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Abstract Allostatic load, which is characterized by the dysregulation of physiological activity across multiple systems in the body, has been linked to an increased risk of chronic diseases such as diabetes, heart disease, and stroke. However, the prevalence of allostatic load is not equally distributed among US subgroups, with Black adults having higher allostatic load than White adults, particularly during middle and older age. The reasons for these disparities are not fully understood, despite research into factors such as stressors, diet, and socioeconomic position. Discrimination has been identified as a risk factor for allostatic load. While discrimination is understood as a multidimensional construct that operates at multiple levels and in different social contexts, the association between multiple forms of discrimination and allostatic load remains understudied, as well as the underlying mechanisms by which discrimination may affect physiological function. The cellular-level processes through which discrimination "gets under the skin" and leads to physiological dysregulation remain unclear. This study aims to define the relationship between multiple forms of discrimination and allostatic load using data from three large, population-based cohort studies, in order to increase the efficacy of prevention efforts and treatment to reduce allostatic load and Black-White disparities in allostatic load. By assessing the associations between multiple forms of discrimination (neighborhood and interpersonal) with allostatic load, the study will quantify the extent to which discrimination explains racial disparities in allostatic load.

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