title: What stresses men? Predictors of perceived stress in a population-based multi-ethnic cross sectional cohort.
abstract: BACKGROUND
  Perceived stress (PS) is a risk factor for a variety of diseases. However, relatively little is known about age- or ethnicity-specific differences in the effect of potential predictors of PS in men.
  
  
  METHODS
  We used a population-based survey of 6,773 White, 1,681 Black, and 617 Hispanic men in Southeastern Pennsylvania to evaluate the relationship of self-reported PS and financial security, health status, social factors, and health behaviors. Interactions across levels of age and ethnicity were tested using logistic regression models adjusted for overall health status, education, and household poverty.
  
  
  RESULTS
  High PS decreased significantly with age (p < 0.0001) and varied by ethnicity (p = 0.0001). Exposure to health-related and economic factors were more consistently associated with elevated PS in all ethnicities and ages, while social factors and health behaviors were less strongly or not at all associated with PS in most groups. Significant differences in the relationship of high PS by age and ethnicity were observed among men who are medically uninsured (p = 0.0002), reported missing a meal due to cost (p < 0.0001), or had spent a night in the hospital (p = 0.020). In contrast, not filling a prescription due to cost and diagnosed with a mental health condition were associated with high PS but did not differ by age and ethnicity subgroup.
  
  
  CONCLUSIONS
  These data suggest that some, but not all, factors associated with high PS differ by age and/or ethnicity. Research, clinical, or public health initiatives that involve social stressors should consider differences by age and ethnicity.
authors: Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, 217 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. rebbeck@mail.med.upenn.edu
authors: Timothy R
authors: TR
authors: Rebbeck
authors: Anita L
authors: AL
authors: Weber
authors: Elaine
authors: E
authors: Spangler
authors: Charnita M
authors: CM
authors: Zeigler-Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology*; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
references: Exp Biol Med (Maywood). 2010 Oct;235(10):1150-62
references: 20881319
references: Neurosci Biobehav Rev. 2010 Sep;35(1):2-16
references: 19822172
references: Nat Rev Cancer. 2006 Mar;6(3):240-8
references: 16498446
references: Neurosci Biobehav Rev. 2010 Sep;35(1):58-68
references: 19963006
references: Br J Psychiatry. 2010 Feb;196(2):96-101
references: 20118451
references: Am J Epidemiol. 1979 Feb;109(2):186-204
references: 425958
references: Curr Opin Psychiatry. 2010 Jul;23(4):369-72
references: 20495459
references: Am J Public Health. 2011 Dec;101 Suppl 1:S131-9
references: 22021312
references: Clin Geriatr Med. 2011 Feb;27(1):39-52
references: 21093721
references: Complement Ther Clin Pract. 2010 Feb;16(1):13-9
references: 20129404
references: J Health Soc Behav. 2010;51 Suppl:S54-66
references: 20943583
references: Minerva Endocrinol. 2010 Jun;35(2):109-25
references: 20595939
references: J Psychosom Res. 2010 Jun;68(6):539-44
references: 20488270
references: Fertil Steril. 2011 Jan;95(1):116-23
references: 20674912
references: Neurosci Biobehav Rev. 2010 Sep;35(1):33-8
references: 19751761