How does accumulated stress, or allostatic load, affect a community’s ability to respond to shocks or crises?
The Issue
Public health practitioners have long understood the impact of allostatic load—accumulated stress at the individual level. When a person experiences long-term or repeated stress, the body can remain in a heightened state to the point where an individual’s health can begin to decline.
In the public health sector, this concept has been the focus of a growing body of research on how chronic stress and trauma—such as witnessing violence or experiencing discrimination or abuse—affect individual health across the lifespan.
Building on key findings in this area, the Robert Wood Johnson Foundation (RWJF) engaged RAND to investigate a slightly different question: whether a community that experiences challenges—for instance, high unemployment, community violence, segregation, or high opioid use—could develop community allostatic load, which, in turn, could affect how it responds to future traumatic events.
The research team developed a framework for community allostatic load, and explored whether it could explain why two similar communities might respond to the same traumatic event in different ways.