Project Summary
Cancer disparities impacting African Americans are deeply rooted in historical social injustices such as
structural racism, housing discrimination and redlining, struggling educational systems, and concentrated
poverty. It is well-established that the neighborhood where a person lives can have a considerable impact on
their health and health behaviors. This includes cancer control behaviors, a primary driver of cancer incidence
and mortality. Our preliminary data suggests that neighborhood characteristics contribute uniquely to cancer
control behaviors beyond individual factors in African Americans. However, little is known about multi-level and
longitudinal influences of structural racism and discrimination in predicting cancer control behaviors, and the
potential role of protective psychosocial resources. This is particularly true among African Americans, who
suffer a disproportionate cancer burden. The proposed study will quantitatively measure SRD, evaluate its
longitudinal role in cancer control behaviors, and examine the moderating role of psychosocial resources in
African American adults. In Aim 1, we will construct an index of structural racism and discrimination from
publicly available data for use in the Aims 2 and 3 analysis. In Aim 2, we will evaluate the relative contributions
of the impact of historical, long-term, and current place-based exposure to structural racism and discrimination
on cancer control behaviors (e.g., diet, smoking, physical activity, screening) in probability samples of African
Americans from four focal states (N=5000) via a multilevel analysis. In Aim 3, we will test the moderating role
of psychosocial resources in the relationship between exposure to SRD and cancer control behaviors in
African Americans. Study findings will have important implications for policy and community interventions to
eliminate persistent cancer disparities that disproportionately impact African Americans.
