185: Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society
Chronic stress from life in an unjust society can have measurable negative impacts on the health of people from marginalized backgrounds.
The concept is known as weathering, and it’s the focus of the aptly named book by Arline Geronimus, a member of the National Academy of Medicine and a professor in the school of public health at the University of Michigan’s Institute for Social Research.
Weathering is exacerbated by racism, sexism and other forms of discrimination, and can contribute to health disparities, leading to earlier onset of diseases like cardiovascular and metabolic diseases.
Geronimus compares modern-day stressors to the literal predators of the past and urges listeners to come together to explore systemic solutions that can help mitigate the effects of weathering.
“We all have to commit to seeing each other, to understanding the differences in our lived experience,” she says, “to seeing that different people have different ‘lions’ and ‘tigers’ …and figuring out what it is we have to do to change that.”
Geronimus joined Movement Is Life’s summit and spoke with Board Member Christin Zollicoffer for this podcast episode.
Never miss an episode – be sure to subscribe to The Health Disparities podcast from Movement Is Life on Apple Podcasts, YouTube, or wherever you get your podcasts.
The transcript from today’s episode has been lightly edited for clarity.
Christin Zollicoffer: Today's lions look like being the only one in the boardroom who may be a woman, or being the only person in leadership who's a Black woman, or it could be the only member of the LGBTQ community in a hierarchical space. It could be the single mom who's now divorced, who's responsible for her children, right? Working multiple jobs, the lion looks different in every moment. It could be the professor whose students choose not to do their cultural humility assignment or the structural competency assignment by choice, who feel empowered to ignore. The lion looks very different in every moment of the day, depending on your identities and how they overlap. So it's so important to say, okay, my lion may not even be your lion.
You're listening to the Health Disparities podcast from Movement is Life being recorded live and in person at Movement Is Life's annual health equity summit. Our theme this year is "Health Equity: Solutions from Healthcare Leaders." I'm Christin Zollicoffer, a board member of Movement is Life and strategist and Diversity Equity and Inclusion practitioner. Today, we're going to dive into the topic of "weathering" -- this idea that chronic stress from life in an unjust society can have a measurable negative impacts on people from marginalized backgrounds. Dr. Arline Geronimus is here with us today. I'm so honored. She's a professor in the School of Public Health and a research professor in the Institute for Social Research at the University of Michigan, where she's also affiliated with the Center for Research on ethnicity, culture and health. She's the author of "Weathering: the extraordinary stress of ordinary life in an unjust society." We're so happy that she's here. She's coined the phrase weathering. We will dive into that and what it means. So Dr. Geronimus, welcome to the Health Disparities podcast. Thanks for being here.
Arline Geronimus: Oh, thank you. It's a pleasure to be here.
Zollicoffer: Excellent, excellent, excellent. To start, tell us a bit about yourself. Tell us what set you on this path for studying this phenomenon, and how did you come to the term 'weathering'?
Geronimus: Well, I'm a baby boomer, a child of the sort of '50s and '60s, but I'm also a granddaughter of immigrants who fled genocide and who had to start over and raise their children in working class ghettos in New York, where my parents grew up. And so I've come to realize that kind of the two big influences that set me on this path was a time I was growing up where, which was the heyday of the civil rights movement, and where, thanks to television, even if we weren't right there, we could see many of both the very brave things activists were doing, and also some of the really abusive things that were happening even to young children.
I remember Ruby Bridges walking into the school to integrate it when I was in more or less her age, and so that had, that had the most obvious effect on me, but I've come to realize over time that it's also my grandparents and parents who, in effect, had themselves suffered historical traumas, poverty, racism, and who had persevered and who, when they came to the United States, although their skin color was white, were not classified as white. But then when several groups that hadn't been classified as white sort of got to were welcomed into the other side of the color line, which would have happened shortly before I was born, that meant that my parents had experiences on both sides of the color line, and I think that that actually influenced a lot of my ability to make connections that are as deep as the ones I've tried to make, not simply just watching TV about the civil rights or going to a march or two myself, but because people I loved and cared for and whose biographies I knew intimately and who died often way too young, had lived related, I won't say identical experiences, but related experiences.
Zollicoffer: There are many cultures in New York that were not classified as white, whether it was Italian or Russian, right? And then that is a powerful statement, that you were welcomed. Your generation was welcomed to the other side, to whiteness, right?
