: 10.1037/1089-2680.10.1.21

tion may amplify or buffer the potentially del-

eterious effects of perceived unfairness.

In this

article, we argue that with repeated episodes,

perceiving unfairness may eventually take a toll

on the perceiver’s physical health.

We propose that to understand these pro-

cesses effectively, the time is ripe to link social,

personality, and health psychology literatures

with literature from epidemiology (the science

of public health). Psychology and epidemiology

each have important, complementary contribu-

tions to make to the study of how perceiving

unfairness may be translated into health. To this

end, we introduce the Perceived Unfairness

Model, synthesize relevant research from psy-

chology and epidemiology, and outline direc-

tions for future interdisciplinary research.

There are but a few empirical studies in psy-

chology that examine the physical health con-

sequences of perceiving unfairness (Landrine &

Klonoff, 1996). Yet, there is a growing body of

psychological scholarship—theoretical and em-

pirical—that considers perceiving unfairness,

especially in the form of group discrimination,

as a potential source of psychological stress

(Allison, 1998; Clark, Anderson, Clark, & Wil-

liams, 1999; Foster, 2000; Klonoff, Landrine, &

Campbell, 2000; Landrine, Klonoff, Gibbs,

Manning, & Lund, 1995; Swim, Cohen, &

Hyers, 1998). The overwhelming evidence of

a link between stress and health and illness

(Baum & Posluszny, 1999; Kiecolt-Glaser,

McGuire, Robles, & Glaser, 2002; Krantz &

McCeney, 2002, 1998), suggests that perceiving

unfairness may have important implications for

health.

Interestingly, ﬁndings in the justice literature

suggest that people possess psychological

mechanisms for avoiding the perception of un-

fairness. For example, as shown in studies of

relative deprivation, people acknowledge that

members of their own group experience dis-

crimination, but tend to downplay personally

having experienced discrimination (Corning,

2000; Jackson, 1989). Also, as shown in re-

search on just-world theory, people’s responses

to innocent victims (helping, contempt, harm-

ing) may be attempts to reduce the threat of

conﬁrmation that the world is unjust (Hafer,

2000). Avoidance or denial of perceived unfair-

ness may be a mechanism to deﬂect distress

(Crosby, 1984), in the short term. Why might

people have developed such varied psycholog-

ical mechanisms for avoiding the perception of

unfairness? What is the cost of perceiving un-

fairness? The Perceived Unfairness Model

holds that a key cost is to one of life’s most

precious goods: physical health.

Research in social epidemiology demon-

strates a link between social factors and health,

and thus is potentially informative for the de-

velopment of a model linking factors that are

shaped by the social environment—like per-

ceiving unfairness—with health. Social epide-

miology examines the distribution of health and

illness as a function of social status markers,

such as social class, race/ethnicity, age, and

gender (Berkman & Kawachi, 2000b). Some of

the guiding principles of social epidemiology

are: understanding the (macro) social context of

behavior, health, and illness; conducting con-

textual multilevel analyses; taking a develop-

mental and lifecourse perspective; and examin-

ing factors related to general susceptibility to

disease (Berkman & Kawachi, 2000a). A

strength of social epidemiology is that studies

are typically conducted with large-scale, com-

munity or population-based samples designed

to be ecologically valid. Often data are collected

at multiple time points, with many years of

follow-up, allowing for causal inferences about

social stratiﬁcation and health outcomes using a

time frame that makes it possible to detect

changes in health status.

Though social epidemiology documents the

social patterning of health and disease, a crucial

remaining question is how factors outside the

body (e.g., socioeconomic status) may get under

the skin to inﬂuence health (Jackson, Wright,

Kubzansky, & Weiss, 2004). Psychology offers

”Social location” is a commonly understood term from

sociology and anthropology, referring to the interaction

among one’s social identities (e.g., gender, socioeconomic

status, race/ethnicity, sexual orientation, religion, age, etc.)

and accompanying roles and resources, in specifying an

individual’s place in the social hierarchy. The term is useful

because it encompasses a combination of social identities,

and not merely in an additive manner, but as an interaction.

For example, the experience of being a working-class fe-

male in the United States is not simply the addition of the

experience of being working-class and of being female;

there are unique features emerging from the interaction of

these identities (Tea, 2003). In addition to psychological

aspects of social identities and roles, social location in-

cludes the inﬂuence of material resources. For a psycholog-

ical perspective on social location, see scholarship by Ma-

halingam (2001, 2003).

22 JACKSON

much-needed conceptualizations of factors that

may enable social environments to become in-

ternalized and inﬂuence physical health. A

greater understanding of these mechanisms may

yield more insight into the nature of speciﬁc

psychological experiences, and also offer guid-

ance about how to address the toxicity of par-

ticular environments. Perceiving unfairness

may be an important mechanism by which ex-

ternal inequities become internalized and inﬂu-

ence health. While there is relevant work in

both psychology and epidemiology in this area,

ﬁndings from the two disciplines have not yet

been conceptually integrated. Thus, we develop

a framework for determining the relevant fac-

tors (and their combination) that may modify

the deleterious health effects of perceiving un-

fairness, as well as the pathways by which per-

ceptions of unfairness may inﬂuence health.

The resulting Perceived Unfairness Model may

be a guide to empirical scholarship in this ﬁeld.

The Perceived Unfairness Model:

An Overview

The Perceived Unfairness Model is presented

in Figure 1, and explained more fully in the

following sections. Fundamentally, the model

posits that the perception of unfairness activates

a cascade of psychological and physical pro-

cesses. Over long periods of time, recurrence of

such processes may eventually initiate the de-

velopment of disease. The Perceived Unfairness

Model does not address antecedents of per-

ceived unfairness, but focuses on the point at

which the perception occurs. Once unfairness

has been perceived, its effects may be experi-

enced by low or high status group members,

and by the target or the observer of the per-

ceived unfairness. Perceived unfairness is not

inevitably harmful. Perceptions of unfairness

may be associated with either a stress response

(i.e., toxic) or a benign response. Two key con-

sequences of social location may determine the

nature of the response to perceived unfairness:

identity relevance and perceptions of helpless-

ness to redress the unfairness. If a stress re-

sponse does occur, this contributes to biologi-

cal, social, and behavioral mechanisms that in-

crease physiologic wear and tear, which can

lead to serious health consequences over time.

Model Constructs

In this section we explicate the theoretical

components of the Perceived Unfairness Model

(see Figure 1) and identify relevant empirical

literature.

Benign

responses *

Helplessness

Perceived

unfairness

Stress

responses *

Coping

behaviors

Allostatic

load

Morbidity

Mortality

Identity

relevance

Figure 1. The Perceived Unfairness Model. *Both stress and benign responses have cog-

nitive, emotional, and motivational components; each type of response differs in content and

effect. Stress responses increase allostatic load; benign responses decrease or have a neutral

effect.

23PERCEIVED UNFAIRNESS AND HEALTH

Perceived Unfairness

What is perceived unfairness? We deﬁne

perceived unfairness broadly, encompassing a

breach of entitlements or of psychological con-

tracts (cf. Miller, 2001) related to group mem-

bership or to individual experiences. For exam-

ple, prejudice and discrimination are potent

forms of unfairness—in that they manifest on

both societal and individual levels—that are

related to group membership. There also exists

unfairness that is not a direct function of group

membership, such as a personal breach of either

formal or informal agreements between

individuals.

The simple perception of unfairness may

have deleterious effects, beyond or even with-

out the other more direct material effects of

unfairness. Hence, we use the term “perceived”

unfairness to underscore the impact of subjec-

tive experience on physical health. Our predic-

tion is that stronger, more frequent and longer-

lasting perceptions of unfairness will be associ-

ated with greater activation of the processes

outlined in the model. We also expect that the

processes detailed in the model will occur if the

target of unfairness is a being to which the

perceiver holds some attachment, whether that

is the self, friends, in-group members, or even

objects like natural environments (Merchant,

1980; Oskamp, 2000). We argue that the mere

perception of unfairness— even if one is not a

direct target of the perceived unfairness—may

eventually have health-related consequences.

The degree to which perceptions of unfairness

inﬂuence downstream factors in Figure 1, and

keep those processes activated, is a function of

the intensity, frequency, and duration of these

perceptions (cf. Larsen & Diener, 1987; Larsen,

Diener, & Cropanzano, 1987).

Perceived unfairness is a unique type of

stressor. A basic assumption in health psy-

chology and related ﬁelds is that stress plays a

role in the etiology and progression of a broad

range of physical diseases (Habib, 2001; Seph-

ton & Spiegel, 2003; Wright, Rodriguez, &

Cohen, 1998). However, evidence that stress

contributes to the pathophysiology of human

disease is thin, and, where evidence does exist,

a small proportions of the variance is explained

(Marsland, Cohen, Rabin, & Manuck, 2001).

This dilemma has led to the consideration of

stress potentiators or buffers. These are charac-

teristics that render individuals (or groups of

individuals) more or less vulnerable in the face

of stressful events (e.g., perceived unfairness)

and include psychological (Marsland et al.,

2001), social (Cohen et al., 1998), and biologi-

cal (Cohen & Hamrick, 2003) features. These

factors may vary depending on the stressor ex-

amined. Thus, it is important to develop theo-

retical frameworks better able to characterize

individual vulnerability and resilience with

greater success, so researchers can more deﬁn-

itively understand the relationship between

stress and disease.

Perceived unfairness may be considered a

particular type of stressor, although it does not

ﬁt neatly into current models of stress. There are

two important classes of stressors identiﬁed in

the stress literature: major life events and daily

hassles (Jones & Kinman, 2001). Perceptions of

unfairness share some commonalities with, but

also some important differences from these two

types of stressors. Perceptions of unfairness

may exert pervasive effects across life domains

(like major life events, and unlike daily hassles),

but occur frequently (like daily hassles, and

unlike major life events). Perceived unfairness

may be particularly insidious given that some

individuals and groups, especially those of low

status, experience it so frequently; recent re-

search suggests that the negative mental health

consequences of perceived unfairness (speciﬁ-

cally, sexism) are most likely when it is be-

lieved to be pervasive (Schmitt, Branscombe, &

Postmes, 2003).

Psychological and social epidemiological

models of stress have differed in focus. Psycho-

logical models have tended to classify sources

of stress broadly, with more focus on under-

standing stress appraisals, central components

of the stress process (for a classic example, see

Lazarus & Folkman, 1984). This research al-

lows for understanding individual differences in

experiences of stress, and informs possible in-

dividual-level interventions. Social epidemio-

logical models have generally considered the

kinds of exposures that may contribute to a

toxic environment (e.g., Krieger, 2000). This

research allows for understanding social differ-

ences in the experiences of stress, and informs

an understanding of how the social environment

may inﬂuence health for intervention at the

macrosocial level.

In the biomedical literature on stress, every-

24 JACKSON

day acts of unfairness by and large have not

been conceptualized as stress-producing (for an

exception, see Steffen, McNeilly, Anderson, &

Sherwood, 2003), as are major life events (e.g.,

death of a loved one; divorce) and even the

accumulation of daily hassles (e.g., sitting in

trafﬁc; waiting in a long line at the bank). How-

ever, recent psychological scholarship has be-

gun to document the deleterious effects of “ev-

eryday injustice” (Swim, Cohen, & Hyers,

1998; Swim, Hyers, & Cohen, 2001; also see

Corning, 2002; Fischer & Shaw, 1999; Waldo,

1999). Population perspectives, as those taken

in epidemiology, suggest that even small dele-

terious effects on individuals can, taken to-

gether across a population, have tremendous

public health consequences (Rose, 1992).

Though the observed effect may be modest at

the individual level, these experiences may con-

tribute signiﬁcantly to the population burden of

preventable diseases given the pervasiveness of

the exposure. This suggests that an exploration

of perceiving unfairness and its effects may add

insight to why some social environments are be

more toxic than others, and why some individ-

uals are particularly vulnerable.

There may be times when individuals are able

to respond constructively, and mobilize positive

resources in the context of perceived unfairness.

