Disparities in Allostatic Load Among Different Races: A Comprehensive Scoping Review

Abstract

Background Allostatic load measures the cumulative stress, and it varies across populations. Its accurate measurement among racial groups is essential for understanding the effects of chronic stress on health. This review is aimed at investigating disparities in allostatic load between races and exploring the underlying mechanisms driving these disparities. Methods A systematic search of literature was conducted, resulting in the inclusion of 296 relevant studies. These studies investigated a wide range of allostatic load biomarkers from the cardiovascular, metabolic, neuroendocrine, and immune systems. They involved diverse racial and ethnic populations with variations in age, gender, socioeconomic status (SES), and stress exposure. Results The review revealed disparities in allostatic load biomarkers across different population groups. The extensive examination of a wide range of biomarkers in the selected studies showed systolic and diastolic blood pressure (DBP), heart rate/pulse rate, high-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), body mass index, total cholesterol (TC), C-reactive protein, and interleukin-6 (IL-6)/IL-6 receptor as the most frequently used biomarkers across populations. Socioeconomic status, age, racial discrimination, stressful life events, and adverse health outcomes were associated with allostatic load across different racial groups. Conclusion Disparities exist in previous studies on allostatic load due to differences in biomarker inclusion, calculation methods, study types, and populations studied. In addition, the roles of factors like social determinants of health, discrimination, and constitutive factors like genetics and age were discussed.