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Allostatic load: a mechanism of socioeconomic health disparities?

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TLDR
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.
Abstract
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.

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Citations
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Journal ArticleDOI

Allostatic load biomarkers of chronic stress and impact on health and cognition.

TL;DR: This article reviews theoretical and empirical work using the allostatic load model vis-à-vis the effects of chronic stress on physical and mental health and proposes policies for promoting successful aging.
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The stress of life

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A Systematic Review of Allostatic Load, Health, and Health Disparities

TL;DR: This systematic review examines the empirical literature that quantifies the allostasis and allostatic load construct and evaluates the social, environmental, and genetic antecedents of AL as well as its predictive utility for a variety of health outcomes.
Journal ArticleDOI

The effects of chronic stress on the human brain: From neurotoxicity, to vulnerability, to opportunity.

TL;DR: Modelling the roles that neurotoxic and vulnerability effects can have on the developing brain suggest that developing early stress interventions could potentially counteract the effects of chronic stress on the brain.
Journal ArticleDOI

Allostatic load burden and racial disparities in mortality.

TL;DR: Allostatic load burden partially explains higher mortality among blacks, independent of SES and health behaviors, and underscores the importance of chronic physiologic stressors as a negative influence on the health and lifespan of blacks in the United States.
References
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Journal ArticleDOI

How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions.

TL;DR: This review considers recent findings regarding GC action and generates criteria for determining whether a particular GC action permits, stimulates, or suppresses an ongoing stress-response or, as an additional category, is preparative for a subsequent stressor.
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Protective and Damaging Effects of Stress Mediators

TL;DR: The long-term effect of the physiologic response to stress is reviewed, which I refer to as allostatic load, which is the ability to achieve stability through change.
Book

The Stress of Life

Hans Selye
TL;DR: In this paper, the discovery of stress, the dissection of stress the disease of adaptation sketch for a unified theory implications and applications is described, and the authors propose a unified framework for adaptation.
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Health inequalities among British civil servants: the Whitehall II study

TL;DR: There was an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis, and self-perceived health status and symptoms were worse in subjects in lower status jobs.
Journal ArticleDOI

Stress and the Individual: Mechanisms Leading to Disease

TL;DR: A new formulation of the relationship between stress and the processes leading to disease is presented, emphasizing the cascading relationships between environmental factors and genetic predispositions that lead to large individual differences in susceptibility to stress and, in some cases, to disease.
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