Professor Arline Geronimus developed her theory of “weathering” in 1990. It described the deleterious effects of a racist environment on the health of marginalized peoples, specifically, the effect on infant mortality of blacks versus whites. Previous to her research, it was thought that teen pregnancy was the cause, i.e., giving birth as a teen led to low weight or underdeveloped babies that did not survive. Her research showed the opposite: babies born to Black teens were surviving better than those born to Black women in their 20s. Teen pregnancy was a solution to a racist environment. Opponents of teen pregnancy were aghast.

I wrote about weathering in my book, Beyond Choice, in 2004. 

A few excerpts:

“As Professor Arline T. Geronimus of the University of Michigan has stated: “Fertility-timing varies among populations because of the contingencies members of different populations face in their efforts to provide for the survival and well-being of families.”

“…because of unhealthy living conditions, a sub-standard health system and violence, poor men and women, both minority and white, suffer from higher morbidity and mortality than those with higher incomes who are disproportionately white. Professor Geronimus calls this the “weathering hypothesis”. The weathering hypothesis says that certain groups statistically will “weather”, growing sicker as they age and dying faster than other groups.

“One study by Professor Geronimus in 1999 revealed that poor blacks, who had reached the age of 15, had a relatively low probability of survival until age 65. In Harlem only 37% of black men and 65% of black women who reach age 15 survive until age 65. For black men this represents half the probability of survival to age 65 for whites nationwide. Black girls in Harlem who reach age 15 have the same chance of surviving until age 45 as the average white girl of 15 has of surviving until age 65. Poor blacks get sicker faster and die younger.

“The leading causes of early death in poor communities include diseases of the circulatory system, AIDS, accidents, homicide and cancer. Poverty and race alone do not explain the entire difference in mortality rates. Other factors include crowded living conditions, poor health care, being a victim of crime, living amidst environmental hazards and, as a result of all these factors, experiencing enormous stress. The evidence is clear that many black people in America cannot reasonably expect to live through middle age. Living with this prospect may affect their behavior in a variety of ways, including in risk taking behavior and in reproductive patterns. 

“Studies aiming to confirm the weathering hypothesis have found evidence of a correlation between the average life expectancy in a community and the age at first birth in that community. Generally the lower the life expectancy, the lower the average age of first birth. In one study done in Chicago in 1997 Professors Margo Wilson and Martin Daly of McMaster University found that the median age of women giving birth was 22.6 years in neighborhoods with low life expectancy compared to 27.3 years old in neighborhoods with a longer life expectancy. This finding is in line with of young people, faced with the prospect of a compressed life span, trying to achieve their reproductive goals by accelerating their childbearing. The timing of a young poor woman’s childbearing is, I believe, a decision actively motivated in part by knowledge that her life and the lives of her parents will be shorter and less robust than those of other people. With parenting by not only parents but also grandparents being necessary in poor communities, it is natural for a young woman to have children while her extended family is alive and healthy enough to help care for them and help them grow. 

“Professor Geronimus found that the risk of neonatal death for a black infant increases as a poor, black woman gives birth at older ages, while the risk of neonatal death for a white infant decreases as the white mother gives birth at older ages. The weathering hypothesis says that the effects of social inequality, poverty, poor health and nutrition, stress and other negative environmental circumstances compound with age and have increasingly deleterious effects on fetal and newborn health as a poor, black woman ages and gives birth. 

“Professor Geronimus found that black mothers between the ages of 15-19 were found to have the lowestincidence of low birth weight babies as compared to older black women. For example, the infant mortality rate in Harlem for teens giving birth is 11 deaths per 1000 births. The rate for black women in their 20’s is twice that—22 per 1000. Among whites, mothers in their teens and 30’s experience slightly higher rates of poor birth outcomes than white women in their 20’s. In other words, whites in their 20’s have the best birth outcomes, while the best birth outcomes for blacks is while they are in their late teens. Black women as they age were found to smoke more during pregnancy and have higher rates of hypertension than whites. Black women as they age continue to live more in poverty than white women. Through their young adult years, black women’s health deteriorates more rapidly than white women’s health does, thereby leading to a greater risk of low birth weight babies as black women age. Poor women also generally get less prenatal care than wealthier women. The Geronimus study concluded: “the populations in which early births are most common are those where early births are the lowest risk, raising questions about the social construction of teen childbearing as a universally deleterious behavior.”

“This and other studies suggest that women may consciously or unconsciously time childbirth strategically by taking into account factors that include the status of their own health and their infant’s potential health, as well as the health of those in their kin network who will be helping raise the child. It is arguably a better reproductive strategy for a woman to give birth earlier rather than later in these circumstances. Women know that their premature death will have serious negative consequences for their children. In an environment where life is short it makes evolutionary sense for women to have their children as early as possible.

“Rather than viewing early childbearing as a pathology to be cured, I would argue that it is an adaptive reproductive strategy that is succeeding. In fact, the child of the teen parents is doing reproductively what she should: having children at a time where by her own experience there is a good chance they will survive to have children of their own. The child of teen parents will be a reproductive success if she repeats the pattern and if her children do too. As Geronimus said, “to postpone such goals as childbearing is to risk foregoing them.” 

“There is no one fixed path to reproductive success. Reproductive strategies depend on one’s environment. The environment can encourage a woman to give birth at a certain time and under certain conditions or it may discourage her. Teenagers in poor communities may see a variety of reasons not to postpone childbirth until they are older. They may have fewer choices of men, their health may worsen, and the health of their kin may also. It is also likely that they will give birth to healthier infants if they do so sooner rather than later. The role of her kin network cannot be underestimated. Parents want to be grandparents. They know their time is running short and they want to be around to help raise the child. While there are risks for the teen mother and her child, the families often think these are worth running.”        

I am glad that the scientific and health communities have finally caught up to Dr. Geronimus. See The New York Times, April 18, 2023, p. D7. https://www.nytimes.com/2023/04/12/well/live/weathering-health-racism-discrimination.html

I most definitely remember that certain of my colleagues were aghast at the sections of my book quoted above. It was as if I were a traitor to the Cause. I rather think I was taking a fresh look at sexual and reproductive behavior in the context of human health, the environment, biology, genes and evolution. We like to use the word “intersectionality” now. There are many elements to intersectionality (i.e. life) that contribute to and affect human behavior, reproductive decisions and strategies, and sexual behavior and health. Putting aside preconceptions and taking a clear look at the facts can help devise strategies to promote human wellbeing.