Enduring the daily struggles of racism and poverty not only have significant effects on someone’s mental health—it turns out they can affect someone’s physical health, too.
While it was once thought that genetics, diet and exercise largely account for differences in health outcomes among race and ethnicity, it’s more than that. The weathering hypothesis describes how racism, microaggressions and socioeconomic disadvantages put someone under chronic, daily stress that literally wears down – or weathers – their physical health, leading to accelerated aging and leaving them susceptible to poor health outcomes.
The weathering hypothesis was proposed by public health researcher Arline Geronimus, Sc.D. She says it explains why Black women have healthier babies in their teens than in their 20s. In their 20s, Black women have endured a decade’s more worth of chronic stress, increasing their biological age and leading to higher risk pregnancies and poorer pregnancy outcomes. And what’s more:
- Maternal and infant mortality rates are higher in Black people than any other race or ethnicity.
- Black men are more likely to have poor outcomes of prostate cancer and Black women are more likely to have poor outcomes of breast cancer than the white population.
- Black and Hispanic people are most likely to be afflicted with chronic health conditions like diabetes, kidney failure, high blood pressure and stroke.
- In 2020, life expectancy decreased for all races and ethnicities due to the COVID pandemic. But for white people it decreased by 1.5 years, while for Black and Hispanic people it decreased by 3 years and for Native American people it decreased by 4.5 years. The pandemic magnified longstanding disparities in healthcare, as people of color were disproportionately affected by the pandemic and developed a higher incidence of severe disease.
How Chronic Stress Impacts Your Health
So how does chronic stress impact physical health? When we’re stressed, the body releases a hormone called cortisol. This creates our fight-or-flight response – it helps us think and move quickly when we sense danger. Our heart rate goes up, our blood pressure goes up. The systems in our body that we don’t need at the moment function at a lower level. Our digestive system might be put on the back burner and we might lose our appetite, for example, so we have more energy to focus on the systems in our body that help us get out of the way of danger.
Care At Henry Ford Health
But this fight-or-flight response is meant to last only a few minutes. If we’re under chronic stress, these bodily changes that we undergo when cortisol is released can lead to long-term inflammation, damaging our organs and contributing to a host of health issues. Chronic high blood pressure, for example, can lead to stroke. And if you’re pregnant and under chronic stress, your baby may be impacted – which could even lead to miscarriage – as it’s not optimal to be carrying a child when your body needs to use its energy and nutrients elsewhere.
Race Vs. Income Level
Even minorities who are in a higher socioeconomic bracket endure the physical effects of weathering: the daily injustices of racism and “othering” apply, no matter whether you are low, middle or high income. In fact, research shows that when Black women take their newborns to Black doctors, they have a lower mortality rate. This isn’t to say Black infants should only see Black physicians. Rather, it calls out a need for physicians, nurses and anyone who works in a clinical setting to counteract institutionalized racism and unconscious bias so all patients receive equitable care and the most favorable outcomes.
While this isn’t a problem that can be solved quickly, institutions like Henry Ford Health have implemented a board-approved, five-year, DEIJ strategic plan (which stands for Diversity, Equity, Inclusion and Justice) to ensure diverse and equitable practices, and to identify implicit biases and apply swift action to address them, using education, reflection and understanding.
Kimberlydawn Wisdom, MD, MS, FACEP, is the Senior Vice President of Community Health & Equity and Chief Wellness & Diversity Officer for Henry Ford Health. Read more about Dr. Wisdom.
