Race, sex, bias
category not a biological one, so the stressors that black people face are due to experiences unique to them. These stressors/biomarkers include cortisol levels, sympathetic nerve activity, blood-pressure reactivity, cytokine production, waist-to-hip ratio, and glycated haemoglobin levels which are all known to be related to socioeconomic statuses and have a great influence on birth outcomes. To better understand the effect of weathering, it was McEwen and his colleagues who conceptualized the term ‘allostatic load’, defining it as the physiological burd en imposed by stress. It is measured across physiological systems and includes subclinical indicators of the body’s response to stress using two distinct categories of biomarkers. The first category, primary mediators, comprises the substances released into the body in accordance with when the body felt under stress. 16 The substances included: norepinephrine, epinephrine, cortisol, and dehydroepiandrosterone sulphate (DHEA-S). The second category comprises the effects due to actions of the primary mediators. 17 This includes examples such as: elevated systolic and diastolic blood pressures, cholesterol levels, glycated haemoglobin levels, and waist-to-hip ratio. 18 In general, their various studies through these components has shown that a greater allostatic load is associated heavily with old age, increased mortality, lower socioeconomic status and other stress-related experiences. These experiences, however, are not particularly exclusive to black individuals but through the figures above, it is clear that allostatic load does have a significantly greater effect on the weathering of black men and women.
In Figure 2, there is a clear distinction between the allostatic load between white people and black people as the ages progress. The probability of having a high allostatic load in black people was 60% at age 50, which was not met by their white counterparts until they had reached 60 years of age. Black women were also most likely to have a high allostatic load, gaining a probability of 80% of black woman having a high allostatic load by age 64. 19 Although it wasn’t depicted in the figure 2, the disparities in black women’s allostatic load becomes more pronounced when comparing those of different socioeconomic statuses and backgrounds. It is apparent that ‘biological weathering’ is a key factor in understanding the existence of racial disparities in the health of individuals more susceptible to the stresses of what our racially conscience society offers. Through a numerous amount of studies and data, it is clear black women/black mothers are at the brunt of these disparities and therefore possess higher
Figure 2 11- Probability (based off examination survey collected) of having an allostatic load of 4 or higher, as predicted by race {a} and race and gender {b}.
allostatic load scores than their counterparts. These findings suggest a greater understanding in black maternal health outcomes is required. Education within the healthcare system is imperative to avoid implicit bias in a healthcare environment that’s supposed to guide and nurture them through their womanhood. Only when this is done will black women be able to achieve their optimum health and well-being throughout their life, especially if they choose to become a mother.
17 PMC, ‘ Weathering ’ and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States , 2006. 18 Ibid. 19 Ibid.
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