Dr. Margaret Larkins-Pettigrew frequently lectures regionally and internationally on health issues relating to women’s wellness and strategies that advance diversity, equity, and inclusion in health care. She is also the author of “Embracing My Blackness with History, Family Fear, and Faith,” her recently published autobiography. (Courtesy Photo)

By Mylika Scatliffe,
AFRO Women’s Health Writer

According to dictionary.com, the definition of stress is “a specific response by the body to a stimulus, such as fear or pain, that disturbs or interferes with the normal physiological equilibrium of an organism.” 

Simply put, it iss physical, mental, or emotional strain or tension.   

Senior Vice President and the Chief Clinical Officer of Diversity, Equity and Inclusion for Allegheny Health Network/Highmark Health, Dr. Margaret Larkins-Pettigrew, wants to lift the veil of toxic stress and its impact on Black women’s health.

Larkins-Pettigrew also serves as an associate professor of obstetrics and gynecology for Case Western Reserve University.

Dr. Margaret Larkins-Pettigrew has been at the forefront of healthcare as a global leader and is a champion of diversity and inclusion. An internationally respected expert in cultural humility within the healthcare field, Dr. Larkins-Pettigrew has spent her 30-year career engaging marginalized communities and building programs that focus on promoting outcomes equity for vulnerable patients and mitigating socio-political barriers to care. 

She has a special interest in educating and empowering women, especially those pursuing careers in medicine. Dr. Larkins-Pettigrew is committed to educating and empowering women, as well as helping to shape the next generation of talented physicians. 

What is toxic stress? 

Toxic stress is chronic stress that causes physiological, psychological, social, and economic damage. is continuous and changes your ability to navigate wellness, as defined by Larkins-Pettigrew. Navigating issues surrounding wellness and mental health has been a burden on women, particularly Black women, for ages. 

“We embrace our history and try to move forward while living our lives with joy but continue to be confronted with issues of toxic stress,” stated Dr. Larkins-Pettigrew.  

Mental health and illness in the Black community is cloaked in a longstanding stigma. Even as slaves, our ancestors couldn’t exhibit anything less than strength or resiliency or they risked being whipped, sold away from their families, or murdered. 

Slaves weren’t really viewed as humans.  In the era of Jim Crow, the risks remained largely the same if they dared exhibit anything other than meekness and a conciliatory tone in response when addressed by a White person.  

Now, we need to focus on maintaining physical wellness which is significantly affected by psychiatric wellness.  Maintaining mental health is a complex issue for Black women because we are trying to do so in a country that is built on structural racism and oppression. Toxic stress infiltrates all areas of our lives.  There’s stress when we try to conceive and carry babies to term knowing we might die, or our babies might not see their first birthday.  The stress begins early in life. Studies show that Black girls between the ages of 9- and 12-years-old have a 60 percent higher chance of committing suicide than White girls of the same age.  The police are now called on Black children in school, as early as kindergarten, and they are led away in handcuffs for having tantrums or they might be expelled.  “I raised three Black boys who are now Black men, and I still worry about where they are in this country, who they will be exposed to and what decision someone else will make about them if they are worthy to be on this planet,” said Dr. Larkins-Pettigrew. 

Mental health continues to be a struggle when dealing with poverty and wealth gaps. Black women who are educated and may have fared better economically still suffer daily micro- and macroaggressions.

All of this stress is internalized and manifests itself in physiological break down – heart disease (the No. 1 killer of Black women), obesity, diabetes.

How do we protect ourselves from toxic stress?

Protection starts with us.  Before taking care of anyone else, we must value and nurture ourselves first.  We must not internalize the racist views others have of us.  We must maintain our health by keeping up with breast exams, annual physicals and well-woman visits- not sacrifice them in favor of work and caring for everyone else.   

“We must also indulge in our social wellness,” Dr. Larkins-Pettigrew adamantly stated.  “Bring people into your life who will lift you up, help with your village, who can recognize when you are out of character, not eating or sleeping or when you’re snapping on people!”  Dr. Larkins-Pettigrew also reminds us to choose romantic partners well. We have to be strategic about who we fall in love with by making sure it’s someone who shares the same values and goals, and who will offer support and actually function as a partner. Trying to make a life with someone with whom you don’t agree will be a constant struggle.

Protection from the toxic effects of stress extends to our children.  We do this by protecting them from anyone who will devalue them, knowing who they associate with, asking questions about their friends and what their teachers say to them. 

How do we advocate for ourselves in the medical world?

When searching for health practitioners, it’s imperative to be intentional about seeing your needs met. Choose someone you can trust.  Don’t be afraid to ask specific questions to ascertain if they can relate to your specific needs and issues. When caring for you, a practitioner should make you the center of the universe.  Mental health providers should be asking about your physical state and vice versa. 

When seeing a medical practitioner about a specific issue, especially a serious one, have someone go with you as an ally to help navigate visits and be another set of ears.  Seek community input since there are so few mental health practitioners of color.


Finally, indulge in self-care.  We hear self-care and think of things like spa days, brunches, and girl’s trips.  These are all fine options, but self-care can be achieved without spending money.  It can simply be spending time with yourself by yourself. Exercising, reading, meditating, or simply being quiet.  We don’t have to accept toxic stress and its effects as our normal.

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