Purpose: Decreases in socioeconomic status (SES) are associated with increased risk for poor health outcomes, including morbidity and mortality. The Reserve Capacity Model (RCM; Gallo & Matthews, 2003) represents a theoretical framework for explaining the role of psychosocial and behavioral factors in contributing to poorer health outcomes among lower SES individuals.The current study tested several tenets of the RCM in order to identify underlying psychosocial pathways that influence alcohol use among lower SES individuals in a sample of underserved women with an abnormal breast screening. Participants: Participants were 114 medically underserved female primary care patients in the Tampa Bay area of Florida, who received a screening abnormality suspicious for breast cancer. Participants ranged in age from 20 to 69 years and were primarily of Hispanic ethnicity. Methodology: A secondary analysis of survey data collected from primary care patients in the Tampa Bay area of Florida as part of a nine site cluster randomized controlled trial assessing the efficacy of a patient navigation intervention aimed at improving the timeliness of diagnostic resolution in patients with a cancer screening abnormality was conducted. Results: A path analysis was conducted to test several predictions of the RCM. As hypothesized, education significantly predicted higher ratings of perceived social support (b = .36, p < .001). Additionally, perceived stress significantly predicted higher depressive symptoms (b = .66, p < .001), which, in turn, predicted greater odds of drinking alcohol (OR = 2.85, p <.001). Contrary to hypotheses, perceived social support did not have a significant effect on perceived stress or depressive symptoms (p >.05). No significant associations were found between education and either perceived stress or alcohol consumption (p >.05). Conclusion: Results provide partial support for the RCM as a useful conceptual framework to understand alcohol use among a medically underserved sample of women. Results imply that interventions designed to develop cognitive reappraisal skills in the face of stress may have the potential to positively impact rates of alcohol use among lower SES women.