I am a professor of clinical health psychology who studies how living in a harsh environment can affect one’s mind and body. For several decades I’ve investigated how experiencing poverty, neighborhood disorder, unfair treatment, or violence contributes to cardiovascular disease, chronic pain, alcohol use disorders, and other illnesses. My work indicates that living in a harsh world fosters precarious goals or strivings that automatically activate the body’s stress systems—even when no threat is present. Research in three American cities discloses that our quest to live a valued life generates powerful strivings for growth, social potency, and safety. Harsh environments that threaten strivings for social potency and safety can erode physical health by persistently triggering stress systems and stagnating strivings for personal and social growth.

 Three questions guide my work:

• Can harsh worlds erode physical health by fostering goals that chronically activate the body’s stress systems?

• Do stress-inducing goals—i.e., precarious strivings—forge a toxic social milieu?

• Can the self-regulatory processes that produce precarious strivings explain how adversity engenders relationships, transactions, and habits that imperil physical health?

 I’ve investigated these questions by developing a goal-based ecological framework—social action theory—that expands the analysis of stress processes beyond the traditional fight-or-flight response template. I propose that the theory’s biopsychological model of precarious strivings can afford helpful new insights into six vexing conundrums that long have perplexed health scientists:

• What is stress?

• What makes an adverse event stressful?

• What is healthy coping?

• What distinguishes ‘healthy’ stress from ‘unhealthy’ stress?

• What prolongs stress system activation?

• How do environments create adverse events?

 My multiracial community-based research in Baltimore, Syracuse, and Nashville has consistently replicated the three basic strivings across differences of race, sex, age, and socioeconomic status, and has indicated how they contribute to hypertension, chronic pain, and disordered alcohol use. On a hopeful note, emotionally focused growth strivings bolstered by supportive relationships may help dampen the toxic health impacts of precarious strivings. The evidence indicates that these findings are not explained by the negative emotions, attitudes, or personality traits (e.g., hostility, anger, anxiety, depression) that stress scientists—including me—have traditionally studied. Indeed, those negative emotions and traits may harm physical health only when they arise from or serve precarious strivings. This implies that emotion-regulation training (e.g., self-calming, mindfulness meditation) may benefit physical health mainly in individuals whose stress systems are persistently activated by precarious goals. [For a presentation of theory and supporting evidence, see: Ewart (2024), Precarious Goals: A biopsychological model of adaptive strivings articulates how harsh social worlds erode physical health. (Preprint available at:  https://doi.org/10.31234/osf.io/pjhku).

Building A New Stress Paradigm: Project Heart

My work seeks to construct a new paradigm with promising vistas for stress science by analyzing neurocognitive processes that let people actively anticipate, shape, and avoid adversities—not just react to them. This quest explains two distinctive features of my approach. First, the quest to build and test a novel stress paradigm inspires a naturalistic, causally focused (i.e., “bottom-up”) program of discovery that seeks to identify proactive neurocognitive and social mechanisms of illness that can be demonstrated both in the laboratory and in everyday life. Second, this naturalistic bottom-up approach prioritizes reliable replication of research findings in highly diverse urban communities across differences of age, gender, race, class, cultural region, and disease.   

A centerpiece of this naturalistic community focused approach is Project Heart, a series of school-based experimental and observational studies that I conducted in Baltimore and Syracuse from 1982 to 2014 (see illustrations below). Research partnerships with public schools that served large and densely populated cities produced the first controlled experimental evidence that relaxation training, meditation, and self-calming exercises performed daily in classrooms can reduce arousal and lower blood pressure in young people who live in high stress urban neighborhoods (Ewart et al., 1987; see Publications page). Large community samples that included youths of diverse racial, economic, and neighborhood backgrounds made it possible to discern how everyday environments, personality factors, social relationships, and physiologic response patterns may combine and interact to increase disease risk in individuals whose life circumstances vary widely. The Project Heart research yielded the discovery that youths’ exposures and physiological responses to harsh environments are greatly affected by their adaptive strivings for growth, social potency, and safety—a finding that has been replicated across different American cities, genders, races, age groups (children, adolescents, adults), and illnesses.