The Economy’s Effect on Coping Assets

The stress literature posits, without great controversy, that coping assets mediate an individual’s response to stressors. These assets can be genetic or acquired through interactions with the environment. The latter can be further separated into those that are unintentionally acquired (e.g., immunities induced by naturally occurring exposures to infectious pathogens) and those sought out (e.g., vaccines).

Intentionally acquired coping assets include those purchased with money and those acquired through social arrangements analogous to mutual aid societies or insurance pools. While some have speculated regarding the effect of economic forces on unintentionally acquired, and even genetically endowed, coping assets, the empirical work focuses on those purchased with money or obtained through social arrangements.

Coping assets purchased with money include goods and services explicitly marketed as means to bolster one’s capacity to deal with new or chronic stressors. These assets include professional medical care, leisure activities, organized exercise activity, and dietary supplements. Other goods and services can also help persons cope with stressors.

Advertisers may not often cast nutritious food, decent housing, and entertainment, for example, as stress buffers, but much of the value of these products in the market may well arise from this function. The performance of the economy obviously affects our ability to acquire these resources because it affects how much money we have to spend. Money, in effect, is a generalized coping asset.

The performance of an economy also affects the availability of coping assets acquired outside the market. The literature pays much attention to social support and social capital as mediators of the stress response. These terms refer to all sorts of tangible and intangible resources obtained by stressed persons from their families, social networks, and public and private institutions.

The insurance pool metaphor conveys the effect of the economy on social support and capital. Social networks can be thought of as informal insurance pools to which participants not coping with stressors contribute surplus coping assets, and from which participants coping with stressors draw assets. As with all insurance pools, the arrangement works only if demands do not exceed the pooled resources.

Participants in such pools often underestimate how many resources a pool needs because we intuitively make the actuarial assumption that the incidence of stressors remains relatively constant although those who suffer them may vary. If, however, an ambient shock stresses many persons in the pool, the demand for resources can be unexpectedly high and deplete the pool.

A contracting economy acts as an ambient stressor that causes an unexpectedly large number of individuals and their families to suffer stressful losses and to resort to social networks for coping resources. Other members of the network who fear such a loss withdraw contributions to the pool, believing they themselves will need them. The incidence of stress- related illness therefore rises because social support cannot be gotten from an actuarially insufficient pool.

Persons dealing with chronic stressors or stressful events unrelated to the economy also exhibit elevated incidence of illness because they cannot retrieve their usual support from a depleted pool. The effect of a contracting economy on the incidence of illness in populations embedded in contracting economies thereby grows beyond that expected from studies of individuals who, for example, are forced out of work.

Recent years have seen an increasing interest in the role of economic inequality on the coping process. Social reformers have traditionally drawn an analogy between income disparity and ambient pathogens such as air pollution. This disparity presumably emits a morally numbing pathogen that makes us not only less helpful to the needy, but also less willing to contribute to social support pools that include socioeconomic peers.

Contemporary reformers claim a causal chain in which widening income disparity erodes social cohesion. The loss of social cohesion makes it more difficult for everyone, not just the poor, to cope with biological and behavioral hazards. Failure to cope then manifests in illness and death itself.

The reformers’ argument, although intended primarily to influence the policy debate over the distribution of wealth, has implications for the epidemiology of stress-related illness. If income disparity weakens social cohesion, it will likely reduce the effectiveness of social support networks. Less effective social support increases the likelihood that economic and other stressors will yield illness.