Examining Influences of Place-Based Historical and Contemporary Structural Racism on Racial Disparities in Aging-Related Disease Risk Trajectories: Leveraging the HANDLS Dataset
Project Number1R01AG078675-01A1
Former Number1R01AG078675-01
Contact PI/Project LeaderBEATTY MOODY, DANIELLE LATHEL Other PIs
Awardee OrganizationRUTGERS, THE STATE UNIV OF N.J.
Description
Abstract Text
Project Summary
African Americans (AA) are at disproportionate risk for earlier and more pronounced cognitive and functional
decline and increased frailty. Structural racism (SR)—the systems and processes that create and sustain race-
based inequities—is posited as the fundamental driver of accelerated aging and multi-level determinants through
its impact on the built and social environment (BSE).
We posit that greater and prolonged exposure to historical,
enduring, and contemporary (HEC) SR-BSE across the life course promotes greater cognitive and functional
declines and increased frailty among AAs. It remains crucial to a) understand the longitudinal relations of
cumulative, lifetime exposure to multiple indicators of HEC SR-BSE practices to cognitive aging, functional
decline, and emerging frailty; b) delineate variations by race, age, sex and perosn-level socioecnoic status in
these linkages; c) evaluate the role of interpersonal discrimination in this context; and d) identify underlying
mechanistic pathways of risk (e.g., cardiometabolic disease) and resilience (e.g., social capital). The current
project will be the first to thoroughly assess and integrate these goals. Linked to the ongoing Healthy Aging in
Neighborhoods of Diversity across the Life Span (HANDLS) epidemiological cohort study, we propose an
investigation of up to 800 midlife to older AA and White men and women (ages 30-64 at baseline), tracked up to
13 years across three waves, residing in Baltimore, Maryland. Our sample was born in Baltimore, the U.S. city
with the longest history of legalized BSE-based structural racism. This will allow detailed study of cumulative life
exposure to the H&C markers we characterize through lifetime residential histories and contemporary activity
spaces, obtained by calendar interview and LexisNexis commercial data and linked to rich administrative and
archival data from the last 100 years. We will first model potential interactive and independent relations of H&C
SR to longitudinal change in cognitive and physical function and frailty with effect modification by race and sex.
We will then build structural equation models to address the direct and indirect paths of influence exerted by
H&C SR on trajectories of change in these outcomes via neighborhood BSE, interpersonal discrimination, and
additional psychological, behavioral, and biomedical factors. We will partner with the Baltimore Neighborhood
Indicators Alliance to disseminate our findings to support local, ongoing advocacy and policy work for
transformative health equity changes to the BSE, particularly around housing. Understanding and disseminating
patterns and mechanistic processes linking H&C SR to accelerated cognitive aging, functional decline, and frailty
is critical to the development of appropriate strategies to disrupt racial inequities in accelerated aging via the
BSEs where they live.
Public Health Relevance Statement
Project Narrative
Our understanding of the connection between housing relocation interventions and mental health remains
limited by a lack of high-quality studies assessing projects with effective implementation strategies. Our
proposal integrates and addresses these needs, linking geographic and psychological expertise with
established community partnerships to study the impact of such an intervention on a discrete sub-population of
residents in Flint, Michigan, via a longitudinal assessment of the natural experiment.
NIH Spending Category
No NIH Spending Category available.
Project Terms
AccelerationAddressAdvocacyAffectiveAfrican AmericanAfrican American populationAgeAgingBaltimoreBehavioralBlack PopulationsBlack raceCalendarCardiometabolic DiseaseCharacteristicsCitiesCognitive agingCohort StudiesCommunitiesComplementDataData SetDevelopmentDisadvantagedDiscriminationDiseaseEnvironmentEpidemiologyEquationExposure toFutureGeographic Information SystemsGeographyGoalsHealthHousingImpaired cognitionInterventionInterviewInvestigationKnowledgeLegalLifeLife Cycle StagesLinkMapsMarylandMeasurementMeasuresMediatingMental DepressionMental HealthMichiganModelingModificationNatural experimentNeighborhoodsOutcomeParticipantPathway interactionsPatternPerceptionPersonsPhysical FunctionPoliciesProcessRaceRecording of previous eventsResearchRiskRisk FactorsRoleSamplingSelf AssessmentShapesSmokingSocial EnvironmentSocioeconomic StatusStructural RacismSystemTimeUnited States National Institutes of HealthVariantWomanWorkage accelerationage relatedage related changesaging relatedaging related diseasearchived databehavioral healthbiological sexbiopsychosocialbuilt environmentcardiometabolic riskcognitive functioncohortcommunity partnershipdisorder riskearly onsetfollow-upfrailtyfunctional declinehealth disparityhealth equityhealth inequalitieshealthy agingimplementation strategylife spanmenmiddle agenegative affectprospectivepsychologicracial disparityrate of agingresidential segregationresiliencesexsocial capitalsocioeconomicsvirtual
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