Racial differences in arthritis-related stress, chronic life stress, and depressive symptoms among women with arthritis: a contextual perspective.

OBJECTIVES: This study examined the effects of arthritis-related stress and chronic life stress on depressive symptoms among African Americans and Whites with arthritis.
METHODS: Participants included 175 African American and White women (aged 45-90) who completed structured questionnaires assessing arthritis-related stress (i.e., pain, functional impairment, perceived stress), chronic life stress (i.e., discrimination, financial stress, life stressors), and well-being (i.e., depressive symptoms).
RESULTS: African Americans reported more functional impairment and lower perceived arthritis stress, but more life stressors, financial stress, and discrimination, than Whites. Arthritis-related stress accounted for similar proportions of variance in depressive symptoms across African Americans (DeltaR2=.16, p<.001) and Whites (DeltaR2=.24, p<.001). However, chronic life stressors explained significantly more variance among African Americans (DeltaR2=.20, p<.001, vs DeltaR2=.06, p<.05). DISCUSSION: Findings demonstrate the importance of considering contextual factors influencing women's health and well-being, particularly for those women with a chronic illness, including arthritis. Although arthritis-related stressors may be the predominant factors affecting well-being for Whites with arthritis, well-being in African Americans with arthritis is also closely tied to broader life stressors. Results suggest the importance of looking beyond illness-specific stressors when studying aging and health.