Project Summary
Youth exposure to violence is a pervasive issue. These exposures are theorized to give rise to disparities in
health over time by impacting biological and behavioral processes known to contribute to diseases, including
pulmonary and cardiovascular (CV) diseases. Yet, there is limited empirical test of the enduring effects youth
exposure to violence may have on disease-relevant clinical risks and their progressions. Additionally, there is
limited mechanistic understanding despite theoretical work suggesting pathways through poorer immune
functioning and health behaviors. Finally, the magnitude of the impact violence has on pulmonary and CV
health varies across studies and the synthesized effect size is still unknown. This variability, however, points to
potential factors that may increase vulnerability to, or protect youth from, the negative impact of violence.
Gaining insights about underlying pathways and moderating factors can help reveal promising points of
intervention, targeting youth who may be most at-risk. Thus, the proposed research aims to identify (1) the
synthesized effect size and the longitudinal impact of youth exposure to violence on pulmonary and CV risks;
(2) the immune and behavioral pathways through which violence operates; (3) the sample-, effect-, and
individual-level moderators that may exacerbate or mitigate the impact of violence. Notably, the proposed
study aims will be addressed comprehensively utilizing meta-analytic approaches to gain breadth of knowledge
and primary-analytic approaches to gain depth of knowledge. Meta-analytic approaches will synthesize current
empirical evidence to estimate the magnitude of the impact youth exposure to violence has on pulmonary and
CV health, consolidate existing research to test the synthesized indirect effects and overall model fit of the
proposed pathways, and explore sample (e.g., demographic composition) and effect (e.g., context of violence
exposure) characteristics as potential moderators. Complementarily, primary analytical approaches will draw
from two of Dr. Edith Chen’s NIH-funded longitudinal studies to examine the impact of youth exposure to
violence in the context of asthma and CV risks. Specifically, primary analyses will examine the longitudinal link
from violence to asthma and CV risks, test mediators by probing in-depth inflammatory processes and
assessing medical records and actigraphy data, as well as explore the buffering role of an individual-level
coping factor in mitigating the impact of violence. Gaining breadth and depth of knowledge about youth
exposure to violence not only addresses a public health concern, execution of the proposed research will also
foster the applicant’s goal to be an independent researcher conducting both primary- and meta-analytic
research that elucidates the psychosocial, biological, and behavioral processes underlying health disparities.
Specifically, it will support the training goals of understanding how social factors in youth contribute to health
disparities, acquiring conceptual foundation and laboratory skills for relating social constructs to immune
processes, mastering advanced statistical techniques, and establishing a publication record in these areas.