Exploring Stress, Allostatic Load, And Disparities In Black Womxn's Reproductive Health

Abstract

In a 2022 interview, Senator Bill Cassidy (R-La.) suggested that high maternal mortality among Black womxn is a natural racial disparity, reflecting a widespread belief that the inability to attribute disparities to social factors like income and access to care supports essential biological differences. Rejecting this biological determinism, this dissertation investigates the effects of racism on health as manifested in allostatic load (AL), offering insights into the intersections of race, stress, and health outcomes. Allostatic load (AL) refers to the cumulative burden of chronic stress and is proposed here to quantify the physiological consequences of systemic racism. This framework allows for an examination of how prolonged exposure to stressors impacts health outcomes among Black womxn, thereby transcending simplistic racial explanations. The first chapter is a literature review on AL and its implications for racial disparities in reproductive outcomes. The chapter establishes the foundational framework by explaining how chronic stress and systemic racism contribute to these disparities. The second chapter employs an experimental mouse model to examine the impact of chronic stress on metabolic and physiological systems. This approach provides valuable insights into the biological mechanisms through which chronic stress impacts health, offering a translational perspective to human populations. The third chapter systematically reviews the factors that contribute to assisted reproductive technology (ART) outcomes for Black individuals to dissect further how social barriers and stress interact even in controlled medical settings. This dissertation establishes allostatic load as a critical tool for understanding and addressing health disparities driven by systemic racism through a comprehensive integration of literature review, experimental research, and systematic analysis. By examining chronic stress and its physiological impacts, it challenges prevailing notions of racial health disparities and proposes a robust framework for future research and policy-making. This work offers innovative insights to combat the effects of racism on maternal and reproductive health outcomes among Black womxn.