Skip to Main Content

A Life Course Perspective on Chronic Disease

November 03, 2017
by Rosalind D'Eugenio

Chronic stress across a person’s lifetime contributes significantly to disparities in physical and psychiatric health outcomes, a leading expert in the field of health disparities told an audience this week at the Yale School of Public Health.

James Jackson, Ph.D., co-director of the Center for Integration Approaches to Health Disparities and the Michigan Center for Urban African American Aging Research, provided insights on issues of racial and ethnic influences on life-course development during a lecture at the Laboratory of Epidemiology and Public Health.

Through his work with the R.I.C.E. model–Racial, Immigration, Culture, Ethnicity–Jackson showed the growing diversity of the U.S. population, the need for intra-group and inter-group studies and how poorly understood the role of chronic environmental stressors are on physical and mental well-being.

He described discrimination in the context of social, political, economic and cultural influences that individuals or groups experience over a life course.

“It is the law of small effects,” Jackson said, who is currently writing his 17th book, Ageing in Black America. “There is no one single factor that produces observed physical and mental health disparities in process of outcomes among race and ethnic groups in America. Small differences accumulate and contribute to observed disparity.”

Looking specifically at the depression and mental disorders and comparing prevalence among whites, African Americans and immigrants, Jackson showed the cumulative impact of life stressors. He theorizes that African-American infants are at higher risk of death than their white peers. If an African-American infant lives beyond one year, they have a stronger capacity to deal with stressors than whites–until they reach middle age. By this time, African-American men will have a much higher mortality rate than non-Hispanic whites because the stressors of life will start causing adverse health outcomes. “This is outrageous, but I think it’s true,” he said.

Jackson explained that psychological awareness of symptoms of chronic stress motivates people to do things to alleviate the depression or other mental effects of stressors. Unlike many African-American women who learn to “cope” early on with stressors by eating, thus developing higher rates of obesity, some African-American men were shown to self-regulate their stress later in life with tobacco, drugs and alcohol. These coping habits are harming and addictive, but people stay with them because they work, making it very difficult to make changes over their lifetime.

Jackson concluded by speaking on why race matters in chronic stress, and how being aware of stereotypes leads to “racialization” through lived experiences and unique cultural affects. “The notion of race fixed at birth is not true, color puts you at risk of being more racialized, but bio-ecology models show effects on both African American and white if they are put in similar conditions. Race is not skin tone but experiences,” he said.

Professor Jackson is also the Daniel Katz Distinguished University Professor of Psychology, Professor of Afro-American and African Studies and Research Professor at the Institute for Social Research at the University of Michigan.

The talk was co-sponsored by the Yale School of Public Health, Yale Program on Aging/Pepper Center and Equity Research and Innovation Center.

Submitted by Denise Meyer on November 03, 2017