Biological embedding of neighborhood disadvantage and collective efficacy: Influences on chronic illness via accelerated cardiometabolic age

Long-term Neighborhood Poverty Effects on Internalizing Symptoms in Adolescents: Mediated Through Allostatic Load and Pubertal Timing

PURPOSE

The long-term effect of neighborhood poverty on internalizing symptoms in adolescents and the biological mechanisms underlying this association remain unclear. We defined neighborhood poverty at the village level in two dimensions: intensity (i.e., poverty rate) and duration. This study investigated how the poverty rate and duration of exposure to neighborhood poverty interact to predict internalizing symptoms in adolescents through biological mechanisms (i.e., allostatic load and early pubertal timing).

METHODS

A total of 418 adolescents (50.2% girls; 11-14 years old; mean age = 12.57 years) living in rural China participated in two waves of data collection. Path analysis was conducted to examine the mediating role of allostatic load and pubertal timing in the relationship between the duration of exposure to neighborhood poverty and internalizing symptoms. Moreover, the interactive effect between the poverty rate and duration of neighborhood poverty on the allostatic load was tested.

RESULTS

The positive association between the duration of exposure to neighborhood poverty and internalizing symptoms of adolescents was explained by elevated allostatic load and early pubertal timing after adjusting for gender, age, prior family socioeconomic states and internalizing symptoms. The duration in neighborhood poverty was a stronger predictor of allostatic load for adolescents living in high poverty rate neighborhoods than for those living in low poverty rate neighborhoods.

DISCUSSION

Neighborhood poverty gets "under the skin" through biological pathways and affects internalizing symptoms among adolescents. The findings highlight the importance of considering different dimensions of neighborhood poverty (e.g., intensity and duration) on adolescents' health.

Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis

Aim

The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD).

Methods

We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses.

Results

From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk.

Conclusion

Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.

Sexual Networking and HIV/STI Prevention Among Men who have Sex with Men and Identify as Persons of Color in the Era of COVID-19 in Boston, MA: Qualitative Findings from the National HIV Behavioral Surveillance Project

Men who have sex with men and identify as persons of color (MSM of color) are significantly impacted by HIV in the United States. The COVID-19 pandemic may have disproportionately exacerbated HIV-related disparities among MSM of color by affecting sexual networking behaviors and disrupting access to sexual health care. The current study explored the impact of COVID-19 on sexual networking and HIV/sexually transmitted infection (STI) prevention behaviors among MSM of color in Boston, MA. Eighteen semi-structured interviews were conducted via the 2020-2021 Boston sample of the National HIV Behavioral Surveillance (NHBS) project. Eligible participants were at least 18 years old, identified as a man or non-binary person assigned male at birth and as a person of color, and endorsed ever having sex with men. Interviews were coded using inductive and deductive approaches, and themes were extracted using thematic analysis. When participants were asked about the impact of COVID-19 on sexual networking and HIV/STI prevention, the following themes emerged: (1) differing interpretations of COVID-19 public health guidance, (2) behavior change to meet social and sexual needs, (3) limited or changed access to HIV/STI prevention services; and (4) avoidance of healthcare appointments. Overall, the pandemic affected sexual networking and HIV/STI prevention behaviors among MSM of color. Though changes in sexual networking varied, most participants decreased in-person networking, increased dating app use, and prioritized longer-term relationships. Despite loosening of restrictions, these impacts may persist and should inform the adaptation of sexual networking guidance and interventions to mitigate HIV-related disparities in communities of color.

Biological Age Mediates the Effects of Perceived Neighborhood Problems on Heart Failure Risk Among Black Persons

OBJECTIVE

We assessed whether biological age, measured by the epigenetic clock GrimAge, mediates the association of objective and subjective neighborhood disadvantage with incident HF among Black persons.

METHODS

Participants were 1448 self-reported Black adults (mean age (standard deviation, SD) = 64.3 (5.5)) dually enrolled in two community-based cohorts in Jackson, Mississippi, the ARIC and JHS cohorts, who were free of HF as of January 1, 2000. Incident HF events leading to hospitalization through December 31, 2017, were classified using ICD-9 discharge codes of HF. Multilevel age- and sex-adjusted Cox causal mediation models were used to examine whether biological age (at the person and neighborhood level) mediated the effects of objective (the National Area Deprivation Index, ADI) and subjective (perceived neighborhood problems) neighborhood disadvantage on incident HF.

