摘要：Objectives. We sought to determine whether unhealthy behaviors play a stress-buffering role in observed racial disparities in physical and mental health. Methods. We conducted logistic regressions by race on data from the first 2 waves of the Americans' Changing Lives Survey to determine whether unhealthy behaviors had buffering effects on the relationship between major stressors and chronic health conditions, and on the relationship between major stressors and meeting the criteria for major depression. Results. Among Whites, unhealthy behaviors strengthened the relationship between stressors and meeting major-depression criteria. Among Blacks, however, the relationship between stressors and meeting major-depression criteria was stronger among those who had not engaged in unhealthy behaviors than among those who had. Among both race groups there was a positive association between stressors and chronic health conditions. Among Blacks there was an additional positive association between number of unhealthy behaviors and number of chronic conditions. Conclusions. Those who live in chronically stressful environments often cope with stressors by engaging in unhealthy behaviors that may have protective mental-health effects. However, such unhealthy behaviors can combine with negative environmental conditions to eventually contribute to morbidity and mortality disparities among social groups. The strain of living under inhospitable environmental conditions is hypothesized to result in physical health disparities among racial groups. 1 – 3 In addition, the inequities associated with inhospitable environments—inequalities in employment, income, and educational opportunities that favor non-Hispanic Whites over Blacks—are hypothesized to cause not only poorer physical health but also worse mental health among Blacks. However, epidemiological and clinical data show that in comparison with non-Hispanic Whites, Blacks suffer the same or lower rates of most major mental disorders, even while suffering higher rates of psychological distress. 4 – 7 These apparently contradictory disparities in physical and mental health statuses raise questions about the presumed relationships among negative life conditions and stressors on the one hand and poor physical health and mental disorders on the other. 1 , 3
