Doctors and public health experts have time and again pointed to a culprit when asked why Americans have shorter life expectancies than their peers in countries with comparable resources. self, especially people with chronic diseases in their youth: stress.
A cardiologist, an endocrinologist, an obesity specialist, a health economist, and a social epidemiologist all say versions of the same thing: Striving to get ahead in an unequal society contributes cause people in the United States to age faster, become sicker, and die younger.
Recent polls show that adults are stressed by factors beyond their control, including inflation, violence, politics and race relations. A spring Washington Post-Ipsos poll found that 50% of Americans said insufficient income is a cause of financial stress; 55% said not having enough savings is also a cause of stress.
Elizabeth H. Bradley, president of Vassar College and co-author of the book, said we should take a step back and look at the society we live in and what really determines the level of stress, the level of fatigue, How desperate are we? The American health care paradox. It’s for everyone. Health is greatly influenced by these factors, so that’s why we talk about reconceptualizing health.
The Washington Post’s efforts to gain a deeper understanding of how stress can cause disease, disability and a shorter lifespan have resulted in a once-ridiculed research group becoming part of the mainstream discussion about improving Americans’ health: The weather hypothesis.
Stress is a physiological response that is part of the body’s innate program to protect against external threats.
When danger appears, alarm signals sound in the brain, activating the body’s sympathetic nervous system, the fight-or-flight system. The hypothalamic-pituitary-adrenal axis is activated. Hormones, such as epinephrine and cortisol, flood into the blood from the adrenal glands.
Heart beats faster. Rapid breathing. Blood vessels dilate. More oxygen reaches larger muscles. Blood pressure and blood sugar increase. The immune system’s inflammatory response is activated, promoting rapid wound healing.
Once the threat passes, hormone levels return to normal, blood sugar levels decrease, and heart rate and blood pressure return to baseline levels. That’s how the human body should work.
Life brings a relentless accumulation of stress, especially for those who suffer from inequality and not just from immediate and constant threats. Even predicting those threats in advance causes persistent damage.
The body produces too much cortisol and other stress hormones, trying to return the body to a normal state. Eventually, the body’s machinery malfunctions.
Like tree rings, the body remembers.
The constant stress, the chronic source of stress resets what is normal and the body begins to change.
It is the repetition of this process year after year that is the persistence of striving to overcome the barriers that lead to poor health.
Blood pressure remains high. Inflammation becomes chronic. In the arteries, plaque forms, causing the blood vessel walls to thicken and harden. That forces the heart to work harder. It doesn’t stop there. Other organs begin to weaken.
Struggle and strive
It’s part of the weathering process, a theory first proposed by Arline T. Geronimus, a professor and population health equity researcher at the University of Michigan.
Geronimus, whose book Weather: The Extraordinary Stress of Ordinary Life in an Unjust Society published in March, began studying the health of women and infants as a graduate student in the 1980s, influenced by two distinctly different jobs she held as a college student. : one was an on-campus research assistant, the other a peer at an off-campus school for teen mothers.
At the time, she said, conventional wisdom held that the Black community had higher infant mortality rates because teen mothers were too physically and psychosocially immature to give birth. give birth to healthy children. But her research shows that younger black women have better pregnancy and birth outcomes than black mothers in their mid-to-late 20s and 30s.
Because of this, she has been criticized as an advocate of teenage pregnancy, even though she is not. Shaken but undeterred, she continued to try to understand this phenomenon, which meant better understanding the overall health of the communities these teens were counting on for help. She said, when she studied those networks, she realized people’s lifespans were shorter and they had all these chronic diseases at a young age.
But she still couldn’t think of a name for what she was witnessing. It happened in the early 1990s while sitting in her office: Weather to me is the perfect word.
She said she was trying to grasp two things. First, people’s diverse life experiences affect their health by weakening their bodies. And second, she said: People are not just passive victims of these terrible exposures. They tolerate them. They fight against them. These are the people who weather the storm.
People seem to understand the first instinctively, but she says they often overlook the second. It’s not just living in an unequal society that makes people sick. It is the day after day effort of trying to be equal that causes the body to break down.
