The impact of discrimination on allostatic load in adults: An integrative review of literature

Abstract

Objective: The objective of the paper is to critically review the current state of the literature on the association between discrimination and allostatic load (AL) in adults and determine whether this association differs by sociodemographic characteristics.

Methods: An extensive literature search was conducted in PubMed, CINAHL, PsycINFO, and Embase to identify studies that investigated the association between discrimination and AL. The search was limited to the English language, articles that were peer-reviewed and articles that were published within the last 10 years.

Results: A total of 11 studies met the eligibility criteria for this review, 8 of which were cross-sectional and 3 of which were longitudinal. There was heterogeneity in the type of discrimination measured, the composition of AL summary score, and the analytic approach utilized to examine the relationship of interest. Nine studies found a significant, positive association between discrimination and AL. The types of discrimination found to be positively associated with AL included lifetime discrimination, childhood racial discrimination, everyday discrimination, and everyday weight discrimination. One study found that this association differed by educational attainment.

Conclusion: There is evidence that discrimination is associated with AL. Longitudinal studies with diverse samples are needed to further explore this association and how it differs based on sociodemographic characteristics.

Keywords: Adults; Allostatic load; Discrimination; Racism.

Conflict of interest statement

The authors have no competing interests to report.

Copyright © 2021 Elsevier Inc. All rights reserved.

Figures

Figure 1.

Study Selection Flow Diagram Notes: Adapted From Moher, Liberati, Tetzlaff, & Altman, 2009. AL=Allostatic Load