In the mid-1960s, psychiatrists Thomas Holmes and Richard Rahe conducted intense studies involving the medical records of over 5000 patients to attempt to determine whether stressful events might cause illnesses. Patients were asked to track a list of 43 life events at the times of serious illness in their lives. The results determined a positive correlation between their life events and their illnesses.

How Much Stress Does Someone’s Death Cause?

Holmes and Rahe published their findings as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale. Several studies have been conducted since their original research supporting the links between stress and illness.

Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of a family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to a different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of the law 11


To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life give a rough estimate of how stress can affect health.

A score of 300+ indicates a higher status of “at risk for illness.”  A score of 150 – 299 shows that the risk of illness is moderate. A score of less than 150 shows only a slight risk of illness.

What Happens When Multiple Stress Causing Events Occur?

As one might expect, two of the top five events on the scale involved death: either the death of a spouse or the death of a close family member. Death of a close friend also makes the list. It is also interesting to note that many of the events include loss – divorce, for example – of an individual, job or significant concept. This may indicate that the grieving process is a stressful one, for the intensity of emotion and its lengthy duration.

The American Psychological Association reported that although the stress levels for Americans overall are slowly beginning to drop, they are still critically high and exceed what doctors consider to be healthy. Many Americans report extreme stress – close to 30% – for extended periods of time. Over 39% said that their stress had increased during the past year. Even more – 44% – reported that their stress had increased over the past five years. The findings indicate a serious trend that could have long-term consequences on an individual’s health.

Are There Ways to Overcome the Stress?

Overall the Holmes and Rahe study found that while people recognize that stress can have a negative impact on health and well-being, few Americans are willing to take actions to prevent stress, or even to learn to manage it well.

Managing the stress can be a difficult process. Coping strategies are often put into place to assist in guiding the individual through the difficult times of loss. It is not unusual to need the additional assistance of a trusted friend, professional counselor or similar help organization to navigate the difficult waters of stress related to grief.