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Table 3 Toxic stressors as a determinant of Decline in Self-Rated Health (QOL) over 8 years in the Overall Sample and Within Race/Ethnicity Stratum

From: Change in quality of life over eight years in a nationally representative sample of US adults with heart disease and type 2 diabetes:minority race and toxic stress as keysocial determinants

 

2008

2010

2012

2014

Stress

Time*Stress

Race*Time*Stress

Toxic Stress Domain

Odds Ratio (95% CI)

Odds Ratio (95% CI)

Odds Ratio (95% CI)

Odds Ratio (95% CI)

P-value

P-value

P-value

Recent Stressors

Entire Sample Regardless of Race

 0 vs 2+ Recent stressors

1.04 (0.68, 1.60)

1.08 (0.67, 1.74)

0.74 (0.44, 1.26)

0.68 (0.37, 1.23)

0.7799

0.359

0.0809

 1 vs 2+ Recent stressors

1.14 (0.70, 1.88)

0.99 (0.57, 1.73)

0.66 (0.37, 1.18)

0.73 (0.37, 1.42)

Among Older White Americans

 0 vs 2+ Recent stressors

0.76 (0.53, 1.09)

0.94 (0.65, 1.35)

1.03 (0.70, 1.53)

0.95 (0.63, 1.43)

0.5461

0.1286

n/a

 1 vs 2+ Recent stressors

0.97 (0.66, 1.43)

0.99 (0.66, 1.49)

1.01 (0.65, 1.56)

1.07 (0.67, 1.69)

Among Older African Americans

 0 vs 2+ Recent stressors

1.11 (0.51, 2.42)

0.87 (0.36, 2.08)

0.38 (0.15, 0.99)

0.42 (0.14, 1.23)

0.4727

0.033

n/a

 1 vs 2+ Recent stressors

0.77 (0.34, 1.79)

0.79 (0.31, 2.02)

0.40 (0.15, 1.10)

0.56 (0.18, 1.77)

Among Older Other race

 0 vs 2+ Recent stressors

1.34 (0.51, 3.51)

1.55 (0.52, 4.57)

1.02 (0.30, 3.49)

0.81 (0.21, 3.16)

0.6733

0.5895

n/a

 1 vs 2+ Recent stressors

2.00 (062, 6.43)

1.26 (0.34, 4.65)

0.70 (0.18, 2.82)

0.64 (0.13, 3.11)

Life-course stressors

Entire Sample Regardless of Race

 0 vs 3+ life-course stressors

0.81 (0.59, 1.12)

0.79 (0.55 1.12)

0.77 (0.53, 1.12)

0.62 (0.42, 0.92)

0.1863

0.1227

0.1173

 1 vs 3+ life-course stressors

0.67 (0.49, 0.92)

0.97 (0.69, 1.35)

0.94 (0.67, 1.32)

0.69 (0.48, 0.99)

 2 vs 3+ life-course stressors

0.87 (0.62, 1.22)

0.95 (0.67, 1.36)

0.84 (0.57, 1.19)

0.63 (0.42, 0.95)

Among Older White Americans

 0 vs 3+ life-course stressors

0.76 (0.62, 0.92)

0.78 (0.64, 0.97)

0.73 (0.58, 0.91)

0.86 (0.68, 1.10)

0.0063

0.6654

n/a

 1 vs 3+ life-course stressors

0.72 (0.61, 0.87)

0.79 (0.66, 0.96)

0.71 (0.58, 0.87)

0.85 (0.68, 1.09)

 2 vs 3+ life-course stressors

0.80 (0.66, 0.96)

0.92 (0.76, 1.12)

0.86 (0.69, 1.07)

0.98 (0.78, 1.24)

Among Older African Americans

 0 vs 3+ life-course stressors

0.88 (0.56, 1.42)

0.69 (0.43, 1.12)

0.48 (0.29, 0.79)

0.47 (0.27, 0.83)

