Ethnicity- and socio-economic status-related stresses in context: an integrative review and conceptual model

There continues to be debate about how best to conceptualize and measure the role of exposure to ethnicity-related and socio-economic status-related stressors (e.g. racism, discrimination, class prejudice) in accounting for ethnic health disparities over the lifecourse and across generations. In this review, we provide a brief summary of the evidence of health disparities among ethnic groups, and the major evidence on the role of exposure to ethnicity- and SES-related stressors on health. We then offer a reciprocal and recursive lifespan meta-model that considers the interaction of ethnicity and SES history as impacting exposure to psychosocial adversities, including ethnicity-related stresses, and mediating biopsychosocial mechanisms that interact to result in hypothesized cumulative biopsychosocial vulnerabilities. Ultimately, group differences in the burden of cumulative vulnerabilities are hypothesized as contributing to differential health status over time. Suggestions are offered for future research on the unique role that ethnicity- and SES-related processes are likely to play as contributors to persistent ethnic health disparities.