On October 3, 2024, the fifth Salus Health Care Forum was convened. In attendance were Mitch Applegate, William Bergquist, Perry Pugno and Mark Vukalcic. The Trigger topic for this forum was provided by Mark Vukalcic who provided information regarding Allostatic Load as related to matter of race and socio-economic status.

Following is a summary of Mark’s opening presentation along with links to referenced articles and a listing of allostatic markers.

Mark

I will be addressing the association between allostatic load and such socio-economic issues as race, ethnicity, and discrimination.  I will be looking at how all of this relates to chronic stress and many different pathologies. It was interesting in my review of the literature that there were 100s of studies related to these issues. However, many of the studies were not properly conducted. One of the major review articles paired it down to 11 studies because of problems with many of the studies. The reviewers often perceived biases in many of the studies.  It seems that even with all of these studies being reviewed there was no definitive proof that allostatic load relates to any of these socio-economic factors. However, as I reviewed the literature, I found that there is considerable empirical evidence that points to a relationship between discriminatory factors and allostatic load.  I am optimistic that as this relationship is being more carefully studied it will emerge as a key issue.

[Here are links to abstracts of three meta-analytic essays reviewed by Mark:

Allostatic Load and Social Structures

Discrimination and Allostatic Load

Weathering Hypothesis

Mark

The real challenge is to find a reliable measure of allostatic load to plug into these models. Right now, there are a large number of eligible matrices in terms of allostatic load; however, there is not common agreement. When I looked at the literature on allostatic load, I found that the metrics tended to cluster in four areas: (1) cardiovascular, (2) immunity and inflammation, (3) metabolism, and (4) neuroendocrine.

[Mark prepared a checklist of biomarkers in each of the four areas that were frequently included in the measurement of allostatic load. Following is his list (with each mention of a specific marker in one of the studies being designated by an “X”.