On the persistence of racial health inequities: Maternal exposure to geospatial racism is transmitted to infant
Recommended Citation
Joseph CLM, Greenlee AJ, Sitarik AR, White-Perkins D, Miree C, and Wegienka G. On the persistence of racial health inequities: Maternal exposure to geospatial racism is transmitted to infant. Med Hypotheses 2025;202.
Document Type
Article
Publication Date
9-1-2025
Publication Title
Medical Hypotheses
Abstract
Structural racism (SR) refers to the discriminatory beliefs, methods and strategies that are systemically embedded in the policies and practices of the US. Racial residential segregation, termed “a fundamental cause of health inequities”, is central to SR in the US because it impacts economic stability, education, healthcare, neighborhood and built environment, and social and community context for residents. Segregation systematically injects chronic stress in the lives of residents through a variety of mechanisms including polluting industries and liquor stores in Black communities, chronic unemployment fueled by job loss and decentralization, aggressive policing, increased incarceration rates for Black residents, and under-resourced schools. Spatial manifestations of SR have been linked to stress responses, immune dysregulation, and heightened chronic inflammation among US Black individuals consistent with accumulation of tissue damage or allostatic load which refers to the “cumulative burden of chronic stress and life events”. This chronic stress has been termed “weathering”, a concept which posits that the stress of racial discrimination, including residential segregation, has biological effects that are pro-inflammatory, and predictive of chronic conditions, such as heart disease, diabetes, and cancer. Maternal exposure to chronic stress, resulting in weathering, can create an inflammatory fetal environment that is transferable to the infant. We hypothesize that a heightened propensity in mothers toward chronic inflammation due to mother’s exposure to structural racism can be transferred to her offspring in utero, creating an intergenerational cycle of disadvantage and poor health. Recent and emerging research have introduced methods of objectively measuring exposure to SR as well as measuring the outcome of maternal transfer of the effects of exposure to SR to offspring. Given the evidence that chronic racial stress could lead to inflammation, the observation of elevated levels of inflammatory markers in neonatal dried blood spots (DBS) in relation to maternal exposure to SR, could provide evidence of maternal transfer. Infant blood spots are routinely collected and stored and can be analyzed using untargeted metabolomics to measure metabolite features representing biologically relevant pathways, including biomarkers of inflammation, lipid mediators, and exogenous exposures. Empirical evidence of how SR can initiate processes in early life that manifest in adult disease can corroborate existing theories and generate a paradigm shift that informs interventional research as well as policy.
Medical Subject Headings
Structural racism; Neonatal dried blood spots; Weathering; Residential racial segregation; Health disparities; Immune dysregulation
PubMed ID
Not assigned.
Volume
202
First Page
111713
