The influence of active coping and perceived stress on health disparities in a multi-ethnic low income sample

BACKGROUND Extensive research has shown that ethnic health disparities are prevalent and many psychological and social factors influence health disparities. Understanding what factors influence health disparities and how to eliminate health disparities has become a major research objective. The purpose of this study was to examine the impact of coping style, stress, socioeconomic status (SES), and discrimination on health disparities in a large urban multi-ethnic sample. METHODS Data from 894 participants were collected via telephone interviews. Independent variables included: coping style, SES, sex, perceived stress, and perceived discrimination. Dependent variables included self-rated general and oral health status. Data analysis included multiple linear regression modeling. RESULTS Coping style was related to oral health for Blacks (B = .23, p < .05) and for Whites there was a significant interaction (B = -.59, p < .05) between coping style and SES for oral health. For Blacks, active coping was associated with better self-reported health. For Whites, low active coping coupled with low SES was significantly associated with worse oral health. Coping style was not significantly related to general health. Higher perceived stress was a significant correlate of poorer general health for all ethnoracial groups and poorer oral health for Hispanics and Blacks. SES was directly related to general health for Hispanics (.B = .27, p < .05) and Whites (B = .23, p < .05) but this relationship was mediated by perceived stress. CONCLUSION Our results indicate that perceived stress is a critical component in understanding health outcomes for all ethnoracial groups. While SES related significantly to general health for Whites and Hispanics, this relationship was mediated by perceived stress. Active coping was associated only with oral health.