RESULTS

A total of 334 incident hospitalized HF events occurred over a median follow-up of 18.0 years. The total effect of the ADI and perceived neighborhood problems (SD units) on HF was hazard ration (HR) = 1.26 and 95% confidence interval (CI) 0.98-1.56 and HR = 1.26 and 95% CI 1.10-1.41, respectively. GrimAge mediated a majority of the effect of perceived neighborhood problems on HF (person-level indirect effect HR = 1.07; 95% CI 1.02-1.12 and neighborhood-level indirect effect HR = 1.18; 95% CI 1.03-1.34), with the combined indirect effect explaining 94.8% of the relationship. The combined indirect effect of ADI on incident HF was comparable but not statistically significant.

CONCLUSIONS

Subjective neighborhood disadvantage may confer an increased risk of HF among Black populations.

Flexible Resources Key to Neighborhood Resilience for Children: A Scoping Review

Neighborhoods have been the focus of health researchers seeking to develop upstream strategies to mitigate downstream disease development. In recent years, neighborhoods have become a primary target in efforts to promote health and resilience following deleterious social conditions such as the climate crisis, extreme weather events, the global pandemic, and supply chain disruptions. Children are often the most vulnerable populations after experiencing unexpected shocks. To examine and describe conceptually the construct of Neighborhood Resilience, we conducted a comprehensive scoping review using the terms ("resilience" or "resiliency" or "resilient") AND ("neighborhood"), utilizing MEDLINE (through PubMed) and CINAHL (through EBSCOhost) databases, to assess overall neighborhood themes that impact resilience. A total of 57 articles were extracted that met inclusion criteria. Extracted characteristics included study purpose, country of origin, key findings, environmental protective/risk factors. The analysis revealed a positive relationship between neighborhood resource density, neighborhood resiliency, and individual resiliency. This study reports the finding for studies with a population focus of pre-school age and school age children (1.5-18 years of age). Broadly, we identified that the primary goals regarding neighborhood resilience for childhood can be conceptualized as all activities and resources that (a) prevent trauma during childhood development and/or (b) mitigate or heal childhood trauma once it has occurred. This goal conceptually encompasses antecedents that increase protective factors and reduces risk factors for children and their families. This comprehensive look at the literature showed that a neighborhood's ability to build, promote, and maintain resiliency is often largely dependent on the flexible resources (i.e., knowledge, money, power, prestige, and beneficial social connections) that are available.

Nurse-led approaches to address social determinants of health and advance health equity: A new framework and its implications

BACKGROUND

The U.S. health care system is burdened by inefficiencies, longstanding health inequities, and unstainable costs. Within the nursing profession and the broader health care sector, there is growing recognition of the need for a paradigm shift that addresses persistent structural problems and advances health equity.

PURPOSE

Despite evidence of the importance of the social determinants of health (SDOH) in shaping inequitable health outcomes, practical tools for applying SDOH theory in the development of effective nurse-led programs to mitigate harmful SDOH remain scarce.

METHODS

We synthesize extant SDOH literature into a heuristic framework for conceptualizing core SDOH mechanisms, constructs, and principles.

FINDINGS

To illustrate how nurse scientists can use the framework to guide the development of programs for SDOH mitigation, we outline a three-step exemplar application to the U.S. Latino HIV epidemic.

DISCUSSION

Our framework can inform a paradigm shift toward nurse-led, multi-level SDOH mitigation across practice, education, and research.

Emotional Distress in a Marginalized Population as a Function of Household-Level Social Determinants of Health

Low-income, underrepresented communities of color are disproportionally affected by emotional distress. Little is known about malleable, household-level determinants of emotional distress, addressable by feasible, stigma-neutral interventions. The present study addressed this knowledge gap by analyzing secondary data from a cross-sectional community needs assessment survey in a marginalized urban community (N = 677). Relying on dominance analyses, authors found that, on average, the largest household-level contributions to respondents' emotional distress included exposures to fellow household members' alcohol use and anger-driven behaviors. Both determinants are arguably feasible to address via household-level interventions and community-level preventive efforts. Household members' physical and serious mental illness and drug use were moderately associated with respondents' emotional distress; household cohesion and communications, residential overcrowding, and child behavior played a minimal role. Article concludes with a discussion of public health implications of the results.

