Epidemiology of Stress in the United Kingdom

Abstract

This report explores the context and current situation related to the prevalence, morbidity, and epidemiology of stress in the UK. The document contains a discussion of statistics on the scope of the issue, its influencers, and the rationale for initiating behavior change. The World Health Organization’s strategy for stress management is analyzed; its use of behavioral education approaches and the COM-B model is assessed. The technological, individual, environmental, social, and psychological factors are identified as the most influential for the occurrence of the targeted behavior change. Conclusively, the report presents a set of recommendations for public health care workers to promote stress management in the community of UK citizens. The recommendations are disseminating educational messages, training nursing staff, and promoting mindfulness and coping skills for stress management.

Introduction

The contemporary fast-developing and rapidly globalizing world are overloaded with stressful experiences that disrupt human well-being worldwide. People of different professions, socio-economic statuses, ages, and genders face numerous challenges in their lives that lead to continuous exposure to stress. This report aims to focus on the analysis of the stress management strategy introduced by the World Health Organization (WHO), which aims to educate people on coping with stress, develop coping skills, and minimize the negative effects of stress on health (WHO, 2020). The report is designed to emphasize the negative outcomes of exposure to stress and introduce effective health promotion strategies for stress management for British citizens, given their social, cultural, and historical contexts.

Current scholarly research identifies that excessive exposure to stress leads to both short- and long-term negative mental and physical health outcomes due to reduced immune system functioning (Marrero et al., 2021; O’Connor et al., 2020). Thus, it is essential to address the causes of stress and outline the theoretical basis and practical strategies for reducing stress and managing its impact on human health by implementing behavior change. Thus, the report presents a well-tailored discussion of the problem of stress in the UK, analyzes the WHO strategy for stress management, and provides recommendations for changing human behavior toward less stress and more effective management of its impact.

Current Context

The problem at the core of this report is stress and its negative impact on human health; the context for this problem’s consideration is the contemporary UK with its cultural and social particularities. According to Dadkhah (n. d.), stress “is a complex, dynamic process of interaction between a person and his or her life” (p. 26). In the UK, stress is a significant public health concern due to the high level of people’s exposure to stressful experiences in their private lives and workplace (O’Connor et al., 2019). The severity and prevalence of the problem necessitate effective management for negative outcomes mitigation.

Indeed, given the evidence on stress, occupational stress is one of the most burdensome issues in contemporary Britain (Ajayi et al., 2019; Collin et al., 2019). In particular, such demanding professions as construction engineering, health care, education, and others are characterized by the highest stress level that negatively impacts people’s job satisfaction and well-being (Haque et al., 2019; Imo, 2017). Thus, work-related stress prevails in the UK; “the total number of cases of work-related stress, depression or anxiety in 2020/21 was 822,000, a prevalence rate of 2,480 per 100,000 workers” (The Health and Safety Executive, 2021, p. 5). In such a manner, the morbidity of stress is far-reaching, with negative health implications for large populations. Moreover, the trend widely observed in the UK concerning stress intensification has been related to the challenges of the COVID-19 crisis. Indeed, it has elevated the level of disturbance in the citizens overall (Sharman et al., 2021). The exposure of people in the UK to such a wide range of stress factors necessitates implementing functional coping and prevention strategies.

The Rationale for Healthy Lifestyle Promotion

Social Influences

Within social indicators, stress is a particular part of life in the UK. Since the population in the country values socialization and public image, it is essential to maintain functional social ties commonly characterized by exposure to stress. As indicated by the National Health Service (2018), in the UK, people value their occupations and work some of the longest hours in the world, which exposes them to an elevated level of workplace stress. Moreover, social appreciation of unhealthy behaviors such as drinking and others complicates the problem of coping with stress since it induces an additional challenge for health (National Health Service, 2018). Thus, within the social context, the interactions and social activity of people in the UK expose them to increased stress.

Cultural Influences

From the point of view of cultural influences on health in general and stress exposure in particular, one might refer to the cultural particularities of the UK as a highly individualistic and demanding community. Indeed, according to Cendales and Gómez Ortiz (2019), people representing individualistic cultures are more likely to be burdened by job demands and suffer from more severe stress in their workplace and outside occupational settings. Since the UK is a highly individualistic society, the influence of such an important attribute of culture impacts health outcomes due to a high-stress level (Cendales & Gómez Ortiz, 2019). Thus, it is imperative to incorporate cultural considerations when developing an effective strategy for stress management.

