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New research suggests that nearly half of the life expectancy gap between Black and White adults in the U.S. is driven by discrimination — and the chronic stress and inflammation it triggers over time.
The study, published in JAMA Network Open, followed more than 1,500 Black and White adults in the St. Louis area over nearly two decades and found that Black participants were far more likely to die earlier than White participants. Researchers say the difference is closely tied to higher levels of long-term stress and chronic inflammation — not genetics, but lived experience.
To measure stress, researchers looked at everything from childhood trauma and exposure to violence to experiences of discrimination and economic hardship. Years later, they tested participants’ blood for two markers of inflammation — C-reactive protein and interleukin-6 — which tend to remain elevated when the body is repeatedly pushed into fight-or-flight mode.
The numbers were stark. Over the course of the study, 25 percent of Black participants died, compared with about 12 percent of White participants, meaning Black participants were more likely to die at younger ages. Researchers found that 49.3 percent of that gap could be explained by the combined effects of long-term stress and inflammation.
Dr. Ryan Bogdan, a professor at Washington University in St. Louis and the study’s senior author, told The Washington Post the inflammation markers help capture what stress leaves behind in the body — not just one bad moment, but years of pressure piling up.
Health experts say the findings reinforce what Black communities have long known: racism and inequality wear the body down over time.
Arline T. Geronimus, the University of Michigan researcher who first introduced the “weathering” theory decades ago and was not involved in the study, said the numbers likely understate the problem. Many people most affected by chronic stress, she noted, may not have lived long enough to be counted.
She also pointed out that the study focused on major stressors but didn’t fully capture the daily grind — microaggressions, code-switching, and constantly navigating predominantly White spaces — that also takes a real physical toll.
“It’s not just about trauma,” Geronimus told The Post. “It’s kind of everyday fists in the face.”
Other health equity researchers echoed that concern. Linda Sprague Martinez, director of the Health Disparities Institute at UConn Health, said solutions can’t stop at telling people to manage stress better.
“Stress management class is not going to solve this problem,” she said, calling the findings striking evidence that racism itself drives health disparities.
The researchers emphasized that while stress and inflammation explain a significant portion of the mortality gap, more than half remains. Factors like environmental exposure, housing inequality, wealth gaps, access to care, and other forms of structural racism continue to shape who lives longer — and who doesn’t.
The takeaway is clear: shorter life expectancy for Black Americans isn’t about individual choices. It’s about systems that create constant pressure — and the body keeps score.
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