"This is not a well place": neighborhood and stress in Pigtown

In this study we explored experiences of stress in the lives of 10 mothers and grandmothers living in a low-income, predominantly White, urban neighborhood. Based on interviews, diaries, and photographs, we learned that these women encounter a confluence of stressors related to their everyday lives, their neighborhood, and community culture and institutions. The words and images these women gave us offer insight into how we might improve public health programs and policy, shape epidemiologic variables of interest, and better understand mechanisms related to neighborhoods, stress, and health. We developed a conceptual model representing stressors and sources of stress as overlapping ecological domains. Understanding that low-income, urban women are exposed to multiple, nonindependent types and sources of stress has implications for both research methods and practice. It is our intent that this research will stimulate broad, international dialogue on how living in a poor community may impact the health of women and their children and lead to a new public health that engages whole communities and targets multiple domains.