At such times, a benign psychological response

may occur instead of a stress-related response

(see Figure 1). A benign psychological response

is comprised of positive or neutral emotions,

cognitions, and motivations. For example, in

their germinal paper on the protective effects of

stigma, Crocker and Major (1989) suggest that

when perceiving unfairness (in the form of dis-

crimination) membership in a stigmatized group

may protect an important facet of mental health,

self-esteem. Subsequent studies support this

idea (e.g., Major, Kaiser, McCoy, 2003; McCoy

& Major, 2003; Moradi & Hasan, 2004; Ro-

mero & Roberts, 2003). Burgeoning research on

how positive emotions may neutralize the ef-

fects of negative emotions or buffer stress sug-

gests the potency of benign responses in pro-

moting (Fredrickson, 2000) or even restoring

health (Smith & Baum, 2003). Understanding

when and why perceived unfairness does not

lead to stress-related responses is critical. The

Perceived Unfairness Model predicts that two

key factors shaped by social location—strong

identity relevance and high levels of helpless-

ness—produce the most toxic stress responses.

The occurrence of stress responses is in turn

related to risk of poor health outcomes.

Social Location I: Identity Relevance

Identity is one’s concept of self. It is con-

structed from idiographic experience (individ-

ual identity), and by group membership (social

identity). Under certain circumstances, individ-

ual and social identities are made salient, sepa-

rately or together. The more that something

perceived to be unfair is salient to one’s per-

sonal and/or social identities, the more it may

produce signiﬁcant psychological effects (cf.

Wright, Aron, & Tropp, 2002). The Perceived

Unfairness Model states that social group rele-

vance is particularly potent in heightening the

effects of perceiving unfairness (cf. Mum-

mendey, Kessler, Klink, & Mielke, 1999). Be-

cause the perceiver imagines the impact of the

unfairness not just for the self, but also for all

those for whom the perceiver has positive re-

gard in the group, effects may be ampliﬁed (cf.

Ellemers, Spears, & Doosje, 2002).

A number of theories have proposed related

conceptualizations of stress originating from so-

cial status, although each theory has generally

focused on a particular social group. For exam-

ple, separate theories have considered stress in

relation to African Americans (Clark et al.,

1999), gay men (Meyer, 1995), people of color

(Krieger, 1999), women (Klonoff et al., 2000),

and Native Americans (Walters & Simoni,

2002). Personal and social identities are embed-

ded in a social hierarchy. While it is important

to study the historical, cultural, and geographi-

cal particularities that deﬁne all social identities,

we suggest that it will move research forward

also to acknowledge shared features of models

that link social identities, stress, and health. The

Perceived Unfairness Model is a ﬁrst attempt to

extract the common features of such models and

see whether empirically testable links may be

posited in a single model that encompasses dif-

ferent social groups more parsimoniously than

separate identity-based models. Regardless of

identity, to the degree that these identities are

made relevant so is the social status of the

identity.

Notably, the psychological consequences of

perceiving discrimination have been shown to

be more severe for low status groups than for

25PERCEIVED UNFAIRNESS AND HEALTH

high status groups (Branscombe & Ellemers,

1998; Branscombe, Schmitt, & Harvey, 1999;

Schmitt, Branscombe, Kobrynowicz, & Owen,

2002). As Schmitt et al. (2002) point out, for

low versus high status group members there are

different social meanings, and greater resulting

immediate social costs, of perceived unfairness

directed toward one’s own group. This is at

least in part because unfairness directed toward

low status groups tend to be harsher, more eas-

ily legitimized, and more invisible than unfair-

ness directed toward high status groups.

Unfairness may be perceived by individuals

across social status groups. We argue, how-

ever, that perceived unfairness is not conﬁned to

low status group members. Our model applies

more broadly to any individual who perceives

unfairness, of high or low status, beyond par-

ticular group membership. Higher status mem-

bers may perceive unfairness directed toward

their groups, and may be particularly vulnerable

to perceived unfairness if their status is threat-

ened, especially if they believe that they are

legitimately high status (Major, Gramzow, Mc-

Coy, Levin, Schmader, & Sidanius, 2002). For

example, afﬁrmative action debates are often

fueled by the anger and underlying fear experi-

enced by high status people, who perceive a

potential threat to their entitlements. This un-

derscores a cost of privilege: the chronic mon-

itoring of the possible loss of rank (cf. Allan &

Gilbert, 2002). However, generally individuals

of high status likely experience lower levels of

perceived unfairness, relative to their lower sta-

tus counterparts, accounting for some differ-

ences in outcomes across the groups.

Unfairness may be perceived on behalf of in-

or out-group members. Individuals may also

perceive unfairness that is not directed toward

oneself or one’s own group(s), but toward an

out-group. We hypothesize that simply because

the observer and target of the perceived unfair-

ness are of different groups does not necessarily

preclude empathy across them. Social stratiﬁca-

tion and intergroup conﬂict may make this less

likely than within-group empathy, but not im-

possible, as suggested by interventions that de-

velop empathy among individuals of different

social groups (cf. Aronson, 2002). In Figure 1,

as captured by the link showing identity rele-

vance moderating the effects of perceived un-

fairness, the Perceived Unfairness Model holds

that the severity of the psychological and ensu-

ing physiological consequences of perceiving

unfairness vary as a function of how close the

sense of unfairness is to one’s self. Indeed,

relative deprivation on behalf of others (Tougas

& Veilleux, 1990) and expanding one’s sense of

self to including others and groups (Wright,

Aron, & Tropp, 2002) may be stressful for the

perceiver because each increases the chances

for perceiving unfairness. In this way, then,

targets of perceived unfairness must be in-group

members insofar as they are deemed worthy of

moral consideration. Yet the self (however de-

ﬁned in context) can be associated with phe-

nomenologically unpleasant consequences of

perceived unfairness in more ways that simply

being the target. For example, perceiving inter-

personal unfairness has been demonstrated as an

important component of experiencing guilt

(Berndsen, van der Pligt, Doosje, & Manstead,

2004; Iyer, Leach, & Crosby, 2004). High status

individuals— even when not personally in-

volved as perpetrators—may experience guilt

when they recognize that their group beneﬁts

from the unjust treatment of lower-status groups

(Doosje, Branscombe, Spears, & Manstead,

1998). Guilt may constitute an emotional com-

ponent of the stress response (see below).

Perceptions of unfairness can negatively

harm people regardless of social status or

whether they are the target or observer of the

unfairness, though social status and target sta-

tus—which together contribute to identity rele-

vance—may moderate the effect of perceived

unfairness on the individual response to the

experience.

Social Location II: Helplessness

Why do perceptions of unfairness sometimes

catalyze an individual to act to redress the un-

fairness (Wright & Tropp, 2002) and other

times lead to paralysis? A large body of work

has suggested that stressors that are seen as

uncontrollable may have a particularly strong

long-term impact (Baum, Cohen, & Hall, 1983;

Lazarus & Folkman, 1984) with particularly

toxic effects on physical health (Lachman &

Weaver, 1998). While a separate literature has

examined the direct relationship between help-

We thank a reviewer for suggesting mention of guilt

among those of high social status.

26 JACKSON

lessness and health (Peterson & Seligman,

1987), here we are interested in the role of

helplessness as a potential moderator of the

relationship between perceived unfairness and

health.

As shown in Figure 1, we theorize that per-

ceptions of unfairness and subsequent responses

are modiﬁed by a sense of helplessness; data

support the notion of helplessness or low sense

of control in modifying responses to life stres-

sors more generally (Zakowski, Hall, Cousino

Klein, & Baum, 2001) and discrimination spe-

ciﬁcally (Moradi & Hasan, 2004). Individuals

who have experienced adverse events over

which they had no control show deﬁcits in cog-

nitive, emotional, and motivational functioning

(Colligan, Offord, Malinchoc, Schulman, & Se-

ligman, 1994; Tennen, Afﬂeck, & Gershman,

1986). Such deﬁcits may make constructive re-

sponse to perceived unfairness extremely difﬁ-

cult, or out of the range of one’s behavioral

repertoire. Thus, a sense of helplessness might

be expected to exacerbate or potentiate effects

of perceiving unfairness, whereas less helpless

individuals may be better able to mobilize more

constructive responses.

As the model further suggests, helplessness

and identity relevance interact to moderate of

the effects of perceived unfairness; one useful

illustration of this is in the distinction between

individual and collective efﬁcacy. Researchers

have found that whereas targets of group-based

unfairness may feel personally helpless, they

may be more empowered to change their cir-

cumstances through collective action (Hobfoll,

Jackson, Hobfoll, Pierce, and Young, 2002).

Consistent with an important premise of the

model—that perceived unfairness, as moderated

by identity relevance and helplessness, eventu-

ally may harm physical health—greater collec-

tive efﬁcacy has even been associated with de-

creased mortality (Skrabski, Kopp, Kawachi,

2004).

The model also posits that helplessness mod-

iﬁes the relationship between coping behaviors,

and subsequent outcomes.

A great deal of re

search has suggested that a sense of helpless-

ness is associated with maladaptive coping

mechanisms after stressful events are experi-

enced (Peterson, Seligman, & Vaillant, 1988).

By the same token, individuals who feel less

helpless seem to be better able to mobilize ef-

fective coping behaviors.

We are particularly interested in understand-

ing consequences of perceived unfairness when

one feels helpless to redress the unfairness, and

when relevant personal or social identities are

salient. For example, individuals of lower social

status and those who are targets of unfairness

may have fewer resources and thus have a

greater (and perhaps more realistic) sense of

helplessness to respond to unfairness. Similarly,

a person in a high status position may perceive

unfairness and empathize with a person of low

status who is the target of such unfairness. If

this high status perceiver feels helpless to re-

dress the unfairness, and if the unfairness is

perceived repeatedly over time, he or she may

experience the ensuing negative psychological

and physical consequences of the mere percep-

tion of unfairness. More likely, however, is that

a high status observer has more resources to

enable coping and address unfairness, thereby

reducing the toxic nature of the exposure.

Stress Responses to Perceived Unfairness:

Cognition, Emotion, and Motivation

Perceiving unfairness may cause cognitive,

emotional, and motivational changes that to-

gether comprise a psychological stress re-

sponse. In this section we highlight stress-

related (rather than benign) cognitive, emo-

tional, and motivational responses to perceiving

unfairness. Like other theorists considering the

effects of stressors (cf. Allison, 1998; Clark et

al., 1999; Foster, 2000; Tomaka & Blascovich,

1994), we link perceived unfairness to models

of stress and coping.

Cognitive responses. Perceiving unfairness

may have cognitive consequences, particularly

because situations come to be framed as threat-

ening rather than challenging (Tomaka & Blas-

covich, 1994; Tomaka, Blascovich, Kelsey, &

Leitten, 1993). Threat has been associated with

a variety of cognitive effects such as decreased

problem-solving abilities (Thoits, 1994), and

narrowing of attention (cf. Fredrickson, 2000).

Indeed, a large body of research on stereotype

threat (for review, see Steele, 1997) has dem-

onstrated that even the slight threat of prejudice

Helplessness may be the outcome of perceived unfair

ness. However, for the purposes of the present discussion

we focus on the case when helplessness is primarily a

pre-existing factor.

27PERCEIVED UNFAIRNESS AND HEALTH

can inﬂuence, for example, test performance

and academic identities for lower-status groups

like African Americans and women (Steele,

1998). Similarly, it has been shown that cogni-

tive interference can occur as a function of

threat to and individuals’ belief in a just world

(Hafer, 2000).

Speciﬁc beliefs may also play a stress-buff-

ering role or affect responses to the social en-

vironment. Tomaka and colleagues (Tomaka et

al., 1993) demonstrated that individuals with

greater just world beliefs had more benign cog-

nitive appraisals of stress tasks and had more

adaptive autonomic reactions to stressors con-

sistent with challenge (vs. threat) patterns. Also

using a challenge versus threat paradigm,

Mendes and colleagues (Mendes, Blascovich,

Major & Seery, 2001) demonstrated that when

paired with attitudinally dissimilar partners

(compared to attitudinally similar partners) par-

ticipants displayed greater threat responses dur-

ing upward comparisons and a tendency toward

greater challenge responses during downward

comparisons. Thus, perceiving unfairness, espe-

cially in a relatively low social status position,

may result in cognitive stress responses.

