Weathering framework re-visited: How stress and "strength" influence the health experiences of black women across the lifespan

Background. Common health trajectories for Black women reveal increased incidences of illness, greater complications from illness, and resultant death as a function of illness in comparison to white women. Arline Geronimus' weathering framework suggests that cumulative and “repeated experience(s) with social, economic, or political exclusion” compromises black women's health. Missing from this analysis are details on how black women's unique experience of “strength”- the obligation to respond to life stressors, demands, and exclusions with resilience, self-reliance, and psychological hardiness - may also be a salient factor. Purpose. The study purpose is to supplement the weathering hypothesis with a discussion of “strength” in the lives of black women. Two emergent women's health models, the S.O.S. Model for Daily Life Management and the Superwoman Schema, explain how specific “strength” behaviors (e.g., foregoing task assistance and negotiation, suppressing emotional distress, and prioritizing other-referent care over self-care ) are linked to maladaptive health behaviors that increase black women's vulnerability to chronic illness over the lifespan. Methods. Women's perceptions and experiences of strength in black women's magazines, blogs, and focus group discussions were analyzed to locate specific “strength” behaviors, resultant maladaptive health behaviors, and reports of compromised health. Results. Analyses revealed that hypervigilant role management, emotional suppression, and postponed self-care were linked to emotional eating, sedentary lifestyles, and delayed preventive care. Resultant health experiences included depression, anxiety, heart disease, among others. Conclusions. Understanding “strength” in response to daily stressors, life demands, and exclusions provides an additional evidence for the accelerated disease process among black women.