Stress is a Public Health Crisis

April is Stress Awareness Month. You might not think stress needs awareness, given how often we joke about our stress levels with coworkers or discuss it with our doctor when our blood pressure spikes. But there’s something about stress that really does need awareness – the danger it presents to our health, especially for disadvantaged populations.

In today’s hustle culture, stress is accepted as the price of success. Workplaces offer stress management workshops for good reason – the Global Organization for Stress reports that 75 percent of Americans experienced moderate to high stress levels in the past month. 80 percent of people feel stressed at work. In fact, American employers spend $300 billion every year on healthcare and lost work days linked to stress.

Stress is such an ingrained part of American life that it can seem as inevitable as breathing, and too ubiquitous to solve. But stress can have intense physical and mental consequences, from birth to old age.

The Rising Tide of National Anxiety

Last year, the COVID-19 pandemic spiked stress levels across the world. A 2020 American Psychological Association (APA) survey found that nearly 8 in 10 adults named the pandemic as a significant source of stress in their life. The crisis damaged multiple areas of people’s lives, from job loss to bereavement to financial worries to social isolation. Almost half of adults admitted to negative behavior such as mood swings, irritability, or yelling at family members and friends.

Recent political and cultural volatility has also had a grim impact. Our youngest adults, Generation Z, report the most intense stress of all generations, likely because they’ve come of age in such disruptive times. The last two years have been especially difficult for Americans of color, who’ve experienced a jump in racism-fueled stress. 44% currently report discrimination is a significant source of stress in their life, compared with 38% who said the same in 2019.

These results led the APA to a somber prediction: “We are facing a national mental health crisis that could yield serious health and social consequences for years to come.”

The Stress-Health Connection

The recent increase in stress fuels an already simmering volcano. Before the pandemic, 73 percent of people reported stress that impacted their mental health – with symptoms that ranged from anxiety, apathy, loss of appetite, and emotional eating to substance abuse, suicidal ideation, and exacerbation of existing behavioral disorders. 77 percent experienced stress that affected their physical health, influencing conditions such as heart disease, digestive disorders, high blood pressure, diabetes, cancer, lung disease, and accident-related injuries.  As Tribal EM CEO Dr. John Shufeldt notes, “Stress, like hypertension and sleep apnea, is a silent culprit for many associated medical and behavioral conditions.”

There’s even mounting evidence that stress can be physically contagious. Dr. Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School, found that abnormal levels of pro-inflammatory cytokines during pregnancy can affect fetal brain development. This prenatal exposure to stress influences our immune system, our mental health, and how we handle stress in midlife. “We know that there are developmental roots to major psychiatric disorders such as depression, schizophrenia, and bipolar disorder, and we know that these roots begin in fetal development,” Goldstein said. “We also know these disorders are associated with abnormalities in the brain circuitry that regulates stress — circuitry that is intimately tied to regulating our immune system.”

Just as our health is influenced by economic and environmental factors, so is stress – linking stress levels to health disparities. In driving stress, factors such as poverty, trauma, racial bias, or family dysfunction can also drive an increased risk for medical and behavioral problems.

Improving Care Disparities with Stress Awareness

The pandemic has unleashed a renewed focus on health inequities – and now it’s time to make stress reduction a public health priority. On an individual level, good nutrition, adequate sleep, culturally affirming activities, fitness routines, and programs like yoga or tai chi can help. “Always look for ways to decrease the amount of stress in your life as well as for outlets like exercising, reading, and meditating to help cope,” advises Dr. Shufeldt.

But stress management techniques only change the way we handle stress – not the sources of stress themselves. To really reduce the widespread destructive impact of stress, it’s just as critical to tackle entrenched patterns like poverty, systemic racism, and toxic cultural behaviors. That’s the real key to improving stress-related illness and unlocking an equitable, healthier world for all.

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