But more importantly, the constant calculus of survival will wear down mind and body and deteriorate health over years. Bruce McEwan, one of the pioneers of research in the biology of health inequality, coined the term “allostatic load” to describe the cumulative wear and tear of stress reactions over time. Stress reactions, like floods of adrenaline and cortisol and increased blood pressure, are helpful as short-term reactions to dangerous or challenging situations. But if stress reactions are constant, they create physiological conditions that damage the body. “One of the things having an elevated sympathetic response is that you have an inflammatory tone in the body,” McEwan explains. “Inflammation underlies all of the diseases of modern life — from cancer to depression to neurological diseases.” Those diseases of modern life also include heart disease, hypertension and diabetes — illnesses we typically associate with poverty.
But the implication of McEwan’s research — that poverty itself is making people ill — is not one that Americans are prepared to accept. Instead, we build supermarkets, finance green grocer carts and teach former inmates about fennel, feeling we’re promoting a progressive effort to improve the plight of the disadvantaged. Meanwhile, poor people are living shorter, sicker lives, with no helpful new policy in sight.