Weathering: Stress and Heart Disease in African American Women Living in Chicago

Abstract

Researchers have suggested that lifelong chronic and cumulative exposure to social and economic stressors is associated with early onset of chronic illness in African American women. Recent literature has demonstrated that socioeconomic aspects of neighborhoods contribute to health disparities in heart disease morbidity and mortality. In this article, the author analyzes the stories of older African American women concerning stress and other events related to heart disease, triangulated with individual- and neighborhood-level socioeconomic and environmental data, from the perspective of the weathering conceptual framework. She conducted in-depth qualitative interviews with urban, older Black women with early-stage heart disease. Women described lifelong and recent incidents of stress that they perceived as contributing to their "bad heart." The episodes described were a mixture of chronic social, environmental, and family-related challenges. Findings reveal substantial evidence supporting the weathering conceptual framework and the Sojourner syndrome in this sample of older, chronically ill Black women.

Sojourner Syndrome and Health Disparities in African American Women

“…10 An understanding of the pathways that lead to poor health outcomes has been hindered by the biomedical approach that gives limited attention to potential sources of health disparities in African American women. [21][22][23] Poor health outcomes extend across the life span for many African American women. In addition to shorter life expectancy, a substantial number of young African American women in their 20s and 30s have already developed chronic disease and disability.…”

Powerlessness, Anger, and Stress in African American Women: Implications for Physical and Emotional Health

“…The researcher found that these older, African American women reported that stress was a primary cause of, and an ongoing contributor to, their heart disease. In addition, when their narratives are combined with individual and neighborhood demographics and socioeconomic data, it is evident that these women are aware that their life experiences demonstrate the cumulative effect of exposure to inequality, stress, and negative environmental situations that lead to accelerated aging (Warren-Findlow, 2006). Warren-Findlow further states that, although being a strong woman allows African American women to have some sense of normalcy, the perception that they are strong discredits their assertions that they are sick or in pain.…”

“…Studies have suggested that stress, whether related to low socioeconomic status, discrimination, or other factors, has a detrimental effect on the body and increases the risk of a number of physiological conditions, including hypertension (Webb & Beckstead, 2005), coronary heart disease (Bongard, al'Absi & Lovallo, 1997;Miguel-Tobal, Casado, Cano-Vindel, & Spielberger, 1997;Suarez & Williams, 1989;Warren-Findlow, 2006;Yuen & Kuiper, 1991), cancer (Andersen, Farrar, & Golden-Kreutz, 1998), and obesity (Robert & Reither, 2004;Wamala, Wolk, & Orth-Gomer, 1997), among others. Thomas (1995) suggested that individuals trying to regulate the internal emotional discomfort associated with anger often engage in self-defeating, unhealthy behaviors such as overeating, drinking, and smoking.…”

“…Yet, according to Baker and Bell (1999), data relative to the prevalence of specific psychiatric disorders among African Americans are lacking, and more research is needed in this area. Indeed, researchers (Boardman, 2004;Cohen, Farley, & Mason, 2003;Warren-Findlow, 2006) have suggested that African American women experience early onset of chronic illnesses as a result of their exposure to lifelong chronic and cumulative exposure to social and economic stressors. In fact, chronic anger is an internal stressor that adversely impacts physical health, as suggested in studies that link such anger with cardiovascular disease (Siegman & Smith, 1994;Strike & Steptoe, 2004).…”

Age Differences in Women’s Anger Experience and Expression

“…This perspective ignores available information which suggests that women express anger differently than men, and that long-standing cultural, societal and gender-role expectations discourage women from the direct and open expression of anger, leading women to view expression of anger as a threat to interpersonal relationships (Cox, Stabb, & Bruckner, 1999;Cox, Van Velsor, & Hulgus, 2004;Cox & St. Clair, 2005;Hatch & Forgays, 2001;Munhall, 1993;Sharkin, 1993;Thomas, 1989). Consequently, it seems that women suffer anger in silence, or maladaptively divert it to indirect means of expression which become transformed into other pathologies such as bulimia (Meyer et al, 2005), self-cutting (Abu-Madini & Rahim, 2001;Matsumoto et al, 2004) and substance abuse (Gilbert, Gilbert, & Schultz, 1998;Larimer, Palmer, & Marlatt, 1999) or health problems, such as hypertension, coronary heart disease (Kamarck et al, 2009;Warren-Findlow, 2006;Webb & Beckstead, 2005) or obesity (Ricca et al 2009; underscore the appropriate way experience and express anger within a particular culture (Adam et al, 2010;Konwar & Ram, 2004;Matsumoto et al, 2010). Although such cultural and societal norms may vary from country to country, expressions of anger with some modifications and variability can be found across cultures (Matsumoto, et al, 2010).…”