Allostatic load: a mechanism of socioeconomic health disparities?
Although research on health disparities has been prioritized by the National Institutes of Health, the Institute of Medicine, and Healthy People 2010, little has been published that examines the biology underlying health disparities. Allostatic load is a multisystem construct theorized to quantify stress-induced biological risk. Differences in allostatic load may reflect differences in stress exposure and thus provide a mechanistic link to understanding health disparities. The purpose of this systematic review is to examine the construct of allostatic load and the published studies that employ it in an effort to understand whether the construct can be useful in quantifying health disparities. The published literature demonstrates that allostatic load is elevated in those of low socioeconomic status (SES) as compared to those of high SES. The reviewed articles vary in the justification for inclusion of variables. Recommendations for future research are made in the contexts of measurement, methodology, and racial composition of participants.
Szanton
Sarah L
SL
Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. sszanton@son.jhmi.edu
Gill
Jessica M
JM
Allen
Jerilyn K
JK
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D004522:Educational Status; D015444:Exercise; D005544:Forecasting; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007182:Income; D008019:Life Style; D009017:Morbidity; D009026:Mortality; D011203:Poverty / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D044469:Racial Groups / Q000193:education / Q000208:ethnology / Q000235:genetics / Q000523:psychology; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000208:ethnology / Q000235:genetics; D014481:United States / Q000453:epidemiology