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Accelerated Health Declines among African Americans in the USA: "weathering" or traumas as we say in HIV
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Download the PDF here
Download the PDF here
Despite examining prevalence by race and age groups across a few chronic conditions, African Americans exhibit the worse health even when accounting for demographic and health-related factors. This suggests that there may be something inherent to the African American experience that underlies these disparities in health that was not measured in this study.
Abstract
The weathering hypothesis, an explanation for race disparities in the USA, asserts that the health of African Americans begin to deteriorate prematurely compared to whites as a consequence of long-term exposure to social and environmental risk factors. Using data from 2000–2009 National Health Interview Surveys (NHIS), we sought to describe differences in age-related health outcomes in 619,130 African Americans and whites. Outcome measures included hypertension, diabetes, stroke, and cardiovascular disease. Using a mixed models approach to age-period-cohort analysis, we calculated age- and race-specific prevalence rates that accounted for the complex sampling design of NHIS. African Americans exhibited higher prevalence rates of hypertension, diabetes, and stroke than whites across all age groups. Consistent with the weathering hypothesis, African Americans exhibited equivalent prevalence rates for these three conditions 10 years earlier than whites. This suggests that African Americans are acquiring age-related conditions prematurely compared to whites.
One unmeasured factor that may contribute to the accelerated health declines particularly among African Americans is residential segregation, a form of racial discrimination. The weathering hypothesis contends that the early onset of health declines in African Americans is a consequence of long-term exposure to harmful social and environmental conditions often facilitated by residential segregation.
One plausible explanation for the association between discrimination and accelerated health declines among African Americans is allostatic load. This concept refers to the cumulative wear and tear on many physiological systems in the body as a result of repeatedly adapting to persistent chronic, psychosocial stressors.64
For example, studies suggest that the perception of discrimination ultimately leads to higher diastolic blood pressures66 - 69; 61 and other systemic responses that destabilize the natural stress fighting environment and alternatively hyper-responds to single or multiple insults of stress, irrespective of source.
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