Allostatic Load and Health Inequities

Jordan Mitchell

Dr. Alyssa Grant [MPH]

Jordan Mitchell

Alright, so let’s just dive in. Glaucoma—number one cause of irreversible blindness worldwide.

Dr. Alyssa Grant

Exactly. And it’s not just a medical issue; it’s a public health crisis. What’s particularly alarming is the disparity. Black individuals are not only more likely to develop glaucoma but also more likely to experience severe forms of it.

Jordan Mitchell

Mmm, yeah, it’s wild—

Jordan Mitchell

so we’re not just talking about the disease itself but how it hits certain groups harder. Why is that happening?

Dr. Alyssa Grant

That’s the gap. We know the statistics, but the mechanisms? Less clear. And here’s where it gets interesting: a recent capstone project from Jefferson’s MPH program took a deep dive into this very issue. They didn’t just stop at observing disparities—they analyzed the factors driving them.

Jordan Mitchell

Okay, whoa—wait. For folks who aren’t familiar, what’s a capstone project, exactly?

Dr. Alyssa Grant

Great question. Capstone projects are cornerstone experiences for MPH students. They tackle real-world public health issues—like improving health equity—by conducting original research or designing interventions. Think of it as a bridge between academic knowledge and practical impact.

Jordan Mitchell

Got it. So, this project focused on glaucoma disparities?

Dr. Alyssa Grant

Correct. This student looked at the social stressors contributing to these disparities, using a concept called allostatic load as a lens. Essentially, they tried to connect how life experiences—especially chronic stress—might increase glaucoma risk.

Jordan Mitchell

That’s huge! I mean, it’s—

Jordan Mitchell

it’s one thing to know there’s a disparity, but wrapping actual science around the “why” sounds next level. So, what did they find?

Dr. Alyssa Grant

Well, this study linked allostatic load to glaucoma risk and found it mediates some of the racial disparity. It’s turning data into actionable insights—exactly the kind of work Jefferson’s program excels at.

Jordan Mitchell

Alright, so we’ve touched on chronic stress and allostatic load—let’s link it to this big idea: the weathering hypothesis. What exactly are we talking about here?

Dr. Alyssa Grant

The weathering hypothesis comes from Dr. Arline Geronimus—it’s the idea that chronic exposure to social stressors like racism or economic hardship slowly erodes the body’s health over time. Like the way wind and water weather a rock, these stressors can wear down biological systems, leading to earlier and more severe health issues.

Jordan Mitchell

Okay, so stress isn’t just in our heads—it’s physical, too?

Dr. Alyssa Grant

Exactly. There’s a measurable impact. And that’s where this concept of allostatic load comes in. It’s a score that represents the cumulative toll that chronic stress takes on the body, from cardiovascular strain to immune system dysfunction.

Jordan Mitchell

So, we’re talking blood pressure, cortisol levels—all those biomarkers add up to say, “Here’s how stress is showing up in your body”?

Dr. Alyssa Grant

Precisely. And here’s why this matters: marginalized populations face higher levels of these stressors, which contributes to disparities in health outcomes. For instance, the capstone project we discussed earlier found that allostatic load is not only linked to glaucoma risk but also helps explain part of the racial disparities in that risk.

Jordan Mitchell

Right, and that feels huge. I mean, if we can measure that biological toll—

Jordan Mitchell

doesn’t that give us a tool to intervene before these disparities grow worse?

Dr. Alyssa Grant

Absolutely. That’s the goal. This research is groundbreaking because it provides evidence that we can use to create targeted interventions—whether it’s reducing stressors in a community or developing health policies that address these broader inequities. And this is exactly the kind of training Jefferson’s Public Health program emphasizes for its students—combining research with real-world application.

Jordan Mitchell

You know, that reminds me of this initiative I saw in an urban neighborhood where they built these community spaces with gardening programs, mental health support, and even yoga classes. The idea was to, you know, reduce allostatic load by creating a less stressful environment.

Dr. Alyssa Grant

That’s a great example. And speaking of practical impact, I want to quote directly from the capstone project. The researcher said, "This study provides us with some evidence that allostatic load score can be a measure of glaucoma risk, which in the future could help us to better understand the root causes of health disparities."

Jordan Mitchell

That, right there, feels like a road map. So, we’re moving from identifying the problem to figuring out actionable ways to reduce the risks?

Dr. Alyssa Grant

Exactly. It’s a step closer to addressing disparities and promoting health equity. And for students in public health, projects like this illustrate how research directly impacts lives—whether it’s discovering these links through data or developing interventions that translate science into action.

