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Stress: Notes & Sources

Definitions

Confidence interval (also called "error bar") is the range of values that includes the true value 95% of the time. If the confidence intervals of two groups do not overlap, the difference between groups is statistically significant (meaning that chance or random variation is unlikely to explain the difference).   

King County regions: The geographic boundaries of the four King County sub-regions (North, Seattle, East, and South) are defined by the aggregation of ZIP codes.

Race/Ethnicity: Federal standards mandate that race and ethnicity (Hispanic origin) are distinct concepts requiring 2 separate questions when collecting data from an individual. "Hispanic origin" is meant to capture the heritage, nationality group, lineage, or country of birth of an individual (or his/her parents) before arriving in the United States. Persons of Hispanic ethnicity can be of any race. Communities Count's terms for racial/ethnic groups are derived from those used by the U.S Census Bureau in 2010.

  • Communities Count terms:  Hispanic, Non-Hispanic, White Non-Hispanic, Black, American Indian/Alaska Native (AIAN), Asian, Native Hawaiian/Pacific Islander (NHPI), White, and Multiple Race (Multiple). Persons of Hispanic ethnicity can be of any race and are included in other racial categories. Racial/ethnic groups are sometimes combined when sample sizes are too small for valid statistical comparisons of more discrete groups. 
  • 2010 Census terms: Hispanic or Latino, Not Hispanic or Latino, White alone (Not Hispanic or Latino),  Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, White, Some Other Race, and Two or More Races.

Notes

Specific Stresses by Region:

The questions that make up the stress scale are shown in the table below. For each question, the responses of East Region respondents showed significantly lower stress than the responses of at least one other group.

Percent of Adults Who Report Stress Items ‘All’ or ‘Most of the Time’, King County, 2011

In the past 30 days, how often have you felt:

East

North

Seattle

South

King

 

Region

Region

 

Region

County

…confident about your ability to handle your personal problems?

79%

77%

75%

72%

75%

…that things were going your way?

62%

56%

55%

53%

56%

…that difficulties were piling up so high that you could not overcome them?

3%

6%

7%

8%

6%

…that you were unable to control the important things in your life?

7%

11%

11%

11%

10%

Statistical significance: Unless otherwise noted, any difference mentioned in the text is statistically significant (unlikely to have occurred by chance).

Stress over time: Comparing responses to the 2007 and 2011 Communities Count surveys, stress appeared to be significantly higher in 2011 – in all King County regions except South Region, and in King County as a whole.  However, the apparent increase was due to a change in the way the 2011 survey was conducted (expansion from landline-only sampling to a combination of landline phone sampling plus address-based sampling, with a new internet response option). When we compared stress scores of respondents using the same method (landline only), stress scores in 2011 did not differ significantly from those in 2007. While we feel confident that the new method produced a more representative sample of King County’s population, we cannot report a valid trend analysis.Data Sources

Communities Count Survey (2011):  Respondents came from a random sample of all King County households.  Due to the limitations of surveys that rely exclusively on landline telephones, Communities Count used a mixed-mode survey involving both random-digit-dial phone contact and address-based sampling for mailed questionnaires, with an internet response option as well. Phone interviews were conducted in English, Spanish, and, upon request, a few additional languages. Numbers of children age birth to 5 by region were calculated from Census 2010 SF1 data, Table QT-P2.

Possible limitations of this kind of survey include: (a) people who do not have a telephone or a permanent address are missed; (b) people who do not speak English or Spanish may not participate; (c) people who have less education and lower incomes tend to be under-represented.

Stress Scale: These questions come from the shortened (telephone) version of the Perceived Stress Scale, (Cohen S, Kamarok T, Mermelstein R, “A Global Measure of Perceived Stress”, Journal of Health and Social Behavior 1983 vol. 24: 385-396).  The numbers for the responses are added to give a composite score.  Negative items are reverse coded so that higher-stress responses have higher scores.                                                                 

The next few questions ask you to indicate how often you felt or thought a certain way.

In THE PAST 30 DAYS, how often have you felt…

All of The time

Most of  The time

Some of The time

A little of the time

None of The time

…that you were UNABLE to control the important things in your life?

5

4

3

2

1

…difficulties were piling up so high that you could not overcome them?

5

4

3

2

1

…confident about your ability to handle your personal problems?

1

2

3

4

5

…that things were going your way?

1

2

3

4

5

Other Sources

Aging and decreasing stress:  Catharine Paddock, PhD. (2009, August 10). "Older Means Happier? For Most People It Would Seem So, Say Researchers." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/160268.php, accessed on 02/07/2013.

Childhood stress and adult behavior and health:  Web page on Adverse Childhood Experiences (ACE) Study by the Centers for Disease Control and Prevention links to publications relating ACE to several health outcomes, including unintended pregnancy, alcohol abuse, drug abuse, obesity, smoking, and suicide. http://www.cdc.gov/ace/outcomes.htm & http://www.cdc.gov/ace/outcomes.htm#Pregnancy, accessed on 01/31/2013.

City Health Profiles provide demographic and health information for 25 geographic areas in King County – mostly large cities (e.g., Seattle, Bellevue), groups of small cities (Bothell/Woodinville), or combinations of cities with nearby unincorporated areas (e.g., Renton/Fairwood). Each report has seven sections:

  • Demographics
  • General health status
  • Leading causes of death
  • Health risk factors and chronic diseases
  • Injury and violence-related mortality
  • Maternal and infant health
  • Access to care and preventive services

Maps of King County covering a wide range of topics can be accessed at http://www.kingcounty.gov/operations/GIS/Maps.aspx#PH.  Maps most immediately relevant to Communities Count are under the headings of Community data & demographics, Public health, and Environment & natural resources, but other maps should be useful as well (farmers markets, transit routes, walking and biking routes, parks, traffic counts, etc.).

Stress and brain development: