Theories for Race and Gender Differences in Management of Social Identity-Related Stressors: a Systematic Review

Abstract

Sociodemographic group-specific strategies for stress management may contribute to racial and gender disparities in health outcomes in the USA. We aimed to systematically review theoretical and empirical investigations of factors influencing variation in response to and management of identity-related stress among black and white Americans. OvidPsychInfo and PubMed databases were searched to identify eligible studies. Criteria were participant age of ≥ 18 years, conducted in the US sampling black or white participants, and published in English in a peer-reviewed journal. The final sample included 167 articles. Theories suggesting social status inequities as the primary contributor to disparate strategies employed by black and white women and men to manage social identity-related stress were most frequently tested and supported. Studies disproportionally focused on how women and black persons cope as targets of prejudice and discrimination rather than on how management strategies of men or white persons are affected as perpetrators. Finally, there was theoretical support for an interactive effect of race and gender on stress management, but empirical evidence was lacking, particularly among black men, white women, and white men. The literature could be strengthened through the use of prospective cohorts and nationally representative samples, as well as study designs accounting for potential within-race and within-gender variation in the effects of social identity-related stressors on coping. With greater consistency in methodology, future empirical studies may yield additional information regarding group differences in stress management pertinent to clarifying mechanisms for the health consequences of exposure to social inequity among black and white women and men.

Allostatic Load Biomarker Associations with Depressive Symptoms Vary among US Black and White Women and Men

“…These disparate relationships suggest that, while a genetic predisposition may contribute to the likelihood of developing risk factors for depression such as inflammation [ 42 ], the particular experience of the social environment that is predicated upon one’s gendered race plays an integral part in depression pathogenesis [ 47 ]. This assertion is consistent with evidence for an interactive effect of genotype and social context on depression that varies with gender [ 15 ]. Such social environmental exposures moderating the experience of stress and subsequent effects on mental health may include cultural influences on racially informed gender roles and expectations, as well as the frequency and severity of perceived prejudice [ 47 , 48 , 49 , 50 ].…”

“…The concept of allostatic load within the epidemiological discipline has improved efforts to evaluate the role of race and gender inequity in yielding depression disparities [ 10 ]. Social environment theories for gender differences in depression attribute much of the increased risk for depression among women to chronic strain associated with the subordinate social position women occupy [ 4 , 11 , 15 ]. A growing body of evidence supports a number of key physiological measures as markers of chronic stress burden associated with psychosocial exposures stemming from membership in a disadvantaged social group.…”

Intersectional effects of racial and gender discrimination on cardiovascular health vary among black and white women and men in the CARDIA study

“…Instead, the framework argues that the lived experience of race and gender in a society which advantages some groups while disadvantaging others (Krieger, 2016; Williams et al, 2012) based on these identities yields variation in the efficacy of health-protective factors. This variation in turn manifests as a differential vulnerability to disease across gendered race groups (Bey et al, 2016, 2018a; Crenshaw, 1989, pp. 139–167; Krieger, 2014).…”

Health Disparities at the Intersection of Gender and Race: Beyond Intersectionality Theory in Epidemiologic Research

“…Intersectionality Theory [10] and Multidimensional Identity Theory [11] are among many theoretical frameworks which outline compelling social and psychological explanations for disparate health outcomes along what are frequently conceptualized as "dimensions" of identity-race, gender, socioeconomic status, and other social group designations. From studies of genetic risk, heath service utilization, and health behaviors to the health-impact of identity processes and coping responses, research grounded in these intersectional theories indicates that socially constructed categories such as race can be further divided into meaningfully distinct categories such as "gendered race" with important implications for accurately assessing the causes of, and solutions for, health disparities [12][13][14].…”

“…In this chapter, I use gender and race as one example to explore the validity of a wholistic identity approach in epidemiologic research. Importantly, of the many designations which demarcate social groups in the U.S., there is strong evidence that gender and race exert a substantial, unique influence on health [14,17,18]. Despite the ongoing debate of whether race or socioeconomic status contributes more to poorer health outcomes among black persons in the USA [3], the social categories of gender and race share a number of factors not characteristic of other social constructs.…”