Fusing science and social justice, renowned public health researcher Dr. Arline T. Geronimus offers an urgent, "monumental" book (Ibram X. Kendi, author of Stamped from the Beginning) exploring the ways in which systemic injustice erodes the health of marginalized people.
America has woken up to what many of its citizens have known for centuries and to what public health statistics have evidenced for systemic injustice takes a physical, too often deadly, toll on Black, brown, working class and poor communities, and any group who experiences systemic cultural oppression or economic exploitation. Marginalized Americans are disproportionately more likely to suffer from chronic diseases and to die at much younger ages than their middle- and upper-class white counterparts. Black mothers die during childbirth at a rate three times higher than white mothers. White kids in high-poverty Appalachian regions have a healthy life expectancy of 50 years old, while the vast majority of US youth can expect to both survive and be able-bodied at 50, with decades of healthy life expectancy ahead of them. In the face of such clear inequity, we must ask ourselves why this is, and what we can we do.
Dr. Arline T. Geronimus coined the term “weathering” to describe the effects of systemic oppression—including racism and classism—on the body. In Weathering, based on more than 30 years of research, she argues that health and aging have more to do with how society treats us than how well we take care of ourselves. She explains what happens to human bodies as they attempt to withstand and overcome the challenges and insults that society leverages at them, and details how this process ravages their health. And she proposes solutions.
Until now, there has been little discussion about the insidious effects of social injustice on the body. Weathering shifts the paradigm, shining a light on the topic and offering a roadmap for hope.
4.5 Stars Rounded up This was very well done. Much of this information wasn't new. It was just collected and presented in a new way.
I don't think the author understands fully that racism can't be mitigated until white supremacy is destroyed. The author is a liberal and what's required in this situation is an abolitionist.
3.5 stars rounded up because I am genuinely glad this book exists, flaws and all, and I hope it is part of a much larger conversation to come.
All in all, a significant contribution. The first half of the book was much more compelling than the latter, imo, but overall still very readable. Given the systematic ways weathering has long been built into the fabric of american society but erased from the dominant cultural landscape, I found it reassuring to access some language and data that put this previously unnameable, hard-to-describe (but palpable) phenomenon into context.
That said, Geronimus repeatedly refers to the covid-19 pandemic in the past tense, which really frustrated me as someone who sought this book out in part because I was looking for health-focused, scientific framework to better understand my experience as a multiply-marginalized disabled person navigating an invisibilized pandemic. In other words, as a massively weathering event (to say the least), the ongoing pandemic is quite the ironic detail for a book like this to overlook. A glaring and unfortunate misstep for sure.
I got this book through a Goodreads giveaway. I thought it was interesting in terms of a concept. Some of the facts mentioned I’ve read in other books as well. I don’t know what I’d subscribe fully to the idea that society has as great an impact on everyone equally - I’d say many other factors, such as gender and race play, a huge role in how people are treated also.
Life is hard. It wears you down. If you are oppressed by racism or poverty or something else, it wears you down even more. That's the key concept of the book and it makes sense. I was disappointed though. The author attacks other people for being unscientific and leaping to conclusions by just looking at flimsy associations instead of rigorously seeking hard evidence. And that's fair. But then a lot of what she argues is based on anecdotes (including her own life story) and on associations. This is a shame because it diminishes the credibility of important truths that should get highlighted.
Nerd addendum: Something she comes back to again and again is the idea that Black teens want to get pregnant and that this is a smart thing for them to do because delaying pregnancy (until 20?) will be dangerous and diminish their chances of surviving until their children grow up. There is a ton to unpack here. I will touch on some of it. Interviews with people in a charity for teen mothers is obviously going to give you a biased perspective on that issue. Why not tell us about nationally representative surveys that find very few teens saying they want to get pregnant in the coming year? Why not tell us about all the research on how many teens and young women want contraception when it is offered to them? Why not tell us about the history over the last 50 years of doctors withholding evidence-based contraception? Why not tell us about the general lack of evidence-based sex education in schools in the USA? Why not talk about the economic impact of dropping out of high school? Why not separate out these apples and oranges to make meaningful comparisons? I think there are other voices and other data to look at beyond the story she is telling. For example, see: www.sistersong.net. Of course it's bad to demonize teen moms or to coerce people into contraception, but those are not the same thing as equal access to information and care, and replacing one set of stereotypes with another doesn't seem helpful.