Geronimus: You also learned, if you're not part of the generations and generations of whiteness, you're never completely arrived. But I like being in that kind of slightly liminal marginal status,
Zollicoffeer: Ambiguous, right, but maybe even ambiguous only to you, right? And so that speaks to the term weathering too. Weathering is felt on the inside. And it can be, I don't want to take the words from your mouth, but it was powerful in the book when we talked about the titling and naming weathering for the dual purposes. One, weathering means deteriorating, that because of weathering, you see signs of deterioration, but at the same time, the other side is, if you are enduring and resilient, you've weathered a circumstance. So it's a powerful term.
Geronimus: Yes, I, you know, I coined the term, you know, sort of around 1990. I had been studying the process, but didn't have a name for it before then. And what I liked about the term, as you're suggesting, but I want to place it in its historical context too. At that point, the official lines were that that health inequities were due to people not taking personal responsibility for their health, to doing, you know, self destructive things, to being criminals. It traded on a lot of very racist stereotypes. There's a whole concept that there was an underclass who basically just lived in a pathological culture. And what I was seeing, and again, I think I was able to see this in part because I had seen it actually my parents and grandparents.
But what I was seeing is people were working very hard to be resilient, to make ends meet, to overcome, to at least survive, and hopefully even overcome, or at least overcome for their children, for the next generation. And so the... I don't think I ever would have been attracted to some of the kind of underclass ideology, but it certainly didn't resonate at all with things I had seen about how people who are structurally disadvantaged figure out how to sort of keep on keeping on, and how to, you know, even in this last week since the election, there are people who are despairing, who don't like the outcome of the election, and there are people who are already saying, We've got to do something, roll up your sleeves. And I was seeing more people in structurally constrained positions rolling up their sleeves. And so I was then just kind of wallowing in grief. And I was...
Zollicoffer: There were stages of mourning, yes.
Geronimus: Yes. And so weathering struck me as just the right term. I even remember where I was sitting when it came to me, because it did mean what more and more people were coming to understand: that your body can be weathered by being exposed to hard, material hardship, environmental racism, or, you know, discrimination of various kinds, and that could harm your body. But the other side of it is if you weathered that storm, if you did what psychologists might call persistent high effort coping, if, instead of giving off to despair, you rolled up your sleeves, and if you figured out how to make a way where there is no way, that that was first of all a more accurate depiction of what I saw in communities that suffered major health disadvantages, but also that was necessary to survive.
And so it was shelter, but it also seemed like that high effort coping and not having that recognized, having that misrecognized or erased or seen as pathology or despair, instead of people getting credit for the hard, hard work they were doing day in and day out, I felt like that also unfortunately led to some of the weathering process itself, so that what The term took on both sides, how we structurally, from from outside, expose people to harmful experiences and elements that and laws and life situations that impact their health, but also how in they’re trying to cope with those and overcome those and they both do better than if they didn't and if they just sort of tuned out and got strung out or something, or joined the, you know, criminal economy, but at the same time that was taking a toll on their health too.
Zollicoffer: Absolutely, it's so important to name and clarify that weathering is not exclusive to any social identity, but it's those social identities where there has been historical marginalization or historical minoritization, whether that's by race, by rule where you live, or poverty or LGBTQ status, right? It's whatever identity you hold and what you believe on the inside, then dictates, am I safe? Am I safe in this environment? Am I safe in multiple environments? Can you talk a little bit more about the correlation between socialized identities from ourselves and from within, and its correlation to hypervigilance and weathering?
Geronimus: So we all have our personal identities, and they overlap to some extent with our social identities, but our social identities are a little different, and I think they are what sets weathering trajectories on their course. Our social identities is how others see us, what we've been assigned in the racial or gender hierarchy or sexual orientation hierarchy that our country runs on ideologically, and so we can feel deep in our hearts of pride about being a certain identity that's also marginalized, but we also understand that there are other people who deplore US or denigrate us or just don't see us who who also tend to be people with more authority and power than we have. And so we have to, in any situation, be thinking about, am I somewhere where I feel safe in this identity, or am I somewhere where I need to remember to act respectable, to to code switch, to show that I belong here.
