Tag Archives: stress

Social capital can alleviate youthful stressors that predict poor adult health

Flickr/meganskelly

Just finished a very interesting New Yorker article entitled “The Poverty Clinic” by Paul Tough that focuses on Nadine Burke who runs a San Francisco-based low-income health clinic and her conviction, supported by various studies, that youth trauma scars young people’s health for life.

They cite the ACE (Adverse Childhood Experiences) study of 1998 that showed that adults’ retrospective childhood ACE memories were a strong predictor of all kinds of negative adult health outcomes and this exhibited a dose-response linearity — i.e., exposure to more categories of childhood adversity meant both greater likelihood of negative adolescent outcomes (depression, suicide, binge drinking, etc.) and greater likelihood of poor adult health outcomes.

These ACEs measure youth stress in four areas: 1) physical; 2) sexual; 3) psychological; 4) substance abuse; 5) mental illness; and 6) criminal activity.  Actual list of items appended to this post.

While it is possible that these retrospective memories are flawed (i.e., sick adults are more likely to recall childhood stresses), a basically prospective New Zealand Dunedin study is finding the same thing for early trauma.  And Bruce McEwen (Rockefeller Univ.) and Frances Champagne (Columbia Univ.) have shown that “repeated, full-scale activation of this stress system, especially in early childhood…actually alerts the chemistry of DNA in the brain, through a process called methylation….This process disables these genes [methyl groups], preventing the brain from properly regulating its response to stress.”  Even a decade or more after the stress, these teenagers find it harder to sit still, exhibit higher rates of aggression, show weaker brain function, and can’t as adequately distinguish between real and imaginary threats.

While some doctors are looking at whether drugs (psychopharmacology) could have an impact, social capital can often overcome these stressors.

“Other researchers have produced evidence that they can mend children’s overtaxed stress-response systems by changing the behavior of their parents or caregivers.  A study in Oregon drew this conclusion after assessing a program that encouraged foster parents to be more responsive to the emotional cues of the children in their care.  Another study, in Delaware, tracked a program that promoted secure emotional attachment between children and their foster parents.  In each study, researchers measured, at various points in the day, the children’s level of cortisol, the main stress hormone, and then compared these cortisol patterns with those of a control group of foster kids whose parents weren’t in the program.  In both studies, the children whose foster parents received the intervention subsequently showed cortisol patterns that echoed those of children brought up in stable homes.

“In terms of helping older children and adolescents who have experienced early trauma, the research is less solid.  There is evidence that certain psychological regimens, especially cognitive-behavioral therapy, can reduce anxiety and depression in patients who are suffering from the stress of early trauma.  But, beyond that, little is known…”

Kaiser Permanente started asking about these stressors on intake questionnaires, since the were markers of health problems in the same way as say high cholesterol was.  The article points out that eliminating the negative effects of four ACEs would lower the risk of heart attacks as much as lowering cholesterol below the warning threshold.

With regard to work we are currently doing on a growing social class gap among adolescent youth, it is possible that methylation and ACEs might help explain lingering and persistent growing social class gaps that we see among high schoolers over the last several decades.

Read “The Poverty Clinic” (New Yorker, March 21, 2011)

See earlier post “Doctors Prescribing Social Capital

See early article on Childhood stressors and adult health: Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, et al JS. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine. 1998;14:245-258.

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Specifically ACE questionnaire asks whether:  parent or other adult in household (HH) often or very often swore at you, insulted you or put you down; often or very often acted in way that made you afraid that you would be physically hurt;  often or very often pushed, grabbed, shoved, or slapped you; often or very often hit you so hard that you had marks or were injured; person five+ years older than you ever touched or fondled you in a sexual way; had you touch their body in a sexual way; attempted oral, anal, or vaginal intercourse with you; actually had oral, anal, or vaginal intercourse with you; whether you lived with anyone who was a problem drinker or alcoholic; lived with anyone who used street drugs; whether anyone in HH was depressed or mentally ill; whether HH member attempted suicide; whether your mother was treated violently ; whether your mother or stepmother was sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her; whether mother/stepmother was sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard; whether mother/stepmother was ever repeatedly hit over at least a few minutes; whether mother/stepmother was ever threatened with, or hurt by, a knife or gun; whether HH member ever went to prison.

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Import of best friends and socializing at work

Flickr photo by gwilmore

Bob Putnam and I were recently meeting with Jim Clifton, CEO of Gallup.

Jim related an interesting “social capital” finding of Gallup.  That employees having a ‘best’ friend at work is vitally important to the success of a company.   Gallup faced considerable opposition to this question from CEOs who didn’t want Gallup asking this of their employees and who said they wanted their employees focused on doing their job, not developing a best friend at work.  Gallup tried reformulating the question to ask about ‘close friends’ at work, but found that this question was not nearly as predictive of a whole host of beneficial outcomes.

