[4 MIN READ]
In this article:
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Weathering is a concept that attributes the poor health outcomes frequently experienced by marginalized groups in America to their cumulative experiences.
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The near-constant stress inflicted upon people who are marginalized can make them more at risk for developing chronic health conditions like hypertension.
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Helping people feel validated about the reasons they’re experiencing disproportionately worse health outcomes can help them take control of chronic stress.
What to know about “weathering” and health disparities
Repeated exposure to factors like socioeconomic adversity and discrimination can harm your physical health. That’s the theory behind “weathering,” a concept that attributes the poor health outcomes frequently experienced by culturally oppressed or economically exploited groups to their cumulative lived conditions.
Weathering — a concept coined by public health researcher Arline Geronimus in 1992 — centers around the belief that discrimination and marginalization can slowly chip away at a person’s physical health, causing them to biologically age faster than their peers or even die prematurely.
Geronimus, who teaches at the University of Michigan, developed the “weathering hypothesis” from her work studying trends in women’s fertility. She found that Black women in the United States were more likely to have a healthy pregnancy in their late teens and mid-20s, whereas white women were more likely to have a healthy pregnancy in their 20s and early 30s.
Geronimus attributed this discrepancy to weathering, with Black women in their 20s and 30s experiencing more complications because they had endured the stress of their living conditions longer.
A few years later, Geronimus expanded the weathering hypothesis to apply to Black people in general, not just Black women, due to the racial discrimination and health inequities they face.
Today, weathering applies to all marginalized groups, including immigrants, minorities, people of lower socioeconomic backgrounds and the LGBTQIA+ community. And it’s making its way into conversations doctors are having with their patients.
“Over the past year, I’ve been talking to my patients about weathering,’” says Sonja Maddox, M.D., a family medicine doctor at Providence’s Pacific Medical Centers Primary Care in Renton, Washington. “I like to share this with my patients because I think we’ve been taught — particularly people of color — that we have something in us that causes us to have high blood pressure and other chronic diseases, when actually the things that happen to us perpetuate a lot of that.”
The physical effects of systemic oppression
In the United States, people who are Black, Hispanic and American Indian or Alaska Native (AIAN) have worse health outcomes than people who are white. In fact, Black Americans have the highest prevalence of hypertension in the country, while Hispanic Americans have a prevalence similar to white Americans but lower rates of awareness and treatment.
These groups have also experienced larger declines in life expectancy in recent years. And, notably, they’re more likely to report experiences with discrimination in their daily lives.
The near-constant stress inflicted upon people who are marginalized, according to Geronimus, wears down the heart and arteries, as well as all the systems in the body, causing them to become chronologically old at a young age. It also spikes levels of stress hormones like cortisol.
Dr. Maddox shares the concept of weathering with her patients to help them understand that while behaviors and environment may play a role, much of the health burden they bear isn’t something they could prevent.
“I think [telling them about weathering] helps people realize that the things they’re experiencing are real, and they’re happening to them, and it’s not something they were destined to have,” Dr. Maddox says. “I think they feel validated.”
The relationship between stress and chronic disease
Before the term weathering became widespread, “People didn’t know that these daily stressors can affect us in a big way,” Dr. Maddox says.
Yet long-term stress is a significant risk factor for a whole host of chronic health problems, including heart disease, hypertension and diabetes.
According to psychologists, stress comes from four main sources: the environment, society, physiology and how we think about ourselves. That means your stress may be exponentially compounded by a looming work deadline if you already feel discriminated against or excluded by society.
“All of these things that daily create chronic stress for people, it’s not just their imagination,” Dr. Maddox says. “It does affect their health. And when you are chronically stressed, you release hormones in your body that create changes over time, and I think that acknowledging that for people is a big deal.”
Ways to reduce stress
Simply acknowledging chronic stress and the effects of weathering is, in fact, one of the first ways you can work to combat them and enhance your well-being.
“I do think there is some empowerment in knowing that your feelings are valid,” Dr. Maddox says.
Next, you can try to make some changes in your life to help alleviate some of your stress. This may include prioritizing better sleep or nutrition, or incorporating mindfulness techniques into your routine.
If lifestyle changes aren’t enough, you can also seek behavioral health services. Speaking with a licensed therapist can help you learn other ways to reduce stress-related symptoms, such as developing coping strategies and interventions through cognitive behavioral therapy.
Contributing caregiver
Sonja Maddox, M.D., is a family medicine doctor at Providence’s Pacific Medical Centers Primary Care in Renton, Washington.
Find a doctor
If you are looking for a primary care or family medicine doctor, you can search for one who’s right for you in our provider directory. Our internal medicine specialists are also available to care for people who need ongoing help managing chronic conditions like hypertension. You can also learn more about behavioral health services at Providence.
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Related resources
Mental health in the Black community
Fostering equity in mental health
Lowering hypertension in Black and Latinx communities
The link between stress and heart health
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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