What Is Weathering?, with Dr. Arline Geronimus

Season 6Episode 8June 13, 2024

Dr. Arline Geronimus talks about weathering, how health and aging have more to do with systemic oppression—how society treats us—than how well we take care of ourselves.

Dr. Arline T. Geronimus coined the term “weathering” to describe the effects of systemic oppression—including racism and classism—on the body. In 2023, she published Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society to shine a light on the topic and offer a roadmap for hope. This summer, she joined us at the 2024 NCA Leadership Conference to share her research with child abuse professionals who have dedicated themselves to helping children go on to live happy, healthy lives. This is the conversation Dr. Geronimus had with Teresa Huizar, the CEO of National Children’s Alliance and host of One in Ten podcast, in a plenary session at the conference.

 

Topics in this episode:

Origin story – 03:15

What is weathering? – 10:10

Physiological stress (not just three minutes of terror on the savannah) – 17:12

When weathering starts – 28:33

Our expectations of caregivers – 33:16

Cost of resiliency – 40:20

Solutions – 54:16

 

Links:

Arline T. Geronimus, ScD, professor, health behavior and health education, School of Public Health, University of Michigan

Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society, by Arline Geronimus (Little, Brown Spark; March 2023)

Robert Sapolsky, Ph.D.

The video version of this conversation will also be available on NCA’s YouTube channel. Watch it now!

For more information about National Children’s Alliance and the work of Children’s Advocacy Centers, visit our website at NationalChildrensAlliance.org. And join us on Facebook at One in Ten podcast.

Season 6, Episode 8

“What Is Weathering?”, with Arline T. Geronimus, ScD

Recorded on June 4, 2024, at the 2024 NCA Leadership Conference in Washington, D.C.

[Intro music]

[Intro]

[00:10] Teresa Huizar:
I think you all know, I’ve seen people bring their own book for the book signing, which is great, too, that will happen immediately after the session. But Dr. Geronimus, her book is also being sold at our membership table, which is where the book signing will be. It’s $19.99, and it is worth every penny and more. It’s a fabulous book, which I have read personally myself.

Let me just welcome her to the group and then, as you guys know, we’re recording this as a podcast interview. And I’ll be—we’ll have our discussion together.

I have to tell you, this is a person that I have wanted to have come to our conference and speak since I first listened to her being interviewed by someone else—and I can’t remember if it was on NPR or a podcast or what. But when I heard her talk about weathering, so many things that I had been wondering about made complete sense to me. It was truly an “aha” moment. Have you ever had one of those? Where the light bulb really turns on, and you’re like, “Oh my gosh. I’ve been wondering or thinking a little bit about, or I knew something, but I didn’t know everything that I needed to know about that.” So, I just feel so honored and privileged, and you are going to feel that way as well, to have this opportunity to speak with Dr. Arline Geronimus today as a part of this fireside chat.

And, I will say, she has such an illustrious bio that we could spend 15 minutes just going over that, but I will keep it brief and limited just to a paragraph or so before we start our conversation. But she is a renowned public health researcher, professor, and author of Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society. Fusing science and social justice, Dr. Geronimus explores the ways in which systemic injustice erodes the health of marginalized people.

Weathering is based on more than 30 years of research. She argues that health and aging have more to do with how society treats us than how well we take care of ourselves. And that narrative is really turned on its head.

She explains what happens to human bodies as they attempt to withstand and overcome the challenges and insults that society leverages at them and details how this process ravages their health. And she proposes solutions. So don’t feel like this is just going to be a conversation about problems. It’s also solutions.

She’s a professor in the School of Public Health and research professor in the Institute for Social Research at the University of Michigan, where she is also affiliated with the Center for Research on Ethnicity, Culture, and Health. And she’s an elected member of the Institute of Medicine of the National Academies of Science. Will you join me in welcoming Dr. Geronimus?

[Audience applause]

Arline Geronimus:
Thank you for that nice introduction.

[03:15] Teresa Huizar:
So I am wondering, for those folks who may not yet have read your book—[to audience] and we’re hoping you all do if you haven’t yet—but for those who haven’t, can you talk a little bit about what brought you to this topic? What made you so interested in this intersection between poverty, race, disability, and early death?

Arline Geronimus:
There are many layers to that, you know, to the answer to that question. But I think the most important ones were first just when and where and to whom I was born. I am the granddaughter of political refugee immigrants who fled genocide to come to the United States and then raised their children, my parents, in working class urban ghettos in Harlem and the Bronx and Brooklyn, New York.

And, so I had heard from a very young age the horrible stories and atrocities and traumas that my grandparents had gone through. And I became very aware of how ethnicity or race or other social identity group—it can be LGBTQ, it could be transgender, it could be Islamophobic, whatever, but if you’re in a group that is deplored, that your life is just different. And you carry that with you through your whole life in various ways.

I wasn’t thinking about health, per se, just about how unfair that system was, and the stories I heard from my grandparents about what life was like before they immigrated, and the stories I heard from my parents about growing up in working class areas. And so I think that set the stage.

