by Piper and Chau (Fall 2023)
Weathering is more than the weather itself. Weathering is a metaphor created by Arline T. Geronimus that explains the difference in aging in minority groups. The term “weathering” is an explanation for the rapidly increased aging and increase in age-related diseases in minority groups due to living in a constant state of stress and lack of understanding by society. Minority groups in Western Society, especially black Americans, experience constant exposure to racial, religious, ethnic, and class discrimination, stigma, stress, and cultural oppression. Many of these stressors are in the form of microaggressions, individual attacks against a person of color based on their racial identity. Microaggressions happen constantly and are small acts of aggression that can drastically increase the stress a person of color experiences in their day-to-day life. Explore the interactive image, and read more below to learn more.
Constant exposure to discrimination and racism deteriorates the bodily systems of people of color exposing them to more infectious diseases and age-related illnesses like hypertension and diabetes. Some of the bodily systems that are negatively affected are the cardiovascular system, immune system, and metabolic system. All of these systems contain organs and tissues that are impacted when living in stressful environments, which minority groups are constantly living in within our society. This exposure to physiological stress causes damage to the systems and ages minority groups faster than their white counterparts. Constant stress also negatively impacts the mental health of minority groups. Racism-based traumatic stress leads to overlaps with PTSD like low self-esteem, anxiety, depression, hypervigilance, dissociation, and sleep disturbance. Constant stress is negatively impacting the physical and mental health of minority groups experiencing it. It is also affecting the birth rates and birth success of minority groups. Black mothers are more likely to have traumatic birthing experiences with an increase in mortality rates. Because of the faster aging due to weathering black women’s bodies are biologically older at prime child-bearing years. A biologically older body negatively impacts birth success and adds complications to birth (Geronimus, 1992). When medical professionals overlook the biological age of the body for black women they are overlooking the possible complications and diseases that are preventable during pregnancy and birth. This leads to higher mortality rates and fewer successful births for black mothers.
How can medical professionals combat weathering with pain management? When it comes to pain management, the notion of “chronic pain” is often met with ambivalence from healthcare practitioners due to a lack of a direct cause or a connection between pain and visible injuries/diseases. Therefore, self-reports from patients with chronic pain are not taken seriously and therefore underestimated by physicians in clinical encounters. This phenomenon has been indicated to be more prevalent and severe among patients in racially-ethnically minority groups (Mossey, 2011), which results in chronic health inequity. Studies have shown that Black and Hispanic Americans are more perceptive to discrimination cues, and perceived discrimination has been suggested to be associated with higher levels of perceived pain (Maly & Vallerand, 2017). Due to the nature of “pain” as an idiosyncratic sensation and the lack of objective pain assessment, physicians who lack knowledge of the impact of racism on perceived pain may refute patients’ attempts to describe their discomfort, thereby exacerbating patients’ stress and neglecting their need for pain-relieving medications. Moreover, the major understanding of pain management is Eurocentric and evidence-based, which works against chronic pain or pain in general as a subjective physical reaction to external or internal stressors and thus dismisses coping mechanisms that do not have tangible evidence, one of which is very common among the Black and Hispanic community – spirituality/religiosity. Attempts to improve understanding of pain and effective pain management are focused on the communication between patients and healthcare providers as well as the education of healthcare providers on the impact of racial discrimination on the human body (in this case, an increased rate of aging and age-related diseases). Researchers have advocated for systemic change such as the biopsychosocial model and the RESTORATIVE model, both tackling healthcare disparities among marginalized groups that can be applied to promote chronic health equity.
- Geronimus, A. T. (2023). Weathering widens the gap in racial health disparities. https://spotlightonpoverty.org/spotlight-exclusives/weathering-widens-the-gap-in-racial-health-disparities/
- Geronimus, A. T. (1992). The weathering hypothesis and the health of African-American women and infants: Evidence and speculations. Ethnicity & Disease, 2(3), 207–221. http://www.jstor.org/stable/45403051
- Hood, A. M., Morais, C. A., Fields, L. N., Merriwether, E. N., Brooks, A. K., Clark, J. F., McGill, L. S., Janevic, M. R., Letzen, J. E., & Campbell, L. C. (2023). Racism exposure and trauma accumulation perpetuate pain inequities—advocating for change (RESTORATIVE): A conceptual model. American Psychologist, 78(2), 143–159. https://doi.org/10.1037/amp0001042
- Maly, A., & Vallerand, A. H. (2018). Neighborhood, Socioeconomic, and Racial Influence on Chronic Pain. Pain Management Nursing, 19(1), 14-22. https://doi.org/10.1016/j.pmn.2017.11.004
- Mossey, J.M. Defining Racial and Ethnic Disparities in Pain Management. Clin Orthop Relat Res 469, 1859–1870 (2011). https://doi.org/10.1007/s11999-011-1770-9
- Sandoiu, A. (2021). ‘Weathering’: What are the health effects of stress and discrimination? https://www.medicalnewstoday.com/articles/weathering-what-are-the-health-effects-of-stress-and-discrimination#Poverty-does-not-explain-weathering-gaps
