About

Arline T Geronimus is a Professor of Health Behavior and Health Equity at the University of Michigan School of Public Health. Her scholarly work is centered on developing and testing the 'weathering' framework, which posits that the health of African Americans and other culturally oppressed or economically exploited populations is subject to early health deterioration as a consequence of social exclusion. Her research interests include structural and cultural influences on population variation in family structure and age-at-first birth, the effects of impoverishment, structural racism, and disinvestment in residential areas on health, as well as the collective strategies marginalized communities employ to mitigate, resist, or undo the harmful effects of poverty and structural racism on their health. She examines biological mediators of the weathering process, particularly how social dynamics activate physiological stress arousal in social identity groups in everyday settings. Dr. Geronimus has a background that includes postdoctoral training at Harvard Medical School and a Doctor of Science degree from Harvard School of Public Health. Her research focuses on population health inequity, weathering, contingencies of social identity, racism, racialization processes, maternal health, accelerated aging, and chronic disease onset. She is actively evaluating trends in life expectancy disparities in the US, analyzing data from national vital statistics and census sources to understand the drivers of these disparities and inform policy interventions. Her work also explores the impact of economic declines on years of life lost and the secular trend toward older maternal ages at first birth in relation to maternal mortality rates. She has authored publications on the weathering hypothesis, health inequities, and the biological impacts of social stress, contributing significantly to the understanding of how social and structural factors influence health outcomes across populations.

Research topics

• Sociology
• Demography
• Gerontology
• Demographic economics
• Medicine
• Economics
• Political Science
• Economic growth
• Internal medicine
• Oncology
• Pathology
• Psychology
• Law

Selected publications

• Increasing and inequitable US pregnancy-related mortality ratios among non-Hispanic Black and White women, 2000-2019

  American Journal of Epidemiology · 2026-01-03

  article1st authorCorresponding

  Reported increases in US maternal mortality rates and entrenched Black/White rate inequity are alarming. We analyze rigorously collected US Pregnancy Mortality Surveillance System data to describe pregnancy-related mortality ratios (PRMR) levels and trends, 2000-2019. Conceptually guided by the weathering framework, we hypothesize that the increasing maternal age distribution of births contributed to PRMR increases. Stratifying on maternal age, race, educational level, and cause of death, we find US PRMR inequities persist, yet actual PRMR increases do not apply uniformly. White women with no more than a high school education averaged a 3.61% increase per year, implying a 92% increase over the period, with little growth observed among the more educated. Less-educated Black women exhibited a small proportional increase (9% over the study period). PRMRs for Black women at higher educational levels declined by over 1% per year, still remaining in excess of White rates. Simulations suggest that the shift in the maternal age distribution contributed a small amount to White PRMR increases. It would have increased PRMRs overall for Black mothers by just over 1% per year, suggesting that if the maternal age distribution had not shifted upward, the overall Black/White PRMR inequity would have decreased.

  PublisherDOI

• Long-term Economic Distress and Growing Educational Inequity in Life Expectancy

  Epidemiology · 2025-02-10 · 4 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: The nature and timing of increasing educational inequity in US life expectancy before the coronavirus disease 2019 pandemic suggest that long-term adverse labor market conditions secondary to globalization and technological change played a role for less-educated workers, but this has not been tested. METHODS: We exploit spatiotemporal variation in mortality and long-term economic conditions at the year and commuting zone level to estimate the relationship between macroeconomic restructuring and diverging mortality trends, 1990-2017, by race, sex, and education. Our measure of macroeconomic restructuring is based on the baseline industrial mix of an area, a measure that is plausibly exogenous to mortality. RESULTS: Mortality trends were substantially worse in commuting zones experiencing long-term economic stagnation than in others. For both White and Black adults, this relationship was strongest in the lowest quartile of the education distribution. Residence in commuting zones in the top quartile of our measure of economic conditions was associated with an additional 1-2 years lived between ages 25 and 84 compared with living in a commuting zone in the bottom quartile. The primary mediators of these divergent mortality trends were cancer, cardiovascular and metabolic diseases, and diseases of other internal body systems. Deaths from suicide or substance abuse did not contribute importantly toward accounting for the estimated impact of long-term economic stagnation on mortality. CONCLUSION: In our study, diverging trends in US life expectancy were associated with macroeconomic changes witnessed over the last half-century. The causes of death mediating this link were largely found in rates of death from stress-related internal diseases.

  PublisherOA PDFDOI

• Weapon victimization and long-term cardiovascular disease risk

  Social Science & Medicine · 2025-05-21

  articleOpen access
  PublisherOA PDFDOI

• A web of risk: multilevel factors and feedback loops (re)produce HIV ‘risk’ among gay, bisexual and other men who have sex with men – a global systematic review

  Journal of Epidemiology & Community Health · 2025-12-09

  articleOpen accessSenior author

  BACKGROUND: HIV literature shows that gay, bisexual and men who have sex with other men (GBMSM) experience inequities across social and contextual factors. Given growing inequities, this study used complex systems theory, a scientific approach to understanding the interconnected parts, to identify and visualise the system of factors that shape the emergence or (re)production of HIV risk among GBMSM. METHODS: A meta-synthesis of systematic reviews and meta-analyses was conducted to examine risk factors for HIV in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and quality assessments using A Measurement Tool to Assess Systematic Reviews 2. After screening 255 studies, data were synthesised and visualised from 29 articles with moderate-quality or high-quality assessments. Study characteristics and risk factors for HIV were extracted, and data were thematically analysed into higher-order themes and respective subthemes aligned with Bronfenbrenner's socio-ecological model. Kumu.io, a system mapping software, was used to visualise the system of factors. RESULTS: Our thematic analysis and visualisation portray a dynamic and complex web of HIV risk that GBMSM experience implicated across all levels of the socio-ecological model: individual, interpersonal, community, institutional/organisational and structural/policy levels. These risk factors, in tandem, interact with one another to create pathways and patterns that generate feedback loops, such that the systems of factors create the emergence of GBMSM's HIV risk beyond that accounted for at the individual level. CONCLUSION: GBMSM's HIV risk is socially patterned by a diversity of multilevel and interacting risk factors, which creates a dynamic and reinforcing system of HIV risk that requires attention in its totality to fully address HIV risk.

