- Claire Benjamin & Kathryn Metcalf
Ruby Mendenhall: How stress gets under the skin
David Satcher, former U.S. Surgeon General, noted in his 2005 research that if health disparities were eliminated there would be approximately 80,000 fewer African-American deaths each year. According to the documentary Unnatural Causes: Is Inequality Making Us Sick, the 80,000 deaths is the equivalent of an airplane full of African-Americans falling out of the sky every single day every year. Unfortunately, remarks Ruby Mendenhall, “we don’t fully understand the complexity of problems associated with the high levels of African-American excess death.”
Mendenhall has been invested in understanding health inequality her entire career. After completing an undergraduate degree in occupational therapy, she began work in the pediatrics unit and protective services team of Cook County Hospital (now the John H. Stroger, Jr. Hospital). “A turning point for me there,” said Mendenhall, “was seeing that a lot of the children there were failing to thrive, meaning that they weren’t gaining weight like they should for their age, or had developmental delays.”
“When we asked the children’s mothers what was happening, they would say that they didn’t have enough money to buy formula, so they would water it down and that’s why the child wasn’t gaining weight. Also, many of the families who came in for therapy were living in Robert Taylor [a large Chicago public housing community] at the time, so the mothers didn’t want to put their children down on the floor because of the rats and roaches, which affected their children’s development.”
Those mothers sparked Mendenhall’s desire to examine and attempt to alleviate the costs of chronic poverty and stress for African-American mothers, leading her to complete her Master’s degree at the University of Chicago’s Harris School of Public Policy. From there, she became a lobbyist with the Ounce of Prevention Fund, working at both the federal and local level to address child care and welfare (cash transfers) related issues.
In 1996 while working at the Ounce, Mendenhall helped to write a grant proposal for an Early Head Start program, which would provide educational services to children from birth to three years of age. The Ounce was selected as an Early Head Start site and the program would be housed in the Robert Taylor public housing community. Mendenhall transferred from the policy world to the world of Early Head Start. “I wanted to really get a sense of what it was like being in that environment that we talked about so much when I was at Cook County Hospital, instead of advocating for mothers from our downtown office,” said Mendenhall. “So I went to work in Robert Taylor for two years. It was very stressful being around the gun violence and the mothers struggling every day due to poverty.”
After two years, Mendenhall returned to school and earned a Ph.D. in Human Development and Social Policy from Northwestern University. “I was really interested in merging what I knew about human development, and the conditions that people need to be healthy and well, with what I knew about the role of public policy in creating structural change.”
Mendenhall came to the University of Illinois in 2006, where she has a joint appointment in Sociology, African-American Studies, Urban and Regional Planning, and Social Work. Her interests have since brought her to the IGB, where she’s a member of the Gene Networks in Neural and Developmental Plasticity research theme. She is also an affiliate of the Institute for Computing in Humanities, Arts and Social Sciences.
After receiving a grant from the Illinois Campus Research Board in 2013 Mendenhall, along with Professor of Psychology Brent Roberts, IGB Director Gene Robinson, and eight team members, undertook a pilot study that included interviews with South Side mothers as well as blood draws. “The big question was how do neighborhoods with high levels of violence affect black mothers’ mental and physical health? We did depression screenings, PTSD screenings; we looked at coping behaviors generally associated with Black women such as spirituality and use of social networks. We also wanted to understand factors that allowed them to be resilient, despite their constant exposure to violence and fear. But we also took samples of the mothers’ blood to see how the genes that regulate the immune system may be affected by the high levels of neighborhood stress.”
That study revealed that mothers who reported high levels of subjective neighborhood stress have higher rates of activation of genes regulated by the glucocorticoid receptor, which may suggest increased cortisol output from the hypothalamic pituitary axis (HPA). “Chronic activation of the HPA can create processes that negatively affect health. Stress really can get ‘under their skin.’ That is why our research team is taking a sociogenomics approach to examining how stress in the environment shapes mothers’ health outcomes. The sociogenomics perspective, pioneered by Gene Robinson, highlights the dynamic nature of the genome and how environmental factors can influence patterns of RNA abundance (“gene expression”) to reflect individuals’ historical and current environmental context. But then the question is, can you get stress ‘out from under the skin?’ Can you reduce some of these physiological costs?”
Mendenhall’s current work includes continuing the project she and her team members developed during that pilot study, known as the Developing Responses to poverty through Education And Meaning program, or DREAM. By combining research, intervention and education, DREAM aims to better understand and improve the conditions of low-income African-American communities in Illinois, specifically on the southside of Chicago. The program also seeks to provide stress reduction and health prevention activities. Mendenhall is also working with African-American architects on social design ideas for a DREAM institute in Englewood which seeks to reimagine the social environment of the Black community in a way that fosters optimal human development. The project is called De.SH(ie) for Designing Spaces of Hope (interiors and exteriors).
“When I started the Black mothers project I was thinking about how to make big social changes and affect public policy, but I’ve really been moved by the impact that our pilot study has had on individual women. During one of the interviews, a mother thanked me for coming to talk to her about what was going on in her neighborhood. She said, ‘The little things make a difference. People don’t even understand that.’ What that mother told me shifted my focus and helped me to understand that little things we can do today can have a big impact on families. Even with our limited research resources, just by recognizing that they are human, that their conditions are very difficult, that the children they love dearly are in constant danger, made a difference. For me as an African-American female scholar, when I document the mothers’ lived experiences to create new sociological knowledge, work with them to understand and change unequal social structures, and bring the resources of the land-grant University of Illinois to address their struggles, that’s what I’m most proud of in my research.”
This article originally appeared on the December 2015 Carl R. Woese Institute for Genomic Biology newsletter.