Background The assessment of acculturative stress as synonymous with acculturation level overlooks the dynamic, interactive and developmental nature of the acculturation process. An individual’s unique perception and response to a range of stressors at each stage of the dynamic process of acculturation may be associated with stress-induced alterations in important biological response systems that mediate health outcomes. Evidence suggests the Cortisol Awakening Response (CAR) is a promising pre-clinical biomarker of stress exposure that may link acculturative stress to self-reported health in Mexican Americans. Purpose The aim of the current study was to examine whether alterations in the CAR mediate the relationship between acculturative stress and self-reported health in Mexican Americans. Methods Salivary cortisol samples were collected at awakening, 30, 45, and 60 minutes thereafter, on two consecutive weekdays from a sample of adult Mexican Americans. Acculturative stress and self-reported health were assessed. Data were aggregated and analyzed (n=89) using a mixed effects regression model and path analysis. Results Poorer self-reported health was associated with attenuated CAR profiles (primarily due to a diminished post-awakening rise in cortisol) predicted by both moderate and high levels of exposure to acculturative stress. Stress-induced alterations in the CAR mediated the relationship between exposure to acculturative stressors and self-reported health. Conclusions Findings demonstrate that different levels of acculturative stress are associated with distinct CAR profiles and suggest the CAR is one possible biological pathway through which exposure to culturally unique stressors may be linked to health disparities.

Objective: Social determinants may negatively affect health via Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction. The potential contribution of social determinants and related factors to HPA-axis functioning is important to study among African American adults, who are more likely to experience societal inequities and health disparities relative to other racial/ethnic groups. This study examined the relationship between depressive symptoms and perceived social control on HPA-axis functioning among African American adults. Method: Participants (N = 107; Mage = 50, 79% female) were administered measures including the Center for Epidemiologic Studies–Depression and Informal (neighborhood) Social Control. Study procedures included the provision of 6 saliva samples for cortisol analysis (at wakeup, 30- and 90-min post-wakeup, 2:00 PM, 5:00 PM, and prebedtime). The relationship between depression and social control on the functioning of the HPA-axis were simultaneously examined within a 2-level hierarchical linear model. Results: Variability in the Cortisol Awakening Response (CAR) was accounted for by depressive symptomatology (p = .023) and perceived social control (p = .016), whereby greater depression was associated with a blunted CAR (less awakening cortisol production) and greater perceptions of neighborhood social control with a higher CAR. Conclusions: Elevated depressive symptoms and low perceptions of neighborhood social control may serve as mechanisms that help to explain within-group variability in the functioning of stress physiology among African American adults. Findings enhance understanding of how social determinants may affect African Americans’ health.

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