Race, Class, and Psychological Distress: Contextual Variations across Four American Communities

Abstract

Analyses investigating the role of race and class in the propensity to psychological distress have yielded conflicting results. We contend that one reason for this inconsistency is that previous studies, based on empirical data drawn from different places and times, have interpreted results without reference to the distinctive racial contexts across the country. Because the specific local conditions in which individuals live differentially expose blacks and whites of different socioeconomic classes to psychological stressors, we seek to better understand how race and class patterns in distress are conditioned by place of residence. To examine the links between race, class, place, and distress, we conduct a quantitative analysis using data from the multi-site Epidemiological Catchment Area (ECA) program, which shows different relationships between distress, race, and class across four US communities. We then investigate these differences across place through a qualitative study of the local structural conditions that contextualize these relationships. Our historical review indicates that racial conditions vary substantially across the four sites, in accordance with our empirical analyses. We conclude that epidemiological research will be theoretically enriched and intervention strategies more effective as researchers design improved measures for the specific contextual conditions in which factors related to human health are embedded.