Sex and Gender-based Analysis of this topic
Definition
Stress refers to any adverse stimulus that disturbs a person’s physical or mental equilibrium. That stimulus can be physical, mental, or emotional and can come from external or internal sources. If personal stressors exceed an individual’s ability to cope for an extended period of time, as happens with chronic stress, that individual is at higher risk for a range of negative health consequences. These include, but are not limited to, weakening of the immune system [1], hypertension [2], stress-related disorders, and heart disease [3]. Additionally, people experiencing high levels of stress are more likely to engage in health-damaging activities, such as alcohol/tobacco use, substance abuse, or restricting diet [4] .
Measuring stress presents challenges because stress is both an outcome of other health determinants, such as low socio-economic status, as well as a stand-alone determinant of health. Stress levels are generally measured in two categories: life stress (dealing with difficult life situations) and time stress (having too much to do). Canadian women consistently report both higher time and life stress than men [5-6].
Sex Issues
Over the past ten years, innovative research has indicated that women and men have different physiological reactions to stress. The entire biological mechanism is not yet known, but research suggests that stress stimulates different areas of the brain in men and women [7], that high levels of estrogen amplify the stress response [8], and that high stress levels increase the risks for chronic diseases differently for men and women. For instance, chronic stress increases the risk of developing arthritis, back problems, and stomach ulcers for both sexes, but for women, it also increases the risk of developing asthma and migraines [6]
Gender Issues
Stress can be caused by a single factor or a set of factors. Many of the factors that contribute to chronic stress have a strong gendered component. For example, lower SES is associated with higher levels of chronic stress [9]. Since women are more likely to have low SES, this issue is of particular importance for women. There are a variety of other gendered determinants of health that are associated with higher levels of time and life stress, including poverty, unemployment, job insecurity, overwork, lack of control at work, unpaid work, family violence, lack of social support, and many others.[5]. The combination of these factors and biological differences in the stress response in men and women helps explain why women are also twice as likely to develop stress-related disorders, such as post-traumatic stress disorder [10].
Reported rates of time stress are particularly influenced by gender, with women consistently reporting higher levels than men. Many factors contribute to this higher rate for women, including women spending twice as much time on unpaid, household labour, women’s traditional role as family caregivers, and the involvement of women in the workplace [11]. Those same factors are most likely the reason that women report significantly higher life stress than men, while men are more likely to report work stress [12].
Diversity
There has been limited research on the connections between stress and different subpopulations across Canada, though existing evidence points to potential inequities. Populations with low socioeconomic, education, and social support report consistently higher chronic levels of stress [6]. In 2001, the Canadian Community Health Survey found statistically significant differences in chronic stress levels across the provinces. Thirty percent of Quebec residents report “quite a lot” of life stress, while only 15% of residents of Newfoundland report the same level of stress [5]. Stress rates can be affected by economic fluctuations and other changing factors, so this result warrants further study.
Critique
Measuring the degree, impact, and inequities of women’s chronic stress levels is vital to understanding women’s health. Stress is inter-related with many other determinants of health and should be included in investigations of issues such as poverty, violence, job security, unpaid labour, and other gendered issues. To date, stress has been generally underreported and under-analyzed, especially as it relates to subpopulations of women who have been identified at higher risk for chronic stress. Filling in these gaps of information will also provide insights into the related gender-related issues mentioned above.