Emotional responses. Perceiving unfairness

may have emotional consequences as well,

leading to speciﬁc negative emotions and affec-

tive states, including anger (Allan & Gilbert,

2002), anxiety (Dion & Earn, 1975), depression

(cf. Lipkus, Dalbert, & Siegler, 1996), fear

(Boeckmann & Liew, 2002), feelings of depri-

vation (Crosby, 1976), hostility (Kubzansky,

Kawachi, & Sparrow, 1999), and guilt (Iyer,

Leach, & Crosby, 2004). Adding complexity to

the picture is that as a function of social norms,

emotional consequences may be intricately re-

lated to emotion regulation, inﬂuencing whether

emotions are expressed, suppressed (con-

sciously inhibiting the expression of emotion),

or repressed (failing to attend to emotions)

(Hochschild, 1983). Social psychologists (Par-

kinson & Manstead, 1992) and social epidemi-

ologists (Kubzansky & Kawachi, 2000) alike

point out the social nature of emotion, with

roles in the social hierarchy shaping and con-

straining emotional experiences. As a result, the

experience and expression of certain negative

emotions may be systematically patterned ac-

cording to social status (Kubzansky et al.,

1999). This is particularly important given that

many of these negative emotions are posited to

be at the core of a stress response (Lazarus,

1991). Negative emotions may be an important

psychological mechanism by which perceived

unfairness becomes internalized to inﬂuence

health.

Motivational responses. Perceiving unfair-

ness may change two aspects of the perceiver’s

motivation: justice-speciﬁc motivation, and

general-level motivation. Motivation is the psy-

chological force by which “behavior gets

started, is energized, is sustained, is directed, is

stopped” (Jones, 1955, as quoted in McClel-

land, 1994, p. 4). Factors such as stable indi-

vidual differences (e.g., belief in a just world,

Lipkus et al., 1996; or legitimizing ideology,

Major et al., 2002), as well as situational primes

(e.g., mortality salience, van den Bos &

Miedema, 2000) or relative group status (Major

et al., 2002), may contribute to the motivation to

believe in a just world. These factors may be

important causes of perceived unfairness in the

ﬁrst place, and as such are exogenous to the

Perceived Unfairness Model. But they also may

be important factors endogenous to the model.

Speciﬁcally, perceiving unfairness means ac-

knowledging that the world may not be as fair a

place as one believes; this realization may be

deeply stressful. Indeed, threats to one’s belief

in a just world are so aversive that they have

been theorized to motivate negative behavior

toward innocent victims, in order to maintain a

belief in a just world (Hafer, 2000; Hafer &

Olson, 1993; Lipkus et al., 1996).

Perceived unfairness may also have conse-

quences in the more general motivational cate-

gories of approach and avoidance (Elliot &

Sheldon, 1998). For example, perceiving unfair-

ness may motivate individuals to approach sym-

pathetic others to make emotional connections,

and eventually lead to collective action (Foster

& Matheson, 1998), but under certain condi-

tions perceiving unfairness also may cause in-

dividuals to distance themselves from other

people because of mistrust and fear (cf. Hafer,

2000). When one perceives an unfairness di-

rected toward oneself, this may motivate a shift

in identiﬁcation from self to group, as has been

demonstrated experimentally (Jetten, Brans-

combe, Schmitt, & Spears, 2001), making it

easier to acknowledge and act to redress the

unfairness (Crosby, 1984; cf. Smith & Spears,

1996). Conversely, when one perceives unfair-

ness directed to one’s group, this may motivate

28 JACKSON

a shift in identiﬁcation from group to self, as

theories of relative deprivation suggest (cf.

Corning, 2000). In sum, perceiving unfairness

may cause changes in one’s motivation—to

help others, to afﬁliate with others, to make

changes in the social environment—that, along

with cognitive and emotional responses, com-

prise a psychological stress response and may

inﬂuence allostatic load.

Allostatic Load

Recently theorists have suggested that social

experience resulting in psychological distress

can impact physiological functioning, and over

time, lead to premature aging and illness due

to weathering (Geronimus, 2001; McEwen,

1998a). Whatever the source, chronic stress

contributes to increased physiologic wear on

the body, or what has come to be known as

“allostatic load” (McEwen, 1998b; Taylor et

al., 1997). The concept of allostatic load lends

itself well to the study of perceived unfairness

because it accounts for cumulative effects of

seemingly small, harmless activation over time.

Differences in perceptions of and reactions to

the same event can provoke a variety of endo-

crine, cardiovascular, and immune responses

(Kiecolt-Glaser et al., 2002; Tomaka et al.,

1993). Biological stress research has found that

speciﬁc physiological systems may be activated

in response to psychologically or physically de-

manding environmental conditions (Blanchard,

Sakai, McEwen, Weiss, & Blanchard, 1993;

McKittrick, Blanchard, Blanchard, McEwen, &

Sakai, 1994). However, there is a physiological

cost to adaptation: while in the short term, ad-

aptation may have huge pay offs (i.e., getting

oneself out of imminent danger), in the long

term, repeated adaptation may ironically take a

large physiological toll. Whether from chronic

stress or simply the wear and tear of daily

living, behavioral, physiological, as well as psy-

chological responses are theorized to increase

allostatic load (McEwen & Seeman, 1999).

The Perceived Unfairness Model explicates

the psychological responses—for example, cog-

nitive, emotional, and motivational changes as

mentioned in the last section—that contribute

directly to allostatic load, and that these effects

are moderated by coping behaviors. The model

further suggests that with recurrent perceived

unfairness, there is greater allostatic load. Iden-

tiﬁcation of the exact frequency and/or intensity

of perceptions of unfairness that is needed to

begin to initiate disease-related pathophysiolog-

ical process is as yet undetermined.

The allostatic load literature posits several

scenarios by which physiological wear and tear

may occur (see, e.g., McEwan & Seeman,

1999). Under ideal circumstances—whereby

there is no increase in allostatic load— each

unique exposure to a stressor (in this case, a

perception of unfairness) that leads to a stress

response (vs. a benign response), leads to some

amount of physiological activation, and then a

quick return to a physiological baseline. How-

ever, there are a variety of processes that may

lead to increasing levels of allostatic load. One

is that with repeated exposure to stress, there is

repeated elevation of allostatic processes (e.g.,

stress hormones) over long periods of time.

Another is individuals may fail to habituate or

adapt to stress exposure, or relatedly, fail to turn

off response of the allostatic systems, resulting

in an (unwarranted) prolonged physiological re-

sponse. A third process may be exhaustion; over

time physiological responses become inade-

quate (McEwen, 1998a).

Determining how and when (e.g., critical pe-

riods of exposure) each of these scenarios may

be manifested has yet to be empirically tested

either with perceived unfairness as the expo-

sure, or with other stressors more generally.

Still, the general notion of an accumulated wear

and tear in the human physiological system has

growing empirical support (Seeman, Singer, &

Ryff, 2002; McEwan, 2003).

Coping Behaviors

Individuals engage in numerous behaviors to

cope with stress or to fend off anticipated stress;

the Perceived Unfairness Model posits that cop-

ing behaviors moderate the link between stress

and allostatic load. For instance, proactive cop-

ing represents “the processes by which people

anticipate or detect potential stressors and act in

advance to prevent them or mute their impact”

(Aspinwall & Taylor, 1997, p. 417). One type of

proactive coping is through psychological dis-

engagement. Faced with perceived social

stigma or unfair evaluation, individuals have

been shown to psychologically disengage their

self-worth in that domain (Major, Spencer,

Schmader, Wolfe, & Crocker, 1998), which

29PERCEIVED UNFAIRNESS AND HEALTH

may protect one’s self-esteem and also reduce

stress. Group identiﬁcation may also be an im-

portant strategy, proactively or reactively, for

coping with perceived unfairness. The rejec-

tion-identiﬁcation model maintains that disad-

vantaged groups reduce some of the negative

impact of perceived unfairness by identifying

with their disadvantaged group (Schmitt et al.,

2002). Other research suggests that the salience

of group identity, especially under conditions of

collective disadvantage, makes individuals less

likely to explain disadvantage in personal terms

(Smith & Spears, 1996).

Some coping behaviors used to alleviate ex-

isting stress may themselves have direct effects

on health, including cigarette smoking (Guthrie,

Young, Boyd, & Kintner, 2001), alcohol con-

sumption (Cooper, Frone, Russell, & Mudar,

1995), eating (Jackson, Cooper, Mintz, & Al-

bino, 2003), and exercise (Jackson & Nolen-

Hoeksema, 1997). Other coping behaviors such

as self-focused rumination, repressive coping,

social support, and problem solving (Jackson &

Nolen-Hoeksema, 1997) may mediate the rela-

tionship between stress and health. For exam-

ple, Matheson and Cole (2004) demonstrated

that in reaction to an explicit social identity

challenge, emotion-focused coping predicted

sustained cortisol reactions, which may be

linked to physical health (McEwen et al., 1997).

Collective action (Wright & Tropp, 2002)—

that is, engaging in behaviors on behalf of an

in-group for positive social change—may be

considered a coping behavior (Foster & Mathe-

son, 1995) that buffers the effects of stress.

Collective action may amplify one’s sense of

control and positive emotions (cf. Seeman et al.,

1995), as well encourage the creation of more

healthy environments (Stokols, 1992). Studies

that examine positive effects of coping with

unfairness (e.g., Branscombe & Ellemers, 1998;

Foster, 2000; Gaines, 2001) have yet to be done

in relation to measuring signiﬁcant health

changes over time. When constructive coping

occurs, the effects of perceived unfairness may

indeed be buffered. However, it is worth noting

that there are many instances when such con-

structive coping cannot be initiated in the ﬁrst

place.

The process of collective action in response

to perceiving unfairness may not be without its

costs on the individual level. Laboratory-based

experimental studies suggest that those who are

seen attributing unfairness to discrimination be-

come the targets of further discrimination (Kai-

ser & Miller, 2001, 2003). These studies dem-

onstrate that being seen as a “whistler-blower”

may come with an important social cost. Engag-

ing in collective action means that that one’s

resources—psychological, social, and physi-

cal—are diverted to react to the perceived un-

fairness, instead of being spent on activities of

intrinsic interest that would have been other-

wise freely chosen. Over time, this constructive-

though-reactive coping may lead to psycholog-

ical and even physiological wear and tear if it

depletes an individual’s coping resources. That

is, it requires an expenditure of effort to ac-

knowledge oppression, even if one is doing

something to redress it in the longer term. As

Geronimus (2001) states about one particular

group,

High-effort coping and stress can fuel the progression

of chronic disease, making early health decline a phys-

ical price paid by African American women of all

socioeconomic groups who work actively to overcome

or change ideological, economic, and social barriers to

achievement and well-being. (p. 135)

Morbidity and Mortality

Health is a fundamental good in life because

it enables most all other activities. The Per-

ceived Unfairness Model outlines a pathway by

which perceiving unfairness inﬂuences not only

stress but also physical health.

A variety of research to date has considered

links between allostatic load and major health

outcomes (McEwen, Magarinos & Reagan,

2002; Seeman, McEwen, Rowe & Singer, 2001;

Seeman, Singer, Rowe, Horwitz & McEwen,

1997). McEwen and others have begun to ex-

plore how these effects occur, and have focused

a great deal of attention on effects of alterations

in hypothalamic-pituitary-adrenal (HPA) axis

(Wood, Young, Reagan, & McEwen, 2002).

The direction of the HPA response to chronic

stress may depend on the nature of the stressor

(i.e., with respect to severity, controllability,

and predictability). Though this ﬁeld of research

is still in its infancy, it is widely believed that

the HPA axis may become either hyper- or

hypoactive under certain conditions of ongoing

or chronic stress, reﬂecting a physiological ad-

aptation of the HPA axis that is adaptive in the

30 JACKSON

short-term but maladaptive over the long-term.

Allostatic load theory suggests that some opti-

mal level of physiological activity is needed to

maintain a functional balance (McEwen & See-

man, 1999). When this balance is disrupted, too

many or too few glucocorticoids and cat-

echolamines allow other immune processes to

overreact, increasing the risk of autoimmune,

inﬂammatory, and cardiovascular disorders

(Sternberg, 1997), which in turn are related to

increased risk of premature mortality. Interest-

ingly, research using animal (Abbott 2003);

Bartolomucci et al., 2001) and human (Decker,

2000) models suggests that the balance of phys-

iologic activity is also socially patterned. For

example, Abbott et al. (2003) conducted a re-

view of the literature on social rank differences

in cortisol levels primates, and found that sub-

ordinates produced relatively higher levels of

cortisol when they experienced a higher rate of

stressors than their dominant counterparts. This

lends credence to the idea that a perceived un-

fairness may be a promising way to understand

the toxicity of social environments.

Model Summary

In summary, as we have denoted in detail

throughout the paper thus far, there is at least

some evidence for each single link of the

Perceived Unfairness Model. It is not surpris-

ing that there are not yet large bodies of direct

evidence for each link because researchers

have not conceptualized and integrated a the-

oretical model of the consequences of per-

ceiving unfairness in quite this way before.