The weather helps explain the double-edged sword of dealing with high effort, she said.
Over the years, Geronimus has expanded the scope of his research to include immigrants, Latinos, the LGBTQIA community, poor whites in Appalachia. She found that although weathering is a common human physiological process, it occurs more frequently in marginalized populations.
The regulation of cortisol, which we consider the body’s primary stress hormone, is disrupted. Optimally, it should behave like a wave with a sharp increase in the morning, followed by a rapid, slow decline until reaching a baseline level at bedtime.
But current research shows that is blunted by repeated exposure to psychosocial and environmental stressors, such as perceptions of racism, flattening this rhythm .
High cortisol levels caused by stress stimulate appetite by triggering the release of ghrelin, a peptide that stimulates hunger.
The interaction between elevated cortisol and glucose is particularly complex and insidious, ultimately leading to obesity, fatigue, cardiovascular disease, poor immune function and inflammation, higher breast cancer mortality, and other metabolic disorders. Disturbed cortisol also increases depression, anxiety and interferes with sleep.
The weathering process does not begin in middle age.
It starts in the mother’s womb. Cortisol released into a pregnant person’s bloodstream crosses the placenta, which helps explain why a large number of babies born to parents living in impoverished or frequently discriminated against communities are born prematurely. and too small.
According to a study published this year in Scientific Reports, during the coronavirus pandemic, stressed pregnant women suffered changes in the structure and texture of the placenta.
Toxic fluxes can exist in childhood due to abuse, neglect, poverty. Too much exposure to cortisol can reset the nervous system’s fight-or-flight response, essentially sending the brain into a state of stress that becomes dysfunctional.
Too much stress in children and teens can cause learning, behavioral and health problems, including depression and obesity.
Stress can change the body at the cellular level.
The effects of unrelenting stress can be seen at the chromosomal level, in telomeres, which are repetitive DNA sequences found in almost every cell.
Telomeres are the active ends of chromosomes, and they protect the genetic stability of cells by covering the ends of chromosomes to prevent degeneration. (Think of the plastic ends of shoelaces.)
Researchers have found that in people with chronically high cortisol levels, telomeres shorten at a faster rate, a sign of premature aging.
The shorter the telomere, the older the biological age of the cell.
Shortened telomeres cause a disconnect between biological and chronological age.
A social project
I don’t think most people understand the stress caused by the weather. Stress is a vague term, Geronimus said. But it still gives us a leverage point to get in there and see a more complex and scary picture of what it does to the human body and whose body it is.
A 2019 study published in SSM-Population Health showed that changes in seven biomarkers in heart patients over a 30-year period showed that Black patients had a faster survival time than White people. six years.
Research also shows that black people experience hypertension, diabetes and stroke 10 years earlier than white people, according to a study published in the Journal of Urban Health.
The effects of sustained activation of the body’s stress response are called allostatic load.
Research has shown that Mexican immigrants who have lived in the United States for more than 10 years have elevated attribution scores compared with those who have lived here for less than a decade, and a study of breast cancer patients in Ohio published in May in JAMA Network Open found that women with higher allostatic load who tended to be older, Black, single, and publicly insured were more likely to experience the following complications surgery than those with lower allostatic load.
The argument Weathering is trying to make, Geronimus said, is that these are things we can change, but we have to understand them at a complex level. This should be a social project, not a new app on your phone that will remind you to take deep breaths when you feel stressed.
So, in summary, social inequality causes stress, which leads to shortened telomeres and thus to premature aging, disease, and premature death.
About this story
Reported by Akilah Johnson. Illustration by Charlotte Gomez.
Designed and developed by Stephanie Hays, Agnes Lee and Carson TerBush. Edited design by Christian Font.
Edited by Kainaz Amaria, Stephen Smith and Wendy Galietta. Additional editing by Martha Murdock, Frances Moody and Phil Lueck.
Additional support by Matt Clough, Kyley Schultz, Brandon Carter and Jordan Melendrez.
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