Decompiling Oppression #138
Sam McVeety
I find myself with a lot of thoughts percolating from Elite Capture, Defectors, and our (belated) annual Passover seder, but I want to give those a bit more time to coalesce. As a precursor, I'd like to spend this week on some ideas from Arline Geronimus's Weathering, a book that reflects decades of research about the effects that structural oppression has on the aging process, and how experiencing othering through forces like racism, xenophobia, and heterosexism can have substantially negative health outcomes. For those who prefer video, you can also find many of these ideas in Unnatural Causes (thanks, Sophia!).
Now, you may be thinking that yes, of course: we already know that there are things like social determinants of health, and that things like poverty, diet, housing, and services can all interact to impact people's health. While that is all true, there's an important distinction that weathering layers on top environmental effects, which is the impact of purely social interactions on well-being. For example, the need to code switch and navigate daily microaggressions doesn't "just" mean you have a bunch of unpleasant days; the very act of enduring these circumstances actually lowers your life expectancy:
Weathering results from repeated or sustained activation of the physiological stress response over years and eventually decades. This means that a person’s health and life expectancy depend more on their experiences, their interactions with others, and the physical environment they live in than on their DNA signature or lifestyle.
In many ways, this is a bleak picture. We already know that racism can kill you through police violence, medical neglect, poisoned water, or other factors in your environment. Weathering goes a step further, though, observing that even in subpopulations that should be insulated from these environmental factors (through access to wealth and class privilege, say), health indicators still display negative trends.
We can see these effects in populations of Mexican immigrants, where the second generation has worse average health outcomes than the first generation. This happens in spite of the fact that average income, education, and other standard determinants are better for the second generation, the hypothesis being that the first generation is relatively insulated from the daily grind of racism (e.g. occupying majority Spanish-speaking settings, living in communities with other first generation migrants). Conversely, the second generation is more likely to occupy mixed spaces (moving into majority-white, primarily English-speaking neighborhoods and jobs).
To find these outcomes, we have to look beyond the general trends in data and bust some myths that seek to explain away discrepancies in excess mortality (the additional number of deaths relative to what would be expected from an "average" population) with simple stories. For the immigration example above, the simple story is that these changes are a result of converting to an American diet (nope: the effect persists when controlling for diet). For Black inner city populations, the simple story is guns and drugs (nope: this doesn't nearly account for excess mortality from disease). The effects are not limited to people of color, too: deaths in white rural communities are not neatly explained by acute causes of death like opioids. The common thread here is that these are populations that experience psychological precarity and must navigate indignities daily.
Reproductive health is one area where all of these factors combine. For years (and still), racist narratives blamed societal ills on young Black mothers bearing children "too early". The resulting campaigns to postpone pregnancy to later ages succeeded in doing so, but actually increased Black maternal mortality, because the effects of weathering (conditions like hypertension and blood clotting) make childbearing more dangerous with every passing year. Once again, Dr. Ruth Wilson Gilmore's definition of racism as "state-sanctioned and/or extralegal production and exploitation of group-differentiated vulnerability to premature death" feels uncannily accurate.
Set against the current political climate, studying the effects of weathering is all the more remarkable (and urgent). With NIH and other grants in danger, this is the kind of research that the administration almost certainly is trying to suppress. It casts the paradox at the center of racism into sharp relief: although racial categories were originally built upon a fiction, their effects have created real group differences in life outcomes.
Here are this week's invitations:
Personal: When do you feel "at home" in a given space? When do you feel uneasy?
Communal: How can we work to increase a collective sense of belonging in common spaces, rather than persistent othering?
Solidarity: Support Tubman Health and their work to advance health justice, culturally appropriate care, and integrative medicine.
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