Allostatic load: historical origins, promises and costs of a recent biosocial approach

Abstract

This article provides a critical and genealogical analysis of the allostatic load research framework. AL research is used as a case study to analyse how the current biosocial context is articulated in the field of health inequalities research. Providing a contemporary analysis of AL studies with a genealogy of the AL concept, we show that the ambition to use biological tools to improve measurements, predictions, and ultimately public health action, is rooted in a history that predates current biosocial entanglements. We analyse the conceptual and methodological grounding of AL studies in relation to the ambitious propositions to address health inequalities they often convey. The difficulties in translating AL research findings into public health policies and the risks of biomedicalisation that could emerge through the use of AL are also addressed. While acknowledging these risks, however, we nuance the risk of depoliticisation associated with the biomedicalisation of social inequalities in health. In light of the historical analysis, we qualify the risks associated to a biologisation of social life that could emerge from AL research: it appears that these risks are more specifically rooted in methodological and epistemological problems that researchers would need to consider in the pursuit of AL research.