Wednesday, October 16, 2013
Stress and Illness
Brief Description of Breast Cancer
The illness I have chosen for this discussion is breast cancer. Breast cancer has become a common disease affecting 12% of women (American Cancer Society, 2013). More than 230,000 new cases of breast cancer are diagnosed each year, and approximately 40,000 women will die this year from breast cancer. Although the number of women being diagnosed with breast cancer has declined during the last two decades, this disease continues to affect a significant number of women (ACS, 2013). It remains the second leading cause of death for women (ACS, 2013). Although a significant number of women have no known risk factors, some women are more susceptible than others. Some research has implicated stress as a risk factor for this cancer type (Pudrovska, Carr, McFarland, & Collins, 2013). Other research, however, found women who experienced job strain were less inclined to utilize mammographic screening, but found no association between job stress and breast cancer (Achat, Kawachi, Byrne, Hankinson & Colditz, 2000).
Susceptibility and Vulnerability
The two populations used for this discussion are women in lower socioeconomic occupational positions and women in higher socioeconomic occupational jobs and positions of authority. The latter group, who have the ability to determine the compensation of other employees and the authority to hire and fire workers has a higher risk of being diagnosed with breast cancer than women in the former group (Pudrovska, Carr, McFarland, & Collins, 2013; Pudrovska, 2013). In a longitudinal 54-year study, women exposed to the job stress of positions of authority had an increased risk of breast cancer.
These findings are paradoxical to the idea that individuals in higher socioeconomic life positions and socioeconomic status groups have increased health advantages compared to individuals from lower socioeconomic groups (Jannings & Reibert, 2012; Williams, Mohammed, Leavell, & Collins, 2010). Chandola and Marmot (2011) explained that lower socioeconomic status has been linked to increased stress in the work environment, and further that lower socioeconomic groups might be more susceptible to an increase in biological stress responses. Needham et al., (2013) found leukocyte telomere length, which is a marker of cell aging, and associated with stressful life experiences, was shorter in individuals who failed to complete high school, compared to individuals who were college educated. This augments the body of contemporary scholarship that demonstrates a link between lower socioeconomic status and cell aging, conveying an intrinsic biological benefit to higher socioeconomic groups. However, Pudrovska et al. (2013) found contradictory evidence that suggests high-powered women were more susceptible to breast cancer.
Stress and Coping in Both Populations
Women in higher socioeconomic groups, such as those in positions of occupational power are known to have greater accessibility to resources that enable them to manage stress and cope more effectively in stressful situations (Jannings & Reibert, 2012). Because of more easily accessible resources, the higher socioeconomic group might appraise stress as manageable (Lazarus, 1991). In any event, because of their high-powered positions, they are exposed to long-term stress that affects and causes dysregulation of the clucocorticoid system. Subsequent exposure of breast tissue to chronically elevated cortisol levels explains the higher risk of professional women to breast cancer (Pudrovska et al., 2013).
Women in higher paying jobs may have an increased accessibility to resources and subsequently the ability to appraise stress as more manageable than women without adequate resources. The former group, however, was continually exposed to the stress of occupational positions traditionally reserved for men, and this stress was not experienced by housewives and workers in lower socioeconomic positions to the same extent (Ridgeway, 2001). Chronic social stress and the subsequent exposure to stress hormones has been proven to be at least partly culpable in breast cancer. Stress hormones, specifically cortisol exposure has been shown to be an underlying psychophysiological pathway to breast cancer (Antonova et al., 2011). The higher powered women were chronically exposed to higher cortisol levels (Pudrovska et al., 2013).
Women in higher socioeconomic positions may have the potential to resolve stress in ways less accessible to women in lower socioeconomic positions. However, these benefits do not appear to extend to chronic stress specific to their high powered positions and the subsequent exposure to high levels of cortisol that may lead to breast cancer. Women in positions of authority may be exposed to chronic stress that is less easily mitigated by the resources available to them. Housewives and women in lower socioeconomic occupational settings may have fewer resources for mitigating stress, however, they may not be exposed to the higher intensity chronic stress that may lead to breast cancer.
Achat, H., Kawachi, I., Byrne, C., Hankinson, S., & Colditz, G. (2000). A prospective study of job strain and risk of breast cancer. International Journal of Epidemiology, 29(4), 622-628. doi: 10.1093/ije/29.4.622
Antonova, L., Aronson, K., & Mueller, C. (2011). Stress and breast cancer: from epidemiology to molecular biology. Breast Cancer Research, 13(2).
American Cancer Society. (2013). Breast Cancer. What Are the Key Statistics about Breast Cancer? Retrieved September 15, 2013, from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics
Jannings, A., & Reibert, S. (2012). Socioeconomic Status and Health Implications. Hauppauge, N.Y.: Nova Science Publisher's.
Chandola, T., & Marmot, M. G. (2011). Socioeconomic status and stress. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 185–193). New York, NY: Springer Publishing Company.
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Needham, B. L., Adler, N. Gregorich, S., Rehkopf, D., Lin, J., Blackburn, E. H., & Epel, E. S. (2013). Socioeconomic status, health behavior, and leukocyte telomere length in the National Health and Nutrition Examination Survey, 1999–2002. Social Science & Medicine, 85, 1-8. doi: 10.1016/j.socscimed.2013.02.023
Potts, J. (2007, October). Study of relationship between chronic diseases and stress. Medical News Today. Retrieved from http://www.medicalnewstoday.com/releases/85162.php
Pudrovska, T., Carr, D., McFarland, M., & Collins, C. (2013). Higher-status occupations and breast cancer: A life-course stress approach. Social Science & Medicine, 8953-61. doi:10.1016/j.socscimed.2013.04.013
Pudrovska, T. (2013). Job Authority and Breast Cancer. Social Forces, 92(1), 1-24.
Reibert, S., & Jannings, A. (2012). Socioeconomic status and health implications. New York: Nova Science Publisher.
Ridgeway, C. L. (2001). Gender, Status, and Leadership. Journal of Social Issues, 57(4), 637-655. doi: 10.1111/0022-4537.00233
Williams, D. R., Mohammed, S. A., Leavell, J., Collins, C. (2010). Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities. Annals of the New York Academy of Sciences, 1186, 69-101. doi: 10.1111/j.1749-6632.2009.05339.x