Historical Influences

Another important aspect of exposure to stress is the influence of historical context. In particular, the relatively recent history of stress in general and in the context of the UK’s history diminishes the citizens’ perception of stress as a significant health-related issue. According to research, “it was not before the 1950s that stress was regularly adopted as a scientific term” (Hutmacher, 2021, para. 2). Therefore, since the concept of stress as a serious mental health issue that has a vivid and severe negative impact on human physical health is under-addressed in the public sphere, people’s attention to coping strategies might be diminished. Therefore, to ensure that the historical context of the discussed problem is accurately incorporated, the development of a strategy for changing human behavior concerning stress management. It should include practices and information dissemination to raise awareness about stress, its causes, and its adverse impact on human health.

Epidemiological Studies on Stress

The scope of stress prevalence in the UK is characterized by the omnipresence of the problem across different populations. As demonstrated in Figure 1, the statistical data collected in 2020 for the most common types of stress in the UK include a variety of sources of stress.

Most common types of stress in the United Kingdom
Figure 1. Most common types of stress in the United Kingdom; data for 2020 (Statista, 2022, par. 1).

Indeed, the survey conducted in the UK in 2020 revealed that the most common stress type experienced by British citizens was work stress. (Statista, 2022). Indeed, 79 percent of respondents stated that “they frequently felt this type of stress;” moreover, “60 percent of respondents frequently feel monetary stress, while 48 percent experienced family stress” (Statista, 2022, para. 2). Moreover, the data collected by The Health and Safety Executive (2021) indicates that stress is a decisive contributor to mental illness. In particular, as shown in Figure 2, the most prevalent stress factor leading to mental illness was job-related issues with 42% and interpersonal relationships with 26% of respondents (The Health and Safety Executive, 2021, p. 15). Thus, the epidemiology of stress and its negative impact on human health requires immediate action from public health care workers.

Factors of stress leading to mental illness
Figure 2. Factors of stress leading to mental illness (The Health and Safety Executive, 2021, p. 15).

Theory of Behavioral Change

Supporting its goals with theoretical bases is an important aspect of facilitating a health promotion strategy. Indeed, using a theory or model is an integral aspect of a well-planned and structured intervention. In particular, Bandura’s Social Cognitive Theory, introduced in 1986, is one of the most effective theoretical approaches to stress management from the behavior change perspective (Beauchamp et al., 2019). This theory holds that individuals are motivated to change due to the influence of external factors, such as behavior, environment, and personal interactions (Beauchamp et al., 2019). Indeed, the Social Cognitive Theory allows for facilitating health-related behaviors in people by exposing them to favorable social contacts that set positive examples of behavior (Beauchamp et al., 2019). Moreover, this model allows for cultivating self-efficacy, outcomes expectations, self-control, and emotional coping, which are essential for managing the symptoms of stress (Yang, 2020). Thus, the concepts of the model by Bandura allow for constructing effective health behavior change models for a more effective stress management intervention.

The validation of the Social Cognitive Theory’s relevance to the identified issue is its contribution to the multifaceted nature of the problem of stress. Indeed, the WHO (2020) strategy uses the experiences of different people as a motivating factor for behaviour change. It addressed that since stress occurs in people’s lives within their families, work, social interactions, and psychological experiences, it is essential to incorporate all these factors in one model for behavior change.

As for applying the model to practice, Yazdanpanah et al. (2021) claim that the introduction of resources for stress management and the initiation of training are effective in promoting behaviour change. This consideration applies to the WHO strategy since it equips individuals with effective tools , educational materials, explanations, and practical guidelines on how to cope with stress. In such a manner, the theory allows for setting a favorable context and positive example of successful stress coping techniques, thus motivating the community to develop their coping skills.

Health Promotion Approach

The WHO strategy for stress management is based on a behavior change approach. A model that demonstrates this approach is COM-B Model which holds that for a change to occur effectively, it should be based on capability, opportunity, and motivation (Bhandari et al., 2021). The WHO strategy implicitly outlines the capabilities, opportunities, and motivation for change in behavior through analyzing and recognizing triggers of stress, focusing on coping skills, and responding in a healthy manner.

