Social context, stressors, and disparities in women's health.

OBJECTIVE to describe stressors experienced by women living in an economically disenfranchised urban community and test the relationships between those stressors and women's self-reported health status. METHODS We used a stress process framework to examine the implications of economic divestment and race-based residential segregation on the lives and health of women raising children in Detroit. We conducted qualitative analysis of in-depth interviews with 48 community residents and surveyed 679 women raising children in this community. Regression models controlling for age, education, and income examined the relationships of each of these stressors to symptoms of depression and general health status. RESULTS Stressors described by women in the in-depth interviews included financial, work, family, safety, police and other municipal services, and disrespect or unfair treatment. Financial, police, and safety stress and unfair treatment were significantly associated with symptoms of depression; financial and family stress were significantly associated with self-reported general health status. CONCLUSION Our results support the hypothesis that life stressors associated with economic divestment contribute to the disproportionate burden of disease experienced by African-American women residing in urban communities. Efforts to address racial and socioeconomic disparities in women's health should include policies that support economic development and municipal infrastructure as fundamental to the maintenance of health.