The COVID-19, racism, and violence syndemic: Evidence from a qualitative study with Black residents of Chicago

The COVID-19 pandemic emerged in the United States in the shadows of a vast history of structural racism and community and police violence that disproportionately affect Black communities. Collectively, they have created a syndemic, wherein COVID-19, racism, and violence are mutually reinforcing to produce adverse health outcomes. The purpose of this study was to understand the COVID-19, racism, and violence syndemic and examine how structural racism and violence contributed to the disproportionate impact of COVID-19 on Black communities. In early 2021, we conducted phenomenological qualitative interviews with 50 Black residents of Chicago. Interview transcripts were coded and analyzed using thematic analysis. We identified four primary themes in our analyses: 1) the intersection of racism and violence in Chicago; 2) longstanding inequities were laid bare by COVID-19; 3) the pervasiveness of racism and violence contributes to poor mental health; 4) and COVID-19, racism and violence emerged as a syndemic. Our findings underscore the importance of addressing social and structural factors in remediating the health and social consequences brought about by COVID-19.

Neighborhood-level social vulnerability and individual-level cognitive and motor functioning over time in older non-Latino Black and Latino adults

Introduction

Despite known health disparities in cognitive aging, a comprehensive rationale for the increased burden in older minoritized populations including non-Latino Black and Latino adults has yet to be elucidated. While most work has focused on person-specific risk, studies are increasingly assessing neighborhood-level risk. We evaluated multiple aspects of the environmental milieu that may be critical when considering vulnerability to adverse health outcomes.

Methods

We investigated associations between a Census-tract derived Social Vulnerability Index (SVI) and level of and change in cognitive and motor functioning in 780 older adults (590 non-Latino Black adults, ∼73 years old at baseline; 190 Latinos, ∼70 years old baseline). Total SVI scores (higher = greater neighborhood-level vulnerability) were combined with annual evaluations of cognitive and motor functioning (follow-up ranged from 2 to 18 years). Demographically-adjusted mixed linear regression models tested for associations between SVI and cognitive and motor outcomes in analyses stratified by ethno-racial group.

Results

For non-Latino Black participants, higher SVI scores were associated with lower levels of global cognitive and motor functioning-specifically, episodic memory, motor dexterity and gait-as well as longitudinal change in visuospatial abilities and hand strength. For Latinos, higher SVI scores were associated with lower levels of global motor functioning only-specifically, motor dexterity; there were no significant associations between SVI and change in motor functioning.

Discussion

Neighborhood-level social vulnerability is associated with cognitive and motor functioning in non-Latino Black and Latino older adults, although associations appear to contribute to level more so than longitudinal change.

The neighborhood context and all-cause mortality among older adults in Puerto Rico

Background

Recent efforts have been made to collect data on neighborhood-level attributes and link them to longitudinal population-based surveys. These linked data have allowed researchers to assess the influence of neighborhood characteristics on the health of older adults in the US. However, these data exclude Puerto Rico. Because of significantly differing historical and political contexts, and widely ranging structural factors between the island and the mainland, it may not be appropriate to apply current knowledge on neighborhood health effects based on studies conducted in the US to Puerto Rico. Thus, we aim to (1) examine the types of neighborhood environments older Puerto Rican adults reside in and (2) explore the association between neighborhood environments and all-cause mortality.

Methods

We linked data from the 2000 US Census to the longitudinal Puerto Rican Elderly Health Conditions Project (PREHCO) with mortality follow-up through 2021 to examine the effects of the baseline neighborhood environment on all-cause mortality among 3,469 participants. Latent profile analysis, a model-based clustering technique, classified Puerto Rican neighborhoods based on 19 census block group indicators related to the neighborhood constructs of socioeconomic status, household composition, minority status, and housing and transportation. The associations between the latent classes and all-cause mortality were assessed using multilevel mixed-effects parametric survival models with a Weibull distribution.

Results

A five-class model was fit on 2,477 census block groups in Puerto Rico with varying patterns of social (dis)advantage. Our results show that older adults residing in neighborhoods classified as Urban High Deprivation and Urban High-Moderate Deprivation in Puerto Rico were at higher risk of death over the 19-year study period relative to the Urban Low Deprivation cluster, controlling for individual-level covariates.

Conclusions

Considering Puerto Rico's socio-structural reality, we recommend that policymakers, healthcare providers, and leaders across industries to (1) understand how individual health and mortality is embedded within larger social, cultural, structural, and historical contexts, and (2) make concerted efforts to reach out to residents living in disadvantaged community contexts to understand better what they need to successfully age in place in Puerto Rico.

