Author James Baldwin is quoted as saying “Anyone who has ever struggled with poverty knows how extremely expensive it is to be poor.” It’s also hard to be frugal when you’re poor. As a person who lived in poverty, I can think of many ways that low income Americans pay more and have less. People living with racism and poverty are struggling with daily stress. Marginalized groups of people are so accustomed to carrying this heavy load and may not realize how it affects their overall health.
There are many definitions and types of stress. To keep it fairly simple, according to research, stress can be physiological or biological. It is the body’s method of reacting to a condition such as a threat, challenge, and physical and psychological barrier. In this regard, it is a normal biological reaction to a potentially dangerous situation. When we encounter sudden stress, our brain floods our body with chemicals and hormones such as adrenaline and cortisol. That gets our heart beating faster and sends blood to muscles and important organs in our body.
Other research indicates that our body tells us whether an encounter is stressful or not. This is based on sensory input and processing (things we see and hear in a situation) or based on stored memories (what happened the last time we were in a similar situation). If the situation is judged as being stressful, the hypothalamus (at the base of our brain) is activated.
Physiological stress relates to an organism’s healthy or normal function. A physiological response may cause an increase in blood pressure due to short term mechanical changes in the anatomy of the heart and arteries. Physiological factors are things related to our body that affect our thinking. When our body’s chemistry is off due to unbalanced nutrition, dehydration, alcohol or drug abuse, etc., the neurotransmitters that control our thinking can be affected.
Some examples of biological stressors are diabetes, gut problems and migraines. When stressed our liver produces extra blood glucose (sugar) to give us a boost of energy. If we are under prolonged or chronic stress, our body may not be able to keep up with the extra surge of glucose. This increases our risk of developing Type 2 diabetes. There are also social stressors that are work related and psychological stressors that contribute to depression and anxiety.
Stress is a natural physical and mental reaction to life’s experiences. We all experience some form of stress. The human body is designed to experience stress and react to it. Stress can be positive, keeping us alert, motivated, and ready to avoid danger. It becomes negative when a person faces continuous challenges without relief or relaxation between stressors. As a result, a person becomes overworked, and stress-related tension builds. We have a natural “fight or flight” response. It’s this chemical reaction that prepares our body for a physical reaction because it thinks it’s under attack. This response allows us to protect ourselves in an emergency by preparing us to act quickly. Frequent or prolonged stress can be mentally and physically harmful. When the stress response fires daily, it puts our health at serious risk.
Black people and other marginalized groups of people live with the daily firing of stress responses. Marginalization is the treatment of a group of people as insignificant. Prolonged mistreatment may lead to a loss of self-confidence. They are constantly dominated in society. Even today, this group of people face difficulty in getting access to good education, gainful employment and their mental health is threatened. The stress levels stay elevated longer than necessary for survival and take a toll on a person’s health. Prolonged stress is a major reason for disproportionate health disparities. Prolonged stress affects how people of color and people living in poverty respond to medical treatment. My family and I lived with the daily stress of racial injustice and poverty. Many other families lived or still live the same way. After a while, the way we lived became common place and we adjusted. We had healthy outlets to relieve stress. Some families internalized and engaged in unhealthy behavior.
Marginalized groups of people seem invisible to society. Black people were historically taught to be “on- guard” because we never knew what to expect or when to expect it. There’s a different type of stress that comes with being on-guard, judged and misunderstood. The stress response fires daily. People learn how to internalize daily humiliation and it is manifested in other ways.
As long as I can remember black people have been fighting for justice, equality and human rights. Black people were traumatized through legalized segregation. I lived through segregation and witnessed the trauma first hand. Racist Jim Crow laws ignored black citizens and scorned us as human beings. It is painful to know that people were discriminated against based on skin color. I grew up in a land that told people who look like me where to live, where to go, and what we could or could not do. People who did not look like me could do as they pleased. Civil rights workers walked in enemy fire in their own land while fighting for justice and equality. Civil right laws were passed as the result of the Civil Rights Movement; however, these words written on paper did not change the reality of discrimination. The humiliated and disrupted lives of black people did not end with laws on the books. Covert racism replaced overt racism.
We still live in a society of racial and socioeconomic oppression. Stress may be managed, internalized, or some people may act out because of frustration. The effects of poverty can lead to a higher level of stress, anxiety and mental illness. Poverty can have a huge impact on a person’s psychological and physical development. There is a direct correlation between racism and poverty, poverty and crime, crime and violence. It is a vicious cycle.
