Is Racism Making Black Women Sick?
Our Race to Health columnist, Kenrya Rankin, explores the unique physiological impact of stress on the bodies of Black women.
There aren’t many people who can claim a stress-free existence. Between having to look presentable for my third Zoom meeting of the day, helping my 9-year-old focus on the math lesson unfolding on her Chromebook screen, paying all of the bills (again?!), listening to my sister rant about her ex-girlfriend, obsessing over polling results, and worrying about my safety when I venture out, I certainly can’t get away from it. And I know I’m not alone.
I also know that stress doesn’t happen in a vacuum, and that for Black women like me, just existing in America is linked to carrying a backbreaking amount of it. No, really. Studies show that Black women have a higher allostatic load—a measure of the physiological impact that stress has on the body—than Black men and our white counterparts. Researchers attribute it to walking around with the combined weight of racism and sexism on our shoulders, and that cumulative stress has a direct negative impact on our health, paving the way for chronic diseases. In fact, it makes us more susceptible to developing—and dying from—many conditions. It even has a name: weathering. Coined by Arline T. Geronimus, Sc.D., public health research professor at the University of Michigan’s Population Studies Center, weathering describes the gradual and constant wearing down of our health that comes with repeated exposure to stressors.
We’ve long understood that stress is a precursor to many conditions, and a study published in Circulation: Cardiovascular Quality makes a direct connection between stress and cardiovascular disease (CVD) in Black women. But we also have proof that racism itself has a direct impact on our cardiovascular health. A 2018 study found that even the perception of being discriminated against due to race diminishes our bodies’ ability to bind adrenaline, which wreaks havoc on our hearts. That puts us at increased risk for CVD. And here’s the part that honestly stresses me out even more: If I have the nerve to feel upset—or “hostile” as researchers termed it!—about that perceived racism, the negative impact is multiplied. Boom: My heart is even more vulnerable. Can you say “lose-lose”?
But the risk doesn’t stop at my poor heart. As I briefly discussed in my last column, I suffer from dysmenorrhea, also known as debilitating menstrual pain. A high school visit to the Cleveland Clinic revealed that a retroverted uterus is largely to blame for my pain, but the stress I struggle to leave behind at the end of every day is also associated with this condition. Many studies tie dysmenorrhea like mine to stress. (It probably doesn’t help that being in pain for days on end stresses me out.)
Even more alarming as an asthmatic and mom of an asthmatic? One study concluded that Black children who are discriminated against because of their race are more likely to experience asthma symptoms. Direct discrimination isn’t the only factor in the higher incidence of asthma in Black kids; high pollution levels in our neighborhoods are another culprit. But the numbers around prevalence don’t lie; the Centers for Disease Control and Prevention reports that 14.2% of Black kids develop the condition, versus 6.8% of white kids. And my daughter and I are more than twice as likely to die from this breathtaking chronic condition at any age.
This very real idea that racism is a major contributor to chronic health conditions runs counter to narratives that cite racial biological differences, lifestyle choices, and socioeconomic status as the culprits. Indeed, the studies that point to racism control for all of those things and still come to the same conclusion: Being treated as less than human makes our bodies sick. The amount of money we make and our DNA are not the problem—a system that slots us as “less than” because of the color of our skin is.
While I can opt not to pick up that stressful phone call and turn off my camera for my longer-than-necessary Zoom meeting, it’s not in my power to singlehandedly slay this system that places stress on my body. But I can do my part, which looks like writing about these issues and surfacing the efforts of patient advocates, doctors, nurses, activists, policymakers and others who are dismantling via their work. What part can you play today?
Allostatic Load Burden: Journal of the National Medical Association. (2012). “Allostatic Load Burden and Racial Disparities in Mortality.” ncbi.nlm.nih.gov/pmc/articles/PMC3417124/
Cumulative Stress: Psychoneuroendocrinology. (2019). “Racial discrimination, educational attainment, and biological dysregulation among midlife African American women.” sciencedirect.com/science/article/abs/pii/S0306453018301215
Weathering Info: American Journal of Public Health. (2006). “’Weathering’ and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States.” ajph.aphapublications.org/doi/10.2105/AJPH.2004.060749
Heart Disease in Black Women: Circulation: Cardiovascular Quality Outcomes. (2019). “Stress, Resilience, and Cardiovascular Disease Risk Among Black Women.” ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.118.005284
About Asthma: Centers for Disease Control and Prevention. “Most Recent National Asthma Data.” cdc.gov/asthma/most_recent_national_asthma_data.htm
Asthma and Discrimination: Chest Journal. (2017). “Perceived Discrimination Associated With Asthma and Related Outcomes in Minority Youth.” journal.chestnet.org/article/S0012-3692(16)62550-3/abstract
Asthma and Pollution: Environmental Protection Agency. “Children’s Environmental Health Disparities: Black and African American Children and Asthma.” 19january2017snapshot.epa.gov/sites/production/files/2014-05/documents/hd_aa_asthma.pdf
Dysmenorrhea: Epidemiologic Reviews. (2014). “The Prevalence and Risk Factors of Dysmenorrhea.” academic.oup.com/epirev/article/36/1/104/566554