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found that the intended life lesson sets off a heightened alarm, or hyperarousal. The child's "sense of security and emotional stability is dependent on the parents' well-being," 13 and the perceived threat to security and safety inadvertently activates the chronic phase of stress, resulting in a negative physical and mental outcome. The impact of societal and systemic racism continues into adulthood. In 2002, researchers argued that exposure to highly threatening situations in childhood may generate stress-induced emotional and physiological changes that have long-range mental and physical health consequences. 14 In addition, findings from studies on lifetime perceived racism suggest that the accumulation of racism-related stress across the life course should also be considered. 15 It was US public health researcher Arline Geronimus who proposed the "weathering hypothesis," which looked at the effects of anticipating and managing the idea of racism. Her 2006 study found that racism increases stress levels, and one manifestation of this effect is the increase in infant and maternal deaths among African-American women in the US. 16 Homing in on racism's impact in the US, Tiffany Green found that Black women who immigrated to America— and were not raised in an environment of racism—had better birth outcomes than African-American women born in the US, as well as the same distribution of birth weights as white women born in the US. 17 Another study, conducted in Illinois over a 15-year period, looked at gene mutation to see if it played a role in low birth-weight differential outcomes across US-born white women, US-born Black women, and African-born Black women. The hypothesis of the low birth-weight study assumed that due to the fact that "African-American women have significant European genetic admixture," women who were born in Africa would have the lowest birth-weight outcomes compared to the Black or white women born in the US. 18 But the results of the study determined quite the opposite. After 15 years of data collection, researchers found that both US-born white women and African- born Black women had the same overall birth-weight distribution—even after "appropriate confounders were controlled." African-American women, however, had the lowest birth weights, with infants often weighing hundreds of grams less than the other groups. Furthering this line of inquiry, a similar study (using the Illinois data) looked at birth-weight outcomes for Caribbean-born Black women versus African-born Black women who immigrated to the US, and the results were similar. The Black Caribbean immigrants delivered babies that were hundreds of grams heavier than infants born to African-American women. 19 So why this anomaly for African-American mothers and their newborns? STRESS AND HYPERTENSION When we feel unsafe (physically, emotionally, or mentally), the body's sympathetic response activates and releases cortisol. This key hormone has the ability to increase blood pressure levels by directing various blood C h e c k o u t A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 75

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