We hear stories like Henry Louis Gates, when he moved into a predominantly white, upper class suburb of Boston, went to the police department to show his face so if he were found at night, you know, walking into his house. Now, it didn't end up actually protecting him as much as he thought, but, but that would be a kind of high effort coping that it is showing that he's vigilant to the problems. Claude Steele, the social psychologist, wrote a book which he called "Whistling Vivaldi," which is about when he was walking like as a student or even a professor at Stanford through white spaces at night, he would whistle Vivaldi as a way to kind of signal anyone who might have wondered, What is a Black man doing here? And am I threatened by that Black man? as a way to to say, No, I'm an okay Black man.
And so when we realize that some of those ideological and stereotypical and just plain racist beliefs are kind of in the air, or could be because we're in a white neighborhood or at an Ivy League institution when we're a first gen student, we naturally, our bodies go on alert. They physiologically, just automatically start the same, maybe not to the same degree physiological stress arousal system that would happen if a raging Beast was coming at us. Might be more on a simmer than a boil, but it's there, and we're staying woke and we're staying alert, and we're staying aware of our surroundings and that starts the same physiological stress process. And what that physiological stress process does is in the moment, it can be protective, if you're being hounded by a raging beast, you're in true life or death danger, it's what gets the blood to your large muscles so you can fight or flee. It's what gives as much oxygen to those muscles so that you can, you know, engage and maybe prevail in an altercation. It is what sets immune cells running through your body. So if you get mauled in that altercation, you might still not get an infection, or you might survive. It sends fat, it sends sugars through your blood system to keep fueling the energy for those large muscles. So a lot of things happen in your body when you have the stress arousal.
Now, they're wonderful if you are being attacked by a lion and they're your only hope. But they also only last a few minutes in those kind of situations. They come to help you when you need to help, and if they succeed and somehow escape the lion, your body goes back to normal and and if they don't succeed, well then you're gone. So either way, as Robert to Polsky puts it, it's only three minutes of terror, and then either it's gone or you're gone. But those same systems get aroused by the kind of alertness you have to have if you think you're walking through a dangerous neighborhood, dangerous for you, and whatever your social identity is, and the problem is if you're a member of a marginalized group, and in particular, if you're a member of one that's also impoverished, without much access to education or medical services. But even if you're a highly accomplished member of that group, you're having that stress arousal happen constantly, if not constantly, very often, it just those fats and sugars, those immune cells, they stay going through your blood system, and they start becoming plaque in your arteries. They enlarge your heart from all the blood that's being pumped towards your heart. They affect your ability to breathe. Your immune system starts to get dysregulated because you're always pulling up and mobilizing your immune cells. But they sort of are all dressed up, but nowhere to go.
And so over time, and that's what weathering is, over time, being exposed to these chronic stressors in your everyday life, it doesn't have to be a trauma, it doesn't have to be a raging beast, those things certainly would also promote weathering, but it can just be the ins and outs of banging your head against a structural wall day in and day out, having to when you just want to be go to sleep on the bus because you've worked the night shift. But you know, the bus may not be a safe place to be asleep. It's having to be awake even longer and alert for all the cues that you can see, unconsciously as well as consciously. Those, being able to see, have that street smart, or unconsciously, you know, after one tiger has come after you, you kind of hear some rustling in the grass, and you get on alert again. Maybe it's another one, though. Maybe it's just the wind.
Zollicoffer: It could be. Today's lions look like being the only one in the boardroom who may be a woman, or being the only person in leadership who's a Black woman, or it could be the only member of the LGBTQ community in a hierarchical space. It could be the single mom who's now divorced, who's responsible for her children, right? Working multiple jobs, the lion looks different in every moment. It could be the professor whose students choose not to do their cultural humility assignment or the structural competency assignment by choice, who feel empowered to ignore. The lion looks very different in every moment of the day, depending on your identities and how they overlap. So it's so important to say, okay, my lion may not even be your lion.
Geronimus: Absolutely, absolutely.
Zollicoffer: Can you even see my lion for the day? And that speaks to, then, if you can't see it, how do you help me? How do you support me and in those scenarios, Henry Louis Gates and the other person you were, I can't remember the person's name, but those responsibilities fall on ourself. We have to figure out our own solutions in the moment they were being proactive, right, going to the police. So what happens when you don't even know that you're seeing in line is because you feel like you're in the jungle every day.
