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What Predicts a Mayoral Official’s Opinion about the Role of Stress in Health Disparities?

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Abstract

High stress is a public health issue in the United States (US), that disproportionately affects socially-marginalized group members, including racial and ethnic minorities and those of low socioeconomic status. While city governments have the potential to reduce stress exposure and health disparities through municipal policies, very little is known about factors that are associated with mayor officials’ beliefs about stress as a determinant of disparities. This information is important because it can inform the design of interventions to educate city policymakers about evidence related to stress and health disparities. Using data from a 2016 survey of 230 mayor officials (101 mayors, 129 senior staff), multivariable logistic regression was used to determine the extent to which respondents’ individual characteristics (e.g., ideology, highest level of education) and the characteristics of their city’s population (e.g., percentage of residents non-white) were associated with their identification of stress as a factor that has a “very strong effect” on health disparities. Forty-four percent of respondents identified stress as having a very strong effect on health disparities. In the fully adjusted model, every percentage point increase in the proportion of a respondent’s city population that was non-White increased the odds of identifying stress as having a very strong effect on health disparities by 2% [adjusted odds ratio (aOR) = 1.02; 95% CI = 1.00,1.04]. Interventions are needed to increase city policymakers’ knowledge about the role of stress in the production of health disparities, which could, in turn, help cultivate political will for city policies that reduce disparities.

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Funding

Dr. Adolfo Cuevas was partially supported by the National Institute of Health 3R25CA057711. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The development of the manuscript was partially supported by Cancer Disparities Research Network/Geographic Management Program (GMaP) Region 4 funded by 3 P30 CA006927-52S2 and CTSI Mentored Career Development Award (KL2 TR002545). The study was supported by the Robert Wood Johnson Foundation (RWJF; grant 73,960). The views expressed here do not necessarily reflect the views of the RWJF.

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Authors and Affiliations

  1. Department of Community Health, Tufts University, 574 Boston Ave, Suite 208, Medford, MA, 02155, USA

    Adolfo G. Cuevas & Sarah Levine

  2. Department of Health Management & Policy, Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA

    Jonathan Purtle

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  1. Adolfo G. Cuevas
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  2. Sarah Levine
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Correspondence to Adolfo G. Cuevas.

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Cuevas, A.G., Levine, S. & Purtle, J. What Predicts a Mayoral Official’s Opinion about the Role of Stress in Health Disparities?. J. Racial and Ethnic Health Disparities 7, 109–116 (2020). https://doi.org/10.1007/s40615-019-00639-z

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