Cultural diversity, stress, and depression: working women in the Americas

Social support lengthens life, and stressors induce morbidity early in life and death later. Social supports and stressors, however, particularly those embedded in daily social interactions, exhibit important forms of cultural variation not yet incorporated into stress measurements. This article reports a clinically useful measure of stress applicable to culturally diverse populations. Ninety working women with a wide range of ages, educational attainments, class backgrounds, and historical origins (Africa, northwest Europe, Hispanic, and Native Americans) provided cultural data on the meaning of stress. Consensus analysis, principal components analysis and Cronbach's alpha, and logistic regression document content validity of the stress scale items and the reliability and construct validity of the stress scale. The meaning of social supports (words or acts that imply respect, equality, or help or otherwise lead one to feel special and important) and stressors (words or acts that demean, imply inferiority, impede achievement, or otherwise lead one to feel bad about oneself) experienced in the course of daily social interaction cuts across cultural differences in other realms of life. Informants with a recent history of stress experienced a risk of depressive symptoms 85 times higher than informants without such a history. Standardized cultural research methods yield an instrument based on potential cultural universals that can facilitate clinical assessment and management of stress and health outcomes, such as depression, in culturally diverse populations.