In a recent interview with US National Public Radio, public health researcher Arline Geronimus at the University of Michigan discusses how poverty and racism can impact health and accelerate aging and disease. She explains that the reduction in life expectancy in the US during the COVID-19 pandemic has not been shared equally among the general population, with Native American, Black and Hispanic people experiencing greater reductions than white people. Geronimus argues that traditional beliefs that attribute these disparities, such as genetics, diet and exercise, do not fully explain the data. Rather, she suggests that marginalized people suffer chronic stress from poverty and discrimination, which can damage their bodies at the cellular level, leading to serious health problems over time.

In the National Public Radio (NPR) interview, she describes “wear and tear” as something that “literally wears out your heart, your arteries, your neuroendocrine systems, [...] all of your bodily systems, so that, in practice, you become chronologically old at a young age” . This chronic stress can be caused by a variety of factors, such as poverty, discrimination and lack of social support.

According to the publication, Arline Geronimus's theories have been criticized in the past, but in recent years her work has generated a lot of support. She points to data showing that black and Hispanic individuals, as well as those living in poverty, have worse health outcomes than the general population. For example, black women who give birth in their 20s have more complications than those who become mothers in their teens, due to the stress they endured over a longer period.

Geronimus explains that the body's natural stress response, which is designed to help us in life-threatening situations, can be harmful when it is chronically activated due to everyday stressors. When stress hormones flood the body, they increase heart rate, breathing, and drive oxygenated blood to the big muscles. While this process is adaptive in the short term, when stress is chronic it can lead to an enlarged heart, hypertension and other health problems.

A key difference between the stress experienced by middle- and upper-class individuals and those who are marginalized is that the former have more resources to deal with stress. They can take vacations, hire people to do their housework, and order food for delivery. They also don't face the same level of discrimination and racism, which can further compound the effects of chronic stress.

When it comes to maternal death rates, Geronimus acknowledges that there are many factors at play, but she believes that systematic racism in the healthcare system is part of the problem. She suggests that having birth attendants who are doulas or midwives rather than doctors, or having home births, can help reduce stress and make individuals feel more secure during the birthing process. However, there is currently a shortage of midwives and doulas and more needs to be done to train more people in these roles.

In addition to the shortage of maternal care providers, the scientist notes that there are other systemic problems that need to be addressed to reduce health disparities. For example, individuals living in poverty may not have access to healthy food options or safe places to exercise. Addressing these issues requires a multifaceted approach that involves policy changes at the local and national levels.

The scientist believes that the chronic stress she coined “weathering” is a serious issue that needs to be addressed if we are to improve health outcomes for marginalized individuals. By understanding the root causes of chronic stress and its effects on the body, we can work towards developing targeted interventions that help reduce stress and improve health outcomes. While the problem is complex and multifaceted, Geronimus remains hopeful that progress can be made with the right interventions and policies in place.