My parents were able to go to college, so by the time I came around we were middle class. But they were able to go to college because, living in New York, they had access both to great public tuition-free colleges and they had access to a great subway system. So they could live at home and get to college. And so I also understood how policies can make a difference. And how even for my parents’ generation, who did achieve and became accomplished people and financially secure, I saw how hard that was. Yes, there’s a subway, but it took my father two hours each way to get to school every day, college every day, on that subway. And my mother had to still work full-time and go to night school in order to help support her family at the same time as she was getting her education.

So I really had a sense, given my circumstances, that they were different than my parents’, which were different from my grandparents’. But they were all of a piece in the sense of the kind of match that lit, you know, the fuse in all of them was racism of some kind, and poverty.

And that I had also seen in both those generations ahead of me that the reaction to being in those circumstances was what, you know, we might call high-effort coping. They didn’t just give up. They didn’t, you know, just tune out and take drugs. They did whatever it took—my grandparents to get out of the genocide. Then to feed their families in a country where they didn’t even speak the language and didn’t know anyone. Then my parents even to kind of take the baton and go to college, even though their own parents, you know, hadn’t even gone to high school and didn’t even speak English.

And so, but I was hearing about all these “lazy people.” You know, all, that the reason immigrants, people of color, you know, poor Americans were in the predicaments they were in is because they just were, either didn’t know enough, or they were drawn in by the drug economy, or they were just plain lazy. Old stereotypes, as old as this country. Racist stereotypes. And I knew that, I knew in my heart that wasn’t true because I had seen what my parents and grandparents had lived through and how they had responded with some hope, with tenacity and persistence, and met their responsibilities as best they could.

I also saw a lot of illness across my family. So from an early age I also had some sense of maybe a tie to health, though I wasn’t really thinking about that much. But so many of my aunts and uncles were diabetic. My uncles, my favorite two uncles, died in their early fifties. Two of my father’s brothers died as infants. I just was seeing—my own mother died when I was a child. So I was seeing this kind of death all around, and that, I cannot claim that when I was 5 or 10 I linked that to these other concepts, but I think it kind of was grist for the mill for later in life.

And then I grew up in sort of the ’50s and ’60s during the height of the civil rights movement. So I was very aware of social justice issues and how—well I didn’t know how to talk about them about my own family history. I had a very clear sense of how you talk about them in terms of race in the United States at that time. I watched, you know, Bull Connor as he hosed down little children. I watched Ruby go into the, as a little girl, Ruby Bridges go into the school to integrate with all these, you know, security details and all these people yelling horrible things at her. And so I was very aware of the civil rights movement and that unfairness. And so I knew I wanted to do something in life that would deal with racism and social justice.

It was only much later that I started realizing, well, that has health implications, too. It’s not only whether you get to go to the integrated school. It’s not only whether you get to live in certain neighborhoods.

[10:10] Teresa Huizar:
And so for those folks, you know, to segue a little bit into those health effects, for those folks who may not know what you mean when we talk about weathering, the title of your book, can you just talk a little bit about that and how this concept runs maybe counter to society’s narrative—

Arline Geronimus:
Mm-hmm.

Teresa Huizar:
about those things?

Arline Geronimus:
Weathering is a human—and I want to be very clear, it’s human; it would happen to anyone who was treated, you know, with consistent systematic injustice—it’s a human biological process whereby both the many stressors to which you’re exposed if you’re a member, say, of a marginalized group—and this can also apply to individuals who have been traumatized or abused—but if you’re in a situation, whether it’s your family or society, where you don’t have much power to get out of it and you’re treated very poorly. And that’s kind of a euphemism. It’s those exposures combined with—and this is what I think I got from my grandparents and parents, though I didn’t realize it for decades—it’s your high effort coping with it.

It’s the combination of remaining, you know, banging your head against that wall, being resilient, doing whatever it takes. If you have to, you know, if the only jobs you can get are minimum wage jobs, and they won’t support your family, you do three of them. And if you can’t own a car because you can’t afford it, you know, you take whatever buses or public transportation, however—you know, the New York City public transportation was pretty great when my parents were going to college, but a lot of public transportation systems, where they exist at all in this country, are not so great. And so you’re taking your three different buses, you’re working out, you know, you’re constantly vigilant about how you’re behaving at work, you’re also worrying about your kids and how you’re getting home, you can’t take—you have no personal time. Most Americans have no breaks, no time off.

When you’re kind of taking the bull by the horns even though you have minimal societal support and a lot of societal actually degradation and denigration, that weathers you, too. The combination of the exposures and the act of coping to survive and maybe even overcome or at least make things better for the next generation.

And so I picked the word “weathering” because I thought it spoke to both sides of that. I think people intuitively get the first part, which is the exposures. Like a rock is weathered by storms. You know, people who are dealing with all kinds of racism, poverty, lack of support for child care, being demeaned at work, having to work, you know, 16-hour days and then go home and get your kids off to school. People who are living in neighborhoods with literally toxic exposures in the air or the soil or the water. That those, that part of weathering, harms you and your health. And I can go into the weeds later, if anyone wants to, exactly how that happens. But it does.