Geronimus: Right. That's a perfect description of what's happening and and most of the time, you don't know most of it, or you have some sense of it. You're not feeling comfortable, or you're noticing you're afraid to raise your hand in a class or speak up in a boardroom. Yes, all of that is about managing your social identity, and all of that is activating your stress process. But these are all human reactions. And so if we think we can change them ourselves as individuals, we're not adapted physiologically to do that. We have to change the settings. We have to have that professor, you know, take not just a one hour training, but maybe a six week training to come and understand what it means to be a first gen student or a Black student or a woman student in a STEM classroom, we need to change the cues in that classroom.
I've talked about a study where women in STEM classrooms did better when the posters on the wall were nature pictures compared to if they were Star Trek pictures. So these cues are subtle. They're everywhere, but they're easy to change, if you know it, but it has to be a societal project. In the education field, there have been researchers social psychologists, who have worked with teachers and professors to help them have growth mindset, language, for example, to help, you know, not at least stir the pot of this vigilance, you know, instead of saying, Look to your right, look to your left, one of the one of you three is not going to be here at midterm, and basically saying only if you're already good enough, you know, that stirs the pot. And then you have to prove you're good enough, or you have to wonder, Am I good enough? And that takes too much bandwidth away from the cognitive learning you would otherwise be able to do. But if teachers are taught not to say that, but to say, everybody should be able to understand this, it will be hard for some people than others, and some parts of it will be harder for different people. And but if you put the work in, and if you come and talk to me, and I can help you put the work in or help clarify what you're not understanding, everybody should pass this course.
Zollicoffer: There's so much we can talk about Dr. Geronimus. And you know, I think about this new generation, I am empowered, and I am hopeful that this new generation that's coming in has a different baseline of expectations for creating those equitable settings and for being open and inclusive. So here's to we're passing a large mantle to them, but we do have to help them create the space. So expanding a little bit more on life expectancy in your book, you note that even before the pandemic, life expectancy had stagnated or decreased among working class Americans, and the gap in healthy life expectancy has been growing in spite of medical and healthy lifestyle advances. What do we know about the primary causes of this growing inequity?
Geronimus: We know a few things. We know that the things we thought caused this obviously weren't the problem because we've done interventions to address the things we thought were causing it, like health education interventions and self help books and all those things that and tearing down public housing and a whole range of things that look to people like would make the difference, but they didn't. So one thing is, we know, we have to come up with new things and different things. The other thing I think we've learned is there's a literature on if you take this other side of weathering, this high effort coping, or it's actually both sides of weathering. We went through a major macroeconomic restructuring of the United States, starting around 1980 with globalization, with bringing in automation into workplaces, with moving out of our industrial to more service industries. And what we did was for working class people of any race or ethnicity, so they may disproportionately be of color, but but this applies, and we see it in the statistics and the life expectancies of white Americans too. We took away their livelihoods. We took away those who even kept jobs did the real wages didn't go up. We made housing unaffordable. Medical Care became more privatized and competitive and way more expensive and less accessible and and you can imagine that that makes it much harder to survive, but it also puts a lot of indignities on people, a lot of anger for some, even rage for some. And because I don't think most people in those situations just give up, they had to work that much harder, or improvise that much better, or take jobs that were more dangerous, or live in neighborhoods with more toxins, or eat least healthy food just to make it ends meet and feed their families.
And I think over time that change in their standard of living, literal change in their standard of living, but also the psychosocial impacts that they had to be working overtime figuring out, how could they, you know, feed their family on what they were earning or not earning? How could they get the landlord to get the heat back on in the winter when they had no power to do that. How could they take care of now their parents, who who are unhealthy in a variety of ways as they age, but also their children, who now have asthma and themselves who are getting depressed and and also having, you know, hypertension at early ages, or diabetes, that high effort, coping that and will it ever end? And what we've kind of seen is for 40 years now, for our the least educated people in our country, and people who, before might have been in in in working class jobs that gave them benefits and a decent salary for those groups who were robbed by this macroeconomic restructuring of their place in society as well as their material resources and put in a place where they had to do more high stressful, high effort coping. I think that, and there is evidence, scientific evidence to bear this out, is a major way there that longevity has been affected. It's primarily been affected by earlier onset of diseases of aging, like cardiovascular diseases, metabolic diseases, immune diseases, not so much from what we hear about in the news about opioids and suicide, although there are those, but But it shows all the signs of having both in terms of what positions it placed people In and what human beings naturally do, who are industrious and who also have have these automatic physiological reactions, it shows all the signs of weathering has contributed, in large ways, to the growing inequities in health.
