Open AccessAcknowledging and Addressing Allostatic Load in Pregnancy Care
Author(s) -
Kirsten A. Riggan,
Anna Gavin,
Megan Allyse
Publication year - 2020
Publication title -
journal of racial and ethnic health disparities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.644
H-Index - 21
eISSN - 2197-3792
pISSN - 2196-8837
DOI - 10.1007/s40615-020-00757-z
Subject(s) - allostatic load , socioeconomic status , pregnancy , stressor , gerontology , women of color , childbirth , medicine , health equity , psychology , public health , environmental health , population , psychiatry , sociology , race (biology) , nursing , gender studies , biology , genetics
The USA is one of the few countries in the world in which maternal and infant morbidity and mortality continue to increase, with the greatest disparities observed among non-Hispanic Black women and their infants. Traditional explanations for disparate outcomes, such as personal health behaviors, socioeconomic status, health literacy, and access to healthcare, do not sufficiently explain why non-Hispanic Black women continue to die at three to four times the rate of White women during pregnancy, childbirth, or postpartum. One theory gaining prominence to explain the magnitude of this disparity is allostatic load or the cumulative physiological effects of stress over the life course. People of color disproportionally experience social, structural, and environmental stressors that are frequently the product of historic and present-day racism. In this essay, we present the growing body of evidence implicating the role of elevated allostatic load in adverse pregnancy outcomes among women of color. We argue that there is a moral imperative to assign additional resources to reduce the effects of elevated allostatic load before, during, and after pregnancy to improve the health of women and their children.