{
  "abstract": "ImportanceChronic stress may contribute to adverse health outcomes through cumulative physiologic dysregulation. Allostatic load (AL), a composite measure of multisystem physiologic burden, may capture biologic effects of structural, social, and psychosocial stress not reflected by self-reported measures.\n\nObjectiveTo evaluate racial and ethnic differences in AL among women with familial cancer risk and examine how socioeconomic status, psychosocial factors, clinical characteristics, and health behaviors contribute to variations in AL.\n\nDesignCross-sectional study of underrepresented minority participants enrolled in the HERSTORY cohort from October 2023 through September 2025, with comparison participants from the UCLA ATLAS biobank.\n\nSettingUCLA academic health system.\n\nParticipantsThe study included 303 racially and ethnically diverse female HERSTORY participants aged [≥]35 years with a family history of cancer and matched non-Hispanic White female ATLAS participants (n=709).\n\nExposuresRace and ethnicity, age, neighborhood deprivation, cancer history and stage, depression, perceived stress, cancer worry, and physical activity.\n\nMain Outcomes and MeasuresThe primary outcome was AL, calculated from cardiometabolic and organ-function measures. A secondary index incorporated race- and ethnicity-specific neutrophil-to-lymphocyte ratio (NLR) derived from 326,826 women in the UCLA Health population. Multivariable regression models evaluated factors associated with elevated AL.\n\nResultsCompared with matched non-Hispanic White participants, Black and Asian/Pacific Islander HERSTORY participants had significantly higher AL after adjustment. Hispanic/Latina participants did not have significantly elevated AL. Older age, greater area-level socioeconomic deprivation, and depression were independently associated with higher AL. Prior cancer diagnosis, cancer worry and perceived stress were not significantly associated with AL, whereas regular physical activity was associated with lower AL. Among cancer patients, advanced stage was associated with greater AL.\n\nConclusions and RelevanceThis study demonstrates elevated AL among understudied racial/ethnic minority groups with familial cancer risk and identifies associations with neighborhood deprivation, depression, and physical activity. The association between cancer stage and AL suggests that physiologic stress may reflect variation in cancer burden. The lack of association with perceived stress and cancer worry further indicates that physiologic and self-reported psychosocial measures capture distinct dimensions of stress. The development of race/ethnicity-specific NLR thresholds derived from large population samples provide a benchmark for future studies.",
  "abstract_shown": true,
  "affiliations": [
    "University of California, Los Angeles"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "name": "E. K. Shachar"
    },
    {
      "name": "R. Haas"
    },
    {
      "name": "V. E. Rodriguez"
    },
    {
      "name": "J. Lester"
    },
    {
      "name": "M. A. Siavoshi"
    },
    {
      "name": "L. Kwan"
    },
    {
      "name": "M. Niell-Swiller"
    },
    {
      "name": "P. T. Spellman"
    },
    {
      "name": "P. C. Boutros"
    },
    {
      "name": "V. Y. Chang"
    },
    {
      "affs": [
        0
      ],
      "name": "B. Y. Karlan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b3htyz6amyqvd.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.26.26361226",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361226v1.full",
  "id": "b3htyz6amyqvd",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361226v1",
  "language": null,
  "licence": "CC-BY-ND",
  "licence_label": "CC BY-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "public and global health"
    ],
    [
      "openalex",
      "3306|Health disparities and outcomes"
    ]
  ],
  "openalex": "W7204845023",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361226v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-26",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b3htyz6amyqvd.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:21Z",
      "native_id": "10.64898/2026.08.26.26361226",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361226v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:public and global health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Psychosocial Stress and Allostatic Load Among Underrepresented Minority Women with Familial Cancer Risk",
  "title_text": "Psychosocial Stress and Allostatic Load Among Underrepresented Minority Women with Familial Cancer Risk",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:21Z",
  "url": "https://research.draconitic.com/paper/b3htyz6amyqvd",
  "venue": "medRxiv",
  "versions": []
}