The importance of psychosocial stressors for socio-economic inequalities in perceived health

Soc Sci Med. Feb-Mar 1998;46(4-5):611-23. doi: 10.1016/s0277-9536(97)00206-2.


The uneven distribution of psychosocial stressors as well as their differential health impact have been suggested as a possible explanation for socio-economic inequalities in health. We assessed the importance of both explanations, using data from the baseline of a Dutch longitudinal study. The outcome measure was the prevalence of perceived health problems. Educational level was used as an indicator of socio-economic status, whilst both life-events and long-term difficulties were included as stressors. We controlled for educational differences in neuroticism in order to eliminate any bias which might arise from the fact that people in lower educational groups are more inclined to report both stressors and health problems. The higher exposure to stressors was found to contribute to the increased risk of perceived health problems, even after differences in neuroticism were taken into account. Long-term difficulties, especially those related to material conditions, account for most of the effect. The impact of stress on health was hardly found to be moderated by educational level. The implications for future research are discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Educational Status
  • Female
  • Health Status Indicators*
  • Humans
  • Life Change Events
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Neurotic Disorders
  • Odds Ratio
  • Socioeconomic Factors
  • Stress, Psychological / economics
  • Stress, Psychological / epidemiology*