Journal article
Discrimination and allostatic load in black middle-aged and older adults: A systematic review and meta-analysis
Psychoneuroendocrinology, Vol.184, 107714
02/01/2026
DOI: 10.1016/j.psyneuen.2025.107714
PMID: 41370963
Abstract
Perceived discrimination has been associated with elevated allostatic load (AL), but findings among Black middle-aged and older adults are inconsistent. A focused synthesis is lacking, limiting understanding of how discrimination becomes biologically embedded. This systematic review and meta-analysis aim to clarify the discrimination and AL relationship in Black individuals during aging and highlight key methodological and contextual factors.
A systematic search of seven databases following PRISMA guidelines included studies on discrimination and AL in Black adults aged 40 and older. AL measures were multisystem indexes of stress-related biomarkers. Study quality was assessed using ROBINS-E, and a random-effects meta-analysis estimated the overall effect size.
Five studies met the inclusion criteria. Four reported significant associations between discrimination, particularly everyday or adolescent exposure, and higher AL. One study found a negative association moderated by coping mechanisms, while another revealed a significant interaction with hopefulness. Meta-analysis of four studies showed a small, non-significant pooled effect (Hedges’s g = 0.132; 95 % CI: −0.338–0.602; p = 0.582) with high heterogeneity (I² = 94.24 %). Stronger associations appeared in studies using broader biomarker panels and more recent discrimination measures.
This study highlights an inconsistent and heterogeneous relationship between discrimination and AL in Black middle-aged and older adults. While evidence suggests a general link, findings remain mixed due to methodological variability. The meta-analysis found no significant pooled effect, reflecting limited and diverse studies. Future research should prioritize longitudinal designs, standardized measures, and consideration of coping and resilience factors.
•Discrimination is linked to allostatic load, but pooled effects are inconclusive.•Cardiovascular and metabolic markers most consistently contribute to elevated allostatic load.•Biomarker selection and scoring methods vary widely between studies.•Findings highlight need for standardizing allostatic load measurement in disparities research.
Details
- Title: Subtitle
- Discrimination and allostatic load in black middle-aged and older adults: A systematic review and meta-analysis
- Creators
- Alaa Harb - University of IowaJuliana Souza-Talarico - University of IowaPeter B. Abad - University of the Philippines ManilaKaren Lawrence - University of KentuckyJihye Lee - Children's Hospital of Los AngelesAna W. Capuano - Rush University Medical CenterLisa L. Barnes - Rush University Medical CenterJennifer Deberg - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Psychoneuroendocrinology, Vol.184, 107714
- DOI
- 10.1016/j.psyneuen.2025.107714
- PMID
- 41370963
- NLM abbreviation
- Psychoneuroendocrinology
- ISSN
- 0306-4530
- eISSN
- 1873-3360
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 02/01/2026
- Academic Unit
- Iowa Neuroscience Institute; Nursing; Hardin Library; University College Courses
- Record Identifier
- 9985091809202771
Metrics
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