Stressful events throughout the life cycle and social inequalities in a cohort study

Abstract

Stressful events are avoidable and potentially traumatic situations that cause damage to physical and mental health. Research on this topic is generally carried out in contexts without significant social inequalities. We described the prevalence and inequality measures for exposure to different stressful events according to sex, skin color, family income, and schooling using data from five follow-ups of the 1993 Pelotas (Brazil) birth cohort. We evaluated stressful events until adolescence (< 18 years, n = 2,755), in adulthood (18-30 years, n = 1,752), and in both periods (n = 1,400). The characteristics of the analytical samples were approximated to baseline using inverse probability weighting. Simple and complex measures were used to measure inequalities (difference, ratio, SII, and CIX). Until adolescence, the most prevalent stressful events were parental separation (67.5% of men) and the death of a relative (66.1% of women). The death of a relative was the most prevalent stressful event for both sexes in adulthood (men: 65.8%; women: 63.2%) and in both periods (men: 44.1%; women: 44.2%). Regardless of the period of life, black, less educated, and poorer individuals were the most exposed to the majority of stressful events. Emotional neglect, incarceration, parental separation, and discrimination were among the most unequal exposures, with blacks, those with less schooling, and the poorest being most affected, women being more exposed to emotional neglect and discrimination, and men to the other exposures. Physical and mental health care programs should be developed to prevent such exposures and minimize their damage to health, especially in the most vulnerable groups.