Epigenetics, Chronic Disease, and Black Trauma

I shadowed at Central City Concern, Imani Center in Portland, Oregon two years ago during a pre-health clinical experience. The Imani Center at CCC provides culturally specific and responsive Afrocentric approaches to the Black community of Portland. While there, I perused the literature on display at the center. A book caught my eye: Post Traumatic Slave Syndrome by Dr. Joy DeGruy. Post Traumatic Slave Syndrome is a condition resulting from multi-generational oppression of Africans and their descendants. DeGruy believes this results in MAP: multi-generational trauma together with continued oppression, absence of opportunity to heal or access the benefits of society and post traumatic slave syndrome.

Epigenetics is a possible expansion of the DeGruy’s work on Post Traumatic Slave Syndrome. Epigenetics could potentially explain disproportionate health disparities between African-Americans and non-Hispanic whites. Additionally, it may explain why African-Americans and their children are more likely to suffer from chronic diseases, usually referred to as “predispositions.” Epigenetics is the heritable changes in the chromatin that does not affect underlying gene structure. There are three driving forces that contribute to epigenetic changes –non-coding mRNAs, histone modifications via acetylation, and DNA methylation. These factors are sensitive to environmental input and life experiences like accumulated stress, childhood trauma, racial discrimination, etc. Epigenetic study has shown that these changes are lasting and can be passed from one generation to the next. In theory, African-Americans can inherit the trauma of their ancestors, that combined with continued oppression and life stress, African-Americans are predisposed and more likely to suffer from chronic disorders.

According to Goosby & Heidbrink, 2013, African-American children more likely have higher rates of chronic health conditions such as asthma and obesity across socioeconomic status and during adulthood, African-American exhibit higher rates of hypertension and cancer mortality. Aroke et al., 2019 refers to lived experiences and adverse childhood experiences (ACEs). Aroke et al. claims the more ACEs, the chance of illness increases. It is well known that different races experience different lived experiences, with Black people living more stressful lives that influences their health and their health outcomes.

One study found there were mediating responses to ACEs in children as young as nine. In subjects so young it would appear the body’s response happens much earlier than the ACE itself, likely during development where the maternal psychosocial stress influences the neurocognitive development in a complex biosocial process (Aroke et al., 2019). Racial discrimination and oppression is a salient mechanism thus its impact and the health consequences is persistent and pervasive, passed from one generation to the next.

David W. Johnson of 4sightHealth oversimplifies the issue by stating that the environment impacts our health and that we must choose to interact with it differently in order not to succumb to its forces. His reference points are President Clinton winning his fight with obesity after adopting a vegan diet in so that he could attend his daughter’s wedding. Eat less meat. Exercise more. Breathe fresh air. This is not bad advice; it is incomplete. Different lived experiences, especially the disadvantaged lives of Black Americans, can only allow for some much control over your environment.

Epigenetics as an explanation for chronic disease is still being explored. Single-episode, present-life trauma has more understanding whereas transgenerational trauma has not made so many strides. Yael Danieli, PhD, founder of the International Center for Study, Prevention, and Treatment of Multi-generation Legacies of Trauma says, “Massive traumas like these [systematic oppression, slavery] affect people and societies in multidimensional ways. It behooves us to study this area as widely as possible, so we can learn from people’s suffering and how to prevent it for future generations.” Danieli encourages use of coping skills such as improving family communication, reducing family conflict and teaching children substance use resistance skills. Embracing self-care techniques such as mindfulness, exercise, or other nurturing activities as well as emphasizing prevention to reduce exposure potential triggers like the news (The Legacy of Trauma). Danieli’s approach differs from Johnson’s in that her approach allows for some control in a more trauma informed way.

To flip the switches of transgenerational trauma and mitigate the impact of chronic disease on vulnerable populations, we must have a better understanding of epigenetics and continue to approach our external environment in a culturally specific and healing way.

Bibliography

Aroke, E. N., Joseph, P. V., Roy, A., Overstreet, D. S., Tollefsbol, T. O., Vance, D. E., & Goodin, B. R. (2019). Could epigenetics help explain racial disparities in chronic pain? In Journal of Pain Research (Vol. 12, pp. 701–710). Dove Medical Press Ltd. https://doi.org/10.2147/JPR.S191848

Goosby, B. J., & Heidbrink, C. (2013). The transgenerational consequences of discrimination on African-American health outcomes. Sociology Compass, 7(8), 630–643. https://doi.org/10.1111/soc4.12054

POST TRAUMATIC SLAVE SYNDROME — Dr. Joy DeGruy. (n.d.). Retrieved January 17, 2021, from https://www.joydegruy.com/post-traumatic-slave-syndrome

The legacy of trauma. (n.d.). Retrieved January 17, 2021, from https://www.apa.org/monitor/2019/02/legacy-trauma