Human behavior is determined by the environment. When I was a child living in poverty, we all had dreams and aspirations. We knew we would wear our skin color all our life; however, no one aspired to be poor all their life. Our skin color shouldn’t matter. Many children did not have parents who knew how to encourage or comfort them. They didn’t know how to answer their questions about racism and poverty. Their parents lived a stressful life and were trying to survive the best way they knew how. Sometimes, this survival involved unhealthy or criminal behaviors. Some of their children stopped walking down the long road out of poverty and they began engaging in the same behaviors and activities. Crime may occur when a person feels that all other opportunities are not in their reach. We lived daily in a world of racism, inequality and poverty. When you live in this environment, the view is different. You can easily feel trapped and helpless. When we ventured outside our environment, we got slapped back into it. Some people chose crime as a way to escape. Sadly, it provided a temporary relief from the pain. Many people engage in unhealthy behaviors and activities in an effort to cope with stress.
During my professional career, I was a certified psychiatric nurse and taught stress management classes. My diverse group of clients had various diagnoses, were from various socioeconomic backgrounds, races, ages and gender. As a psychiatric nurse, I knew that any form of post- traumatic stress disorder can have long term cognitive effects and my client’s memory and problem-solving skills may be altered. The goal of the class was to learn to manage stress and lead healthier lives. We discussed stress management strategies like keeping a positive attitude, being assertive instead of aggressive, relaxation techniques (meditation, yoga, tai-chi ), exercise, healthy and well balanced meals, time management, setting limits, having hobbies, proper rest and sleep, professional treatment with mental health providers, etc. These stress management strategies were researched and proven to be effective. I learned that people living in poverty and with racism also had difficulty concentrating. At the time, I did not associate racism and poverty as post- traumatic stress events. Studies support that if racism and poverty were removed, a person’s mental health and stress levels would improve.
According to an interesting article by Kristen Rogers with CNN Health, there was a study about how racism may harm black people’s cognitive health. According to Lynn Rosenberg, the senior author of the study and epidemiologist at the Slone Epidemiology Center at Boston University and professor of epidemiology at the Boston University School of Public Health, racism related stress is a form of chronic and prolonged stress. The author wrote, “The effects of discriminatory experiences are stored in the hippocampus (the brain’s storage unit for long-term memories). Because the hippocampus regulates emotion and stress, it has a high concentration of receptors that detect stress and communicate to the rest of our body. Racism related stress can lead to conditions such as diabetes.”
As a society and medical community, we must also address social determinants of health and health disparities. Health Care Providers need to understand how poverty affects a person’s health. They should always screen for poverty and try to discover the root cause of stress. Racism and poverty may be the underlying cause of a patient’s illness. Not meeting basic physical and psychological needs may affect a person’s health. People need to feel included and valued. This is not treated with medication.
Health Care Providers also need to know what to do with the information they gather. When I worked as a case manager, we had a robust list of helpful resources and advocated for better funding for the social safety net programs. We know that poverty has long term effects. The Adverse Childhood Experiences (ACE) Study unearths a disheartening connection between the number of adverse childhood experiences and various health problems in adulthood.
There are some agencies that are involved with the community to combat poverty. We must become change agents and continue to work to eradicate systemic racism, and help people overcome their unconscious biases. We are our brothers and sisters keepers. We must take an honest look at ourselves and take action to help our fellow men and women. The heavy load of stress is too much for a person to carry. We can all help lighten the load.
If you or anyone you know are thinking about suicide, please contact the National Suicide Prevention Line at 1-800-273-8255. Mental health experts will help lighten the load.
I’ve listed some resources for educational purposes only. They are not endorsed by the writer.
Some Resources
National Suicide Prevention 1-800-273-8255
National Alliance on Mental Illness (NAMI) Helpline: 1-800-950-NAMI (6264)
Veterans Crisis Line- 1-800-273-8255 and press (1). Support for hearing impaired- 1-800-799-4889.
National Call Center for Homeless Veterans-1-877-424-3838
Women Veterans Program Manager-1-855-829-6636
Administration for Children and Families- See website for regional office contacts.
Children’s Hunger Alliance-(614) -341-7700
Local Community Service Agencies -Contact website or Medicaid offices for additional information.
Mazon- (800)-813-0557
Oxfam America-(800) 776-9326
Stand Together Foundation (Catalyst Network)-See website for information. The Hunger Project-(212) 251-9100
References
“Adverse Childhood Experiences Study. “Wikipedia. Accessed July 27, 2020.
McLeod, S. A. (2010). What is the stress response. Simply Psychology. https://www.simplypsychology.org/stress-biology.html
Rogers, Kristen. CNN. Racial discrimination may harm Black people’s cognitive health, study finds. Website. Updated 12:03 a.m. ET July 21, 2020. Accessed July 27, 2020.
Stand Together Foundation. How to Heal From the Effects of Poverty. April 18, 2017. Website. Accessed July 27, 2020.
“Stress.” Wikipedia. Accessed July 27, 2020.