Chronic stress and social changes: socioeconomic determination of chronic stress.

In the last decades in the transforming societies of Central and Eastern Europe, premature mortality increased dramatically, especially among men. Increasing disparities in socioeconomic conditions have been accompanied by a widening socioeconomic gradient in mortality among men. Social cohesion and meaning in life may help to counterbalance the widening gap in material circumstances. Not the difficult social situation in itself, but the subjective experience of relative disadvantage, the prolonged negative emotional state, that is, chronic stress seems to be the most important risk factor. The health consequences of a low socioeconomic situation among men might be mostly explained by chronic stress caused by work and close-partner-related factors, and the toxic components of this interaction are depression and hopelessness. In the case of women, the broader personal and family relations are the most important health-related factors. Weekend workload, low social support at work and low control at work accounted for a large part of variation in male premature cardiovascular mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most markedly to variations in premature cardiovascular mortality rates among women. There are two general approaches that scientists and practitioners might take: train individuals and groups to use skills that will enable them to cope better with the stressful conditions that are damaging their health; and lobby governments to adopt policies that will result in decreased chronic stress on the societal level.