WHO’s behavioral education strategy differs from the approaches emphasizing adverse outcomes of stress and the diagnoses of mental and physical health issues developed due to exposure to stress (Dubey, 2018; O’Connor et al., 2020). The initiation of health promotion programs aimed at stress management in educational, healthcare, and occupational settings have been very effective due to the use of training sessions and facilitation of strengths and particular skills (María-Ángeles et al., 2021; Otto et al., 2019). Thus, the health promotion approach within the developed strategy is training coping skills for detecting stress triggers and managing health impairments based on the harmful influence of stress.

When comparing the stress management approach to health promotion with other approaches, one might identify a preventative approach. Indeed, comparing such two approaches might help evaluate the effectiveness of the stress management strategy as the one that fails to avert illnesses in the community. Indeed, through preventative measures, it is more likely that people will develop coping mechanisms and alter their lifestyle to improve their resistance to stress to avoid the malfunctioning of their bodies (Recabarren et al., 2019). One of the characteristic tools of a preventative approach is mindfulness. According to Recabarren et al. (2019), “mindfulness is characterized by paying attention in the present moment, non-judgmentally, with self-awareness, and is related to the reduction of stress perception and stress-related symptoms” (pp. 2-3). Its use within other techniques of stress symptom prevention is an effective means of minimizing health deterioration and the decline of well-being in individuals exposed to stressful environments. Nonetheless, the strategy based on the coping approach is effective in combating the adverse manifestations of stress, promoting treatment, and facilitating communities’ awareness of the problem from a long-term perspective.

Factors of Behavioral Change

The factors that are likely to induce the change of behavior in the UK include various issues at individual, social, and environmental levels. Indeed, for the alteration in human behavior concerning stress management to occur, the factor of individual perception of stress will play an important role (Brown, 2020). Indeed, the WHO (2020) strategy identifies the individual particularities of responding to stress and integrates them into the educational model. Since people perceive stress differently and might not recognize their emotions or experiences as stressful, they might fail to cope with the negative impact of stress (Cocchiara et al., 2019). Moreover, the level of exposure to stress is another significant factor that should be addressed. Community awareness about stress and the availability of resources and publically distributed information about stress are influential factors as well.

Furthermore, technology is an important factor in behaviour change for effective stress management strategies. Indeed, according to Huberty et al. (2019), the use of mobile healthcare applications aimed at promoting mindfulness as a means of preventing and coping with stress is essential in the contemporary digitalized society. Overall, the stress management strategy introduced by WHO (2020) is effective in achieving its educational and behavioral change goals. It uses simple concepts and educational materials to motivate the community to change in their response to stressful events. However, it might be suggested that the strategy to include more advanced research-based educational materials for a deeper understanding of the outcomes of stress.

Conclusion

This report has discussed and assessed the factors predetermining stress in the contemporary UK and its antecedents. It has provided the rationale for effective management to reduce the negative impact of stress on British citizens from both short- and long-term perspectives. The reason the community should adhere to the change in behavior is the extensive exposure of the British population to work-related and family-related stress coupled with the diminished awareness of the problem. The model most applicable to the public health approach for reducing stress and facilitating stress management in the community of UK citizens is the Social Cognitive Theory. It is imperative to consider various factors, including the individual perception of stress, level of awareness, setting, and technology, to ensure the achievement of positive behavior change. With the integration of the strategy for better recognition of stress symptoms and their mitigation, the population will be able to preserve their well-being and maximize long-term health benefits. The recommendations presented below will help public healthcare workers implement the strategy.

Recommendations

There are several recommendations for the implementation of a strategy for stress management in the United Kingdom to promote healthy coping mechanisms and change the behavior of people with excessive exposure to stress. The recommendations integrate preventative and management-based interventions and tools to ensure that the needs of a diverse population are addressed. They include:

  • Development and dissemination of informative messages across media to raise awareness about the adverse impact of stress;
  • Initiation of nurses’ promotion of stress management among their patients’ scheduled visits;
  • Facilitation of occupational and psychological interventions in workplace settings to mitigate negative outcomes of stressful work experiences;
  • Promotion of mindfulness, meditation, and physical activity;
  • Promotion of healthy diet and sleep for better-coping capabilities;
  • Integration of mobile technologies for stress coping skills development.

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