THE EPIDEMIOLOGY OF SOCIAL STRESS

We examine the social distribution of exposure to stress to test the h ypothesis that differences in stress exposure are one factor in sociod emographic variations in mental health. We make a more comprehensive e ffort to estimate stress exposure than has been typical, and present d ata that challenge the prevailing view that differences in exposure to stress are of only minimal significance for understanding variations in mental health. We report several findings, principal among which ar e: Differences in exposure to stress account for substantially more va riability in depressive symptoms and major depressive disorder than pr evious reports have suggested; the distributions of stress exposure ac ross sex, age, marital status, and occupational status precisely corre spond to the distributions of depressive symptoms and major depressive disorder across the same factors; and differences in exposure to stre ss alone account for between 23 and 50 percent of observed differences in mental health by sex, marital status, and occupation. These findin gs contrast with the prevailing view that differences in vulnerability to stress across social statuses account for social status variations in mental health.