What is new is the synthesis and conﬁguration

of each of these links as captured by the

model overall. Speciﬁcally, viewing helpless-

ness and identity relevance as joint modera-

tors of the effect of perceived unfairness on

stress responses has yet to be tested empiri-

cally; the same is true for the interaction of

helplessness and coping behaviors in moder-

ating the effects of stress (and benign) re-

sponses on allostatic load. Thus, we intend it

as a model to spur new research, taken from

this somewhat novel perspective. Indeed, the

centerpiece of this model—allostatic load—is

a relatively new concept itself with direct

tests now only beginning to accrue.

Other Issues

Development Over the Life Span

The model as shown in Figure 1 may be

understood in a life span developmental frame-

work. Perceptions of unfairness, and ensuing

health consequences, conceivably occur starting

early in life (Chen, Matthews, & Boyce, 2002;

Repetti, Taylor & Seeman, 2002). The magni-

tude of impact on health may be a function of

whether such perceptions occur at particular

developmental windows. That is, at certain

times in life individuals may be particularly

vulnerable to the deleterious consequences that

come with perceiving unfairness (Chen et al.,

2002). We also posit that the effects of per-

ceived unfairness are cumulative. Thus, the ef-

fects of perceiving even seemingly small, dis-

crete unfairness may accrue to have major ef-

fects on health over the life span. Thus allostatic

load is a useful way to capture the relationship

between perceived unfairness, stress, and phys-

ical health, because inherent in the deﬁnition of

allostatic load is a cumulative component of

“wear and tear” on the body. As suggested by

allostatic load theory, there may be a cumula-

tive cost of adaptation (Seeman et al., 2001).

This is consistent with research on daily hassles,

suggesting that microstressors can cumulatively

inﬂuence health (Lazarus, 1984). As with mi-

crostressors, one could argue that frequently

perceiving unfairness may be harmless if the

exposure is brief. But research using animal

models paradoxically suggests that brief expo-

sures to stressors result in potent stress reac-

tions, because adaptation does not occur (Maier,

2001). Thus, perceiving unfairness over the life

span—whether as a prolonged exposure result-

ing in adaptation, or brieﬂy and repeatedly—

may be harmful to health.

Understanding Perceived Unfairness in

Context

We want to guard carefully against using this

model as a justiﬁcation for victim-blaming; that

is, attributing characteristics to an individual

(e.g., neurotic, paranoid, oversensitive) that are

better explained by also understanding situa-

tional factors (Steele, 1997). One might point

out that if indeed perceiving unfairness leads to

negative health consequences, the solution to

31PERCEIVED UNFAIRNESS AND HEALTH

avert these negative effects is to persuade peo-

ple to stop perceiving unfairness. This would

require that people somehow avoid consciously

processing or recognizing the occurrence of un-

fairness. Should such a strategy be possible, it

could hardly be endorsed, particularly in light of

objective unfairness, and research suggesting

the negative health effects of suppressing neg-

ative affect (Petrie & Booth, 1998; also see

Consedine, Magai, & Bonanno, 2002). Rather

than focusing on the individual, it may be more

useful—from theoretical, empirical, and inter-

vention perspectives—to consider how the so-

cial environment inﬂuences health (Berkman,

Glass, Brissette, & Seeman, 2000; Kawachi,

2002), and to recognize the importance of the

social context in shaping health outcomes

(Chen et al., 2002; Repetti et al., 2002; Stokols,

1992). Thus, we believe that the goal is in the

short term ought to be to empower individuals

to cope effectively, and in the longer term to

engage in collective action to bring about a

fairer society.

Positive Outcomes of Perceived

Unfairness

The examples we have reviewed to illus-

trate the Perceived Unfairness Model address

negative outcomes of perceiving unfairness.

Justice research in psychology has shown that

under certain conditions, perceiving unfair-

ness may also be associated with cognitions

like challenge (cf. Tomaka et al., 1993; To-

maka & Blascovich, 1994), emotions like loy-

alty (Ellemers et al., 2002), motivations like

approach (afﬁliation) (Foster, 2000; Leets,

2002), and coping behaviors like collective

action (Foster, 2000; Foster & Matheson,

1998). Research is needed to understand

when and how such benign or positive out-

comes may occur, and whether and how they

inﬂuence physiological processes. Findings in

the trauma and personal growth literature sug-

gest that sometimes, undergoing a major

stressor can lead to an upward spiral of cog-

nitive, emotional, motivational consequences.

Positive experiences may be a consequence of

ﬁnding new meaning and construing beneﬁts

from the experience (Davis, Nolen-Hoek-

sema, & Larson, 1998). Similarly, research on

optimism and stressor-related immune change

suggests that optimists may pay short-term

physiological costs in their persistence to gain

long-term rewards (Segerstrom, 2001). How-

ever, precisely when the psychological

growth to be gained outweighs increases in

allostatic load and subsequent disease pro-

cesses remains an empirical question.

Though here we focus on negative effects

of perceiving unfairness, positive outcomes

as such are not incompatible with the model.

Positive cognitions, emotions, and motiva-

tions have a critical role to play in mediating

or moderating the effects of unfairness on

stress (Folkman & Moskowitz, 2000). Recent

research on perceived racial discrimination

and resulting distress suggest that for African

Americans certain dimensions of racial iden-

tity—racial ideology and public regard be-

liefs— buffers the effects of perceived racial

discrimination (Sellers & Shelton, 2003).

Other research suggests that social change

through collective action may come about

because of perceived unfairness on behalf on

groups rather than individuals (Postmes,

Branscombe, Spears, & Young, 1999). There

is growing interest in psychology to focus on

strengths and resilience, and not only on neg-

ative psychological characteristics (Peterson

& Seligman, 2004). Similarly, one of the ba-

sic tenets of social epidemiology is to exam-

ine the factors that create healthy populations.

To date, more research in psychology has

focused on negative rather than positive out-

comes; the research to fully support the links

in this model that include a “strengths” ap-

proach remain for future study.

Future Directions for Research

We propose ﬁve directions for future research

on the Perceived Unfairness Model. Because

few studies have directly considered perceived

unfairness in relation to health, evidence for a

number of the relationships hypothesized in our

model is often sparse. Thus, much of the evi-

dence cited is indirect. We hope that the pre-

sentation of this model will encourage direct

tests of the links set forth in Figure 1, model

reﬁnement, and more generally a consideration

of public health perspectives in psychology and

vice versa.

32 JACKSON

Perceived Unfairness Versus

Discrimination

First, researchers need to examine whether

the effects of perceived discrimination differ

from other perceived unfairness. The Perceived

Unfairness Model is framed broadly enough to

include discrimination— unfairness based on

group membership of the target—as a special

case of perceived unfairness. It is also meant to

apply to more idiosyncratic perceived unfair-

ness that is not based on power differentials

between groups, or the degree to which an in-

dividual internalizes one’s group membership

as part of the self. To date some social epide-

miology research has focused exclusively on

the health consequences of discrimination, a

subcategory of unfairness regarding unfair

treatment as a function of (usually low status)

group membership. A recent chapter by Krieger

(2000) reviews social epidemiological views on

actual (v. perceived) discrimination and health.

She identiﬁes key social pathways through

which discrimination may inﬂuence health (p.

42). The pathways involve exposure, suscepti-

bility, and biological and social responses to

economic and social deprivation; toxic sub-

stances and hazardous conditions; socially in-

ﬂicted trauma (mental, physical, or sexual); tar-

geted marketing of legal and illegal psychoac-

tive substances and other commodities (e.g.,

junk food); and inadequate health care. How-

ever, starting from psychological perspectives

to distinguish the nature (perceived discrimina-

tion vs. personal slight) and source (distributive

vs. procedural domains, Tyler, 1994) of per-

ceived discrimination, and understanding their

differential health effects on health, remains an

empirical question.

Identity-Speciﬁc and -General

Components

Second, as part of model reﬁnement, re-

searchers must establish which processes and

mechanisms of the models can be generalized

across social status groups, and which are tied

to speciﬁc identity groups. Which psychological

processes resulting from perceiving racism

(Clark et al., 1999), sexism (Klonoff et al.,

2000), or homophobia (Meyer, 1995) are simi-

lar and which operate differently (cf. Miller &

Major, 2000)? For example, Sellers and col-

leagues conceptualize African American racial

identity along several dimensions, including:

racial centrality (which captures the signiﬁ-

cance of one’s racial identity), and racial ideol-

ogy and racial regard (which capture aspects of

the meaning of racial identity) (Sellers, Smith,

Shelton, Rowley, & Chavous, 1998). In a recent

study (Sellers & Shelton, 2003), racial central-

ity predicted perceived racial discrimination,

whereas racial ideology and racial regard mod-

erated the effect of perceived racial discrimina-

tion on psychological distress. Research is war-

ranted on the conditions under which identity

centrality, ideology, and regard can be general-

ized to other social identities (e.g., gender iden-

tities), including intersecting identities (e.g.,

middle-class Black men).

Integrating Methods Across Psychology

and Epidemiology

Third, to most effectively understand the

pathways between perceived unfairness and

health, there needs to be a broadening of meth-

ods used across disciplines. For example, the

prospective epidemiological research needs to

include more psychologically detailed mea-

sures, appropriate to measuring the problem that

researchers set out to examine (Krieger, 2000).

Investigators often cite a social epidemiology

study by Krieger and Sidney (1996) as a dem-

onstration of the effects of perceived racial dis-

crimination on health (in this case, as indexed

by blood pressure). One of the major ﬁndings

was that low perceived discrimination was

linked to elevated blood pressure for certain

groups (e.g., Black working class men and

women). These ﬁndings may be more widely

generalized than ﬁndings of typical experimen-

tal research, because of the strengths of the

study design. These include (a) it was a large

(N ⫽ 4,086), (b) community-based study (c) of

a sample with diversity across gender (men and

women), race/ethnicity (Blacks and Whites),

and class (professional and working class), (d)

with blood pressure obtained by physical exam-

ination using standardized protocols to ensure

consistent measurement among all participants.

Importantly, one of the key interpretations of

the ﬁndings was based on the notion that effects

were due to denial of discrimination, and denial

was associated with physiological effort that in

turn adversely affected blood pressure. How-

33PERCEIVED UNFAIRNESS AND HEALTH

ever, it was unclear whether the investigators

considered denial to be analogous to conscious

or nonconscious processes, although this dis-

tinction has critical implications for the inter-

pretation of these ﬁndings. More importantly,

the health effects of denial, emotion suppres-

sion, or repression are not currently well under-

stood. And, in fact, the notion that denial could

explain these effects was largely speculative

because psychological measures of denial of

discrimination were not included the study. This

is an instance where experimental research in

psychology may usefully inform more epidemi-

ologically based ﬁndings. In turn, these epide-

miologic ﬁndings may inform further psycho-

logically based studies of perceived discrimina-

tion and health. For example, qualitative studies

may be more informative as well as more prac-

tical than large, standardized community-based

studies to capture meanings of perceived dis-

crimination. Quasi-experimental or daily diary

research might look at the links between failure

to perceived unfairness, emotion, and physio-

logical sequelae. New methods such as life his-

tory calendars (Lin, Ensel, & Lai, 1997) and

survival analysis to study event occurrence

(Willett & Singer, 1997) may be used by psy-

chologists and public health researchers alike to

examine the occurrence and effects of perceived

unfairness across the life course.

Upstream and Downstream Factors

Affecting Health

Fourth, to support the development of a the-

ory of perceived unfairness and health, addi-

tional research is needed to establish both up-

stream and downstream mechanisms affecting

health. For example, one essential concept for

understanding macrolevel factors may be the

notion of “fundamental causes” (Link & Phelan,

1995). Social epidemiologists have argued that

macrolevel factors such as socioeconomic sta-

tus (SES) are a fundamental cause of disease in

that they affect health through many pathways.

Such factors likely shape many individual-level

experiences including perceiving unfairness, as

well as other important moderators in the

model, like group identiﬁcation, helplessness,

and coping. It is also important to study down-

stream, microlevel biological processes in rela-

tion to psychosocial factors (Seeman et al.,

1995; Seeman, 2001), in order to understand the

precise mechanisms by which perceived unfair-

ness becomes internalized (Taylor et al., 1997).