Zollicoffer: So you've laid out good amount of the causes, and how do we cope? So let's talk about how we can be protective. So there's so much variation in how an individual can weather what can we do?
Geronimus: There are smaller things and hopefully bigger things. And depending on what week it is or which election cycle, I'm more hopeful or less.
Zollicoffer: It's a tough time. It's a tough time right now.
Geronimus: Yeah, but I think first of all, recognizing weathering and recognizing that the other narratives we have for health inequities don't fit the facts, and we need to move on to other things, but weathering is one of the things that does fit what's happened, and so we need to think about, well, if I'm looking through a weathering lens now, what is it we need to do? And because weathering happens from these cues and signals and situations that are everywhere. It also means we can go situation by situation. So the education profession has done a lot of work, at least research work. How much of it has been applied yet remains to be seen. But where there are ways they can, as we talked about, even just a different way you're welcomed into a classroom, even just a different poster on the, you know, on on the wall, there are a lot of things you do to at least make educational settings not places where children and young people have to be weathering already. There are things that can be done in hospitals maternal mortality, which is very much caused by weathering and our tendency to push childbearing to later and later ages without giving the supports that especially working class mothers need, but that all mothers need.
People are finding, and again, scientifically and randomized, controlled trials, that having doulas having home births sometimes are much safer than in hospital, but obviously you have certain very clear high risks you want to either be in a hospital or get to a hospital. But for most unproblematic births, having your main authority figure be someone you trust that you feel comfortable with, who literally got your back is there the whole time, and that caters, you know, not just to some medical need or. Some beep that goes off in a machine, but to how you're actually feeling, it helps you calm down if you're starting to have your stress arousal. So there are, there are places, and I think also some local revitalization approaches that aren't just, let's you know, tear down all the disinvested areas and send people to opportunity, while we instead make tons and tons on real estate where they were and increase the cost of housing and income inequality or or real income inequality, but who instead are working with people in those communities to have wellness based development that invests in the people in the places, to make those healthier places, so people don't have to just move away from them and leave their support networks and leave their feelings of safety among those support networks.
Zollicoffer: What I hear Dr. Geronimus is that one of the solutions is relationship. Relationship, whether that's relationship of trust with your doula, your midwife, your educator, your teacher, your supervisor, your physician, right one another. And I can tell you that if we as a society, know that we are all in this together, that I can see no matter who you voted for, right, no matter how you feel on one issue or another, if I can see you and be in a relationship with you that helps to ease the feeling of safety and helps to ease or at least decrease those high coping situations, stress situations where you feel the need to cope. So perhaps relationship is a strong problem solver.
Geronimus: I think health is very tied to being rooted with people who share your lived experience, who see you. That's part of why,I think the ideas about fragmenting communities was not the way to go. Trust is important, but we have so many reasons not to trust each other. But I also think that you know part it's also there are these negative recursive processes if in school, you're already being labeled as not intelligent because of your race, or not quite having the right brain to be a scientist, if you're a woman, or any of these stereotypes that are very alive and well in many schools, yeah. Then one of the things weathering does is it actually can affect your your developing brain architecture in ways where you're going to be more sensitive to possible cues, even if they're false alarms. And that's adaptive. That's called a stress adapted brain. It's not being a snowflake. It's not being, you know, psychotic. It's not being paranoid. It's very adaptive to have street smarts in a dangerous place. But what it also means is you're you're actually going to be more likely to weather more to see those lions and tigers where they are, and so we all have to commit, you know, to seeing each other, to understanding the differences in our lived experience, to seeing that different people have different lions and tigers are more or fewer, and figuring out what It is we have to do to change that.
Zollicoffer: Dr. Geronimus, it's been an absolute pleasure to have you on our podcast. I'd like to thank you, our guest, for being with us today. You can find more links and more information about Dr. Arline Geronimus and her book "Weathering" at the link in our show notes. That brings us to the end of another episode of the Health Disparities podcast from Movement is Life. I'm Christin Zollicoffer. Until next time, be safe and be well. Thank you again. Dr. Geronimus.
Geronimus: Thank you.