Jordan Mitchell

That makes me wonder—if we’re looking at racial disparities through the lens of allostatic load, how do the numbers tie back to glaucoma risk?

Dr. Alyssa Grant

Let’s look at the data. Among people over 40, Black individuals have a glaucoma prevalence of 2.9%, while for White individuals, it’s 1.8%. That’s nearly double.

Jordan Mitchell

Double. That’s striking.

Dr. Alyssa Grant

It absolutely is. And when we layer allostatic load onto this, it gets even more compelling. Individuals with high allostatic load scores have twice the odds of glaucoma.

Jordan Mitchell

Wait—so this biological toll isn’t just, like, marginal—it’s doubling the risk?

Dr. Alyssa Grant

Exactly. It’s the same kind of increased odds observed for Black individuals compared to White individuals, tying back to how chronic stress accumulates and affects health outcomes.

Jordan Mitchell

And this capstone project—what did Young Sheng uncover?

Dr. Alyssa Grant

Their study essentially quantified that relationship. They found that allostatic load mediates about 13.7% of the racial disparity in glaucoma.

Jordan Mitchell

Whoa. Okay, can you break that part down for us—the mediation part?

Dr. Alyssa Grant

Sure. Mediation means that allostatic load acts as a middle factor—linking systemic stressors directly to the higher glaucoma risk seen in Black populations.

Jordan Mitchell

It’s like the missing piece in understanding the “why,” right?

Dr. Alyssa Grant

Exactly. And to quote Young Sheng directly: "This study provides us with some evidence that allostatic load score can be a measure of glaucoma risk, which could help us to better understand the root causes of health disparities."

Jordan Mitchell

Yeah, and that kind of clarity feels like it’s unlocking something big—not just identifying causes but pointing toward, you know, solutions.

Dr. Alyssa Grant

Absolutely. And that’s where Jefferson’s MPH program really shines. Students like Young aren’t just learning—they’re driving research that bridges gaps, creating actionable insights. The capstone experience they’ve designed fosters this direct connection between science and societal impact.

Jordan Mitchell

So, this isn’t just a theoretical exercise—this is work that can change lives. That’s huge.

Jordan Mitchell

So, we’ve explored this link between allostatic load, racial disparities, and glaucoma. But what does it mean for the bigger picture—like public health policies and real-world interventions? How do we start turning this insight into action?

Dr. Alyssa Grant

It means we need to put these findings into action. The evidence is telling us that to reduce health disparities, we need to focus on lowering allostatic load—especially in communities facing systemic stressors like racism or poverty. This could include interventions like creating green spaces, providing financial counseling, or increasing access to mental health care.

Jordan Mitchell

Yeah, I’ve seen that in action. Back when I was organizing, we had a program tackling housing instability. Just giving people a stable place to live—man, it reduced stress for so many families.

Dr. Alyssa Grant

That’s a perfect example. Stabilizing housing, reducing food insecurity—those kinds of initiatives directly address the root causes of stress. And by tackling allostatic load at the community level, we can actually improve health outcomes across the board.

Jordan Mitchell

And it’s not just the immediate effects, right? Like, long term, you’re building resilience in the community.

Dr. Alyssa Grant

Exactly. That’s where future research needs to focus—not just measuring the toll of stress but finding more ways to counteract it. The capstone project we’ve been highlighting already opens that door, offering a framework for understanding and addressing these disparities. It’s an incredible jumping-off point.

Jordan Mitchell

And you know, what strikes me is how Jefferson’s MPH program shaped that journey. I mean, turning questions about health equity into a project that, honestly, could guide public health strategies? That’s big.

Dr. Alyssa Grant

Well, that’s the beauty of the program. The capstone project equips students with the tools to do hands-on, impactful research. It’s not just about learning—it’s about creating solutions. Mentorship, interdisciplinary collaboration, all of it works together to turn data into action.

Jordan Mitchell

And action’s what it’s all about. On that note, it’s clear we’ve got the roadmap. Now it’s up to all of us to keep this momentum going, whether it’s through research, policy, or work on the ground. And that’s, uh, that’s the takeaway here, right?

Dr. Alyssa Grant

Absolutely. The work starts with understanding, but it ends with action. And that’s how we change systems, one step at a time. Thank you all for joining us on this deep dive into health equity and science-driven solutions.

Jordan Mitchell

Couldn’t have said it better.

Jordan Mitchell

Jordan Mitchell

Thanks for listening, everyone. We’ll catch you next time.