Cumulative Stress Implications for Physical, Mental, and Social Health in Young Adults

Background and Purpose: Young adulthood is a stage of personal and social changes across multiple domains from adolescence, including romantic relationship, family formation, and employment. Longitudinal studies have considered the impact of stress burden on young adulthood psychosocial and physical health. However, research is still needed to investigate the multifaceted impact of additive stress and social disadvantage on young adult health. This study used data from a study of diverse youth, with a large proportion of immigrants, to examine the impact of cumulative disadvantage and stress on a wide range of physical, mental, and social health indicators 10 years later.

Methods: The study includes 902 (514 females, 388 males) youth who participated in the baseline at age 18 and the follow-up survey at 28. A cumulative stress index was created by summing 17 items tapping into a range of social and economic disadvantage (e.g., racial/ethnic minority status, poverty, family structure, experience of social-status based discrimination) and adverse childhood experiences (depression, drug use, extreme anger and criminal justice involvement). The young adults were divided into three cumulative stress groups: low (0-2 characteristics; 21%), moderate (3-4; 31%), and high (5 or more; 48%). Differences in health domains at age 28 based on stress grouping were assessed. Physical and mental health were assessed by subjective health rating, health impacted daily activities past week, perceived physical and mental health, health problems (e.g., severe headaches, insomnia, anxiety), and perceived longevity. Social health was measured by currently employed, personal income, married/partnered, precocious childbirth, number of children, and friendship. MANOVA, ANOVA, and chi-squared tests were conducted. The Tukey’s HSD procedure was used for post-hoc comparisons.

Results: The MANOVA test revealed that there was a significant difference across outcomes based on multiple stress groups, F (22, 1458) = 3.27, p < .001; Wilk’s Ʌ = .91, partial η² = .05. Tukey tests indicated that there are significant mean differences between low and high, and moderate and high groups on most (82%) of physical and mental health indicators. The ANOVA test on personal income was significant, F (2, 8) = 6.51, p = .002. There was a significant mean difference between low and high groups. The ANOVA test on friendship was significant, F (2, 47) = 8.38, p < .001. There were significant mean differences between low and high, and moderate and high groups. No chi-squared test was significant.

Conclusions and Implications: At age 18, the effects of cumulative disadvantage were evidenced in this population of young adults. Ten years later, we see continued decrements across domains of functioning based on additive burden of stress. Significantly, physical health symptoms may be the precursor of underlying stress effects on body systems that can lead to chronic illness. A major implication for practice is the need to address the role of ongoing stress on parent physical and mental health, as well as in relationships with children. Stress buffers, including social support from friends, is one promising area; however, we also see decline in this arena for the highly stress-burdened young adults.