Neighborhood disadvantage, race/ethnicity and neural sensitivity to social threat and reward among adolescents

Experiences within one's social environment shape neural sensitivity to threatening and rewarding social cues. However, in racialized societies like the USA, youth from minoritized racial/ethnic backgrounds can have different experiences and perceptions within neighborhoods that share similar characteristics. The current study examined how neighborhood disadvantage intersects with racial/ethnic background in relation to neural sensitivity to social cues. A racially diverse (59 Hispanic/Latine, 48 White, 37 Black/African American, 15 multi-racial and 6 other) and primarily low to middle socioeconomic status sample of 165 adolescents (88 female; Mage = 12.89) completed a social incentive delay task while undergoing functional magnetic resonance imaging (fMRI) scanning. We tested for differences in the association between neighborhood disadvantage and neural responses to social threat and reward cues across racial/ethnic groups. For threat processing, compared to White youth, neighborhood disadvantage was related to greater neural activation in regions involved in salience detection (e.g. anterior cingulate cortex) for Black youth and regions involved in mentalizing (e.g. temporoparietal junction) for Latine youth. For reward processing, neighborhood disadvantage was related to greater brain activation in reward, salience and mentalizing regions for Black youth only. This study offers a novel exploration of diversity within adolescent neural development and important insights into our understanding of how social environments may 'get under the skull' differentially across racial/ethnic groups.

Childhood adversity and adult health: A dyadic analysis of Black American couples

OBJECTIVE

The association between childhood adversity and adulthood health is well established, but few studies have examined potential effects of childhood adversity on partner health in couples. This study examined the long-term health impact of childhood adversity on individuals as well as their significant others.

METHOD

The participants were 163 distinguishable dyads from the Family and Community Health Study. Health outcomes included both self-reported chronic illness and a messenger RNA index of accelerated aging. The actor-partner interdependence model with structural equation methods was used to test the hypothesis.

RESULTS

Replicating prior research, childhood adversity was associated with more chronic illness and an accelerated speed of aging. Further, participants' health in adulthood was affected by both own and partner experiences of childhood adversity. There were no gender differences.

CONCLUSION

Our findings replicate and extend prior research on the long-term impact of exposure to childhood adversity, suggesting that adverse childhood experiences are also harmful to romantic partners. Further studies are required to examine potential mechanisms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood neighborhoods and health: Census-based neighborhood measures versus residential lived experiences

This study examines the impact of neighborhood disadvantage and neighborhood social connectedness during childhood on subsequent health status during early adulthood. We link longitudinal data from the Panel Study of Income Dynamics with Census data on children's surrounding neighborhoods. We estimate results with conventional linear regression and novel methods that better adjust for neighborhood selection processes. We find that neighborhood connectedness in childhood is protective against psychological distress in early adulthood, net of selection effects. However, greater connectedness exacerbates the risk of obesity within disadvantaged contexts for Black youth. Our results highlight a potential pathway for improving population health by investing in the social connectedness of neighborhoods alongside reducing structural inequalities.

Incarceration exposure and epigenetic aging in neighborhood context

OBJECTIVE

Research has implicated incarceration exposure as a social determinant of health, with recent work suggesting incarceration may trigger a stress response that accelerates physiological deterioration. The objective of the current study is to assess whether neighborhood stressors intensify the health consequences of incarceration exposure.

METHODS

We test whether two neighborhood context measures - socioeconomic disadvantage and perceived crime - moderate the association between incarceration exposure and a measure of accelerated epigenetic aging based on the GrimAge index. Our sample included 408 African American young adults from the Family and Community Health study.

RESULTS

Results from regression analyses with inverse probability of treatment weights suggest that incarceration exposure and neighborhood disadvantage are independently associated with accelerated biological aging. The results also show that the impact of incarceration exposure on accelerated aging is amplified for individuals in neighborhoods with higher levels of perceived crime.

CONCLUSIONS

These findings indicate that the neighborhood contexts where formerly incarcerated individuals return have a substantial impact on their pace of biological aging. Policies aimed at reducing ambient stressors after release may promote healthy aging among formerly incarcerated African American adults.

