We sat down with Geronimus to discuss her current work and to learn more about her perspective on wellness.
What are you working on now?
I’m developing a general approach to disrupting weathering in affected populations, “Jedi Public Health,” which applies social psychological understandings of social identity, environmental cues, and stereotype threat as they affect physiological stress process activation among social identity groups. Many researchers have established a troubling fact: The gap in life expectancy between higher and lower educated Americans has been growing at least since 1990. Life expectancy for some has actually fallen in the last few years, with low-educated white women experiencing the biggest decline. The opioid epidemic explains some of the gap. But that’s only a partial explanation and it applies mostly to white men. Blacks still have a much lower life expectancy and opioids play only a small part in black deaths.
Dr. Geronimus on Stress
We all need to be better informed about stress. What is something we should know to increase our stress IQ?
I wish more people knew that for some groups and some individuals in any group, chronic stress isn’t something over which they have control. Our society burdens some people more than others. For those people, our society creates the conditions that give rise to the chronic stress that leads to chronic disease. The problem can’t be solved by members of those groups alone or by encouraging them simply to reframe how they see the world more positively. In this way, the causes of the inequitable burden of chronic stress is something we all must grapple with as a society. That’s why I truly believe we need to demand health impact statements for all social policies.
Dr. Geronimus on Resilience
How do you define resilience?
I define resilience as the ability to withstand adversity — trauma, barriers, challenges — and keep kicking, though maybe not to the same height as before. I don’t think resilience means being able to bounce back to where you were. There are costs to surviving and to recovering — physiological, psychological, emotional. There can be growth or new direction to your life. For better or worse, you are not the same. What concerns me is that people often talk about being resilient as if it’s innate and defines some people as being better than others; stronger than others. There’s almost a macho quality to it and a moral dimension. We have to stop thinking about and defining resilience as solely a quality of the individual. You can’t independently buffer the pain of a traumatic event. It’s more about what else you have to deal with in your life; who can help you deal with it; the nature of the society in which you live; your cultural history; whether you can access some kind of motivating wisdom to keep going. This can be as simple as having someone to tell you, “This, too, will pass.” We have to minimize the “me” in our notions of resilience and the burden we place on individuals to become more resilient, to learn resilience, even when they may be facing multiple challenges all the time — any one of which could be overwhelming. We need to emphasize, instead, the society and culture that is the staging ground for these traumatic experiences in the first place. No one can escape adversity completely. But some people face societal adversities and we should take responsibility as a society for reducing them. Which would be more effective at reducing childhood trauma, for example: Ending the family separation policy at the border or teaching 2-year-olds separated from their parents how to be more resilient? That one’s obvious. There are subtle versions of this happening every day, disproportionately to members of some groups compared with others. Again, the burden should be on our society, our culture to reduce the challenges that various people and populations face every day. You know there are whole cultures who have been oppressed for so many generations that they’ve devised folk wisdoms — such as “keeping on keeping on” — and strategies to survive. I was certainly helped by a very strong motivating perception of my grandparents, who escaped oppression in Russia to come here with nothing, not even speaking English. People I knew and loved had horrific things happen to them and had come out the other side. I thought early on that if they could manage that, I could manage this — whatever “this” was.
We all at one time or another have a life experience that challenges our resilience. Can you describe what you learned about your own resilience after such an experience?
That assumes I believe in resilience as an individual property! For me, a foundational challenging experience was my mother dying when I was 13. She died within six months of diagnosis, which made hers not only a death at a young age but also sudden. In my community there weren’t a lot of mothers who died so young. It was, in fact, a culture that expected kids to have mothers. No one knew how to help me, and I had no words for the loss. I learned that I could survive that kind of trauma. I could be resourceful on my own. I learned that my initial reaction of acting out as I struggled with the unfathomable pain mixed with anger, abandonment, and complete disorientation — wasn’t gratifying. In the longer run, it wasn’t going to do anyone any good; especially not me. I was able to throw myself into my school work and extracurriculars instead, since a lot of my identity was already bound up in those. And then there were the Beatles. The Beatles very much helped get me through, which makes me think that maybe you don’t need community, just a good rock band. I listened to them endlessly. I danced to their music all the time, which I now understand was exercise and raised the level of endorphins, the body’s natural pain relievers, in my brain. No wonder it made me feel good. I sang “Let It Be” and substituted in my mother’s name — Miriam — for Mary in the lyrics: [I’ve inserted the lyrics for those unfortunates who never heard The Beatles or their songs.] “When I find myself in times of trouble / Mother (Miriam) Mary comes to meSpeaking words of wisdom / Let it beAnd in my hour of darkness / She is standing right in front of meSpeaking words of wisdom / Let it be” It was a way in which I could express and comfort myself, a kind of self-soothing that offered some pseudo-wisdom that I wasn’t getting anywhere else. The reality is that I didn’t do anything consciously. After being hurled into the maelstrom, I somehow managed to float and then swim. I learned by empirical observation that after this terrible trauma, I could continue to be a living, breathing, productive human being. And I could comfort and provide validation to others. I believe this experience informed my interest in understanding inequities in life expectancy — not only their epidemiologic causes, but also their implications for children, families, and communities.