If some of these biological processes are also

accurate measures of subsequent disease devel-

opment (e.g., C-reactive protein as a marker of

heart disease; Ridker, Rifai, Rose, Buring &

Cook, 2002) then they could be utilized as tools

to determine how perceived unfairness inﬂu-

ences those mediating processes, rather than

having to wait—often for decades—for dis-

eases to develop.

Intervention Research

Fifth, the task of social scientists goes beyond

documenting problems, but also testing solu-

tions. Psychologists use intervention research to

inform both theory and practice (Wandersman

& Nation, 1998). Intervention research may

help researchers ﬁgure out effective strategies

for promoting individuals to engage in effective

coping with unfairness—such as studying the

best way to foster proactive coping (Aspinwall

& Taylor, 1997)—while clarifying stress and

coping processes. Given that one of the basic

questions in social epidemiology is “Why is this

society unhealthy?” (Kawachi, 2002), research-

ers may also help promote collective action as a

form of health-promotion (cf. Glass, 2000;

Stokols, 1992). Finally, such solutions may

form an important basis for guiding public pol-

icy (see Raphael, 2002).

Conclusion

The Perceived Unfairness Model is a unique

and potentially useful research tool in that it (a)

brings together research from subﬁelds of psy-

chology and public health, (b) may be applied

across social groups, and (c) demonstrates em-

pirically testable links. The model frames how

perceiving unfairness may have an impact on

one of the most crucial goods in life: one’s

health. Further, it makes a new contribution by

suggesting that allostatic load is a way to ac-

count for how deleterious physical effects may

accrue from seemingly minor, but repeated, per-

ceptions of unfairness.

Intervention is the cornerstone of public

health. We believe, as do others (cf. Clark et al.,

1999; Walters & Simoni, 2002), that to effec-

tively intervene to reduce disease burden, we

must understand the speciﬁc types of stressors

34 JACKSON

that contribute to morbidity, as well as the par-

ticular psychological landscapes that produce

stress. Thus, it may be important to approach

perceived unfairness as a unique and signiﬁcant

type of stressor. We acknowledge that the rela-

tionships between the constructs are no doubt

more complicated (e.g., feedback loops, re-

verse-causality; cf. Foster, 2000; Grote & Clark,

2001), but also believe this model offers a good

starting point for positing testable relationships.

Future scholarship will entail further theoretical

development and reﬁnement of the model, as

well as empirical tests of the model and com-

parisons with alternative models.

References

Abbott, D. H., Keverne, E. B., Bercovitch, F. B.,

Shively, C. A., Mendoza, S. P., Saltzman, W., et

al. (2003). Are subordinates always stressed? A

comparative analysis of rank differences in cortisol

levels among primates. Hormones and Behav-

ior, 43, 67– 82.

Adler, N. E., & Ostrove, J. M. (1999). Socioeco-

nomic status and health: What we know and what

we don’t. Annals of the New York Academy of

Sciences, 896, 3–15.

Allan, S., & Gilbert, P. (2002). Anger and anger

expression in relation to perceptions of social rank,

entrapment and depressive symptoms. Personality

and Individual Differences, 32, 551–565.

Allison, K. W. (1998). Stress and oppressed social

category membership. In. J. K. Swim & C. Stangor

(Eds.), Prejudice: The target’s perspective. San

Diego, CA: Academic Press.

Anderson, R. N., & Smith, B. L. (2005). Deaths:

Leading causes for 2002. National vital statistics

reports, 53. Hyattsville, MD: National Center for

Health Statistics.

Aronson, E. (2002). Building empathy, compassion,

and achievement in the jigsaw classroom. In. J.

Aronson (Ed.), Improving academic achievement:

Impact of psychological factors on education

(209 –225). San Diego, CA: Academic Press.

Aspinwall, L. G., & Taylor, S. E. (1997). A stitch in

time: Self-regulation and proactive coping. Psy-

chological Bulletin, 121, 417– 436.

Bartolomucci, A., Palanza, P., Gaspani, L., Limiroli,

E., Panerai, A. E., Ceresini, G., et al. (2001). Social

status in mice: Behavioral, endocrine and immune

changes are context dependent. Physiology and

Behavior, 73, 401– 410.

Baum, A., Cohen, L., & Hall, M. H. (1983). Control

and intrusive memories as possible determinants of

chronic stress. Psychosomatic Medicine, 55, 274 –

286.

Baum, A., & Posluszny, D. M. (1999). Health Psy-

chology: Mapping biobehavioral contributions to

health and illness. Annual Review of Psychol-

ogy, 50, 137–163.

Berkman, L. F., Glass, T., Brissette, I., & Seeman,

T. E. (2000). From social integration to health:

Durkheim in the new millennium. Social Science

and Medicine, 51, 843– 857.

Berkman, L. F., & Kawachi, I. (2000a). A historical

framework for social epidemiology. In. L. F. Berk-

man & I. Kawachi (Eds.), Social epidemiology (pp.

3–12). New York: Oxford.

Berkman, L. F., & Kawachi, I., Eds. (2000b). Social

epidemiology. New York: Oxford.

Berndsen, M., van der Pligt, J., Doosje, B., & Man-

stead, A. S. R. (2004). Guilt and regret: The de-

termining role of interpersonal and intrapersonal

harm. Cognition & Emotion, 18(1), 55–70.

Blanchard, D. C., Sakai, R. R., McEwen, B., Weiss,

S. M., & Blanchard, R. J. (1993). Subordination

stress: Behavioral, brain, and neuroendocrine cor-

relates. Behavioural Brain Research, 58, 113–121.

Boeckmann, R. J., & Liew, J. (2002). Hate speech:

Asian American students’ justice judgements and

psychological responses. Journal of Social Is-

sues, 58, 363–381.

Branscombe, N. R., & Ellemers, N. (1998). Coping

with group-based discrimination: Individualistic

versus group-level strategies. In. J. K. Swim & C.

Stangor (Eds.), Prejudice: The target’s perspective

(243–266). San Diego: Academic Press.

Branscombe, N. R., Schmitt, M. T., & Harvey, R. D.

(1999). Perceiving pervasive discrimination

among African Americans: Implications for group

identiﬁcation and well-being. Journal of Person-

ality and Social Psychology, 77, 135–149.

Chen, E., Matthews, K., & Boyce, W. (2002). Socio-

economic differences in children’s health: How

and why do these relationships change with age?

Psychological Bulletin, 128, 295–329.

Clark, R., Anderson, N. B., Clark, V. R., & Williams,

D. R. (1999). Racism as a stressor for African

Americans: A biopsychosocial model. American

Psychologist, 54, 805– 816.

Cohen, S., Frank, E., Doyle, W. J., et al. (1998).

Types of stressors that increase susceptibility to

the common cold in healthy adults. Health Psy-

chology, 17, 214 –223.

Cohen, S., & Hamrick, N. (2003). Stable individual

differences in physiological response to stressors:

Implications for stress-elicited changes in immune

relationed health. Brain, Behavior, and Immu-

nity, 17, 407– 414.

Colligan, R. C., Offord, K. P., Malinchoc, M., Schul-

man, P., & Seligman, M. E. P. (1994). Journal of

Clinical Psychology. CAVEing the MMPI for an

optimism-pessimism scale: Seligman’s attribu-

35PERCEIVED UNFAIRNESS AND HEALTH

tional model and the assessment of explanatory

style, 50, 71–95.

Consedine, N. S., Magai, C., & Bonanno, G. A.

(2002). Moderators of the emotion inhibition-

health relationship: A review and research agenda.

Review of General Psychology, 6, 204 –228.

Cooper, M., Frone, M., Russell, M., & Mudar, P.

(1995). Drinking to regulate positive and negative

emotions: A motivational model of alcohol use.

Journal of Personality and Social Psychology, 69,

990 –1005.

Corning, A. F. (2000). Assessing perceived social

inequity: A relative deprivation framework. Jour-

nal of Personality and Social Psychology, 78, 463–

477.

Corning, A. F. (2002). Self-esteem as a moderator

between perceived discrimination and psycholog-

ical distress among women. Journal of Counseling

Psychology, 49, 117–126.

Crocker, J. & Major, B. (1989). Social stigma and

self-esteem: The self-protective properties of

stigma. Psychological Review, 96, 608 –630.

Crosby, F. (1976). A model of egoistical relative

deprivation. Psychological Review, 83, 85–113.

Crosby, F. (1984). The denial of personal discrimi-

nation. American Behavioral Scientist, 27, 371–

386.

Davis, C. G., Nolen-Hoeksema, S., & Larson, J.

(1998). Making sense of loss and beneﬁting from

the experience: Two construals of meaning. Jour-

nal of Personality and Social Psychology, 75, 561–

574.

Decker, S. A. (2000). Salivary cortisol and social

status among Dominican men. Hormones and Be-

havior, 38, 29 –38.

Dion, K. L., & Earn, B. M. (1975). The phenome-

nology of being a target of prejudice. Journal of

Personality and Social Psychology, 32, 944 –950.

Doosje, B., Branscombe, N. R., Spears, R., & Man-

stead, A. S. R. (1988). Guilty by association: When

one’s group has a negative history. Journal of

Personality and Social Psychology, 75, 872– 886.

Ellemers, N., Spears, R., & Doosje, B. (2002). Self

and social identity. Annual Review of Psychol-

ogy, 53, 161–186.

Elliot, A. J., & Sheldon, K. M. (1998). Avoidance

personal goals and the personality-illness relation-

ship. Journal of Personality and Social Psychol-

ogy, 75, 1282–1299.

Fischer, A. R., & Shaw, C. M. (1999). African Amer-

icans’ mental health and perceptions of racist dis-

crimination: The moderating effects of racial so-

cialization experiences and self-esteem. Journal of

Counseling Psychology, 46, 395– 407.

Folkman, S., & Moskowitz, J. T. (2000). Positive

affect and the other side of coping. American Psy-

chologist, 55, 647– 654.

Foster, M. D. (2000). Positive and negative responses

to personal discrimination: Does coping make a

difference? Journal of Social Psychology, 140, 93–

106.

Foster, M. D., & Matheson, K. (1995). Double rela-

tive deprivation: Combining the personal and po-

litical. Personality & Social Psychology Bulle-

tin, 21, 1167–1177.

Foster, M. D., & Matheson, K. (1998). Perceiving

and feeling personal discrimination: Motivation or

inhibition for collective action? Group Processes

and Intergroup Relations, 1, 165–174.

Fredrickson, B. L. (2000). Cultivating positive emo-

tions to optimize health and well-being. Preven-

tion & Treatment, 3(Article 1).

Gaines, S. O. (2001). Coping with prejudice: Per-

sonal relationship partners as sources of socioemo-

tional support for stigmatized individuals. Journal

of Social Issues, 57, 113–128.

Geronimus, A. T. (2001). Understanding and elimi-

nating racial inequalities in women’s health in the

United States: The role of the weathering concep-

tual framework. Journal of the American Medical

Women’s Association, 56, 133–136.

Glass, T. A. (2000). Psychosocial intervention. In.

L. F. Berkman & I. Kawachi (Eds.), Social epide-

miology (pp. 267–305). New York: Oxford Uni-

versity Press.

Grote, N., & Clark, M. (2001). Perceiving unfairness

in the family: Cause or consequence of marital

distress? Journal of Personality and Social Psy-

chology, 80, 281–93.

Guthrie, B. J., Young, A. M., Boyd, C. J., & Kintner,

E. K. (2001). Dealing with daily hassles: Smoking

and African-American adolescent girls. Journal of

Adolescent Health, 29, 109 –115.

Habib, K. (2001). Neuroendocrinology of stress. En-

docrinology and Metabolism Clinics of North

America, 30, 695–728.

Hafer, C. L. (2000). Do innocent victims threaten the

belief in a just world? Evidence from a modiﬁed

Stroop task. Journal of Personality and Social

Psychology, 79, 165–73.

Hafer, C. L., & Olson, J. M. (1993). Beliefs in a just

world, discontent, and assertive actions by work-

ing women. Personality & Social Psychology Bul-

letin, 19, 30 –38.

Hobfoll, S. E., Jackson, A., Hobfoll, I., Pierce, C. A.,

& Young, S. (2002). The impact of communal-

mastery versus self-mastery on emotional out-

comes during stressful conditions: A prospective

study of Native American women. American Jour-

nal of Community Psychology, 30, 853– 872.

Hochschild, A. R. (1983). The managed heart: Com-

mercialization of human feeling. Berkeley, CA:

University of California Press.

