Department of Sociology, University of Georgia, 324 Baldwin Hall, Athens, GA, 30602, USA.
Center for Family Research, University of Georgia, 1095 College Station Road, Athens, GA, 30605, USA.
Soc Sci Med. 2021 Aug;282:113169. doi: 10.1016/j.socscimed.2020.113169. Epub 2020 Jul 7.
The weathering hypothesis views the elevated rates of illness, disability, and mortality seen among Black Americans as a physiological response to the structural barriers, material hardships, and identity threats that comprise the Black experience. While granting that lifestyle may have some significance, the fundamental explanation for heath inequalities is seen as race-related stressors that accelerate biological aging.
The present study tests the weathering hypothesis by examining the impact on accelerated aging of four types of adversity frequently experienced by Black Americans. Further, we investigate whether health risk behaviors mediate the effect of these conditions.
Our analyses utilize data from 494 middle-age, African American men and women participating in the Family and Community Healthy Study. The newly developed GrimAge index of accelerated aging is used as an indicator of weathering. Education, income, neighborhood disadvantage, and discrimination serve as the independent variables. Three health risk behaviors - diet, exercise, and alcohol consumption - are included as potential mediators of the four types of adversity. Marital status and gender are entered as controls.
Multivariate analyses indicated that the four types of adversity predicted acceleration whereas marriage predicted deceleration in speed of aging. Males showed greater accelerated aging than females, but there was no evidence that gender conditioned the effect of adversity. The health risk behaviors were unrelated to accelerated aging and did not mediate the effect of the stressors.
Modern medicine's emphasis on life style as the primary explanation for race-based health disparities ignores the way race-related adversity rooted in structural and cultural conditions serves to accelerate biological decline, thereby increasing risk of early onset of illness and death. Importantly, these social conditions can only be addressed through social policies and programs that target institutional racism and promote economic equity.
“磨损假说”认为，黑人群体中较高的发病率、残疾率和死亡率是对构成黑人经历的结构性障碍、物质困难和身份威胁的生理反应。虽然承认生活方式可能有一定的意义，但健康不平等的根本原因被认为是与种族相关的压力源，这些压力源加速了生物衰老。
本研究通过考察黑人群体中经常经历的四种逆境对加速衰老的影响，来检验“磨损假说”。此外，我们还研究了健康风险行为是否在这些条件的影响中起中介作用。
我们的分析利用了参加家庭和社区健康研究的 494 名中年非裔美国男性和女性的数据。新开发的 GrimAge 加速衰老指数被用作磨损的指标。教育、收入、邻里劣势和歧视作为自变量。三种健康风险行为——饮食、运动和饮酒——被纳入作为四种逆境的潜在中介。婚姻状况和性别作为控制因素。
多元分析表明，四种逆境预测了加速衰老，而婚姻则预测了衰老速度的减缓。男性比女性表现出更大的加速衰老，但没有证据表明性别调节了逆境的影响。健康风险行为与加速衰老无关，也不能中介压力源的影响。
现代医学将生活方式作为解释基于种族的健康差异的主要因素，忽视了根植于结构性和文化条件的种族相关逆境加速生物衰退的方式，从而增加了疾病和早逝的风险。重要的是，这些社会条件只能通过针对制度种族主义和促进经济公平的社会政策和方案来解决。