Also problematic is her take on solutions. She says we need evidence-based approaches to decrease maternal and infant mortality--wonderful! But then she goes on to list all kinds of things that sound nice without offering evidence that they decrease deaths in mothers or babies. I listened to the audio, so maybe there are references that I missed. If she did provide references for something proven to improve these outcomes, I would really appreciate it if someone would send those to me. I looked at the PDF supplement and there were none there. (A graph about midwives in Austria does not prove something about what will work here; that's exactly the kind of flimsy association that she is correctly criticizing.)
A great introduction to health disparities and how aging is more difficult for those experiencing poverty and racial injustice. This book serves as a great beginning and introduction on these topics- it was very much written for the general public and shows that health disparities are not genetic and are not a cause of individual choices. Systemic injustice makes disease and aging worse. I took several courses in college on health disparities and how they affect certain populations and didn’t feel like this offered any new information to me, but I think this would serve as a great introduction for someone wanting to learn more about them.
I was really looking forward to reading this book, and unfortunately it did not live up to my expectations.
The main positive is the wealth of scientific findings the author presents, many of which were new to me and which debunk popular racist stereotypes about health.
That was about all that was good for me, though. The organization of the book was confusing and felt repetitive. It’s written at a very introductory level, which may be helpful for some readers but made a boring read for me.
Most importantly, Geronimus fails to really unpack the systemic underpinnings of race-based health disparities, though she claims this is what she wants to do. This was most glaring for me in her rampant fatphobia (i.e., her assumption that obesity is a “disease” with negative health outcomes, and no discussion of how fatphobia is rooted in anti-Black racism). Despite advocating for structural change in the second half of the book, she offers a handful of surface-level, individualistic changes, including “encouraging stigmatized people to develop counternarratives about their predicaments.” Excuse me????
She ultimately does not perceive the inherent link between capitalism and white supremacy. Her recommended policy changes sound fine, but what we really need is a total upheaval of our current political economy. What Geronimus calls “weathering” has always been a core component of imperialist capitalism and will not end until capitalism does.
While I was hoping for a little more science, I can see this was written for the general public as an introduction to social determinants of health, the idea that health disparities are not rooted in genetics or individual behaviors, and that systemic injustice is killing people. It certainly does a good job at countering all of the race based myths that are taught in medical school and I will definitely be recommending it to the residents.
If there were ever a God-level text that was not the Bible or the Quran or something such as any historically recognized religious text, this is it, for me!
I can't believe I almost missed this.
After a couple of years of going hard with my consumption of journal abstracts, health memoirs, news articles, and various non-fiction titles on the subjects of health, research, trauma, coping, etc., I'd stopped seeking.
Then one day, as I was shelf-reading I come across Weathering and I ask myself, "Is this actually discussing the weathering that I'd previously come across while researching health and medical systems and all of that?"
YES! Oh sh*t.
But is it actually talking about the weathering of Black Americans in the US?
OMG, YES!
Say less.
I'm pretty sure I'd decided the significance of the research and results presented in this book before I finished reading the introduction.
I ordered my own copy.
I knew what I was getting into because I'm living it.
On the other hand, I didn't know what I was getting into because the data is so unbelievable.
Like the years long journey that it was coming into the progression of the ADOS movement, the unfolding of the history of weathering for Black women, specifically, made me want to scream about it from the rooftop.
If only it were that simple.
The fact every negro, every educated, well-informed, well-read, well-connected Black person or ally isn't talking about this publicly has me shaking my head and I'm telling you now, I am going to be extremely pissed off it if takes those people another 10 years to read this.
