Mark

The implications of these biomarkers reside somewhere between family medicine and public health.  The family docs are probably in the best position to be at the forefront of this research.  I am just giving you the way allostatic load is currently defined.  With regard to social economic factors, there was a large CDC/Kaiser study conducted in 1998. The metrics were based on ACE (Adverse childhood experiences).  Physical, sexual and emotional abuse were studied, along with many other trauma-related factors.  The more types of abuse that the child experienced the greater the possibility of ischemic heart disease, cancer, obesity, depression, alcoholism, and other forms of drug abuse.  So, there is a relationship between allostatic load (using the ACE metrics) and health. We are facing a greater challenge when it comes to the effect of racism on health, for it is important to acknowledge that racism isn’t just a single entity that can be carefully studies. It is challenging to look through the literature on race, ethnicity and discrimination as these factors relate to allostatic load. There are few consistent results. However, several ameliorating factors do stand out—especially strong positive support. It should not come as a surprise to find that people living with the challenges of discrimination are less likely to be burdened by high allostatic load if they have one supporting figure in their life –be it a high school coach or minister. Also, allostatic load is lower if this this person knows another person who lives in a less violent neighborhood and if that person’s parents provide positive support and feedback.  The other ameliorating factor seemed to be education. The more education a child gets, the lower will be allostatic load.

Following is a narrative based on comments made after Mark concluded his presentation.

Bill

Mark, it struck me that one of the notions repeatedly brought up during the last several sessions of the Salus forum concerns the neighborhood islands or deserts where there is no healthy food.  People live in communities where they can’t find healthy food. It is a case not that these people are bad or ignorant or whatever, they live on an island—a community where any healthy food has gone somewhere else.  Furthermore, Mark, you are indicating that race is essentially leading to life on one of these islands where residents are deprived of any support—unless there is a minister, coach or whatever.  Deprived of healthy role models. Deprived of security.  So, when we have been talking during the past few forums about people living in settings where they can’t get nutritious food, Mark you are talking about these people living in a setting where they can’t find sanity.  So, in some sense it is not about race, The racially based ghettos that people find themselves in provide environments of lower quality with regard to health.  I was thinking of the work of Robert Sapolsky and his work regarding stress.  His work is directly aligned, Mark, with what you are talking about.