Arline T. Geronimus is with the Population Studies Center, Institute for Social Research, and the Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor.
Am J Public Health. 2013 Oct;103 Suppl 1(Suppl 1):S56-63. doi: 10.2105/AJPH.2013.301380. Epub 2013 Aug 8.
Advances in stress physiology and molecular dynamics can illuminate population health inequality. The "weathering" hypothesis posits that socially structured, repeated stress process activation can accumulate and increase disease vulnerability across the life course in marginalized groups. The developmental origins of health and disease (DOHaD) hypothesis focuses on youthful programming for later life disease via epigenetic modifications to limiting uterine or early environments. Weathering and DOHaD are overlapping biopsychosocial models; yet, their emphases and implications vary. Evidence for the primacy of early development over experiences in young through middle adulthood for explaining population health inequality is lacking. By considering weathering and DOHaD together, we call for biomedical researchers to be more cautious in their claims about the social world and for a broader range of social researchers--including qualitative ones--to collaborate with them.
压力生理学和分子动力学的进展可以阐明人口健康不平等现象。“风化”假说认为，在边缘化群体中，社会结构、反复的压力过程激活可以积累并增加整个生命周期的疾病易感性。健康与疾病的发育起源（DOHaD）假说则关注通过限制子宫或早期环境的表观遗传修饰，为晚年疾病进行年轻时的编程。风化和 DOHaD 是重叠的生物心理社会模型；然而，它们的重点和影响有所不同。缺乏证据表明，早期发展比青年到中年的经历更能解释人口健康不平等。通过将风化和 DOHaD 放在一起考虑，我们呼吁生物医学研究人员在其对社会世界的主张中更加谨慎，同时呼吁更广泛的社会研究人员（包括定性研究人员）与他们合作。