But it’s also, I liked “weathering” as the name because it’s also this idea of weathering the storm. Being resilient. Not just lying down and taking it, or just giving up or committing suicide or—it’s not that maybe your behaviors of certain kinds are not—they’re also affected by these stressors—but for the most part, you’re not that, you know, “urban pathological underclass” that I heard all about in the ’80s and ’90s. You’re not evil. You’re actually completely in sync with American values of working hard, playing by the rules, supporting your children, doing the best you can under such hard situations. So I thought “weathering” captured both sides.

And both of them lead to this chronic activation of your physiological stress. And that’s why I say it’s a human process. We’re all made to react to any kind of stressor with some degree of physiological arousal. But for most of us, that’s in, you know, occasional doses. But if you’re constantly activating your physiological stress process, over time that erodes your arteries, that enlarges your heart, that causes blood sugar problems, obesity—all the things we think of as health problems that in our minds we’ve all been told are about personal behavior for the most part, or maybe poverty, we have some sense poverty has something, that’s our, you know, our sense of social determinants of health, which people do talk about now, they didn’t when I was beginning.

But there’s still a very limited set. They don’t understand that interaction of this lived experience under systemic structural oppression or exploitation and how that leads to just across all your body systems, tissues, and organs, down to your cells, leads to your accelerated aging, your susceptibility to all kinds of infectious diseases, came into play during COVID. Your early onset of chronic diseases, like I was seeing in my aunts and uncles. And so it’s a very different picture, both of what it is that causes health inequities that people are now aware exist between racialized groups and how we think about how the people under this experience, the dynamic between them and trying to survive anyway.

It’s about their characters. It’s a different depiction of their character. It’s a different depiction of their motivations. And so for all these reasons, it has to lead to different policies and ideological changes and normative changes if we’re going to eliminate these inequities.

[17:12] Teresa Huizar:
One of the threads that I felt was throughout the book was really noting the way in which common narratives are in many ways sort of victim blaming. You know, you were talking about it in regard to health. What you eat, you know, what causes folks to become diabetic or have some sort of chronic health condition or early disability. That the sort of societal narrative around that tends to be very much: Well, why didn’t you take better care of yourself? You know, why don’t you make different choices?

When in fact, as you’re describing, and as we saw in the book, even if someone made completely different choices it would have such limited impact on any change to those things. Can you talk about why that is?

Arline Geronimus:
Yes. I think to do that, I need to get a little bit in the weeds of this actual physiologic process.

Teresa Huizar:
Go right ahead.

Arline Geronimus:
We are all adapted as human beings to respond to stressors. We’re adapted to do two things. We’re adapted to constantly understand our environment and any challenges in it, however small and what our body has to do to adapt. So when I have to stand up from the chair, my body is actually doing things to keep me on balance.

We’re probably all aware of the most extreme version of this, which is the fight or flight or freeze, which is, we were all kind of evolutionarily created to, in the face of a life-threatening situation, to go into this physiological stress arousal. Now what happens in that physiological stress arousal is that you start pumping blood much harder to your large muscles so you could fight or flee.

You also do other things. You start mobilizing glycogen, which is sugar that’s stored throughout your body to give you energy. Same with fats in your body. You also mobilize immune cells already in case you get, you know, mauled by the tiger, to be ready to help you heal or avoid infection or heal from infection and wounds.

And meanwhile, your body is also not sending oxygenated blood and nutrients to other tissues and organs. In part, it’s actually even degrading some of your other tissues and organs to bring protein. Everything in your body is saying: We have to feed those large muscles. We have to get this person able to do, you know, superhuman feats of running or fighting or, or whatever. When you hear about, you know, how a mother can pick up a car if her child is under it. And so everything else in your body either is sort of shut off or it’s used actually to promote your large muscles. Well, that’s what gives you any fighting chance against the tiger who’s about to eat you.

But that—so it’s very protective in those situations. But that is meant to last about three minutes. As Robert Sapolsky, who’s done a lot of work on this physiological stress process puts it, you know, physiological stress reactions are three minutes of terror on the savannah after which you’ve either escaped or you’re dead. Either way, it’s over in three minutes. And then your body, if you escaped, your body returns to normal.

Now what happens when you’re growing up under really hard life experiences is that, first of all, the three minutes are never up. There’s this stressor, there’s that stressor, there’s having to stay vigilant to stressors. Part of having that response is you have to be able—and we talk about street smarts sometimes, or being able to just know something’s in the air about to happen. So there’s a kind of vigilance that you keep up all the time that leads you to sometimes have false alarms. But it’s better, if you’re in a high stress situation, to overreact to a false alarm than to miss a true threatening alarm.

So if this has happened to you constantly, and you’re ready for it to happen, you’re kind of mobilized. You have your armor on. You’re listening for all those things other people will miss, but that you know might mean danger’s lurking. What that means is that blood is pumped that through your body forcefully, endlessly. That those sugars, those fats, those immune cells, the proteins that get degraded in some other tissues are circulating.

We think that happens from eating the wrong thing. There’s less and less evidence that it makes a whole lot of difference. I mean, I’m not saying don’t try to eat healthy. Please don’t quote me in any way that suggests I think that’s a total waste of time. But we’ve overstated how much we can control our weight or our cholesterol or our sugar in our blood, etc., through diet.