Radically reframing studies on neurobiology and socioeconomic circumstances: A call for social justice-oriented neuroscience

Socioeconomic circumstances are associated with symptoms and diagnostic status of nearly all mental health conditions. Given these robust relationships, neuroscientists have attempted to elucidate how socioeconomic-based adversity "gets under the skin." Historically, this work emphasized individual proxies of socioeconomic position (e.g., income, education), ignoring the effects of broader socioeconomic contexts (e.g., neighborhood socioeconomic disadvantage) which may uniquely contribute to chronic stress. This omission represented a disconnect between neuroscience and other allied fields that have recognized health is undeniably linked to interactions between systems of power and individual characteristics. More recently, neuroscience work has considered how sociopolitical context affects brain structure and function; however, the products of this exciting line of research have lacked critical sociological and historical perspectives. While empirical evidence on this topic is burgeoning, the cultural, ethical, societal, and legal implications of this work have been elusive. Although the mechanisms by which socioeconomic circumstances impact brain structure and function may be similar across people, not everyone is exposed to these factors at similar rates. Individuals from ethnoracially minoritized groups are disproportionally exposed to neighborhood disadvantage. Thus, socioeconomic inequities examined in neuroscience research are undergirding with other forms of oppression, namely structural racism. We utilize a holistic, interdisciplinary approach to interpret findings from neuroscience research and interweave relevant theories from the fields of public health, social sciences, and Black feminist thought. In this perspective piece, we discuss the complex relationship that continues to exist between academic institutions and underserved surrounding communities, acknowledging the areas in which neuroscience research has historically harmed and/or excluded structurally disadvantaged communities. We conclude by envisioning how this work can be used; not just to inform policymakers, but also to engage and partner with communities and shape the future direction of human neuroscience research.

Neighborhood disadvantage is associated with biological aging: Intervention-induced enhancement of couple functioning confers resilience

The accelerated pace of biological aging predicts mortality and morbidity later in life. The current study examines whether a change in supportive couple functioning buffers accelerated aging associated with stressful community environments among Black Americans who live in rural, Southern, disadvantaged neighborhoods. We examined 348 Black American middle-aged adults assigned randomly to receive the Protecting Strong African American Families (ProSAAF) intervention or a control condition. The program was designed to enhance supportive couple functioning among Black Americans. We used DunedinPoAm to quantify the methylation pace of aging and employed the Area Deprivation Index at the census block group level to measure neighborhood disadvantage. Neighborhood disadvantage was associated with the accelerated pace of aging. Further, participation in ProSAAF enhanced supportive couple functioning, and improvement in couple functioning protected participants from the harmful effects of neighborhood disadvantage on the accelerated pace of aging. These findings supported mediated moderation and suggested that family-based prevention programs that enhance couple support may decrease the erosive effects of neighborhood disadvantage and improve prospects for healthy aging among rural, Southern, Black Americans living in difficult circumstances. This may provide a supplemental strategy for decreasing health disparities due to neighborhood disadvantage by enhancing family systems.

The impact of neighborhood context on telomere length: A systematic review

A growing body of research demonstrates the association between neighborhood context and health. The underlying biological mechanisms of this association are not fully understood. We conducted a systematic review of studies that investigated the association between neighborhood context and telomere length (TL), a DNA-protein complex that shortens after cell division. Short TL is linked to age-related diseases and may be impacted by chronic stress. Nineteen eligible articles identified through PubMed and Scopus met inclusion criteria. Results demonstrated inconsistent support for the relationship between neighborhood disadvantage and short TL. However, findings across several studies provide evidence for an inverse association between perceived neighborhood problems and TL, suggesting that TL may be an important factor in understanding health vulnerabilities associated specifically with negative perceptions of the neighborhood context.

Neighborhood structural disadvantage and biological aging in a sample of Black middle age and young adults

OBJECTIVES

Research on the social determinants of health has suggested that neighborhood disadvantage may undermine healthy aging and is particularly relevant for understanding health disparities. Recently, this work has examined deoxyribonucleic acid methylation (DNAm)-based measures of biological aging to understand the risk factors for morbidity and mortality. However, it is unknown whether neighborhood disadvantage is related to different indices of DNAm-based aging among Black Americans and whether such neighborhood effects vary as a function of age or gender.

METHODS

Our analyses of a Black American sample included 448 young adults and 493 middle-aged adults. We measured neighborhood disadvantage using the Area Deprivation Index at the census block group level. DNAm-based accelerated aging indices were measured using established procedures. Regressions with clustered standard errors were used for the analysis.

RESULTS

Neighborhood disadvantage was independently associated with acceleration in PhenoAge, GrimAge, and DunedinPoAm, among young and middle-aged adults. Further, there was no evidence that gender conditioned the effects of neighborhood disadvantage on the aging indices.

