Understanding and eliminating racial inequalities in women's health in the United States: the role of the weathering conceptual framework.

I emphasize 3 features of racial inequality in women's health: It is greatest during young and middle adulthood; in some instances its severity is far greater than national comparisons suggest; and excessive levels of chronic morbidity and disability are widespread among African-American women, regardless of socioeconomic position. I propose that the weathering framework better captures these aspects of health inequality than do developmental models or those that focus on the role of poverty or individual unhealthy behaviors alone. Instead, weathering suggests that African-American women experience early health deterioration as a consequence of the cumulative impact of repeated experience with social, economic, or political exclusion. This includes the physical cost of engaging actively to address structural barriers to achievement and well-being. The weathering framework can be applied to research, to clinical and public health practice, and to social policy and political action.