Life Under Pressure: Intergenerational Origins of Hypertension Among African Americans

Abstract

Medical and social scientists have traditionally viewed heart disease as the outcome of current or recent conditions such as poverty, smoking and obesity. Guided by recent medical research, a new understanding of the developmental origins of chronic disease has emerged. In this paper, we apply developmental origins concepts, also known as the fetal origins hypothesis, to understand how intergenerational socioeconomic history can help explain disparities in hypertension across states of the United States for African Americans. Specifically, southerners and especially southern blacks experienced generations of poverty following the Civil War, but by the middle of the twentieth century witnessed rapid income growth and other changes related to industrialization. The intergenerational poverty experience prepped the major organs of developing fetuses in cohorts born after the middle of the century for lean living conditions, but also primed them for adult chronic disease when they encountered greatly improved nutritional conditions as older children and adults.