Weathering in Detroit: Place, Race, Ethnicity, and Poverty as Conceptually Fluctuating Social Constructs Shaping Variation in Allostatic Load

Abstract

r Despite 30 years of attention to eliminating population health inequity, it remains entrenched, calling for new approaches. r Targeted universalism, wellness-based local development, and Jedi Public Health approaches that are community informed, evidence based, and focused on improving everyday settings and diverse lived experiences are important policy directions. r State and federal revenue transfers are necessary to mitigate the harms of austerity and assure greater equity in fiscal and population health in places like Detroit, Michigan. Context: US population health inequity remains entrenched, despite mandates to eliminate it. To promote a public health approach of consequence in this domain, stakeholders call for moving from risk-factor epidemiology toward consideration of dynamic local variations in the physiological impacts of structured lived experience. Methods: Using a community-based, participatory research approach, we collected and analyzed a unique data set of 239 black, white, and Mexican adults

Relationship intervention indirectly buffers financial strain’s effect on biological aging among Black adults.

“…Accordingly, the current results using the “DunedinPoAm” index have important practical and theoretical implications. Results are consistent with the broad hypothesis that differential exposure to chronic social stressors linked to race and structural racism, such as financial strain, can result in physiological dysregulation over the life course and ultimately set the stage for elevated rates of chronic illness (Geronimus et al, 2006, 2020). Our emphasis on pace of aging as a key outcome is consistent with a broader literature suggesting that the basic process of aging has prognostic significance for health and health disparities (Forde et al, 2019; Kennedy et al, 2014; Robles et al, 2014; Umberson et al, 2006), making prevention of its progression an important outcome for social and medical scientists.…”

“…Hypothesis 1: As predicted by the weathering hypothesis (Geronimus et al, 2006, 2020), those experiencing greater cumulative financial strain will exhibit faster pace of aging as measured by DunedinPoAm (Pathway a).…”

“…Recently, a tool of this sort has been developed. Consistent with the weathering hypothesis that chronic exposure to stress can result in an elevated rate of biological wear and tear, setting the stage for early onset of chronic illness and death (Geronimus et al, 2006, 2020), Belsky et al (2015) developed a broad measure of biological aging that captured rate of change in a composite measure of 28 biomarkers related to cardiovascular, metabolic, pulmonary, renal, hepatic, immune, and dental health systems. This index, called Dunedin(P)ace(o)f(A)ging (DunedinPoA), was designed to capture rate of aging across health-relevant systems.…”

Mexican-Origin Women's Construction and Navigation of Racialized Identities: Implications for Health Amid Restrictive Immigrant Policies

“…Over time, exposures to stressful political and social contexts and the identity management strategies required to navigate them, may contribute to the deterioration of mental health (Pearlin et al 1981). In the longer term, physical costs of such efforts may include risk of cardiovascular and metabolic conditions linked to stress over the life course (Geronimus et al 2020;Jackson, Knight, and Rafferty 2010).…”

“…Over the longer term, prolonged engagement of strategies to prevent confrontations with the immigrant policing infrastructure may exact health consequences through the dysregulation of multiple biological systems (Geronimus et al 2020). How these health consequences unfold may depend on contextual factors and individual and network resources (Geronimus et al 2020;LeBrón et al 2019a). In the following paragraphs, we consider mechanisms by which these processes may affect health.…”