CONCLUSIONS

Regardless of age groups or gender, accelerated biological aging among Black Americans is partly rooted in differences in neighborhood disadvantage. From a policy standpoint, our findings suggest that programs that decrease neighborhood disadvantage are likely to increase healthy aging, especially among Black Americans.

Losing Years Doing Time: Incarceration Exposure and Accelerated Biological Aging among African American Adults

Research suggests that incarceration exposure increases the prevalence of morbidity and premature mortality. This work is only beginning to examine whether the stressors of the incarceration experience become biologically embedded in ways that affect physiological deterioration. Using data from a longitudinal sample of 410 African American adults in the Family and Community Health Study and an epigenetic index of aging, this study tests the extent to which incarceration accelerates epigenetic aging and whether experiences with violence moderate this association. Results from models that adjust for selection effects suggest that incarceration exposure predicted accelerated aging, leaving formerly incarcerated African American individuals biologically older than their calendar age. Direct experiences with violence also exacerbated the effects of incarceration. These findings suggest that incarceration possibly triggers a stress response that affects a biological signature of physiological deterioration.

Methylation of FKBP5 is associated with accelerated DNA methylation ageing and cardiometabolic risk: replication in young-adult and middle-aged Black Americans

Methylation of FKBP5 is involved in the regulation of the stress response and is influenced by early stress exposure. Two CpG sites, cg20813374 and cg00130530, have been identified as potential reporters of early stress. We examined whether FKBP5 methylation was associated with accelerated DNA methylation ageing and indirectly predicted poorer cardiovascular health among both young adult and middle-aged Black Americans. Four hundred and forty-nine young adults, with a mean age of 28.67 and N = 469 middle-age parents and their current partners with a mean age of 57.21, provided self-reports, biometric assessments, and blood draws. Methylation values were obtained using the Illumina Epic Array. Cardiometabolic risk was calculated by summing the standardized log-transformed scores for the body mass index, mean arterial blood pressure, and HbA1c. We also used a more standard index of risk, the Framingham 10-year cardiometabolic risk index, as an alternative measure of cardiometabolic risk. To measure accelerated ageing, four widely used indices of accelerated, DNA methylation-based ageing were used controlling sex, age, other variation in FKBP5, and cell-type. Exposure to community danger was associated with demethylation of FKBP5. FKBP5 methylation was significantly associated with accelerated ageing for both young-adult and middle-aged samples, with significant indirect effects from FKBP5 methylation to cardiometabolic risk through accelerated ageing for both. Early exposure to danger may influence FKBP5 methylation. In turn, FKBP5 methylation may help explain intrinsic accelerated ageing and elevated cardiometabolic risk in adulthood for Black Americans.

Protective parenting behavior buffers the impact of racial discrimination on depression among Black youth

The adverse impact of racial discrimination on youth, and particularly its impact on the development of depressive symptoms, has prompted attention regarding the potential for family processes to protect youth from these erosive effects. Evidence from non-experimental studies indicates that protective parenting behavior (PPB) which occurs naturally in many Black families can buffer youth from the negative impact of racial discrimination. Of interest is whether "constructed resilience" developed through family-centered prevention programming can add to this protective buffering. The current paper examines the impact of constructed resilience in the form of increased protective parenting using 295 families randomly assigned either to a control condition or to the Protecting Strong African American Families (ProSAAF) program, a family-based prevention program previously shown to enhance protective parenting. We found that baseline racial discrimination was predictive of change in youths' depressive symptoms across the pre-post study period. Second, we found that parents participating in ProSAAF, relative to those randomly assigned to the control group, significantly improved in their use of an intervention targeting PPB. Third, we found a significant effect of change in PPB on the association of discrimination with change in depressive symptoms. Finally, we found that ProSAAF participation buffered the impact of racial discrimination on change in depressive symptoms through change in PPB. Results provide experimental support for constructed resilience in the form of change in PPB and call for increased attention to the development of family-based intervention programs to protect Black youth from the pernicious effects of racial discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Association between Neighborhood Disorder and Health: Exploring the Moderating Role of Genotype and Marriage

The present study extends prior research on the link between neighborhood disorder and health by testing an integrated model that combines various social and biological factors. Hypotheses were tested using a sample of 325 African American women from the Family and Community Health Study (FACHS). As expected, inflammatory burden was the biophysiological mechanism that mediated much of the association between neighborhood physical disorder and perceived physical health. This finding provided additional support for the view that global self-ratings of health are powerful predictors of morbidity because, in large measure, they are indicators of chronic, systemic inflammation. Further, both genetic variation and marital status served to moderate the association between neighborhood disorder and health. Finally, being married largely eliminated the probability that neighborhood disorder would combine with genetic vulnerability to increase inflammatory burden and perceived illness. Overall, the findings demonstrate the value of constructing integrated models that specify various biophysiological mechanisms that link social conditions to physical health.

