Community Determinants of Stress

Earlier this month, we wrote a blog highlighting four tips to reduce individual stress for yourself and your community members. Learning to manage stress is important, but understanding determinants of stress helps inspire long-term solutions. As National Stress Awareness Month comes to a close, we want to bring attention to a few determinants of stress for communities that may be helpful for those working in public health, city planning, grant writing, and related fields. Using our Community Needs Assessment, we will exemplify how you can assess community determinants of stress in your service area. Specifically, we will examine data indicators related to:

Income and Economics,
Education,
Other Social and Economic Factors, and
Health Outcomes.

Let’s get started!

Income and Economics

Economic insecurity is a public health problem. Consistently, researchers find strong links between financial worry and psychological destress.¹ Unemployment and poverty are two key markers of the economic landscape in a community. Using data from the US Department of Labor, Labor Bureau Statistics available in the Community Needs Assessment you can easily view the unemployment rate of any U.S. County. Throughout the remainder of this blog, we will use Maricopa County, AZ as our example. Feel free to access our example Community Needs Assessment Report and follow along.

In the report, note that you can compare the unemployment rate of Maricopa County, AZ to the state of Arizona, and the country as a whole (Figure 1). With this information, you can gain a more realistic understanding of the percentage of your population impacted by unemployment and how much of a priority it should be to allocate resources to job creation.

*Figure 1: Unemployment rate of Maricopa County, AZ compared to state and national levels.*

Another resource for assessing economic security in your area is the Poverty Profile, created using US Census Bureau’s American Community Survey data. The Poverty Profile allows you to examine the percentage of households with incomes at various levels relative to the Federal Poverty Level. Using this indicator, you can easily see the percentage of households earning 50% or less to over 500% of the Federal Poverty Level (Figure 2).

Circle graph showing 5.6% of the households in Maricopa County, AZ are at 50% or less of the FPL; 6.4% of households are at 51-100% of the FPL; 7.8% of households are at 101-150% of the FPL; 8.8% of households are at 151-200% of the FPL; 42.1% of households are at 201-500% of the FPL; and 29.3% of households are at over 500% of the FPL. — *Figure 2: Poverty profile for Maricopa County, AZ depicting percentage of population at various rates of the Federal Poverty Level.*

Armed with this knowledge, you can better target counties within your community that have higher levels of unemployment, poverty, and economic insecurity. When these problems are addressed, individuals have more capacity to access stress-reducing necessities like insurance, health services, and healthy food.

Education

Another indicator that may provide insight into community stress is educational attainment. Education is one of the strongest influences on individual health and success.²Those with at least a high school diploma tend to have higher income, lower death rates, and decreased levels of risky health behavior. Using the American Community Survey’s education data, you can easily check the educational attainment of citizens 25+ in your service area and compare it against state- and US-level benchmarks (Figure 3). In the Community Needs Assessment, you can also view these data by gender, age, ethnicity, and race.

Population aged 25+ with and without a high school diploma for Maricopa County, AZ compared to the state and nation. Maricopa County fares better than the state percentage, but just worse than the national percentage. The county percentage of adults 25+ without a high school diploma is 11.16%, Arizona state percentage is 11.70%, and United States percentage is 11.13%. — *Figure 3: Population aged 25+ with and without a high school diploma for Maricopa County, AZ compared to state and national levels.*

Other Social and Economic Factors

In addition to low-income levels and educational status, lack of health insurance is highly correlated with poor individual health, including mental health. When individuals can easily and affordably access primary care, specialty care, and other health services, they are more likely to address health problems and experience less physical distress. Using American Community Survey data, you can quickly understand the uninsured population in your community with breakouts for gender (Figure 4), age group, ethnicity, and race for your county and compare these data to state and national averages.

Uninsured population by gender for Maricopa County, AZ compared to the state and nation. By comparison, more men and women are uninsured in Maricopa County, AZ, than the state or nation. — *Figure 4: Uninsured population by gender for Maricopa County, AZ compared to state and national levels.*

An additional social and economic factor to consider when improving community stress is food security. When individuals are food secure, they can focus on larger issues in their life than meeting basic needs. With our small-area estimates of the US Census Bureau’s Income and Poverty Estimate data you can track the percentage of your population receiving SNAP benefits over 10 years (Figure 5). This is a great way to track the long-term needs of your community and better understand if resources are being allocated in the most beneficial places.

Percentage of population receiving SNAP over the last 10 years. In 2020, the most recent year, Maricopa County had 10.7% of their population receiving SNAP. This was lower than state (12.5%) and national (12.6%) percentages. — *Figure 5: Percentage of population receiving SNAP over the last 10 years.*

Health Outcomes

Finally, you can gauge community-level stress using citizens’ self-health assessments. By understanding the prevalence of chronic health conditions, as well as morbidity and mortality rates, you can gain a more comprehensive understanding of what you can do to improve the health of those in your community. Using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS) data, you can see the percentage of adults 18+ who reported “fair” or “poor” health in the BRFSS survey. Additionally, you can access maps providing poor or fair health prevalence percentages down to the ZCTA (Figure 6).

Map showing areas of poor or fair health prevalence among adults age 18+ by ZCTA in Phoenix, AZ. — *Figure 6: Poor or fair health prevalence among adults age 18+ by ZCTA in Phoenix, AZ.*

Conclusion

In this blog, we just scratched the surface of how you can use the SparkMap Community Needs Assessment to understand determinants of stress in your service areas. However, by targeting unemployment, poverty, educational attainment, insurance rates, food security, and/or poor health, you are on your way to improving the lives of your community members. Be sure to check out the Community Needs Assessment we walked through in this blog to see all the breakout data and summary information we were unable to cover. And don’t forget, for more granular reporting, you can always create a ZIP code-level Assessment Report with a Premium Subscription.

References

Ryu, S., & Fan, L. (2023). The relationship between financial worries and psychological distress among U.S. adults. Journal of Family and Economic Issues, 44, 16-33. https://doi.org/10.1007/s10834-022-09820-9
Freudenberg, N., Ruglis, J. (2007). Reframing school dropout as a public health issue. Preventing Chronic Disease: Public Health Research, Practice, and Policy. http://www.cdc.gov/pcd/issues/2007/oct/07_0063.htm