The stress pathway
: a biosocial investigation of neighbourhood deprivation and health relationships

Student thesis: Doctoral ThesisDoctor of Philosophy (PhD)


This thesis explores the stress pathway between places and health, investigating a biosocial process by which deprivation can later manifest in the health outcomes of individuals and contribute to health inequalities. This thesis brings together conceptual and methodological innovations in health geography, lifecourse epidemiology and the emerging biosocial paradigm to address two vital gaps in current understandings of health and place relations. The first is the need for longitudinal research which advances knowledge on how health changes over the lifecourse and its long-term relationships with personal and neighbourhood circumstances. The second gap relates to research which attends to the mechanisms for the biological embodiment of context and exposure histories. The British Household Panel Survey and Understanding Society are used to quantitatively investigate through multilevel modelling the shape of trajectories in mental and general health over time and how these relate to neighbourhood and individual-level deprivation exposure. Additionally, this thesis integrates biodata from Understanding Society to explicitly test the stress pathway by investigating: whether relationships of neighbourhood deprivation with physical and mental health are mediated by allostatic load – as a marker of cumulative biological weathering in response to chronic stress; and how different exposure histories of deprivation and social capital are related to later allostatic load. Overall, this thesis offers support for the stress pathway, with neighbourhood deprivation exposure consistently associated with inequalities in allostatic load, different health dimensions and health through allostatic load. However, the story is also one of heterogeneity: in the development of mental and general health over time and in the varying strength of health relationships with deprivation when considered proximally or distally, both in scale and temporally.
Date of Award1 Oct 2019
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorDavid J Manley (Supervisor) & Richard J Harris (Supervisor)

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