Can We Uncouple Neighborhood Disadvantage and Delinquent Behaviors? An Experimental Test of Family Resilience Guided by the Social Disorganization Theory of Delinquent Behaviors

Although the influence of neighborhood disadvantage on youth development of delinquent behavior is well established, findings from this research have yet to inform the development of family-centered prevention programming to protect youth from these erosive effects. The current paper examines the role of family integration in buffering the impact of social disadvantage in a sample of N = 298 families randomly assigned either to a control condition or to a family-based prevention program previously shown to enhance marriage and parenting. We first confirmed that neighborhood concentrated disadvantage predicted change in delinquent behaviors across the course of the study. Additionally, replicating prior work, parents participating in the Protecting Strong African American Families (ProSAAF) program, relative to those randomly assigned to the control group, significantly improved their use of effective communication strategies with each other and reduced ineffective conflict in front of youth. This resulted in a significant indirect effect of ProSAAF on change in youth delinquent behaviors. Furthermore, using mediated moderation analysis, the study tested the buffering effect of greater family integration, showing that experimentally produced change in interparental communication skills and the resulting reduction in youth exposure to parental conflict buffered the effect of neighborhood disadvantage on change in youth delinquent behaviors, supporting a mediated moderation model in which family environments buffer neighborhood effects.

Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications

The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.

Neighborhood Disorder, Family Functioning, and Risky Sexual Behaviors in Adolescence

Adolescent risky sexual behaviors can result in negative consequences such as sexually transmitted infection. However, much research effort has been placed on understanding individual characteristics, rather than the role of neighborhood environment. This study addressed the prospective effects of neighborhood and family functioning in preadolescence on risky sexual behaviors. Participants included 4179 youth (Mage = 11.01 years, range 8.64-13.83; 51% female) and their caregivers. Using objective and self-reported measures of neighborhood and family functioning, results from multilevel regression analyses indicated that youth residing in disordered neighborhoods or had poorer family functioning in preadolescence were more likely to initiate sexual intercourse at younger ages 5 years later. Specifically, neighborhood poverty and decay were linked to early sexual initiation, whereas neighborhood social and family processes were protective against early sexual initiation. Males were more likely to engage in risky sexual behaviors in neighborhoods with greater poverty or decay; neighborhood poverty was linked with sexual initiation in White but not African American youth. Finally, parental monitoring moderated relationships between neighborhood social resources and contraceptive use, with neighborhood social resources linked with greater contraceptive use at low levels of parental monitoring, but lower contraceptive use at high levels of parental monitoring. These findings underscore the importance of neighborhood and family contexts in adolescents' risky sexual behavior, suggesting that males and White youth are more vulnerable to the effects of neighborhood poverty and that more research is needed on the possible counterproductive function of parental monitoring in neighborhoods with greater social resources.

Immune cell phenotyping in low blood volumes for assessment of cardiovascular disease risk, development, and progression: a pilot study

Background

Cardiovascular disease (CVD) is the leading cause of death in the world. Given the role of immune cells in atherosclerosis development and progression, effective methods for characterizing immune cell populations are needed, particularly among populations disproportionately at risk for CVD.

Results

By using a variety of antibodies combined in one staining protocol, we were able to identify granulocyte, lymphocyte, and monocyte sub-populations by CD-antigen expression from 500 µl of whole blood, enabling a more extensive comparison than what is possible with a complete blood count and differential (CBC). The flow cytometry panel was established and tested in a total of 29 healthy men and women. As a proof of principle, these 29 samples were split by their race/ethnicity: African-Americans (AA) (N = 14) and Caucasians (N = 15). We found in accordance with the literature that AA had fewer granulocytes and more lymphocytes when compared to Caucasians, though the proportion of total monocytes was similar in both groups. Several new differences between AA and Caucasians were noted that had not been previously described. For example, AA had a greater proportion of platelet adhesion on non-classical monocytes when compared to Caucasians, a cell-to-cell interaction described as crucially important in CVD. We also examined our flow panel in a clinical population of AA women with known CVD risk factors (N = 20). Several of the flow cytometry parameters that cannot be measured with the CBC displayed correlations with clinical CVD risk markers. For instance, Framingham Risk Score (FRS) calculated for each participant correlated with immune cell platelet aggregates (PA) (e.g. T cell PA β = 0.59, p = 0.03 or non-classical monocyte PA β = 0.54, p = 0.02) after adjustment for body mass index (BMI).