But what does happen is if you’re chronically circulating the immune cells, the fats, the sugars, and degrading proteins in other muscles, you will find that over time, you get hypertension. You get diabetes. Your heart enlarges, like any exercising muscle that’s overexercised. You develop plaque in your arteries. You get embolisms. You have strokes. You become disabled.

In terms of the immune system, that endless kind of mobilization of your immune system when they, sort of, it’s like all dressed up and nowhere to go because you’re not mauled by a tiger. It dysregulates your immune system so that your immune system doesn’t—it either responds very weakly or can’t respond to real infections or it over-responds. So you get autoimmune diseases. A lot of autoimmune diseases is about the over-response of your dysregulated immune system.

I believe that a key reason for COVID-19 inequities by race were because people who were already weathered, you know, had dysregulated immune response, were more likely to have what you may have heard of in the news about the cytokine storms that preceded many COVID deaths. Many people who died of COVID didn’t die directly of COVID, but they died because their own immune systems got overly aggressive and attacked their lungs and their hearts. And that’s what literally killed them. Well, that’s a classic sign that you’re weathered.

So this narrative we’ve all been taught, 1) that health and age are related just by development. You know, there’s a developmental process where you grow, and you become an adolescent, and then you become a mature adult, and your health is fine, you know, for 30 years, and then you start to age. It’s not that that isn’t happening or isn’t part of it. Again, I don’t want to ever be misunderstood as saying these things don’t matter at all. But they don’t matter the way we think they do, or to the degree. And just trying to deal with them is not going to make the difference. Instead, your rate of aging is about how often, you know, I think weathering is sort of three parts of your experience.

One is whether your stressors, we all have stress, but whether the stressors are acute or chronic. So again, avoiding a tiger that’s attacking you is a major stressor, but it’s really great we have this response and that’s protective. But if you’re having that response every hour of every day. And it continues while you’re sleeping because you’re so burnt out, stressed out, or you’re living somewhere where you actually do need to stay a little vigilant, even at night. Whether what you’re staying vigilant to is criminal activity, or whether what you’re staying vigilant to is police activity, coming, you know, thinking they have your address is the address of the drug dealers they want, you have to remain vigilant while you sleep. And so these processes are also happening in your sleep.

And so it’s just a very different explanation of why—and a far more plausible one than people just don’t eat the right foods, or do the right behaviors, or have good sleep hygiene. Things that may make marginal differences in very affluent or privileged people who are members of dominant groups. But those are not the things that really matter to the health of the most disadvantaged and structurally oppressed.

And the other problem we have as a society is I think we also think of each condition separately. You either have diabetes or you have hypertension, you know, and you try to exercise not to be fat, but you try to eat not too much sugar or not too much starch not to, you know, get diabetes. The reality is it’s a whole lived experience and it weathers every part of your body. And so you could get any or all of these diseases.

And there we come to some of the disability too, which is that, more often than not, people who are weathered by middle age have multiple morbidities. It’s not just one thing or another. And they start getting health-induced disabilities. So that they are living lives—again, you know, our world is just not made for people who are disabled. That’s wrong. And that should change. I’m not trying to be ableistic about this, or ableist about this. But the reality is that, you know, if you have lost, you know, good use of your mobility, if you’re not mobile, if you’re functionally limited in any sort of ways, it does make life that much harder.

And so what some of the research, our research has shown is that how early and how young people who are subjected to weathering start having these functional limitations that interfere with their everyday lives, interfere with their ability to work. So—

[28:33] Teresa Huizar:
And can you actually talk about that? Because you and I were talking at the table about how young that happens and the differences—and I was really struck by that in your book, the data tables really showing at what early ages even that individuals are experiencing this disability and early death, and how different that is from dominant culture. Can you just share that with the group?

Arline Geronimus:
In populations subject to weathering, people start showing signs of being weathered really, in their late teens, early 20s, certainly by their 30s. Many of them get precursors to worse diseases, like those who have metabolic syndrome in their 20s, which is often a precursor to hypertension, obesity, you know, this spectrum of diseases, all of which are bad for your longevity and your health. Their immune systems get dysregulated at an early age.

People will have—you know, I haven’t talked much about the impacts of weathering on maternal and infant mortality, but those are important, too. If your body’s very weathered, you’re more likely, you know, in going through childbirth to hemorrhage. You’re more likely to—your baby will be growth-retarded, more likely, or come out early. Because, as I said, when you’re in this constant stress situation, your body automatically doesn’t send nutrients to any part of the body that is either not going to help you fight or flee or will even be a drag on your fighting or fleeing. So a fetus is suddenly not very important at all to your body. And so it will lose nutrients. It will lose oxygen. You may go into preterm labor. And even if you don’t, you may, because of the lack of nutrients and oxygen to the fetus over a prolonged period of time, it will be born too early or too small, growth retarded, low birth weight, very low birth weight, much more likely to die or to survive with disabilities itself.

So some of these disabilities are happening as you’re born. Some of these disabilities, you start seeing them in very large percentages in the 30s and 40s. And you see their precursors in the teens and the 20s. And they can even affect infants through what’s happening in the mother’s body while she’s pregnant or delivering.

