Neighborhood-level Structural Racism and Cardiovascular Health Among African American Youth and Young Adults - 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.
