NIH funded study finds protection from stress reduces health problems
The podcast is available at http://www.nichd.nih.gov/news/releases/Documents/031014-family-protection-stress.mp3 (MP3 - 8 MB).
Barrett Whitener: Health problems affect members of different groups in different ways. And some groups have more than their share of health issues. Researchers refer to these health differences as health disparities. On average, African Americans, for example, experience illnesses such as diabetes, high blood pressure, heart disease, and stroke more frequently than do members of other groups.
They also tend to experience those diseases earlier and in more severe forms. Although some of these differences may be due to genetic factors, others are clearly linked to environment. Coming from a poor background can place people at a health disadvantage, with many health problems having strong links to lack of educational opportunities, lack of access to health care, and poor nutrition.
Stress, particularly if it's long term, can also affect someone's health. With me today is Dr. Gene Brody, who is studying how a particularly corrosive form of stress, being on the receiving end of prejudice and racial discrimination, can also impair someone's health. Dr. Brody is founder and director of the Center for Family Research at the University of Georgia in Athens.
His work, however, has also uncovered a ray of hope, suggesting that strong ties to one's family and community can lessen the health effects of racial discrimination. He and his colleagues working with African American youth in the rural South found that a good home life with a supportive family and emotional support from one's peers can lessen many of these stress-linked health problems.
From the National Institutes of Health, I'm Barrett Whitener, and this is Research Developments, a podcast from the Eunice Kennedy Shriver National Institute of Child Health and Human Development—the NICHD.
Dr. Brody is on the phone to tell us about the results of a study of rural African American youth that he recently conducted, which was funded by the NICHD and another NIH Institute, the National Institute on Drug Abuse. Thank you, doctor, and welcome.
Dr. Gene Brody: Good to be here.
Mr. Whitener: Why did your study focus on African American youth?
Dr. Brody: We began 30 years ago examining African American youth living in the rural South in an area that is commonly referred to as the "Black Belt," that stretches across South Carolina, Georgia, Alabama, Mississippi, and Louisiana. And in this place there are 20 million African American families, many of whom face challenges associated with economic hardship.
When we looked at the well-being of these families and the youth who grow up in them, we found that they were understudied. Not a lot of was known about them, and more importantly, not much was known about the factors that produce healthy children and adults. So we thought a focus on this particular population was important not only for them, but for public health in general.
Mr. Whitener: And why is adolescence in particular a good period of life to study for your purposes?
Dr. Brody: During adolescence, kids gets out from the umbrella of their families and venture out more into the world on their own. And it's during this time that risks, both for psychosocial and psychological well-being outcomes, become prominent. But also, youth are exposed at this time to other risk factors that are race related, such as discrimination. So that, as youths make their way into the rural South, on occasion they experience discriminatory events, which have been shown to influence psychological well-being. And we wanted to see if it also had implications for health outcomes.
Mr. Whitener: Dr. Brody, why are there such long-term effects of stress on the body?
Dr. Brody: Well that is truly an interesting question, Barrett, because people used to think that the origins of health problems that first showed themselves during mid-life, like diabetes, hypertension, and cardiovascular disease, began during mid-life. And more and more research is showing that the origins of what we call these chronic diseases of aging may have their beginnings during childhood and adolescence.
And this occurs through an interesting process, where exposure to stress causes the body to have to mobilize responses to combat that stress. And these responses, usually in the form of stress hormones, actually, over time, weather the body's ability to function as it should.
Mr. Whitener: Now other researchers have proposed explanations other than racial discrimination as a contributor to long-term health problems, but your study rules them out. Could you tell us about that?
Dr. Brody: Yes. We took great pains in this study to try to see whether, really, the racial discrimination makes a unique contribution to the well-being of young people's bodies. And so we did this by first trying to rule out causes of this physiological wear and tear on the body that we measured. We ruled this out by accounting for everyday life stress that had nothing to do with discrimination that these adolescents may have encountered. We also tried to rule out factors like exposure to economic hardship.
We also tried to rule out psychological well-being, and lastly we tried to rule out health-related behaviors like diet and exercise and getting enough sleep. And after ruling out all these factors we wanted to see if racial discrimination, over and above those factors, contributed uniquely to health—to physiological health risk.
Mr. Whitener: The study also looked at adolescents at specific ages. What ages did you examine, and why did you take that approach?
Dr. Brody: We took a look at kids' exposure to discrimination across the ages of 16, 17, and 18. And these are the years that kids are truly out and about in their communities. Truly out from under watchful guidance of their parents and are interacting with larger segments of their world.