So it, it’s disability all through life, which then has implications for caretaking, for,  you know, who you can count on to help you raise your children. If you’re living in a, you know, poor families, very often—you probably know this very well—work out these multigenerational, I guess what anthropologists would call them kin network systems. Where, you know, where more affluent people might be able to buy child care or hire a nanny or a house cleaner or, you know, anything to get the domestic chores done. People who don’t have those kind of resources or access to those kinds of systems or solutions will often pool their resources, pool their domestic and caretaking work and work across generations.

Well when people are getting disabled or dying at early ages, that first means that just as the adults are kind of being—your adults in your network are being depleted through maybe death or disability themselves, is that when there’s more and more disability, and so you have to, you know, we have no good programs to support the disabled. So you have to do caretaking of your elderly parents, who aren’t elderly, they’re 45 or 50.

Teresa Huizar:
They’re weathered.

Arline Geronimus:
They’re weathered, exactly. Same time you might need to be taking care of your kids, or if your parents had still, or other older members of your network, had still been healthy, they could have helped with your kids.

So it has implications for when you have your children. Both in terms of the physical, when you’re still physically healthy enough to reduce your risk of maternal or infant morbidity and mortality. But it also has to do with, how do you fulfill all these different social roles? Who’s going to be healthy enough to help you out? Or who’s not going to be healthy enough and is going to need you to help them out? Or you to have had children young enough that your children are old enough to be a resource rather than a drain in this kind of informal caretaking.

[33:16] Teresa Huizar:
One of the things I was thinking about as you were talking about that, in your book as well, was, you know, when we think about the families who come to Children’s Advocacy Centers, you know, we have children who’ve had some sort of trauma from child sexual abuse or some other form. And they’re brought by caretakers who care deeply about them. But in light of your book, I’m wondering, you know, we have all these expectations of those caretakers, right? Get your child to therapy. Now they need a medical exam. Here are all the things we want you to be doing. And in some cases, we’re asking people who are struggling with their own disability, potentially. Or their—certainly their own weathering, their own traumas, their own experience in this unjust society, to also be, because they do love their children so much, taking care of them. And I just wonder—also, because we often frame this in the context of a nuclear family—are we even taking into account some of those kinship networks and all the additional burden that you are talking about that people are carrying into our Children’s Advocacy Center just when they’re showing up to care for their kids?

Arline Geronimus:
Right. Well, one of the things I want to highlight about weathering is that the worst weathering ages are exactly the ages where we think everybody’s in their prime health, based on this more developmental model. It is the reproductive and working ages. And that’s because people are being stressed in all these ways, pulled in all these directions. And they do the high-effort coping. And they do the high-effort coping to survive themselves, but also because they love their children, or their parents, or, you know, care about this broader network of people.

So people who are raising children or working age, the very people you will tell, “Now do this. Do this. Do this,” well of course I’m not saying don’t tell them that. But that will probably add to their weathering, which will also probably mean their children have a greater chance of being orphaned or have their parents disabled at a young age or unemployable at a young age.

So I think we have to think about all the moving parts and all the intersecting oppressions and physical sequelae and what kind of programs can help those parents do the things you’re telling them to do.

Teresa Huizar:
What sort of supports are in place to do those things that we’re asking people to do and adding to their a laundry list of things that they have to be responsible for, caring about?

Arline Geronimus:
Weathering is incredibly pernicious in this regard. And that’s also part of the high-effort coping and vigilance. You know everything’s a tradeoff. And you have very few resources to deal with those tradeoffs. So, you know, do you take the third job so you’ll have money all through the month to feed your child? Or, do you not take that third job so you can get the sleep you need and maybe be a more present parent in certain ways? Or have time to take them to the therapist or whatever. Do you take care of your ailing 50-year-old mother who can’t even take a bath on her own because she’s so disabled? You know, or do you take care of your school-aged child who can’t even, you know, who you could just leave as a latchkey kid and would probably be literally okay but who you know will do better if you’re actually there to be responsive to them.

So it’s also vigilance to constantly—people sometimes talk about men and women in more affluent circumstances where the woman does all the emotional labor. Many of us have this experience. That we’re the ones who are always making all the plans and coordinating everything. Our experience, if we are more financially secure, is nothing compared to the moment-by-moment improvisation, almost, that people who have so much less and have to deal not only with literal and practical—so their literal and practical dilemmas are really tough but they’re also dealing with, how do you raise a child in a world where other, you know, the rest of the world doesn’t love your child? How do you raise a child in a racist world? Or how do you help them be resilient, but not so—you know, this is the other irony, perverse irony.

As I said, resilience is the high-effort coping. So it’s shelter and it’s also storm. How do you try to make the balance there so it’s not all storm? It’s not all high-effort coping that leads to the erosion of your health.

Sometimes in families, and I think this happens a lot, is it is the women, across classes, who take on more of the burden of being resilient and figuring all these things out. So women also weather the worst.

We can see that, if you few look in some of the research we’ve done. We’ve looked over time at disability, early death. People think, for example, that Black men are the least healthy. They’re pretty unhealthy. I’m not trying to say anything’s, you know, great for them. But in fact, because the women are the ones who are more likely to be engaging in high-effort coping and staying on top of all the things that have to be done. In part because our own racism means we might be more likely to hire a Black woman than a Black man.

