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Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study


  • Mattei, Josiemer
  • Demissie, Serkalem
  • Falcon, Luis M.
  • Ordovas, Jose M.
  • Tucker, Katherine


Puerto Ricans living in the United States mainland present multiple disparities in prevalence of chronic diseases, relative to other racial and ethnic groups. Allostatic load (AL), or the cumulative wear and tear of physiological responses to stressors such as major life events, social and environmental burden, has been proposed as a possible mechanism for the inequalities observed in minority groups, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to six chronic diseases (abdominal obesity, hypertension, diabetes, and self-reported cardiovascular disease (CVD), arthritis and cancer) in Puerto Ricans, and to contrast AL to metabolic syndrome (MetS). Participants of the Boston Puerto Rican Health Study (n = 1116, ages 45-75 years) underwent a home-based interview, where questionnaires were completed and biological samples collected. A summary definition of AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Logistic regression models were run to determine associations between AL score and disease status, controlling for age, sex, smoking, alcohol use, physical activity, total fat intake and energy intake. Parallel models were also run with MetS score replacing AL. We found that increasing categories of AL score were significantly associated with abdominal obesity, hypertension, diabetes and self-reported cardiovascular disease (CVD) and arthritis, but not with self-reported cancer. The strength of associations of AL with all conditions, except diabetes and cancer, was similar to or larger than those of MetS score. In conclusion, Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions. AL was more strongly associated with most conditions, compared to MetS, suggesting that this cumulative measure may be a better predictor of disease. These results have prospective research implications for Puerto Ricans and other ethnic groups.

Suggested Citation

  • Mattei, Josiemer & Demissie, Serkalem & Falcon, Luis M. & Ordovas, Jose M. & Tucker, Katherine, 2010. "Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study," Social Science & Medicine, Elsevier, vol. 70(12), pages 1988-1996, June.
  • Handle: RePEc:eee:socmed:v:70:y:2010:i:12:p:1988-1996

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    References listed on IDEAS

    1. Seeman, Teresa & Merkin, Sharon S. & Crimmins, Eileen & Koretz, Brandon & Charette, Susan & Karlamangla, Arun, 2008. "Education, income and ethnic differences in cumulative biological risk profiles in a national sample of US adults: NHANES III (1988-1994)," Social Science & Medicine, Elsevier, vol. 66(1), pages 72-87, January.
    2. Seeman, Teresa E. & Crimmins, Eileen & Huang, Mei-Hua & Singer, Burton & Bucur, Alexander & Gruenewald, Tara & Berkman, Lisa F. & Reuben, David B., 2004. "Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging," Social Science & Medicine, Elsevier, vol. 58(10), pages 1985-1997, May.
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    4. Gersten, Omer, 2008. "Neuroendocrine biomarkers, social relations, and the cumulative costs of stress in Taiwan," Social Science & Medicine, Elsevier, vol. 66(3), pages 507-519, February.
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    7. Loucks, Eric B. & Juster, Robert P. & Pruessner, Jens C., 2008. "Neuroendocrine biomarkers, allostatic load, and the challenge of measurement: A commentary on Gersten," Social Science & Medicine, Elsevier, vol. 66(3), pages 525-530, February.
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    Cited by:

    1. Arévalo, Sandra P. & Tucker, Katherine L. & Falcón, Luis M., 2014. "Life events trajectories, allostatic load, and the moderating role of age at arrival from Puerto Rico to the US mainland," Social Science & Medicine, Elsevier, vol. 120(C), pages 301-310.
    2. Guimarães, Joanna M.N. & Clarke, Philippa & Tate, Denise & Coeli, Claudia Medina & Griep, Rosane Harter & Fonseca, Maria de Jesus Mendes da & Santos, Itamar S. & Melo, Enirtes Caetano Prates & Chor, D, 2016. "Social mobility and subclinical atherosclerosis in a middle-income country: Association of intra- and inter-generational social mobility with carotid intima-media thickness in the Brazilian Longitudin," Social Science & Medicine, Elsevier, vol. 169(C), pages 9-17.
    3. Schwartz, Joseph A., 2017. "Long-term physical health consequences of perceived inequality: Results from a twin comparison design," Social Science & Medicine, Elsevier, vol. 187(C), pages 184-192.


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