Mr. Whitener: How many adolescents did your study include, and how did you go about inviting them to participate in it?
Dr. Brody: We were fortunate to have 489 African American adolescents and their families. And they have been part of the study, which began when they were 11 years old, and we recruited them from schools in the rural South. And the vast majority of youth whom we recruited at age 11 participated when they were 16, 17, 18, and 19.
Mr. Whitener: And how did you go about inviting them to get involved?
Dr. Brody: We would send letters to them, to their parents. We would then go to their homes and explain the purposes of the study. We talked about why this particular study was important to help us learn about the factors that promote the health and well-being of African American youth. And the families, as it turned out, were very receptive to having their children participate and their own participation as well.
Mr. Whitener: Why does emotional support do so much to negate the health effects of stress? Why is a strong connection to family and community so helpful?
Dr. Gene Brody: Well this is an interesting question that has been studied, not only in children, but there are studies involving primates and studies involving rodents, which show that access to emotional support is a tremendous stress reliever. And these studies have received further support in studies with pre-schoolers, with school-aged children, with pre-adolescents, and now adolescents, in the health realm. And you know, having access to parental support and parental involvement has been shown to make youth less reactive to stressors in their world. They feel that they're not in these stressful situations alone, and more importantly, parents help their children to figure out that experiences like discrimination are not their fault, and it's not about them, but the problem resides elsewhere.
Mr. Whitener: How did you measure the degree of emotional support that the adolescents you studied received?
Dr. Brody: Well, actually, we used some scientific instruments, which parents gave us answers to, which assessed or measured the degree of involvement that parents had in their adolescents' day-to-day lives: their availability to listen and help their adolescents cope with problems they confront in day-to-day living, and the willingness of their adolescents to come to them with problems that they encounter.
Mr. Whitener: What did you learn from studying the effect of discrimination-related stress on these youths?
Dr. Brody: Well firstly, we learned that adolescents across the ages of 16, 17, and 18, who experienced the highest levels of discrimination, had higher levels of what we called allostatic load, which is the measure of physiological responses to stress on the body. And this measure, this allostatic load, measures the presence of stress hormones on the body, like cortisol, epinephrine, or norepinephrine. It measures blood pressure, and it measures body mass index.
And those youth who were exposed to the very highest levels of racial discrimination across those three years during adolescence had higher levels of stress hormones in their body, they had higher blood pressure, and they had higher body mass indices. And what's important about that is that allostatic load, in other studies, forecast the onset of the chronic diseases of aging like cardiovascular disease, diabetes, and hypertension.
So even at this young age, youth who were exposed to the very highest levels of discrimination were developing physiological stress profiles that make them vulnerable to those diseases later in life.
Mr. Whitener: And did you find that emotional support actually did help to reduce stress for these adolescents?
Dr Gene Brody:
Oh, emotional support was terribly important. In fact, emotional support erased the effects of discrimination for those youth who experienced the highest levels. This is terrifically important, because, despite the fact that discrimination is linked to higher levels of physiologic stress, it only was linked to higher levels of physiologic stress in adolescents who have lower levels of emotional support.
Mr. Whitener: Now based on your findings, how do you think we can help to reduce health disparities in the African American community?
Dr. Brody: Well that is a challenging question. Probably you know our findings illustrate the power of family strength and the power of strong families to inoculate African American children against some of the most pernicious stressors that they face. And to the extent that families do or are able to form relationships with their children that enable children to access them for support, it can tamp down or ameliorate completely some of the effects of pernicious stressors like discrimination.
Probably also, helping African American youth to cope with pernicious stressors like discrimination, with coping strategies that encourage them not to internalize these messages, but instead to attribute them to characteristics of others, will be health promoting.
Mr. Whitener: Are you planning any future studies on how to reduce the negative health effects of high stress among African Americans?
Dr. Brody: You know, we are starting to do some work. We have some preliminary research showing that participation in prevention programs that enhance family levels of support and communication with their adolescents reduce their physiological stress response and other kinds of response to stress like increased inflammatory reactions in their bodies.
Mr. Whitener: Anything else you'd like to add for us, Dr. Brody?
Dr. Brody: No, I'm really grateful to the families and the communities that have embraced our work, and we hope to go forward with some solutions that can be used in communities to promote the health of these youth and decrease disparities.
Mr. Whitener: We've been speaking with Dr. Gene Brody, who is founder and director of the Center for Family Research at the University of Georgia in Athens. Thanks so much for joining us today, Dr. Brody.
Dr. Brody: My pleasure.
About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute's website at http://www.nichd.nih.gov/.