So that kind of, we see that as discrimination against the men. And it is. But without understanding this whole maelstrom of weathering, we don’t understand. But that means the women are the ones who have to get the three jobs, very often. The women are the ones who have to do all the juggling and the high-effort coping. So in fact, while Black men’s health at the younger ages is worse than Black women’s, as time goes on through the working and middle ages, it’s Black women who have by far the worst health, the greatest level of disability, the more years of life that are unhealthy, Men may die a little younger, for a variety of reasons. But it’s the women who have—who, what is the phrase? Get sicker and die.

I guess the men die quicker, the women get sicker. And they also die quicker than they should.

[40:20] Teresa Huizar:
Well, and to speak about racism for a moment, you know, one of the things that I was really struck by in the book as well, is you gave a number of examples where you had individuals who you would say on the surface are wildly successful, right? That they had used this high level of coping in order to advance their careers to very high levels. However, they still died young. They still experienced disability. And you—I remember one in particular, it was a Black man who was a lawyer and he had gone to Harvard and had this wildly successful career, who died at, I don’t know, maybe it was 52 or 49 or something. But you were using that as an example of what you’re talking about, this sort of cost of resiliency as well.

Arline Geronimus:
Mm-hmm.

Teresa Huizar:
And so can you talk a little bit about that? Because I think sometimes we think that if we can help a child become more successful and become a more successful adult, that that in and of itself will somehow buffer against all the effects of racism. And so I think what you were pointing out in your book is, you know, resilience is a double-edged sword. And when we help someone be more resilient, we also are contributing to some degree to weathering as well.

Arline Geronimus:
Yes, and I’ll give you some examples. But I also say it doesn’t have to be that way. There’s always this, what is the support that could be given? If we recognize that getting a higher education, being successful in your profession or even just in, you know, a working-class job market doesn’t solve all these problems. And if instead we realize we have to deal with the broader issues that racism causes and the way it contributes to weathering, then one wouldn’t have to choose between, you know, getting a college education or being healthier.

There’s now so much work on, you know, down even to the cellular level. Work we’ve done on the length of telomeres in your cells. Work other people have done on what’s called epigenetic aging. And across a broad range of diseases. That if you’re—this is not true for white Americans. And again, everything I’m saying is on average. There are individuals in every group, you know, who, who, somehow evade weathering or somehow are weathered despite their, what look like good circumstances.

But if we just look on average across the groups, there are people who, Black Americans who are born into poverty. It’s the ones who actually we think are being—[hits the microphone, apologizes] I’m sorry—are being, you know, have the most self-control, the higher executive function. They get themselves through school. They avoid drugs or, you know, bad behaviors or getting in with the wrong crowd. They go to college, against all the odds.

They may even, and in this case we’re talking about people—the person I think you’re talking about went to Princeton undergrad. First-generation college. Black American. Then went to Harvard Law School, did very well. By all our measures of success, this person was so successful. And yet we don’t understand that success brings—in our society where there’s so little support and so much racism—success brings its own weathering challenges.

That, you know, you have to work twice as hard. You have to code-switch. You know, you have to always be—that’s the vigilance. You’re vigilant all the time, too, because you’re kind of—there’s a lot of psychological studies, many of you may be familiar with that, where if you’re a person of color who enters a room in a predominantly white institution, say, that you’re immediately on your guard, trying to see whether you can be authentic or need to manage your social identity. Wondering if you’ll be treated fairly. Wondering what it’s safe to disclose about yourself or not.

Wondering whether this is a fool’s errand to go to this college class. Or whether you’ll make it through being reminded in every classroom, everywhere that there’s what’s known as “stereotype threat” you may be familiar with. Which is just sort of in the air, the knowledge that our racist stereotypes brand you as less intelligent, or less likely to succeed, or an affirmative action case who didn’t deserve to be there. All of that, dealing with all of that in various ways causes this vigilance and stress arousal to be chronic. So you haven’t escaped weathering. It’s coming from different things. You still have your love for your family, who may be poor, or working class, or have a lot, you know, may be dying young. You’re now looked at as the person who’s supposed to support them all and help them all financially.

And so there’s a different set of stressors. And so what we’ve found and others have found, there’s actually a very solid literature about this—I talk about it in the book if you’re interested—is that people who come from, say, rural Georgia, there’s been a study that’s followed them 30, 40 years, from high poverty in rural Georgia, some of the worst poverty in the country. If you follow them, the ones who actually went to college, the ones who, when they were young, you know, school-age, in high school or middle school, their teachers wrote about how they had great planful self-control. They are more likely to be weathered than their peers who didn’t do all those things.

The ones we think of as the ones who are really the troubled kids, often in their health do better. They don’t in their health do well. I am not saying that they don’t weather pretty badly. But we’ve just misunderstood all the sources of weathering and that it’s not 100% solved by having financial resources and education.

Those are important things. We should make the school systems more supportive in various ways so they don’t happen. You shouldn’t have to persevere in those ways and make the sacrifices you make and put in all that time and high-effort coping just to end up, you know, with hypertension, you know, when you’re 30 and cancer when you’re 35 and death from a heart attack if you’ve made it to 49, or a stroke.