0.0828

0.3159

n/a

 1 vs 3+ life-course stressors

0.75 (0.46, 1.20)

0.72 (0.45, 1.15)

0.73 (0.44, 1.20)

0.59 (0.33, 1.04)

 2 vs 3+ life-course stressors

0.72 (0.45, 1.14)

0.83 (0.51, 1.36)

0.80 (0.47, 1.35)

0.72 (0.41, 1.26)

Among Older Other race

 0 vs 3+ life-course stressors

0.80 (0.35, 1.83)

0.90 (0.35, 2.27)

1.24 (0.46, 3.33)

0.59 (0.22, 1.61)

0.9943

0.0204

n/a

 1 vs 3+ life-course stressors

0.55 (0.25, 1.23)

1.58 (0.67, 3.75)

1.58 (0.66, 3.75)

0.66 (0.27, 1.65)

 2 vs 3+ life-course stressors

1.15 (0.48, 2.77)

1.12 (0.44, 2.86)

0.83 (0.33, 2.04)

0.36 (0.12, 1.04)

Cumulative stressors

Entire Sample Regardless of Race

 0 vs 3+ Cumulative stressors

0.83 (0.60, 1.15)

0.76 (0.54, 1.08)

0.75 (0.51, 1.11)

0.68 (0.45, 1.01)

0.361

0.1035

0.0282

 1 vs 3+ Cumulative stressors

0.77 (0.56, 1.07)

1.24 (0.89, 1.74)

1.06 (0.74, 1.51)

0.86 (0.59, 1.24)

 2 vs 3+ Cumulative stressors

0.95 (0.69, 1.32)

1.03 (0.73, 1.46)

0.85 (0.61, 1.19)

0.83 (0.56, 1.23)

Among Older White Americans

 0 vs 3+ Cumulative stressors

0.73 (0.60, 0.89)

0.79 (0.64, 0.98)

0.78 (0.62, 0.98)

0.82 (0.65, 1.05)

0.0091

0.8348

n/a

 1 vs 3+ Cumulative stressors

0.74 (0.62, 0.88)

0.79 (0.66, 0.96)

0.76 (0.62, 0.92)

0.89 (0.71, 1.11)

 2 vs 3+ Cumulative stressors

0.83 (0.70, 0.99)

0.94 (0.78, 1.14)

0.92 (0.74, 1.13)

0.98 (0.79, 1.23)

Among Older African Americans

 0 vs 3+ Cumulative stressors

1.04 (0.65, 1.66)

0.69 (0.43, 1.11)

0.44 (0.27, 0.74)

0.45 (0.26, 0.79)

0.0934

0.1424

n/a

 1 vs 3+ Cumulative

0.84 (0.53, 1.33)

0.83 (0.53, 1.31)

0.71 (0.43, 1.16)

0.56 (0.32, 0.97)

 stressors

       

 2 vs 3+ Cumulative stressors

1.04 (0.66, 1.63)

0.91 (0.56, 1.48)

0.76 (0.46, 1.26)

0.82 (0.46, 1.44)

Among Older Other race

 0 vs 3+ Cumulative stressors

0.76 (0.33, 1.75)

0.82 (0.33, 2.02)

1.34 (0.54, 3.29)

0.83 (0.29, 2.33)

0.452

0.0973

n/a

 1 vs 3+ Cumulative stressors

0.75 (0.33, 1.72)

2.93 (1.22, 7.08)

2.23 (0.90, 5.55)

1.27 (0.51, 3.20)

 2 vs 3+ Cumulative stressors

1.00 (0.43, 2.33)

1.28 (0.52, 3.17)

0.89 (0.38, 2.08)

0.72 (0.26, 1.98)

  1. Notes: CI confidence interval. Odds Ratios in bold are statistically significant. Models adjusted for race, age, sex, education, marital status, BMI, cigarette use, alcohol consumption and interaction terms for race*time, stress*time as well as three -way terms for race*stress*time