Iyer, A., Leach, C. W., & Crosby, F. J. (2003). White

guilt and racial compensation: The beneﬁts and

36 JACKSON

limits of self-focus. Personality & Social Psychol-

ogy Bulletin, 29, 117–129.

Jackson, B., Cooper, M., Mintz, L., & Albino, A.

(2003). Motivations to Eat: Scale development and

validation. Journal of Research in Personality, 37,

297–318.

Jackson, B., & Nolen-Hoeksema, S. (1997). The

Emotion-Focused Coping Measure.

Jackson, B., Wright, R. J., Kubzansky, L. D., &

Weiss, S. T. (2004). Examining the inﬂuence of

early life socioeconomic position on pulmonary

function across the life span: Where do we go from

here? Thorax, 59, 186 –188.

Jackson, L. A. (1989). Relative deprivation and the

gender wage gap. Journal of Social Issues, 45,

117–133.

Jetten, J., Branscombe, N. R., Schmitt, M. T., &

Spears, R. (2001). Rebels with a cause: Group

identiﬁcation as a response to perceived discrimi-

nation from the mainstream. Personality & Social

Psychology Bulletin, 27, 1204 –1213.

Jones, F., & Kinman, G. (2001). Approaches to

studying stress. In. F. Jones & J. Bright (Eds.),

Stress: Myth, theory and research (pp.17–45).

Harlow, England: Prentice Hall.

Kaiser, C. R., & Miller, C. T. (2001). Stop complain-

ing! The social costs of making attributions to

discrimination. Personality & Social Psychology

Bulletin, 27, 254 –263.

Kaiser, C. R., & Miller, C. T. (2003). Derogating the

victim: The interpersonal consequences of blaming

events on discrimination. Group Processes & In-

tergroup Relations, 6, 227–237.

Kawachi, I. (2002). Social epidemiolgy. Social Sci-

ence and Medicine, 54, 1739 –1741.

Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F., &

Glaser, R. (2002). Psychoneuroimmunology: Psy-

chological inﬂuences on immune function and

health. Journal of Consulting and Clinical Psy-

chology, 70, 537–547.

Klonoff, E. A., Landrine, H., & Campbell, R. (2000).

Sexist discrimination may account for well-known

gender differences in psychiatric symptoms. Psy-

chology of Women Quarterly, 24, 93–99.

Krantz, D. S., & McCeney, M. K. (2002). Effects of

psychological and social factors on organic dis-

ease: A critical assessment of research on coronary

heart disease. Annual Review of Psychology, 53,

341–369.

Krieger, N. (1999). Embodying inequality: A review

of concepts, measures, and methods for studying

health consequences of discrimination. Interna-

tional Journal of Health Services, 29, 295–352.

Krieger, N. (2000). Discrimination and health. In.

L. F. Berkman & I. Kawachi (Eds.), Social Epide-

miology (pp. 36 –75). New York: Oxford Univer-

sity Press.

Krieger, N., & Sidney, S. (1996). Racial discrimina-

tion and blood pressure: The CARDIA study of

young Black and White adults. American Journal

of Public Health, 86, 1370 –1378.

Kubzansky, L. D., & Kawachi, I. (2000). Affective

states and health. In. L. F. Berkman & I. Kawachi

(Eds.), Social epidemiology (pp. 213–241). New

York: Oxford University Press, Inc.

Kubzansky, L. D., Kawachi, I., & Sparrow, D.

(1999). Socioeconomic status, hostility, and risk

factor clustering in the Normative Aging Study:

Any help from the concept of allostatic load? An-

nals of Behavioral Medicine, 21, 330 –338.

Lachman, M. E., & Weaver, S. L. (1998). The sense

of control as a moderator of social class differ-

ences in health and well-being. Journal of Person-

ality and Social Psychology, 74, 763–773.

Landrine, H., & Klonoff, E. A. (1996). The schedule

of racist events: A measure of racial discrimination

and a study of its negative physical and mental

health consequences. Journal of Black Psychol-

ogy, 22, 144 –168.

Landrine, H., Klonoff, E. A., Gibbs, J., Manning, V.,

& Lund, M. (1995). Physical and psychiatric cor-

relates of gender discrimination: An application of

the Schedule of Sexist Events. Psychology of

Women Quarterly, 19, 473– 492.

Larsen, R. J., & Diener, E. (1987). Affect intensity as

an individual difference characteristic: A review.

Journal of Research in Personality, 21, 1–39.

Larsen, R. J., Diener, E., & Cropanzano, R. S. (1987).

Cognitive operations associated with individual

differences in affect intensity. Journal of Person-

ality and Social Psychology, 53, 767–774.

Lazarus, R., & Folkman, S. (1984). Stress, appraisal,

and coping. New York: Springer.

Lazarus, R. S. (1984). Puzzles in the study of daily

hassles. Journal of Behavioral Medicine, 7, 375–

389.

Lazarus, R. S. (1991). Cognition and motivation in

emotion. American Psychologist, 46, 352–367.

Leets, L. (2002). Experiencing hate speech: Percep-

tions and responses to anti-semitism and antigay

speech. Journal of Social Issues, 58, 341–361.

Lin, N., Ensel, W. M., & Lai, W.-F. G. (1997).

Construction and use of the life history calendar:

Reliability and validity of recall data. In. I. H.

Gotlib & B. Wheaton (Eds.), Stress and adversity

over the life course: Trajectories and turning

points (pp. 249 –272). Cambridge, England: Cam-

bridge University Press.

Link, B. G., & Phelan, J. (1995). Social conditions as

fundamental causes of disease. Journal of Health

& Social Behavior, (Extra Issue), 80 –94.

Lipkus, I. M., Dalbert, C., & Siegler, I. C. (1996).

The importance of distinguishing the belief in a

just world for self versus for others: Implications

37PERCEIVED UNFAIRNESS AND HEALTH

for psychological well-being. Personality & Social

Psychology Bulletin, 22, 666 –677.

Mahalingam, R. (2001, May). Intersectionality: Un-

derstanding the interplay between person and so-

cial location. Paper presented at the conference on

Intersectionality: Race, Class and Gender, Ann

Arbor, MI.

Mahalingam, R. (2003). Essentialism, culture, and

power: Representations of social class. Journal of

Social Issues, 59, 733–749.

Maier, S. F. (2001). Exposure to the stressor envi-

ronment prevents the temporal dissipation of be-

havioral depression/learned helplessness. Biologi-

cal Psychiatry, 49, 763–773.

Major, B., Gramzow, R. H., McCoy, S. K., Levin, S.,

Schmader, T., & Sidanius, J. (2002). Perceiving

personal discrimination: The role of group status

and legitimizing ideology. Journal of Personality

and Social Psychology, 82, 269 –282.

Major, B., Kaiser, C. R., & McCoy, S. K. (2003). It’s

not my fault: When and why attributions to prej-

udice protect self-esteem. Personality & Social

Psychology Bulletin, 29, 772–781.

Major, B., Spencer, S., Schmader, T., Wolfe, C., &

Crocker, J. (1998). Coping with negative stereo-

types about intellectual performance: The role of

psychological disengagement. Personality & So-

cial Psychology Bulletin, 24, 34 –50.

Marsland, A. L., Cohen, S., Rabin, B. S., & Manuck,

S. B. (2001). Associations between stress, trait

negative affect, acute immune reactivity, and anti-

body response to hepatitis B injection in healthy

young adults. Health Psychology, 20, 4 –11.

Matheson, K., & Cole, B. M. (2004). Coping with a

threatened group identity: Psychosocial and neu-

roendocrine responses. Journal of Experimental

Social Psychology, 40, 777–786.

McClelland, D. C. (1994). Human motivation. New

York: Cambridge University Press.

McCoy, S. K., & Major, B. (2003). Group identiﬁ-

cation moderates emotional responses to perceived

prejudice. Personality & Social Psychology Bulle-

tin, 29, 1005–1017.

McEwen, B. S. (1998a). Protective and damaging

effects of stress mediators. New England Journal

of Medicine, 338, 171–179.

McEwen, B. S. (1998b). Stress, adaptation, and dis-

ease: Allostasis and allostatic load. Annals of the

New York Academy of Sciences, 840, 33– 44.

McEwen, B. S. (2003). Early life inﬂuences on life-

long patterns of behavior and health. Mental Re-

tardation & Developmental Disabilities Research

Reviews, 9, 2003, 149 –154.

McEwen, B. S., Biron, C. A., Brunson, K. W., Bul-

loch, K., Chambers, W. H., Dhabhar, F. S., et al.

(1997). The role of adrenocorticoids as modulators

of immune function in health and disease: Neural,

endocrine and immune interactions. Brain Re-

search Reviews, 23, 79 –133.

McEwen, B. S., Magarinos, A. M., & Reagan, L. P.

(2002). Studies of hormone action in the hip-

pocampal formation: Possible relevance to depres-

sion and diabetes. Journal of Psychosomatic Re-

search, 53, 883– 890.

McEwen, B. S., & Seeman, T. (1999). Protective and

damaging effects of mediators of stress: Elaborat-

ing and testing the concepts of allostasis and allo-

static load. Annals of the New York Academy of

Sciences, 896, 30 –47.

McKittrick, C. R., Blanchard, D. C., Blanchard, R. J.,

McEwen, B. S., & Sakai, R. R. (1994). Serotonin

receptor binding in a colony model of chronic

social stress. Biological Psychiatry, 37, 383–393.

Mendes, W. B., Blascovich, J., Major, B., & Seery,

M. (2001). Challenge and threat responses during

downward and upward social comparisons. Euro-

pean Journal of Social Psychology, 31, 477– 497.

Merchant, C. (1980). The death of nature: Women,

ecology, and the scientiﬁc revolution. New York:

Harper Collins.

Meyer, I. H. (1995). Minority stress and mental

health in gay men. Journal of Health and Social

Behavior, 36, 38 –56.

Miller, C. T., & Major, B. (2000). Coping with

stigma and prejudice. In. T. F. Heatherton, R. E.

Kleck, ande. al (Eds.), The social psychology of

stigma (pp. 243–272). New York: The Guilford

Press.

Miller, D. (2001). Disrespect and the experience of

injustice. Annual Review of Psychology, 52, 527–

553.

Moradi, B., & Hasan, N. T. (2004). Arab American

persons’ reported experiences of discrimination

and mental health: The mediating role of personal

control. Journal of Counseling Psychology, 51,

418 –428.

Mummendey, A., Kessler, T., Klink, A., & Mielke,

R. (1999). Strategies to cope with negative social

identity: Predictions by social identity theory and

relative deprivation theory. Journal of Personality

and Social Psychology, 76, 229 –245.

Oskamp, S. (2000). A sustainable future for human-

ity? How can psychology help? American Psychol-

ogist, 55, 496 –508.

Parkinson, B., & Manstead, A. S. R. (1992). Ap-

praisal as a cause of emotion. In. M. S. Clark (Ed.),

Emotion (pp. 122–149). Newbury Park, CA: Sage

Peterson, C., & Seligman, M. E. (1987). Explanatory

style and illness. Journal of Personality, 55, 237–

265.

Peterson, C., & Seligman, M. E., Eds. (2004). Char-

acter strengths and virtues: A handbook of classi-

ﬁcation. Washington, DC: American Psychologi-

cal Association & Oxford University Press.

38 JACKSON

Peterson, C., Seligman, M. E. P., & Vaillant, G.

(1988). Pessimistic explanatory style is a risk fac-

tor for physical illness: A thirty-ﬁve-year longitu-

dinal study. Journal of Personality and Social Psy-

chology, 55, 23–27.

Petrie, K. J., & Booth, R. J. (1998). The immunolog-

ical effects of thought suppression. Journal of Per-

sonality and Social Psychology, 75, 1264 –1272.

Postmes, T., Branscombe, N. R., Spears, R., &

Young, H. (1999). Comparative processes in per-

sonal and group judgments: Resolving the discrep-

ancy. Journal of Personality and Social Psychol-

ogy, 76, 320 –338.

Raphael, D. (2002). Social justice is good for our

hearts. Why societal factors – not lifestyles – are

major causes of heart disease in Canada and else-

where. Toronto, CA, CSJ Foundation for Research

and Education, 1–103.

Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002).

Risky families: Family social environments and

the mental and physical health of offspring. Psy-

chological Bulletin, 128, 330 –366.