And so we’ve seen, for example, in studies of this Georgia cohort, that it’s the people we think of as successful are more likely to have, again, metabolic syndrome, or any of these chronic diseases. Or to die even more young than their peers. We see a fascinating study that one of my former students did using this weathering framework, was she looked at Black college graduates across the country. And looked at whether they had metabolic syndrome by the time they were 27. That’s an arbitrary choice of where the data stopped. And whether they—so these are only college graduates—and whether they went to predominantly white colleges or historically Black colleges. And you can, I hope you can, guess who was doing better. The ones at historically Black colleges.

So from my experience and the work I’ve done, I would say that the most likely explanation is the ones who went to predominantly white institutions had to maintain that vigilance. They didn’t know the hidden curriculum. They had to wonder who, whether their professors were going to treat them fairly. Whether their friends were going to treat them fairly. They had to see that their roommates came from much wealthier situations and didn’t seem to understand at all.

I mean, this is a true story from actually when I went to college. My roommate my first year was the daughter of the editorial page editor of The New York Times and part of the broader family that started The New York Times and still published it. And so she started talking about how we should buy these curtains that she thought would be beautiful in our room. And they were insanely expensive. I didn’t even know curtains could cost that much money. For a dorm room! Her first, the first thing she said to me, in fact, when we met, I mean, this isn’t literally—I’m sure she said hello before this. But very early in our relationship, she said, “I wouldn’t let my parents”—this is in the early 70s, so, $1,000 would be probably more like $5,000 today. “I wouldn’t,”—or maybe even 10. “I wouldn’t let my parents spend more than $1,000 on my debutante dress. I couldn’t see them spending more than that on a dress I would wear only once.” And she seemed to be very proud of herself.

And I, first of all, had no clue what a debutante dress was.

Teresa Huizar:
Oh yeah.

[Laughter]

Arline Geronimus:
I had no clue what a $1,000 dress was.

Teresa Huizar:
Yeah.

Arline Geronimus:
I had brought with me a couple dresses I had bought in case I needed dresses, that I bought in Filene’s Basement. I don’t know if any of you know anything—

Teresa Huizar:
Yes!

Arline Geronimus:
about Filene’s Basement in Boston, that had cost me $25 apiece, that were very fancy, I thought.

So a $1,000 dress, and that allegedly they’re even higher, more expensive dresses that most debutantes, whoever they are, get.

So again, you can see right away, I don’t know how to have a conversation with this person. I see she’s proud of herself about this, and she thinks she’s being frugal. And she doesn’t understand why I can’t pay 50/50 for these curtains.

Teresa Huizar:
Yeah.

Arline Geronimus:
You know, that were probably on the order of $500 apiece. And we had two windows, so $1,000. So the first day at college I’m supposed to shell out.

Teresa Huizar:
Yes.

Arline Geronimus:
And she actually complained to other people about how I wasn’t holding my weight, or carrying my weight. And, you know, I—and then I’m left with the dilemma. Do I somehow try to do this anyway? Do I try to explain to her? Will she understand? You know, do I try to find some cheaper curtains and say, “Aren’t these beautiful?” [Laughter] You know, how do I cope? And how do I manage? You know, do I tell her right away, “Are you kidding me?” You know? Or I’m trying to make friends with this person who I’m going to live with for the next year.

So I think people going to the historically Black colleges didn’t have to deal with all that stuff. You know, whereas the ones going to the predominantly white institutions more likely did. And that’s a fairly trivial example. What about when you’re in your organic chemistry class and your whole life you’ve wanted to become a doctor and the professor gets up and says, “Some of you shouldn’t be here”? Or that “Look to the left, look to the right,” you know, “one of those people or yourself will not be here by midterm”? Or whatever.

And, you know, and you see all these people who came out of wealthy prep schools and just the top public schools in the nation, you know. And actually you don’t know this because you don’t know the hidden curriculum, but they all sat in on organic chemistry last year so they would be able to take it and get a good grade this year.

Then you, you know, you have this extra pressure on you to do well on the course. To prove you’re not lazy or stupid, as a stereotype threat is. But that stereotype threat at the same time is causing you to have physiological stress reactions. Not only will that contribute to your weathering it will make your performance worse in the class.

Because it—part of this physiological stress reaction is to shut down your cognitive capacities.

Teresa Huizar:
Weighing on you, right?

Arline Geronimus:
Right. Yes. And it literally shuts down your cognitive capacities and it increases your brain, you know, your amygdala full of, you know, it’s your emotional—because when you have to run from that, if we keep going back to the poor tiger, when you have to run from that tiger, you can’t think about it. You can’t kind of think, “Hmm, what should I do now?” You just have to have the terror and emotion and the movement.

And so it actually can make the fact that you’ll be the one who, who flunks out and loses your whole dream of being a doctor. Because you do poorly on tests. Because a test for you is not just a test on the, on the material, but you’re carrying with it the weight of: Will I support the stereotype my classmates and professors have? Or will I show them that I really do deserve to be here and I’m as smart as anybody?

And as soon as you’re perseverating about some of those things—

Teresa Huizar:
It’s hard to concentrate. Yes.