  PublisherOA PDFDOI

• Provider Adaptations to Legislative Efforts to Ban Gender-Affirming Care for Adolescents

  Journal of Adolescent Health · 2025-12-29

  article
  PublisherDOI

• An Interview With Arline Geronimus on the Origins and Development of the Weathering Hypothesis

  American Public Health Association eBooks · 2025-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• Increasing and Inequitable U.S. Pregnancy-Related Mortality Ratios Among Nonhispanic Black and White Women, 2000-2019

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access1st authorCorresponding
  PublisherDOI

• Building the Worlds That Kill Us: Disease, Death, and Inequality in American History, by David Rosner and Gerald Markowitz. New York: Columbia University Press, 2024

  Journal of Medical Humanities · 2025-05-28

  article1st authorCorresponding
  PublisherDOI

• Spiraling Risk: Visualizing the multilevel factors that socially pattern HIV risk among gay, bisexual & other men who have sex with men using Complex Systems Theory

  Current HIV/AIDS Reports · 2023-07-24 · 3 citations

  reviewOpen accessSenior author

  PURPOSE OF REVIEW: Global disparities in HIV infection, particularly among gay, bisexual, and other men who have sex with men (GBMSM), indicate the importance of exploring the multi-level processes that shape HIV's spread. We used Complex Systems Theory and the PRISMA guidelines to conduct a systematic review of 63 global reviews to understand how HIV is socially patterned among GBMSM. The purpose was to conduct a thematic analysis of the reviews to (1) synthesize the multi-level risk factors of HIV risk, (2) categorize risk across the socioecological model, and (3) develop a conceptual model that visualizes the interrelated factors that shape GBMSMS's HIV "risk." RECENT FINDINGS: We included 49 studies of high and moderate quality studies. Results indicated that GBMSM's HIV risk stems from the individual, interpersonal, and structural levels of the socioecological model. We identified a few themes that shape GBMSM's risk of HIV infection related to biomedical prevention methods; sexual and sex-seeking behaviors; behavioral prevention methods; individual-level characteristics and syndemic infections; lived experiences and interpersonal relationships; country-level income; country-level HIV prevalence; and structural stigma. The multi-level factors, in tandem, serve to perpetuate GBMSM's risk of HIV infection globally. The amalgamation of our thematic analyses from our systematic reviews of reviews suggests that the risk of HIV infection operates in an emergent, dynamic, and complex nature across multiple levels of the socioecological model. Applying complex systems theory indicates how multilevel factors create a dynamic and reinforcing system of HIV risk among GBMSM.

  PublisherOA PDFDOI

• Trend Toward Older Maternal Age Contributed To Growing Racial Inequity In Very-Low-Birthweight Infants In The US

  Health Affairs · 2023-05-01 · 13 citations

  articleOpen access1st authorCorresponding

  In 2016 the Centers for Disease Control and Prevention reported that for the first time, US women in their thirties were bearing more children than those in their twenties. Analyzing US vital statistics data from the period 1989-2019, we simulated the effect that the distributional shift to older maternal ages at first birth had on health inequity between Black and White infants. Net of maternal socioeconomic indicators, this shift increased the relative odds that White women gave birth to very-low-birthweight (VLBW) infants by 10 percent, versus 19 percent for Black women, largely accounting for the rise in VLBW and the increase in racial inequity seen in the years analyzed. Reductions in infant mortality over the period were dampened by the maternal age shift, especially among Black babies, exacerbating Black-White inequity. Policy implications for promoting reproductive justice include universal tertiary care access, increasing the supply and distribution of maternity care providers, addressing the holistic needs of mothers throughout pregnancy and postpartum, and expanding family support policies. Conceptually, we recommend centering the realities of pregnancy and parenting from the perspective of the populations at highest risk-centering on the margins-and taking into account their implications for maternal weathering (accelerated deterioration due to disparate impacts of structural racism).

  PublisherOA PDFDOI

Recent grants

• NIH Grant R21HD056307

  NIH · $477k · 2011

• Economic distress and growing educational disparities in life expectancy: Weathering, high effort coping, and despair

  NIH · $1.9M · 2018–2025

• NIH Grant R01AG032632

  NIH · $1.7M · 2014

• NIH Grant R01HD024122

  NIH · $821k · 1995

Frequent coauthors

• John Bound

  91 shared

• Javier M. Rodríguez

  Claremont Graduate University

  22 shared

• Timothy Waidmann

  Urban Institute

  18 shared

• Stacy S. Drury

  Boston Children's Hospital

  16 shared

• Nancy Lee Jones

  National Institute on Minority Health and Health Disparities

  16 shared

• Tina L. Cheng

  Stanford University

  16 shared

• Carl V. Hill

  16 shared

• Stephen E. Gilman

  Johns Hopkins University

  16 shared