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Arline T. Geronimus, ScD, Margaret Hicken, MPH, Danya Keene, MAT and John Bound, PhD

Arline T. Geronimus, Margaret Hicken, and Danya Keene are with the Department of Health Behavior and Health Education and the Population Studies Center, University of Michigan, Ann Arbor. John Bound is with the Department of Economics and the Population Studies Center, University of Michigan, Ann Arbor, and the National Bureau of Economic Research, Cambridge, Mass.

Correspondence: Requests for reprints should be sent to Arline T. Geronimus, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109-2029 (e-mail: arline{at}umich.edu).

Objectives. We considered whether US Blacks experience early health deterioration, as measured across biological indicators of repeated exposure and adaptation to stressors.

Methods. Using National Health and Nutrition Examination Survey data, we examined allostatic load scores for adults aged 18–64 years. We estimated probability of a high score by age, race, gender, and poverty status and Blacks’ odds of having a high score relative to Whites’ odds.

Results. Blacks had higher scores than did Whites and had a greater probability of a high score at all ages, particularly at 35–64 years. Racial differences were not explained by poverty. Poor and nonpoor Black women had the highest and second highest probability of high allostatic load scores, respectively, and the highest excess scores compared with their male or White counterparts.

Conclusions. We found evidence that racial inequalities in health exist across a range of biological systems among adults and are not explained by racial differences in poverty. The weathering effects of living in a race-conscious society may be greatest among those Blacks most likely to engage in high-effort coping.

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