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Allostatic load burden and racial disparities in mortality
O Kenrik Duru1, Nina T Harawa, Dulcie Kermah
1Division of General Infernal Medicine/Health Services Research, University of California, Los Angeles, 911 Broxton Plaza, Los Angeles, CA 90095, USA. kduru@mednet.ucla.edu
Journal of the National Medical Association
|June 20, 2012
Summary
Chronic stress, measured as allostatic load, partially explains higher mortality rates in Black individuals compared to White individuals, independent of socioeconomic status and health behaviors. This highlights the significant impact of physiological stress on health disparities.
Area of Science:
- Public Health
- Sociomedical Sciences
- Epidemiology
Background:
- Persistent black-white disparities in mortality exist even after accounting for socioeconomic status and health behaviors.
- Allostatic load, a measure of physiological wear and tear from chronic stress, was investigated as a potential explanatory factor.
Purpose of the Study:
- To examine if allostatic load is associated with black-white mortality disparities independently of traditional risk factors.
- To quantify the impact of allostatic load on mortality disparities between Black and White individuals.
Main Methods:
- Analysis of 4515 Black and White adults (35-64 years) from NHANES III (1988-1994) with mortality follow-up through 2006.
- Calculation of allostatic load scores based on 10 biomarkers.
- Sex-stratified multivariate models sequentially adjusted for age, clinical conditions, socioeconomic status, health behaviors, and allostatic load to assess mortality disparities.
Main Results:
- Black individuals exhibited higher allostatic load scores than White individuals (men: 2.5 vs 2.1; women: 2.6 vs 1.9).
- Allostatic load partially attenuated black-white disparities in cardiovascular/diabetes-related and noninjury mortality among women.
- While disparities were attenuated in men, they persisted after allostatic load adjustment.
Conclusions:
- Allostatic load burden contributes to the higher mortality observed in Black individuals, independent of socioeconomic status and health behaviors.
- Chronic physiological stressors significantly impact the health and lifespan of Black Americans.
- Addressing allostatic load may be crucial for reducing racial disparities in mortality.
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