I can't say how much feeling and respect I have for Arline T. Geronimus for giving this to us. I really can't.
that's about all I can say about this one. Ugh. This is a tough read. It's kind of draining when you realize how those at the losing end of societies standards are affected by that physically. Weathering is a concept about the body ages more when faced with societal injustices. The case Geronimus focuses on most in this book is maternal death and birth rates.
It's jarring. It's uncomfortable and at times depressing. That being said, it's an important book and I feel that most people should read this. It's not too academic that you can't follow along. Seeing how being any of the following can affect health is eye opening in the best way: poor, racial minority, sexual minority, any other sort othering society places.
Having this knowledge can help us view people with empathy and look at ways to making society more equitable by adding compassion and empathy. Pick it up, prepare yourself, and take what you can to heart. When you have a stacked deck, how can you find ways of managing your body and not over aging it?
I really enjoyed this book and the way that information was presented. I think it was very surprising to hear about these injustices in a new light, rather than just reading statistics. It really opened my eyes to the impact of society on the lives of peoples and just how stress negatively impacts the human body and mind. I specifically enjoyed the ending of the book, where the author gives ways that we can improve our society. I would challenge anyone wanting to understand stress on the body more to read this book, or those wanting to understand how to change our current standing as a society.
I read this book for a class so I am excited to see how others interpreted the book and what they took away from the information presented.
It took forever to finish this book, because it requires concentration and thinking. However, it was time well spent. It presents anecdotes and research about the aging/disabling affects of stress on bodies, particularly in marginal communities.
This book should be required reading for anyone interested in public health, as well as medical students, nursing students and policy makers. Well-reasoned, well-written and supported with citations to the underlying research, it makes a compelling case for the profound health effects of racism in our society.
I think everyone should read this. It gave me language to name what I felt at a meeting not long ago where I couldn’t quite figure out why I was so uncomfortable. Terms like othering and weathering were clearly explained and I felt understood. It explains so much that goes beyond where antiracist conversations seem to have paused. Sadly, I can’t undo the weathering I have experienced, but I can be more aware of the causes and impact it has on me. A few studies were revisited like the statistics on teen pregnancy and the marshmallow test. It was interesting how they can be understood so differently based on culture and experience
- The fact of being in an constant state of stress actually "weathers" people, as the author observed: people are physically looking more aged. They're also more prone to have conditions like asmatha, obesity, high blood sugar etc
- The author pointed out that the very fact many low income families have children early is precisely because they believe they soon would have adverse health conditions as they age. That for many of the young girls, they prefer having children early so they could raise the child before their body takes more brutal toll (versus the more conventional, affluent area thinking of delay motherhood because they have expectation of somewhat well maintained body even when they age)
I wouldn’t have picked up this book on my own - it was selected for a professional book club - but I’m really glad I read it. Geronimus’ work is extraordinarily illuminating and paradigm-shifting, positing “health and aging have more to do with how society treats us than how well we take care of ourselves”.
I can see how it’s important for any education or healthcare professional to read this, but I honestly think everyone should be aware of this information. We had some great discussions within our workplace and I hope we continue the conversations and take action to impact meaningful holistic change. As the book says - all our fates are linked.
How systemic oppression and inequities have lasting and unhealthy effects on your body. Many things I already knew but many facts I was unaware of especially around other minorities. How society treats us has a direct correlation to our longevity and quality of life. It definitely stirred in me to do as much as I can to fight for equity. It’s not just as simple to say exercise and eat right, there are so many factors that play apart in our overall health and well being and it is something that all of humankind should care about but not everyone cares about. I appreciate all the data and statistics provided in the book. I felt compelled to take notes to reference.
This book has deeply informed my understanding of the devastating impact of white supremacy and other systems of oppression on our physiology, people’s health, and wellbeing in US society, with global implications. It’s impacted my worldview on a fundamental level, which is the ultimate qualification for a 5-star rating in my book (no pun intended). I think anyone who wants to be well informed, particularly those of us who hold privileged identities, would benefit from reading this book. I particularly enjoyed the author’s narration.
Important, necessary information presented in readable and well-organized fashion. (I read most of the book in a few days, but don’t remember when started.)