Structural racism (SR) denotes the multidimensional and systemic oppression of Black individuals in the US.
Residential segregation is a central component of SR. According to experts, race-based residential
segregation is a fundamental determinant of racial disparities in health through neighborhood disadvantage
leading to high rates of chronic disease and lower life expectancy in these communities. According to the
concept of “weathering”, cumulative exposure to racial injustices (including segregation) over the life course
wear at the physical and mental health of minoritized communities. Spatial manifestations of SR have been
linked to stress responses, immune dysregulation, and heightened chronic inflammation among US Black
individuals. Transfer of a propensity toward chronic inflammation from mother to infant can create an
intergenerational cycle of disadvantage and poor health, leading to the health inequities observed today. We
posit that maternal exposure to SR is linked to observed evidence of initial stages of disease processes in their
offspring. We propose to examine the association between maternal lifetime exposure to SR and the presence
of inflammatory markers in the child’s neonatal dried blood spots (DBS) using a cohort of women who have
delivered a child at Henry Ford Health (HFH), a Detroit-based health care organization serving a diverse
population with respect to race and socioeconomic status. DBS are routinely collected at birth and stored by
the State of Michigan. Our plan to define the proposed exposure, SR, builds on existing literature and the
expertise of our team. We will characterize neighborhoods in the Detroit metropolitan area and assign a
“Neighborhood SR Score” using existing spatial measures of SR (e.g., racial inequities in the domains of
housing, education, employment, etc.). Aim 1 is to create a cumulative Lifetime SR Exposure Score for each
participant based on their lifetime residential history. Aim 2 is to associate the Lifetime SR Exposure Score to
the levels of inflammatory markers measured in the DBS of participant offspring using an untargeted
metabolomics platform. We have the investigator expertise needed to achieve our aims, including
epidemiology, biostatistics, untargeted metabolomics, and urban planning, and we have access to the targeted
population. This R21 will assess the feasibility of creating exposure and outcome measures as well recruitment
and data collection. Our work includes the domains of influence reflective of SR from the National Minority
Health and Health Disparities Research Framework and will inform a larger study. Empirical evidence of how
SR can initiate processes in early life that manifest in adult disease is an invaluable step in eliminating health
inequities.