Those who had best friends at work (only 30% of Americans) were 7 times more likely to be engaged with their job, they exhibited higher sales and profitability, better engaged customers,  produced higher quality work, had greater commitment to the firm’s mission,  had better safety records (since friends often made sure they were complying with safety precautions), were happier at work, and had a higher chance of sticking with a firm.  If workers didn’t have a best friend, only 8% of them were engaged in their job.

Gallup also observed that employees who report having a best friend at work were:

  • 43% more likely to report having received praise or recognition for their work in the last seven days.
  • 37% more likely to report that someone at work encourages their development.
  • 35% more likely to report coworker commitment to quality.
  • 28% more likely to report that in the last six months, someone at work has talked to them about their progress.
  • 27% more likely to report that the mission of their company makes them feel their job is important.
  • 27% more likely to report that their opinions seem to count at work.
  • 21% more likely to report that at work, they have the opportunity to do what they do best every day.

Gallup also found other social capital measures to be key to successful business organizations: having someone at work who cares about you, and having a mentor.

This finding gibes with workplace social-capital work that we have done and work of John Helliwell and Haifang Huang on the importance of trust of management in ensuring wellbeing of those at the workplace.

Two MIT researchers (Sandy Pentland and Benjamin Waber) also found using sociometers that even apparently idle workplace socializing increases productivity.  [Here’s a link to earlier work of Sandy Pentland.]

Gallup also noted that they do 1000 US surveys a day and one question they ask is for people to give their weight, and they can actually see American obesity inching up day by day.

In two other social capital results, not focused on the workplace:

1) Gallup has also found that people need 6 hours of social time a day (on the phone, at work, at home, talking to friends, on e-mail) in order to “thrive”.  with no social time in a day, one has an equal chance of having a good or bad day, but with 3 hours of social time, the chance of a bad day drops to 10%.

2) Through Gallup we also learned of an experiment by researchers at Ohio State University  on the connection between stress and physical health.   42 married couples were given 8 tiny identical blisters; the skin was removed and a suction devices put on top that monitored the rate of healing. Researchers found that in marital relationships with hostility, wounds took almost twice as long to heal.  The magnitude was shocking; such hostility and lack of relational closeness could rival or exceed traditional physical factors.

For more background on some of this, see Gallup Management Journal piece or  Tom Rath, Vital Friends: The People You Can’t Live Without or Wellbeing (with James Harter)

For the Ohio State University study, see Kiecolt-Glaser, Janice K., Timothy J. Loving, Jeffrey R. Stowell, William B. Malarkey, Stanley Lemeshow, Stephanie L. Dickinson, Ronald Glaser, “Hostile Marital Interactions, Proinflammatory Cytokine Production, and Wound Healing,” Archives of General Psychiatry. 2005;62:1377-1384.

Health benefits of volunteering

The NY Times had an interesting piece yesterday on the health benefits of volunteering.

They cite Stephen Post’s work, which I have discussed earlier, but also notes a 2002 Boston College study (Paul Arnstein et al.) and a California Buck Institute for Age Research study (Doug Oman et al.).

The article discusses several studies that suggest that the causal pathway may run through lower stress and a “helper’s high”.

See the underlying article:  “In Month of Giving, a Healthy Reward” (NYT, Science Times, Tara Parker-Pope, 12/1/09)

Being lonely raises blood pressure? (UPDATED 5/2013)

Julie Silver, a doctor at Harvard Medical School, discussed a study in the current issue of Psychology and Aging, that suggests loneliness might be a strong risk factor for blood hypertension.

 The study conducted by Chicago-based researchers surveyed 229 men and women ages 50 to 68 about standard risk factors for hypertension and about their degree of social isolation. “Blood pressure was measured and correlated with the subjects’ answers about social interactions. The results were remarkable: the highest blood pressures were measured in the people who were most lonely. And loneliness was common: just over half were considered at least moderately lonely and 15% were ‘highly lonely.’ The link between social isolation and high blood pressure remained strong even when standard risk factors for hypertension were taken into account. ”

As Silver admits, strong correlation cannot show that loneliness causes high blood pressure.  It could be some third factor related to loneliness and blood pressure that is the critical link.  For example, “lonely people might exercise less and eat a higher salt diet and that’s what raises blood pressure, not the social isolation.”

 Nevertheless, Silver points out the growing list of negative health outcomes associated with loneliness: oneliness abnormal blood vessel response to stress; higher risk of cardiovascular disease; and an increased risk of death.

For the full article by Silver, and ideas of hers about how to become less lonely read here.

See article “The Science of Loneliness” (New Republic, Judith Shulevitz, May 2013)