The relationship between socioeconomic status, stress, and substance use among women of childbearing age

Abstract

Substance use is associated with many health problems. Alcohol use is associated with high blood pressure, stroke, cardiovascular diseases, liver disease, and neurological damage (Center for Disease Center and Prevention (CDC), 2006a). Cancer, which is the second leading cause of death in the U.S., was among the first diseases to be casually linked to smoking (CDC, 2006b). Smoking also causes coronary heart disease and increases a person's risk for stroke (CDC, 2006b). Use of illicit drugs (e.g., marijuana, cocaine. heroin, and methamphetamine) is associated with chronic depression, psychosis, and higher risk of contracting human immunodeficiency virus (HIV) (Department of Health and Human Services, 2000). Women face unique health effects from substance use in relation to menstrual and reproductive functions. Evidence also shows that for some substances, like alcohol and tobacco, women may be more vulnerable than men in regards to both acute and long-term effects (as cited in United Nations Office on Drugs and Crime, 2004). Substance use bas been found to be influenced by both socioeconomic status and stress. Substance use varies across groups of differing socioeconomic status. For example, excessive alcohol consumption is more common among lower educational groups (Droomers, Schrijvers, Karien, van de Mheen, & Mackenbach, 1999). Smoking prevalence is also related to educational level. Women with 9-11 years of education are nearly three times more likely than women with sixteen or more years of education to smoke (CDC, 2006b). Stress bas also been found to be associated with substance use. It bas been shown that as stress increases, drinking increases as well (Abbey, Smith, & Scott, 1993; Cole, Tucker, & Friedman, 1990). Associations have also been found between a variety of indices of stress and increased risk for smoking uptake. Current smokers report smoking more when stressed and report experiencing more stress than non-smokers (as cited in Kassel, Stroud, & Paronis, 2003). Stress also plays a role in the decision to begin using drugs (Ladwig & Anderson, 1989; Lindenberg, Reiskin, & Gendrop, 1994). The Stress Process Model developed by Pearlin (1989) provides the opportunity to study the effects the social structure and its stratification based on social and economic class, race and ethnicity, gender, and age bas on the stress process. The overarching strategy of social stress research is to identify the many links that join forms of social organization to individual stress. The stress process is continually being influenced by the social structure and its interrelated levels including social stratification, social institutions, and interpersonal relationships. Therefore, to the extent to which these different systems embody the unequal distribution of opportunities, resources, power, and prestige, a low status within them may in and of itself be a source of stressful life conditions (Pearlin, 1989). Stress is generally divided into two distinct types of stress: eventful stressors and chronic stress. Eventful stressors surface at discrete points in time while chronic stressors may either surface repeatedly or remain over a considerable amount of time. Eventful and chronic stressors may originate from the relatively stable systems of inequality like social class and from the many domains of social and economic organizations (Pearlin, 2002). Overall, stress could be acting as a mediator between socioeconomic status and substance use. A mediator is a third variable whose function is to represent the mechanism through which the independent variable, in this case socioeconomic status, is able to influence the dependent variable, substance use. Therefore, it is essential to take a closer look into the relationship between socioeconomic status, stress, and substance use.