Conclusion

A flow cytometry panel identified differences in granulocytes, monocytes, and lymphocytes between AA and Caucasians which may contribute to increased CVD risk in AA. Moreover, this flow panel identifies immune cell sub-populations and platelet aggregates associated with CVD risk. This flow cytometry panel may serve as an effective method for phenotyping immune cell populations involved in the development and progression of CVD.

Association between telomere length and neighborhood characteristics by race and region in US midlife and older adults

Disadvantaged neighborhoods are correlated with worse health outcomes, particularly among US Blacks. However, less is known about the link between neighborhood characteristics and biomarkers of cellular age, such as telomere length (TL), which may be implicated in racial health inequities. Moreover, this relationship may vary across US region given patterns of racial segregation across the US. Therefore, this study analyzed 2008 Health and Retirement Study data on 3,869 US-born white and Black adults >50 years old to examine race differences in the relationship between salivary TL and (1) neighborhood safety, cleanliness, and social cohesion and (2) interactions between neighborhood characteristics and US region. Neighborhood characteristics were not associated with TL in whites. However, significant associations were found among Blacks with variation by region. Blacks living in less clean neighborhoods in the Northeast (b = -0.03, SE = 0.01, p < 0.05), Midwest (b = -0.04, SE = 0.01, p < 0.01), and South (b = -0.05, SE = 0.01, p < 0.01) as well as those reporting less neighborhood safety and social cohesion in the Midwest (b = -0.03, SE = 0.02, p < 0.05 and b = -0.03, SE = 0.01, p < 0.05) and South (b = -0.03, SE = 0.01, p < 0.05 for both characteristics) had shorter TL than Blacks in the West. Therefore, exposure to neighborhood level historical discrimination and neglect may be detrimental to TL in Blacks. Future research should further examine how neighborhoods contribute to aging disparities.

A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health

The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability. This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented. The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior. Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.

The impact of neighborhood disadvantage on health-related quality of life among African American and White cancer survivors

Following improvements in cancer survival rates quality of life (QOL) has become a key health outcome among cancer survivors. Neighborhood disadvantage has been shown to have a detrimental effect on health outcomes. To date, little is known regarding the influence of neighborhood disadvantage on the health-related QOL of cancer survivors. This study aimed to examine the associations between neighborhood disadvantage and health-related QOL among African American and White cancer survivors. Data were obtained from a retrospective survey study of African American (n=248) and White (n=244) cancer survivors. Physical (PHQOL) and mental health (MHQOL) QOL was measured by the Rand 36-Item Short Form. The neighborhood disadvantage index was created based four components, including prevalence of poverty, mother-only households, home ownership and the prevalence of college educated individuals living in the area. Covariates included demographic characteristics and clinical factors. To adjust the nesting effects of participants living in neighborhoods, a mixed effect linear regression model was conducted to test the association between neighborhood disadvantage and PHQOL and MHQOL after controlling for covariates. Regression results showed that patients living in more disadvantaged neighborhoods reported lower PHQOL than those in more advantaged places (β =−1.21, P=0.020). However, this relationship was not observed for MHQOL outcomes (β =−0.06, P=0.49). Race did not exert an independent influence on observed relationships. Study results contribute to a growing body of research documenting the detrimental effects of neighborhood disadvantage on cancer related outcomes.

Cultural development and psychopathology

Culture plays a pivotal role in adaptive and maladaptive development. However, culture remains disconnected from theory, research, training, assessment, and interventions in developmental psychopathology, limiting our understanding of the genesis and epigenesis of mental health. Cultural development and psychopathology research can help overcome this limitation by focusing on the elucidation of cultural risk, protective, and promotive factors, at the individual and social levels, that initiate, derail, or maintain trajectories of normal and abnormal behavior. The goal of this Special Issue is to showcase research on the association between culture, development, and psychopathology that investigates equifinality and multifinality in cultural development, the interplay between culture and biology, cultural assessment and interventions, and cultural differences and similarities.