Project Summary/Abstract Cardiovascular disease (CVD) is a leading cause of adult mortality and health inequity in the U.S, with African Americans carrying a significantly higher risk for CVD compared to non-Hispanic Whites. Given that disparities in risk factors for CVD development are already present in childhood, there is a large public health need for research on factors that can contribute to CVD risk disparities among youth. Notably, exposure to racial discrimination leads to increased risk of cardiovascular events and CVD among African Americans. Furthermore, among African American youth, racial discrimination predicted elevated levels of inflammation in adulthood. However, up to this point, research on racial discrimination and CVD risk has focused on individual-level experiences of racial discrimination, while more broad-ranging aspects of structural racism have been understudied. Structural racism, defined as the macrolevel systems and social forces that impact inequities among racial groups, includes issues related to education, employment, housing, and law enforcement. One previous study identified that individuals living in states with higher structural racism had higher rates of myocardial infarction, highlighting a need for more research in this area. Examining the relationship between structural racism and biobehavioral processes involved in early CVD progression among African American youth has potential to provide significant impacts in terms of the prevention of CVD in future work. To address these gaps in the literature, the proposed project aims to assess how structural racism may be associated with CVD risk among African American youth and young adults. Using neighborhood-based indicators of structural racism (i.e., neighborhood-level racial disparities in education, employment, housing, and law enforcement) from publicly available data, the research will 1) examine the association between structural racism and cardiometabolic health, reflected by signs of metabolic syndrome and endothelial function, among African American youth and young adults over time, 2) examine the association between structural racism and another marker of CVD risk, inflammation, among African American youth and young adults over time, and 3) test inflammation as a mediator between structural racism and cardiometabolic health among African American youth and young adults over time. The research will utilize two studies, including the sponsor’s R01 data and the National Longitudinal Study of Adolescent to Adult Health to determine whether findings replicate and generalize. The proposed research is part of a broader post-doctoral training program, whose goal is to prepare the applicant for a career as a PI at a major research university, focused on understanding disparities related to CVD pathogenesis in youth. In addition to the research outlined above, the applicant will complete coursework on the pathophysiology of CVD, immunology, statistical methods, and adolescent health disparities, gain experience measuring inflammatory and cardiometabolic biomarkers, and develop a knowledge base about analyzing large- scale neighborhood-level data to better understand the social environment contributors to CVD disparities.

Project Narrative Cardiovascular disease (CVD) is a leading cause of adult mortality and health inequity in the United States, with African Americans at the highest risk for CVD and African American youth at the highest risk for CVD risk factors. This research examines the relationship between structural racism (i.e., neighborhood-level racial disparities in the educational, employment, housing, and law enforcement systems) and biobehavioral processes involved in early CVD progression, including metabolic syndrome, endothelial function, and inflammation, and also tests inflammation as a possible mechanism explaining the association between structural racism and cardiometabolic health (i.e., metabolic syndrome and endothelial function) across 2 samples of African American youth and young adults over time. Examining the relationship between structural racism and biobehavioral processes involved in early CVD progression among African American youth has potential to provide significant impacts in terms of the prevention of CVD in future work.