Minority stress

Minority stress describes chronically high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status, but the most well understood causes of minority stress are interpersonal prejudice and discrimination. Indeed, numerous scientific studies have shown that minority individuals experience a high degree of prejudice, which causes stress responses (e.g., high blood pressure, anxiety) that accrue over time, eventually leading to poor mental and physical health. Minority stress theory summarizes these scientific studies to explain how difficult social situations lead to chronic stress and poor health among minority individuals. It is an important concept for psychologists and public health officials who seek to understand and reduce minority health disparities. Minority stress describes chronically high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status, but the most well understood causes of minority stress are interpersonal prejudice and discrimination. Indeed, numerous scientific studies have shown that minority individuals experience a high degree of prejudice, which causes stress responses (e.g., high blood pressure, anxiety) that accrue over time, eventually leading to poor mental and physical health. Minority stress theory summarizes these scientific studies to explain how difficult social situations lead to chronic stress and poor health among minority individuals. It is an important concept for psychologists and public health officials who seek to understand and reduce minority health disparities. Over the past three decades, social scientists have found that minority individuals suffer from mental and physical health disparities compared to their peers in majority groups. This research has focused primarily on racial and sexual minorities. For example, African Americans have been found to suffer elevated rates of hypertension compared to Whites. Lesbian, gay, and bisexual (LGB) individuals face higher rates of suicide, substance abuse, and cancer relative to heterosexuals. These health disparities impact day-to-day well-being as well as overall life expectancy, leading social scientists to ask: How can we reduce minority health disparities? In order to answer this question, it was first important to explore the underlying causes of the disparities. One causal explanation for minority health disparities is the social selection hypothesis, which holds that there is something inherent to being in a minority group (e.g., genetics) that makes individuals susceptible to health problems. In general, this view has not been supported by empirical research. If minority individuals were genetically predisposed to poor health outcomes, the vast majority of them should face health disparities. However, large-scale empirical studies have shown that most of LGB individuals do not suffer psychopathology and that many African Americans do not have heart disease. Instead, research suggests that environmental factors explain minority health disparities better than do genetic factors. While the social selection hypothesis is still debated, it is clear that genetic and dispositional factors do not fully explain the health disparities observed in minority groups. A second hypothesis regarding the causes of minority health disparities suggests that minority group members face difficult social situations that lead to poor health. This hypothesis has received broad empirical support. Indeed, social psychologists have long recognized that minority individuals have different social experiences compared to majority individuals, including prejudice and discrimination, unequal socioeconomic status, and limited access to health care. According to the social causation hypothesis, such difficult social experiences explain health differences between minority and majority individuals. Minority stress theory extends the social causation hypothesis by suggesting that social situations do not lead directly to poor health for minority individuals, but that difficult social situations cause stress for minority individuals, which accrues over time, resulting in long-term health deficits. Furthermore, minority stress theory distinguishes between distal and proximal stress processes. Distal stress processes are external to the minority individual, including experiences with rejection, prejudice, and discrimination. Proximal stress processes are internal, and are often the byproduct of distal stressors; they include concealment of one’s minority identity, vigilance and anxiety about prejudice, and negative feelings about one’s own minority group. Together, distal and proximal stressors accrue over time, leading to chronically high levels of stress that cause poor health outcomes. Thus, minority stress theory has three primary tenets: These three tenets of the minority stress theory have been tested in over 134 empirical studies, most of which examined racial and sexual minority populations. Generally, the studies have confirmed that difficult social situations are associated with stress among minority individuals, and that minority stress helps to explain health disparities. The first tenet of minority stress theory holds that being in a minority group is associated with increased exposure to distal stressors, such as prejudice and discrimination. Indeed, despite significant improvement over the past several decades, numerous studies have confirmed that minority individuals continue to face high rates of distal stressors. For example, in large-scale national surveys, LGB individuals report high rates of prejudice and discrimination across the lifespan. One survey found that one-fourth of LGB adults have experienced victimization related to their sexual orientation, and another found that as many as 90% of LGBT youth report hearing prejudiced remarks at school. Similarly, up to 60% of African Americans report experiencing distal stressors throughout their lives, ranging from social rejection at school to housing discrimination and employment discrimination. In one study, 37 African American respondents recalled over 100 discrete experiences with racist prejudice in a two-year period. In another study, 98% of Black participants reported experiencing at least one incidence of prejudice in the past year. Rates of exposure to distal stressors are much higher among racial and sexual minorities than among majority individuals. For example, LGB adults are twice as likely to recall experiencing prejudice throughout their lives compared to heterosexuals, and LGBT youth report significantly higher rates of prejudice and discrimination compared to their heterosexual peers. In one carefully controlled study, researchers compared rates of victimization among LGBT youth and their heterosexual siblings, and they found significantly higher rates of abuse among the LGB individuals. Comparing rates of perceived discrimination among African American and White individuals, researchers have found large differences in reports of discrimination: 30.9% of Whites reported experiencing 'major discrimination' throughout their lives compared to 48.9% of African Americans. Similarly, 3.4% of Whites reported experiencing discrimination 'often' in their lives, compared to 24.8% of African Americans. Thus, collectively, research suggests that minority individuals face frequent exposure to distal stressors compared to their majority group counterparts. Proximal stressors are internal processes that are presumed to occur following exposure to distal stressors. Examples of proximal stressors include fear of rejection, rumination (psychology) on previous experiences with prejudice, and distaste for one’s own minority group following a prejudice event. Most research on this topic focuses on either sexual minorities or African Americans, and it is unclear whether the proximal stress processes are conceptually similar between these two groups. Thus, it is necessary to review proximal stress processes separately for sexual minority and African American populations.