Ridker, P. M., Rifai, N., Rose, L., Buring, J. E., &

Cook, N. R. (2002). Comparison of C-reactive

protein and low-density lipoprotein cholesterol

levels in the prediction of ﬁrst cardiovascular

events. New England Journal of Medicine, 347,

1557–1565.

Romero, A. J. &Roberts, R. E. (2003). The impact of

multiple dimensions of ethnic identity on discrim-

ination and adolescents’ self-esteem. Journal of

Applied Social Psychology, 33, 2288 –2305.

Rose, G. (1992). The population strategy of preven-

tion. In. G. Rose (Ed.), The strategy of preventive

medicine (pp. 95–106). New York: Oxford Uni-

versity Press.

Schmitt, M. T., Branscombe, N. R., Kobrynowicz,

D., & Owen, S. (2002). Perceiving discrimination

against one’s gender group has different implica-

tions for well-being in women and men. Person-

ality & Social Psychology Bulletin, 28, 197–210.

Schmitt, M. T., Branscombe, N. R., & Postmes, T.

(2003). Women’s emotional responses to the per-

vasiveness of gender discrimination. European

Journal of Social Psychology, 33, 297–312.

Seeman, T. (2001). How do others get under our

skin? Social relationships and health. In. C. D.

Ryff & B. H. Singer (Eds.), Emotion, social rela-

tionships, and health (pp. 189 –210). New York:

Oxford University Press.

Seeman, T. E., Berkman, L. F., Gulanski, B. I., et al.

(1995). Self-esteem and neuroendocrine response

to challenge: MacArthur Studies of Successful Ag-

ing. Journal of Psychosomatic Medicine, 39, 69 –

84.

Seeman, T. E., McEwen, B. S., Rowe, J. W., &

Singer, B. H. (2001). Allostatic load as a marker of

cumulative biological risk: MacArthur studies of

successful aging. Proceedings of the National

Academy of Sciences, USA, 98, 4770 –4775.

Seeman, T. E., Singer, B. H., Rowe, J. W., Horwitz,

R. I., & McEwen, B. S. (1997). Price of adapta-

tion–allostatic load and its health consequences.

MacArthur studies of successful aging. Archives of

Internal Medicine, 157, 2259 –2268.

Seeman, T. E., Singer, B. H., Ryff, C. D. (2002).

Social relationships, gender, and allostatic load

across two age cohorts. Psychosomatic Medi-

cine, 64, 395– 406.

Segerstrom, S. C. (2001). Optimism, goal conﬂict,

and stressor-related immune change. Journal of

Behavioral Medicine, 24, 441– 467.

Sellers, R. M., & Shelton, J. N. (2003). The role of

racial identity in perceived racial discrimination.

Journal of Personality and Social Psychology, 84,

1079 –1092.

Sellers, R. M., Smith, M. A., Shelton, J. N., Rowley,

S. A. J., & Chavous, T. M. (1998). Multidimen-

sional model of racial identity: A reconceptualiza-

tion of African American racial identity. Person-

ality and Social Psychology Review, 2, 18 –39.

Sephton, S., & Spiegel, D. (2003). Circadian disrup-

tion in cancer: A neuroendocrine-immune pathway

from stress to disease? Brain, Behavior, and Im-

munity, 17, 321–328.

Skrabski, A

., Kopp, M., & Kawachi, I. (2004). Social

capital and collective efﬁcacy in Hungary: Cross

sectional associations with middle aged female and

male mortality rates. Journal of Epidemiology &

Community Health, 58, 340 –345.

Smith, A. W., & Baum, A. (2003). The inﬂuence of

psychological factors on restorative function in

health and illness. In. J. Suls & K. A. Wallston

(Eds.), Social psychological foundations of health

and illness (pp. 431– 457). Malden, MA: Black-

well Publishing.

Smith, H. J., & Spears, R. (1996). Ability and out-

come evaluations as a function of personal and

collective (dis)advantage: A group escape from

individual bias. Personality & Social Psychology

Bulletin, 22, 690 –704.

Steele, C. (1997). A threat in the air: How stereotypes

shape intellectual identity and performance. Amer-

ican Psychologist, 52, 613– 629.

Steele, C. (1998). Stereotyping and its threat are real.

American Psychologist, 53, 680 –681.

Steffen, P. R., McNeilly, M., Anderson, N., & Sher-

wood, A. (2003). Effects of perceived racism and

anger inibition on ambulatory blood pressure in

African Americans. Psychosomatic Medicine, 65,

746 –750.

Sternberg, E. (1997). Neural-immune interactions in

health and disease. Journal of Clinical Investiga-

tion, 100, 2641–2647.

Stokols, D. (1992). Establishing and maintaining

healthy environments: Toward a social ecology of

39PERCEIVED UNFAIRNESS AND HEALTH

health promotion. American Psychologist, 47,

6 –22.

Swim, J. K., Cohen, L. L., & Hyers, L. L. (1998).

Experiencing everday prejudice and discrimina-

tion. In. J. K. Swim & C. Stangor (Eds.), Preju-

dice: The target’s perspective (pp. 38 –60). San

Diego, CA: Academic Press.

Swim,J.K., Hyers, L. L., Cohen, L. L. (2001).

Everyday sexism: Evidence for its incidence, na-

ture, and psychological impact from three daily

diary studies. Journal of Social Issues, 57, 31–53.

Taylor, S. E., Repetti, R. L., & Seeman, T. (1997).

Health psychology: What is an unhealthy environ-

ment and how does it get under the skin? Annual

Review of Psychology, 48, 411– 447.

Tea, M. (Ed.). (2003). Without a net: The female

experience of growing up working class. Em-

eryville, CA: Seal Press.

Tennen, H., Afﬂeck, G., & Gershman, K. (1986).

Self-blame among parents of infants with perinatal

complications: The role of self-protective motives.

Journal of Personality and Social Psychology, 50,

690 –696.

Thoits, P. A. (1994). Stressors and problem-solving:

The individual as psychological activist. Journal

of Health and Social Behavior, 35(June), 143–159.

Tomaka, J., & Blascovich, J. (1994). Effects of jus-

tice beliefs on cognitive appraisal of and subjective

physiological, and behavioral responses to poten-

tial stress. Journal of Personality and Social Psy-

chology, 67, 732–740.

Tomaka, J., Blascovich, J., Kelsey, R. M., & Leitten,

C. L. (1993). Subjective, physiological, and behav-

ioral effects of threat and challenge appraisal.

Journal of Personality and Social Psychology, 65,

248 –260.

Tougas, F., & Veilleux, F. (1990). The response of

men to afﬁrmative action strategies for women:

The study of a predictive model. Canadian Jour-

nal of Behavioural Science, 22, 424 –432.

Tyler, T. R. (1994). Psychological models of the

justice motive: Antecedents of distributive and

procedural justice. Journal of Personality and So-

cial Psychology, 67, 850 –863.

van den Bos, K., & Miedema, J. (2000). Toward

understanding why fairness matters: The inﬂuence

of mortality salience on reactions to procedural

fairness. Journal of Personality and Social Psy-

chology, 79, 355–366.

Waldo, C. R. (1999). Working in a majority context:

A structural model of heterosexism as minority

stress in the workplace. Journal of Counseling

Psychology, 46, 218 –232.

Walters, K., & Simoni, J. (2002). Reconceptualizing

native women’s health: An “indigenist” stress-cop-

ing model. American Journal of Public Health,

520 –524.

Wandersman, A., & Nation, M. (1998). Urban neigh-

borhoods and mental health: Psychological contri-

butions to understanding toxicity, resilience, and

interventions. American Psychologist, 53, 647–

656.

Willett, J. B., & Singer, J. D. (1997). Using discrete-

time survival analysis to study event occurrences

across the life course. In. I. H. Gotlib & B.

Wheaton (Eds.), Stress and adversity over the life

course: Trajectories and turning points (pp. 273–

294). Cambridge, England: Cambridge University

Press.

Wood, G. E., Young, L. T., Reagan, L. P., & McE-

wen, B. S. (2002). Acute and chronic restraint

stress alter the incidence of social conﬂict in male

rats. Hormones and Behavior, 43, 205–213.

Wright, R. J., Rodriguez, M., & Cohen, S. (1998).

Review of psychosocial stress and asthma: An

integrated biopsychosocial approach. Thorax, 53,

1066 –1074.

Wright, S. C., Aron, A., & Tropp, L. R. (2002).

Including others (and their groups) in the self:

Self-expansion theory and intergroup relations. In.

J. P. Forgas & K. D. Williams (Eds.), The social

self: Cognitive, interpersonal, and intergroup per-

spectives (pp. 343–363). Philadelphia: Psychology

Press.

Wright, S. C., & Tropp, L. R. (2002). Collective

action in response to disadvantage: Intergroup per-

ceptions, social identiﬁcation, and social change.

In. I. Walker & H. Smith (Eds.), Relative depriva-

tion: Speciﬁciation, development, and integration

(200 –236). Cambridge, UK: Cambridge Univer-

sity Press.

Zakowski, S. G., Hall, M. H., Cousino Klein, L., &

Baum, A. (2001). Appraised control, coping, and

stress in a community sample: A test of the Good-

ness-of-Fit hypothesis. Annals of Behavioral Med-

icine, 23, 158 –165.

Received March 14, 2004

Revision received January 23, 2005

Accepted April 15, 2005 䡲

40 JACKSON

The mediating role of job fairness and job burnout between subjective social status and depressive symptoms in Chinese migrant workers: a generational difference analysis

Article

Full-text available

Jan 2025
BMC PUBLIC HEALTH

Background In China, migrant workers (MWs) constitute a significant vulnerable group that may be highly susceptible to depression. However, there is a lack of empirical research exploring the correlation between subjective social status (SSS) and depressive symptoms among MWs. The objective of this study is to examine the mediating roles of job fairness and job burnout, as well as to investigate potential generational differences in this association. Methods A cross-sectional study was conducted in China among two groups of 1,158 MWs (response rate, 89.08%): first generation migrant workers (FGMWs) and new generation migrant workers (NGMWs). The survey assessed SSS, depressive symptoms, job fairness, and job burnout using a questionnaire. Structural equation model was used to primarily analyze mediating roles of job fairness and job burnout in the relationship between SSS and depressive symptoms, as well as to explore potential generational differences in this association. Results The study findings indicate that SSS significantly predicted higher depressive symptoms among MWs. However, the relationship between SSS and depressive symptoms was mediated by job fairness or job burnout. Notably, the indirect effect of SSS on depressive symptoms through job burnout was significant for FGMWs, but not for NGMWs. Conclusion This study fills a critical gap in understanding the connections between SSS, depressive symptoms, job fairness, and job burnout among MWs in China. It emphasizes the role of job fairness and job burnout as significant mediators that either worsen or alleviate the impact of SSS on depressive symptoms among MWs. Moreover, the findings suggest that the mediation differs significantly between FGMWs and NGMWs. These findings imply the need for different intervention methods to address the depressive symptoms of the two generations of MWs.

Towards fair roads -- Why we should & how to improve the fairness in traffic engineering

Preprint

Full-text available

Aug 2024

Traffic engineering aims to control infrastructure and population behavior to achieve optimal usage of road networks. Fairness is fundamental to stimulate cooperation in large populations, and plays an important role in traffic engineering, as it increases the well-being of users, improves driving safety by rule-adherence, and overcomes public resistance at legislative implementation. Despite the importance of fairness, only a few works have translated fairness into the transportation domain, with a focus on transportation planning rather than traffic engineering. This work highlights the importance of fairness when solving conflicts of large populations for scare, public good, road-network resources with traffic engineering, and establishes a connection to the modern fairness theories. Moreover, this work presents a fairness framework that serves when designing traffic engineering solutions, when convincing in public debates with a useful, argumentative tool-set to confront equity considerations, and enables systematic research and design of control systems.

Justice beliefs for self and others: Associations with positive and negative affectivity in African Americans and White Americans

Article

Full-text available

Feb 2024
PLOS ONE

Prior research has shown that a belief in personal justice (i.e., justice for self) is associated with better health and well-being, whereas a belief in justice more generally (i.e., justice for others) is unrelated. However, an emerging perspective is that racial differences may overlay the relationships between multidimensional beliefs about justice and indices of well-being. This includes that well-being among African Americans may be additionally supported by rejecting rather than endorsing some forms of believing in justice. In the present study, we consider racial similarities and differences in the links between beliefs about justice for self and others and emotional well-being. African Americans (N = 117) and White Americans (N = 188) completed measures of beliefs about justice for self and others, and also measures of dispositional tendencies towards experiencing positive and negative emotion (i.e., positive and negative affectivity). In both groups, beliefs about justice for the self were associated with greater positive affect and reduced negative affect. However, beliefs about justice for others were additionally associated with greater negative affect only among African Americans. The link between justice for others and negative affect among African Americans was not attributable to measurement or mean differences in justice beliefs across racial groups, or to socioeconomic differences. Results align with an emerging perspective that simultaneously endorsing and rejecting justice beliefs may be vital to preserving well-being for some racial minorities.