Arline Geronimus:
You can’t concentrate and literally cognitive connections in your brain.

[54:16] Teresa Huizar:
Because we only have five minutes left.

Arline Geronimus:
Oh. Sorry.

Teresa Huizar:
No, no, you’re doing—I can listen to you all day. I wish you could just stay with us.

But I, you know, we’ve been talking about these very serious effects, which we wanted to spend this time to talk about those and help folks understand so they can better understand the people who are coming through their doors every day. But I also want to give you an opportunity to talk about solutions and your framework for what all of us can do to help to try to address this, to make a more just society, ultimately, and a better situation for the kids who, even from their earliest time coming through our doors, are already experiencing the effects of weathering.

What can we do to mitigate that? What can we do to help?

Arline Geronimus:
OK. I know I have had this reaction myself. I’ve seen it in students. I know in some ways this is really daunting. And it sounds like: What could we do about it? It’s everywhere. It’s everywhere.

But I like to turn that around, and maybe this is my own coping mechanism.

I like to turn that around to say: It is everywhere. That means you can do something anywhere.

So, going back, say, even to this organic chemistry class. There are people working on writing scripts and helping edit syllabi in organic—literally in organic chemistry—but in STEM, in particular STEM courses. And actually they’re more interested in helping women than people of color, but it works for both. And you could generalize it to any kind of course in any kind of an oppressed group.

That have a growth mindset. You’re probably all familiar with the concept of a growth mindset. But this is a step mindset. This is saying the growth mindset is not whether you as a student have it or not, it’s whether your professor or teacher has a growth mindset. And gives you growth mindset messages.

So you could say that thing, “Look to the left, look to the right, they’re going to be gone.” Or you could say, “Anybody can succeed in this course if they work, and if, you know, they come to me if they have problems. And I’ll be there to answer your emails, to meet with you in office hours. If you’re having trouble, don’t take too long to come.” So they give you a sense that anyone can, you know—maybe you won’t get the A. Maybe you’re not going to become Einstein or, you know, win the Nobel Prize in chemistry. But you should be able, say, to get a B or even an A. And the people of color who could become Einstein or get the Nobel Prize in chemistry will be freer to do their best work.

So those kind of interventions right in a classroom—which is just about how you write your syllabus, how you do your opening lecture, and then you have to follow through, you have to answer the emails and whatever—have been shown not only to improve the performance of marginalized students in STEM courses, both women and people of color, but to reduce their stress arousal.

There have actually been studies being done recently where during taking, say, a high-stakes test like your organic chemistry final, they look at your heart rates and your skin conductance. Sometimes even, you know, your brain waves. But, won’t go there, that’s kind of intensive. But see that people subjected to the “look left, look right,” are much more under physiological stress arousal—so show signs of it during the exam, which, as I said, then means you’re going to not do your best work—than people who have been told, “Anybody can do this, you do have to put in the work, and I’ll be there to support you.”

[58:24] Teresa Huizar:
Well, in thinking about that, what that means in a CAC setting, right—

Arline Geronimus:
Mm-hmm.

Teresa Huizar:
to also have that growth mindset and the way that we’re talking about that. And I’ve gotten the flag over here. So I know that we are out of time, which I hate.

[Laughter]

[Speaking to the audience] However, folks, all of you who are wanting to talk to Dr. Geronimus, she’s going to be signing her book at the membership table in the back. So you can carry on this conversation and ask her more questions while you do that at that time.

I just so appreciate you coming to talk to us, and I really wish we had made this an hour and a half conversation and not an hour. But we’re so delighted to have you with us and really appreciate this just great information you’ve brought to us. So thank you.

[Applause]

Arline Geronimus:
Can I say one last thing?

[59:10] Teresa Huizar:
Sure. And she’s going to have the final word. So with that, go ahead.

Arline Geronimus:
[Laughter] My parents will tell you I always had to have the final word.

But the one thing I want to say since we didn’t get into solutions very well. What I am hoping my book does or disseminating this weathering information more broadly is it makes us shine.

You know, if you think about the guy who lost his keys and is looking under the streetlight and somebody asked him, “Is this where you lost your keys?” And he says, “No, it was somewhere else. But this is where the light is.” I’m hoping it will move those streetlights. I’m hoping that even if I can’t tell you the solution to everything—which I cannot—that now you’re looking under the right lamppost.

That people who will learn about weathering, whatever their walk of life, whatever their profession, whatever their role in their families, will now realize they should apply their socially situated knowledge, their expertise, their knowledge of their own lived experience  to the right lamppost.

And when we’ve talked about, it’s important to have nuclear families. It’s important to not eat high-fat foods. It’s important to have your exercise. It’s important to eat your vegetables and fruits every day. And therefore, if you’re unhealthy and you’re not old, that’s why, or if you’re not able to live to 142, it’s because you, you know, didn’t do all the right things. That’s the wrong lamppost.

We have to take weathering and use it as a prism through which we look at whatever walk of life we’re in and whatever we’re trying to make better and more socially just and think about:

Now that I know about weathering, what does that suggest I should be doing?

[Outro music]

Teresa Huizar:
Thank you again. So appreciate it.

[Outro music fades out]