Medicine Now Diagnoses the Non-White ‘Oppressed’ With an Oppressive Case of ‘Weathering’

A white professor at the University of Michigan whom The New York Times hailed last year as an “icon,” Geronimus has combined race theory with data and statistics to argue that the chronic stress of living in an oppressive, white-majority society causes damage at the cellular level and results in shorter life expectancies for blacks. In more than 130 published studies, she has expanded the weathering hypothesis into a dystopian sociological worldview that identifies the “American Creed” of hard work as the silent killer of people of color.

“Living life according to the dominant social norms of personal responsibility and virtue is not universally health‑promoting,” she wrote in a Harvard Public Health essay last year. “On the contrary: if you’re Black, working hard and playing by the rules can be part of what kills you.”

The weathering paradox – that “relatively young people can be biologically old” – is now influencing policy decisions at all levels of governance. It has provided the foundation of many of the policy decisions of the White House COVID-19 health equity task force. In New Hampshire, the governor’s COVID-19 Equity Response Team issued a report and recommendations in 2020, citing weathering (and “racial battle fatigue”) as documented and established realities of American life.

The weathering hypothesis medicalizes social relations and politicizes medicine. Weathering prefigured the recent flood of medical research that centers race in public policy and supplies the rationale for such moves as 265 public authorities declaring racism a public health crisis; health officials jettisoning colorblindness and prioritizing people of color for COVID vaccinations and heart treatment; and medical schools training future doctors in social justice activism.

Some critics are pushing back against what they see as the heavy-handed, COVID-era politicization of healthcare. Boston University public health dean Sandro Galea warns that his profession has veered into overcorrection and revolutionary excess. Galea rebukes public health advocates for favoring political narratives over empirical data, denying the reality of social progress, and fixating on a utopian quest “to create a world free of risk.”

Geronimus did not respond to emails requesting an interview for this article.

It’s amply documented that African Americans of all social classes have worse health outcomes, earlier onset of chronic diseases, and average life expectancies reported as five to six years less than whites. Weathering science, as Geronimus calls it, measures various biomarkers of what is presumed to be psychosocial stress – such as cortisol levels, telomere lengths, cytokine storms, and allostatic loads – to make the case that on average black adults are as much as 10 years older biologically than white people of a comparable chronological age.

But the data is complicated and doesn’t always add up. For example, in a 2021 study, a gerontology scholar at the University of Southern California assessed 13 measures of epigenetic aging. It found that some of the measures indicate accelerated aging among African Americans, while others indicate slower aging for African Americans.

Nevertheless, Geronimus compares the black experience of living and working among white people to the fight-or-flight adrenaline rush of a prehistoric human fleeing a cheetah. She describes American society as a relentless onslaught of “microaggressions,” “othering,” “existential insults,” “daily indignities,” “voice erasure,” “identity threat” and other forms of “cultural oppression” that lead to early death.

The scientific conundrum is that the same biological evidence that supports weathering could also be “consistent with a lot of other things,” Robert Kaestner, a University of Chicago public policy professor who co-authored a weathering study with Geronimus in 2009, said in a phone interview. “It’s always a measurement problem.”

“Weathering is a hypothesis, still in search of definitive evidence,” Kaestner said. “I’ve never seen one [study] – including my own – where it’s a definitive study that this really is a smoking gun that racism or prolonged psychosocial stress causes adverse health outcomes.”

Yet the weathering hypothesis is continuing to gain traction. Geronimus writes that in 2020 she was asked by immigration attorney Kari Hong to submit expert testimony on weathering in support of early-release petitions for immigrant asylum seekers who were being held in detention. Hong argued to federal judges that these foreign-born detainees were “biologically older than their chronological age” and should be released “as senior citizen detainees.”

According to the New York Times, Hong won early release for “all seven detainees,” based on Geronimus’s weathering testimony.

This article was adapted from a RealClearInvestigations article published Feb 13.