PROJECT SUMMARY/ABSTRACT Food insecurity is a toxic stressor in the context of forced migration, which increases health risk and contributes to health disparities. The proposed study will capitalize on the expertise, previous work, cultural backgrounds, and community liaisons of leading scientists in migrant health, health disparities, and nutrition to conduct the first prospective, longitudinal study to use a biobehavioral approach to characterize food insecurity as a social determinant of health in a marginalized immigrant population about which little is known. In this study, our team will collect longitudinal, mixed methods data from 450 Latino immigrants varying in migration context to examine how exposure to food insecurity and trauma – concurrently and prospectively influence risk for CVD and diminished psychological well-being via the biological pathways of malnutrition and systemic inflammation. Importantly, the proposed study will also identify individual and cultural factors that might ameliorate the detrimental health effects of food insecurity on CVD risk and psychological well-being among marginalized Latino immigrants. In collaboration with established community partners, participants will be recruited from immigrant camps/shelters on both sides of the U.S.-Mexico border, along with a control/comparison group of established Latino immigrants living in the U.S. (≥ 5 years in U.S.). Using the inflammatory hypothesis of chronic stress as a conceptual framework, the proposed study incorporates state- of-the-art biological markers and mixed methods to provide novel information about biobehavioral mechanisms that underlie health risk and foster resilience across domains and levels. Specific aim 1 is to characterize the food insecurity patterns of Latino immigrants varying in history of trauma and migration context. Specific aim 2 is to characterize the concurrent and prospective relationships between food insecurity, nutritional status, inflammation, CVD risk, and psychological well-being, and to identify disparities in these associations among Latino immigrants varying in history of trauma and migration context. Specific aim 3 is to identify and understand sociocultural and personal factors that moderate the associations between nutritional status, inflammation, CVD risk, and psychological well-being among Latino immigrants varying in history of trauma and migration context. Knowledge gained from the proposed study will (1) fill a gap in the literature and propel scientific evidence about biobehavioral mechanisms through which food insecurity influences cardiovascular health and psychological well-being among Latino immigrants, while accounting for differences in the immigration experience that underlie health disparities in this immigrant population; (2) inform culture and context sensitive assessments, prevention efforts, and intervention to address food insecurity and its detrimental health effects; and (3) guide advocacy and policy to address food insecurity among a marginalized and vulnerable immigrant population.

PROJECT NARRATIVE The proposed study will collect longitudinal data from 450 Latino immigrant adults varying in context of migration to examine how exposure to food insecurity and trauma – concurrently and prospectively influence risk for cardiovascular disease (CVD) and diminished psychological well-being via the biological pathways of malnutrition and systemic inflammation, along with identifying individual and cultural protective factors. Using state-of-the-art biomarkers and mixed methods, this is the first study to identify multi-domain, multi-level factors that promote resilience in this immigrant population at the biological level, as well as qualitatively, and therefore takes first steps towards the development of novel therapeutics to address disparities in CVD and psychological well-being among Latino immigrants. Knowledge gained from this study will propel scientific evidence about biobehavioral mechanisms through which food insecurity influences health risk and contributes to health disparities, as well as inform culture and context sensitive assessments, prevention efforts, interventions, and policies for a marginalized immigrant population about which little is known.