WEATHERING

How systemic oppression erodes the health of members of marginalized communities.

Geronimus, a professor of public health, coined the term weathering to describe the decline in health and life expectancy that results from repeated or sustained activation of physiological stress responses. In this insightful and well-argued book, the author contends that the physiological effects of living in marginalized communities, often caused by racial, ethnic, religious, and class discrimination, play a more significant role in the health of its members than genetics or lifestyle choices. Geronimus also looks at the concept of “age-washing,” which describes a way of thinking that ignores the effects of systemic problems on the health of marginalized individuals and attempts to place the cause elsewhere, leading to the proliferation of the "blame narrative." The author bases her findings on three decades of research, including her own, some of which has contradicted conventional thinking. Though she considered writing a book about weathering for nearly her entire career, she was “stopped cold” and called to action when she learned about shocking increases in mortality rates, “in particular preventable deaths of Black, Indigenous, Latinx, and rural white mothers,” over the same time period. With health inequalities not only remaining entrenched, but continuing to rise in the past 30 years, the author seeks to “spark new narratives and new understandings that will pave the way to new paths toward achieving health equity.” In that, she succeeds, and the text benefits from the author’s inclusion of stories of individuals who have experienced firsthand the effects of weathering, including those of her own family as descendants of Eastern European Jewish immigrants. In the hard-driving second part of the book, Geronimus provides suggestions to create a new path forward, creating action items for readers truly interested in doing something about “racialized injustice and the weathering it causes.”

A compelling contribution to the literature on the important issue of health care inequity.