Allostatic Load in the Neighborhood Context

Shawna Rose Beese

doi:10.7273/000005033

Four decades ago, epidemiologists noted that the primary causes of mortality gradually shifted from communicable illnesses toward degenerative non-communicable diseases. We are now at the tail-end of an epidemiological transition. The trends of the epidemiological transition hold even amidst the global COVID-19 pandemic. To effectively respond, our care paradigms and research foci must continue to elucidate upstream causation. To explore upstream dynamics, social epidemiology has been key in identifying and studying how the social determinants of health interplay with our individual epigenetics, biology, and health behaviors. The neighborhood environment captures many key influences of health outcomes, as neighborhoods are where we grow, live, work, and play. With spatial epidemiology, analysis can uncover spatial neighborhood effects. My dissertation conceptualizes allostatic load as an upstream agent pointing to future all-cause mortality. This dissertation examines the presentation of allostatic load in the neighborhood context. To examine how allostatic load presents and can be studied in a neighborhood context, I developed and pursued the following specific aims:1) Identify commonly used biomarkers, compare measurement approaches and inventory neighborhood considerations for studying allostatic load within neighborhoods; 2) Measure geographic variation in allostatic load among United States adults across the rural-urban spectrum; and 3) Identify and examine the process of how a healthy neighborhood is intentionally created in order to describe a transferable process that can be used with other neighborhoods. This dissertation is composed of three distinct studies. The first study is a systematic review of reviews to assess what allostatic load biomarkers have been most frequently used in the past 30 years to study the overall stress burden of individuals. The second study is a cross-sectional observational study using the Health Retirement Survey (HRS) database to study and compare variations of allostatic load prevalence across the rural-to-urban spectrum. Last, my final study is a qualitative study using Glaserian grounded theory to discover the process and beginning substantive theory of cultivating healthy neighborhoods.

Allostatic Load in the Neighborhood Context

Files and links (1)

Abstract

Metrics

Details