The Relationship Between Social Support, Stress, and Health Among Women on Detroit’s East Side

A conceptual model of the stress process has been useful in examining relationships between numerous social determinants (e.g., chronic stress), protective factors (e.g., social support), and health status. In this arti-cle, the authors examinemultiple sources of chronic stress, instrumental and emotional support, and health out-comes among a random sample (N = 679) of predominantly low-income African American women who reside on Detroit’s east side. The findings suggest that a number of chronic stressors have an impact on depressive symptoms and general health and that even though instrumental and emotional support each have a significant effect over and above the effects of the stressors, when both are included in themodel, instrumental support, and not emotional support, remains as a significant predictor of health outcomes. These findings suggest the need for health education interventions and policy strategies that strengthen social support and aim at macro-level changes necessary to reduce chronic stressful conditions. There is increasing emphasis in the literature on social determinants of health and the need to gain a better understanding of the multiple structural, psychosocial, cultural, and biological factors that have an impact on health status.1-5 A conceptual model of the stress process is one framework that has been useful in examining the relationship between these numerous determinants of health status.6-8 Thismodel posits that environmental an