Sociology’s unique contribution to the study of stress lies in its documentation and explanation of differences among social groups in stress expo- sure, health, and well-being. Sociological studies over several decades have documented marked social inequalities in physical and psychological well-being, and these findings have been remark- ably stable over time: Women live significantly longer than men, but they suffer more acute tran- sient illnesses, more chronic health conditions, and more serious functional disabilities than men (Ver- brugge 1989). Although women and men have equivalent rates of mental health problems, their problems differ in kind. Women report higher lev- els of psychological distress and have higher rates of mood and anxiety disorders, while men have greater alcohol and drug problems, substance use- disorders, aggressive behaviors, and antisocial per- sonality disorders (Kessler et al. 2005b; Kessler and Zhao 1999; Mirowsky and Ross 2003b). African Americans and Hispanics have higher morbidity, disability, and mortality rates than whites (Geronimus 1992; Geronimus et al. 1996, 2006; Hayward et al. 2000; House 2002; Walsemann, Geronimus, and Gee, 2008; Warner and Hayward 2006; Williams and Collins 1995), but they have equal or lower levels of psychological distress and equal or fewer psychiatric disorders than whites (Brown et al. 1999; Kessler et al. 2005b; Kessler and Zhao 1999).3 Not surprisingly, illnesses, disabilities, and mortality climb with age (House et al. 1994; Walsemann et al. 2008), but symptoms of distress or depression are curvilinearly related to age— high in adolescence and young adulthood, low in middle-age, and greater again among older age groups (Kessler et al. 1992; Miech and Shanahan 2000; Mirowsky and Ross 2003b). The onset of psychiatric disorders is most frequent in adoles- cence and young adulthood and drops off with age (Kessler et al. 2005a). In general, physical health declines while psychological well-being improves with age (with the exception of greater distress/ depression among elderly persons). Unmarried individuals, particularly those who are separated, divorced, and widowed, have more illnesses and disabilities (Hughes and Waite 2009), live shorter lives (House, Landis, and Umberson 1988; Rogers 1995), report more symptoms of psychological distress (Mirowsky and Ross 2003b), and have more psychiatric disorders than married persons (Kessler et al. 2005b; Kessler and Zhao 1999). Finally, persons with low education, income, or occupational prestige have the highest rates of mor- bidity, disability, mortality, psychological distress, and mental disorder compared to those in more advantaged socioeconomic positions (Elo and Pres- ton 1996; Hayward et al. 2000; House 2002; House et al. 1994, 2005; Kessler et al. 2005b; Kessler and Zhao 1999; Lantz et al. 2005; Mirowsky and Ross 2003a, 2003b; Ross and Wu 1995). Overall, then, physical and mental health prob- lems are more frequent among women, adoles- cents and young adults (excepting physical conditions), blacks and Hispanics (excepting psy- chological conditions), unmarried individuals, and persons on lower rungs of the socioeconomic lad- der. As Pearlin has observed, “People’s standing in the stratified orders of social and economic class, gender, race, and ethnicity have the potential to pervade the structure of their daily existence . . . shaping the contexts of people’s lives, the stressors to which they are exposed, and the moderating resources they possess” (1999:398–99). It follows that exposure to stressors should vary inversely with social status, and differential stress exposure should at least partially explain the higher rates of morbidity, disability, mortality, distress, and psy- chiatric disorder that are generally found in lower status, disadvantaged social groups (Dohrenwend and Dohrenwend 1974; Pearlin 1999). Initially, sociologists examined only the social distributions of negative life events and obtained mixed findings (Hatch and Dohrenwend 2007). Once attention shifted to ongoing strains and cumulative stressors, however, consistent and tell- ing results were obtained: Females, young adults, members of racial-ethnic minority groups, divorced and widowed persons, and poor and working-class individuals had significantly more chronic difficul- ties in their lives and faced more cumulative bur- dens overall (Avison, Ali, and Walters 2007; Thoits 1995; Turner 2003; Turner and Avison 2003; Turner et al. 1995). Because unequal distributions of cumulative stressors closely paralleled inequalities in rates of physical and/or mental health problems by social status, it seemed likely that stress exposure would at least partially account for such health disparities.
And, indeed, that is what studies showed with respect to self-rated poor health, functional limita- tions, and physical health conditions (Ensel and Lin 2000; House et al. 1994, 2005; Kosteniuk and Dickinson 2003; Lantz et al