Quantitative Fairness -- A Framework For The Design Of Equitable Cybernetic Societies

Preprint

Full-text available

Nov 2024

Advancements in computer science, artificial intelligence, and control systems of the recent have catalyzed the emergence of cybernetic societies, where algorithms play a significant role in decision-making processes affecting the daily life of humans in almost every aspect. Algorithmic decision-making expands into almost every industry, government processes critical infrastructure, and shapes the life-reality of people and the very fabric of social interactions and communication. Besides the great potentials to improve efficiency and reduce corruption, missspecified cybernetic systems harbor the threat to create societal inequities, systematic discrimination, and dystopic, totalitarian societies. Fairness is a crucial component in the design of cybernetic systems, to promote cooperation between selfish individuals, to achieve better outcomes at the system level, to confront public resistance, to gain trust and acceptance for rules and institutions, to perforate self-reinforcing cycles of poverty through social mobility, to incentivize motivation, contribution and satisfaction of people through inclusion, to increase social-cohesion in groups, and ultimately to improve life quality. Quantitative descriptions of fairness are crucial to reflect equity into algorithms, but only few works in the fairness literature offer such measures; the existing quantitative measures in the literature are either too application-specific, suffer from undesirable characteristics, or are not ideology-agnostic. Therefore, this work proposes a quantitative, transactional, distributive fairness framework, which enables systematic design of socially feasible decision-making systems. Moreover, it emphasizes the importance of fairness and transparency when designing algorithms for equitable, cybernetic societies.

Effort–reward imbalance and well-being among psychiatric nurses: the mediating role of burnout and decent work

Article

Full-text available

Sep 2024
BMC Nurs

Background Psychiatric nurses face additional challenges due to negative perceptions, workplace violence, and a lack of respect, impacting their well-being and job satisfaction, which are crucial for improving psychiatric care and patient outcomes. Objectives This study aims to examine the relationship between effort-reward imbalance, well-being, burnout, and decent work among psychiatric nurses. Methods This study used a cross-sectional design. Data were collected using a convenience sampling method in February 2024 from 397 psychiatric nurses at two psychiatric hospitals in Hangzhou and Huzhou, Zhejiang Province. The Effort-Reward Imbalance Scale, Decent Work Perception Scale, Maslach Burnout Inventory-General Survey, and General Well-Being Schedule Scale were used for data collection. Data analysis was conducted using SPSS 26.0 and the PROCESS macro. Results The study found that effort-reward imbalance among psychiatric nurses was negatively correlated with decent work (r = -0.564, p < 0.001) and well-being (r = -0.541, p < 0.001), and positively correlated with burnout (r = 0.603, p < 0.001). Burnout mediated the relationship between effort-reward imbalance and well-being (95% CI [-0.386, -0.257]), while decent work also served as a mediator (95% CI [-0.100, -0.012]). Additionally, burnout and decent work were found to mediate the relationship between effort-reward imbalance and well-being (95% CI [-0.050, -0.006]). Conclusion This study highlights the impact of effort-reward imbalance on well-being, confirming that burnout and decent work serve as mediators. Enhancing support, fair compensation, reasonable work schedules, and professional development can promote psychiatric nurses’ perception of decent work and improve their well-being.

More Just for Me than Which Others? Personal Justice Ascendancy, Perceived Discrimination in Healthcare, and Personal Well-Being in African Americans

Article

Full-text available

Jun 2024
Soc Justice Res

Believing the world is more just for oneself than for others—referred to as personal justice ascendancy—can protect and enhance well-being. For African Americans, personal justice ascendancy may be multifaceted, encompassing comparisons not only to other African Americans but also to White Americans. The present research examined relationships between these two specific personal justice ascendancies and psychological well-being among African Americans. African American adults (N = 274) reported their beliefs about justice for self, for other African Americans, and for White Americans. We measured life satisfaction, perceived stress, and perceptions of healthcare systems as outcomes. Overall, participants believed the world to be more just for White Americans, but less just for other African Americans, than the self. Personal justice ascendancy over African Americans and White Americans both predicted greater life satisfaction and lower perceived stress. Personal justice ascendancy over African Americans predicted more negative perceptions of healthcare, whereas personal justice ascendancy over White Americans predicted more positive healthcare perceptions. Findings suggest effects of personal justice ascendancy on well-being and health-related attitudes are governed by multiple social comparisons for African Americans. Attending to and understanding nuances in these comparisons could further inform efforts to understand and address racial health disparities.

Racism as a Source of Pain

Article

Feb 2023

Health Care Discrimination Affects Patient Activation, Communication Self-Efficacy, and Pain for Black Americans

Article

Aug 2024
J PAIN

Mental health and socio-psychological manifestations of cyclone-induced water insecurity in the Indian Sundarban delta

Article

Nov 2023

Racial Slurs by Police and Posttraumatic Stress Symptoms: Intrusive Policing and Perceived Injustice

Article

Aug 2023

Using the Future of Families and Child Wellbeing Study (N = 785), this article considers the ramifications of police use of racial slurs, a type of intrusive behavior, toward minority youth for posttraumatic stress (PTS). We also examine whether other intrusive police behaviors exacerbate this relationship and test whether perceptions of injustice mediate it. Results indicated that hearing a police officer use a racial slur was positively associated with PTS after controlling for intrusive police behaviors and other covariates. Intrusive policing tended to co-occur with the use of racial slurs and was positively associated with PTS. The association between hearing a racial slur and PTS did not vary by the number of intrusive behaviors exhibited by police. The association between hearing a slur and PTS was partially mediated by perceived procedural injustice. Overall, the use of racial slurs by police may do harm to minority adolescents by putting them at risk for posttraumatic stress disorder. Our results are consistent with prior research that racial slurs may contribute to PTS by eroding the bounds of what is considered just and fair. Interestingly, the association between racial slurs and PTS was independent of other intrusive policing behaviors. Mental health screeners should ask not only about being stopped by police but the characteristics of that encounter as well — including those imbued with racial animus.

Risky Families: Family Social Environments and the Mental and Physical Health of Offspring

Article

Full-text available

Mar 2002

Risky families are characterized by conflict and aggression and by relationships that are cold, unsupportive, and neglectful. These family characteristics create vulnerabilities and/or interact with genetically based vulnerabilities in offspring that produce disruptions in psychosocial functioning (specifically emotion processing and social competence), disruptions in stress-responsive biological regulatory systems, including sympathetic-adrenomedullary and hypothalamic–pituitary–adrenocortical functioning, and poor health behaviors, especially substance abuse. This integrated biobehavioral profile leads to consequent accumulating risk for mental health disorders, major chronic diseases, and early mortality. We conclude that childhood family environments represent vital links for understanding mental and physical health across the life span.

Psychoneuroimmunology: Psychological Influences on Immune Function and Health

Article

Full-text available

Jun 2002

This review focuses on human psychoneuroimmunology studies published in the past decade. Issues discussed include the routes through which psychological factors influence immune function, how a stressor's duration may influence the changes observed, individual difference variables, the ability of interventions to modulate immune function, and the health consequences of psychosocially mediated immune dysregulation. The importance of negative affect and supportive personal relationships are highlighted. Recent data suggest that immune dysregulation may be one core mechanism for a spectrum of conditions associated with aging, including cardiovascular disease, osteoporosis, arthritis, Type 2 diabetes, certain cancers, and frailty and functional decline; production of proinflammatory cytokines that influence these and other conditions can be stimulated directly by negative emotions and indirectly by prolonged infection.

Self-Esteem as a Moderator Between Perceived Discrimination and Psychological Distress Among Women

Article

Full-text available

Jan 2002

Alexandra Filia Corning

The relationship between perceived discrimination and psychological distress was investigated within a social comparison theory framework. Predictions of a variant of social comparison theory—relative deprivation theory—as well as predictions from the stress-buffering literature pertaining to the moderating effects of self-esteem were tested using samples primarily composed of European American women. Results regarding the theorized self-protecting roles of personal self-esteem (Study 1) and collective self-esteem (Study 2) indicated mixed support for personal self-esteem and consistent support for collective self-esteem as moderators of the discrimination–distress relationship. Results are discussed in terms of their implications for theory, practice, and research pertaining to the impact of discrimination and social stigma.

A Sustainable Future for Humanity?

Article

Full-text available

May 2000

Stuart Oskamp

The sustainability of human life on Earth in the future is in danger. Human actions are producing many harmful and possibly irreversible changes to the environmental conditions that support life on Earth. This article summarizes major threats to Earth’s environment, including global warming, ozone layer destruction, exhaustion of fisheries and agricultural land, and widespread exposure to toxic chemicals. Unless they are overcome, these changes will make human life increasingly miserable and eventually may make Earth nearly uninhabitable for future generations. These threats are caused by patterns of human behavior, particularly overpopulation and overconsumption. Urgent changes to human lifestyles and cultural practices are required for the world to escape ecological disaster, and psychologists should lead the way in helping people adopt sustainable patterns of living. Specific steps toward that goal are proposed in this and the following four articles.

Associations Between Stress, Trait Negative Affect, Acute Immune Reactivity, and Antibody Response to Hepatitis B Injection in Healthy Young Adults

Article

Full-text available

Jan 2001

Eighty-four healthy graduate participants were administered the standard course of 3 hepatitis B vaccinations. Five months after the first dose (shortly after the second injection), each participant completed psychosocial measures, and a blood sample was drawn for determination of hepatitis B surface antibody titer. After completion of the vaccination series, participants performed an acute stress protocol, consisting of a 30-min adaptation period and a 5-min evaluative speech task. Blood was drawn at the end of the resting and task periods for assessment of cellular immune measures. Lower antibody response, as assessed after the second hepatitis B injection, was predicted independently by (a) high trait negative affect and (b) diminished T-cell proliferation in response to PHA. These data provide evidence that trait negative affect and the magnitude of stress-induced suppression of immune function may have clinical significance.

Toward Understanding Why Fairness Matters: The Influence of Mortality Salience on Reactions to Procedural Fairness

Article

Full-text available

Sep 2000

This article focuses on the question of why fairness matters to people. On the basis of fairness heuristic theory, the authors argue that people especially need fairness when they are uncertain about things that are important to them. Following terror management theory, the authors focus on a basic kind of human uncertainty: fear of death. Integrating these two theoretical frameworks, it is proposed that thinking about their mortality should make fairness a more important issue to people. The findings of three experiments support the authors’ line of reasoning: Asking participants to think about their mortality led to stronger fair process effects (positive effects of perceived procedural fairness on subsequent reactions) than not asking them to think about mortality. It is argued that these findings suggest that fairness especially matters to people when they are uncertain about fundamental aspects of human life such as human mortality.

The population strategy of prevention

Chapter

Dec 1993

Geoffrey Rose

This is the central theme of Professor Rose's personal and unique book, in which he presents his ideas drawn from many year of work on preventive medicine strategies. Now in available in paperback, he explores the options for prevention, considering them from various view points - theoretical and scientific, sociological and poitical, practical and ethical. He contrasts the individual and population based strategies for prevention, and offers the concept of health as an issue for populations and not just for individuals. The applications of his ideas are illustrated by a variety of examples ranging from heart disease to alcoholism and roa accidents. Professor Rose, who has pioneered thinking on preventive medicine, hbas written an accessible book which will appeal to a wide range of readers, including clinicians, epidemiologists, public health workers, health service managers, and anyone who is concerned with the wider public issues of health.

Social Epidemiology

Article

Mar 2000

The authors of this excellent text define social epidemiology as the epidemiologic study of the social distribution and social determinants of states of health, implying that the aim is to identify socio-environmental exposures which may be related to a broad range of physical and mental health outcomes. In the first systematic account of this field, they focus on methodological approaches but draw widely from related disciplines such as sociology, psychology, physiology, and medicine in the effort to develop and evaluate testable hypotheses about the pathways between social conditions and health. The persistent patterns of social inequalities in health make this a timely publication.

Discrimination and Health

Chapter