Epigenetics, Structural Determinants, and Race: An Integrated Conceptual Framework for Embodied Stress, Resilience, and Black Women’s Cardiometabolic Health

By integrating epigenetic science using a multidisciplinary approach, grounded in nursing theory, this concept paper offers a transformative frontier for understanding and addressing cardiometabolic health inequities experienced by Black women. Building on the legacy and insights of the Black Women’s Health Study and drawing on the Social Ecological Model, the Neuman Systems Model, and the weathering hypothesis, we present a conceptual framework that elucidates how systemic drivers of health shape cardiometabolic health outcomes through psychosocial pathways that mediate epigenetic changes. Methodological and ethical considerations, and implications for theory development, practice, and policy, are discussed.

Duke Scholars

Author Schenita Davis Randolph School of Nursing

Author Keisha L. Bentley-Edwards Medicine, General Internal Medicine

Author Latesha K. Harris School of Nursing