Landscapes of Structural Racism and Health (“Landscapes”) is an interdisciplinary research collective that includes historians, sociologists, psychologists, epidemiologists, and statisticians who bring their expertise in historical and contemporary racial violence and control, environmental justice, epigenomics, and population health to study the link between structural racism and population health. We bring together critical theories from the humanities and innovative potential biological mechanisms from the bench and medical sciences to better understand the root causes of patterns in population health. Our work includes active data collection, work on existing data sets, and the development and implementation of measures. In addition to our focus on the science itself, we are committed to changing the demography of the scholars who drive our epistemology.

Landscapes Collaborators outside of ISR

• Hedwig Lee
• Michael Esposito
• Dayna Johnson
• Sara Adar
• Kelly Bakulski

The overall purpose of this project is to identify modifiable risk factors for Alzheimer’s disease and related dementias that influence DNA methylation and dementia status among groups at increased risk for dementia including women, minorities, rural inhabitants, and those with low educational attainment. Our results may provide an opportunity to identify epigenetic components that contribute to the prevalence and risk of dementia that could lead to a mechanistic understanding or targeted interventions that may substantially decrease the burden of Alzheimer’s disease and related dementias in the US population.

We are only beginning to clarify the ways the COVID-19 pandemic has resulted in substantial changes to American neighborhoods. There has been an excess of permanent business closures, particularly among small neighborhood businesses most vulnerable to social distancing, such as local barbershops and nail salons. COVID-19 outbreaks in late September 2021 caused 2,000 neighborhood schools to close for an average of six days in 39 states.

A burgeoning body of research has tried to understand the forces driving these trends, focusing on infectious disease transmission at the individual level or economic models at the business level. What is not considered is the context in which these changes are taking place. By context, we mean the neighborhood community environment that holds the opportunities, restrictions, risks, and flexibility for post-pandemic growth. The community environment includes:

1. Job opportunities in business sectors robust to social distancing;
2. Comprehensive broadband internet access to facilitate telemedicine, online schooling, remote work, and online grocery shopping;
3. Parks and walkable streets to facilitate socially distanced physical activity and social interaction to mitigate social isolation brought on by the pandemic; and
4. The provision of medical care through the availability of alternate health care providers and pharmacies.

Access to these neighborhood resources is not equally distributed across America, reinforcing risk for vulnerable populations, including older adults, children and adolescents, racial/ethnic minorities, and those in rural areas. However, a lack of national, standardized, longitudinal metrics of the local neighborhood environment has hindered the ability to identify which communities are most vulnerable to the immediate and longer-term consequences of the pandemic for a host of behavioral, psychological, social, and economic outcomes.

To address this limitation in the nation’s data infrastructure, we will augment, curate and disseminate data from our National Neighborhood Data Archive (NaNDA). This dataset includes a wealth of physical, social and economic characteristics of the local neighborhood across the United States (e.g., racial segregation, business density, environmental hazards, broadband internet access, and healthcare availability), in the years both before and since the pandemic. We will participate with the Consortium on Social, Behavioral, and Economic Research on COVID-19 to integrate, share, and analyze spatially referenced neighborhood data that can be readily linked to existing survey data, cohort studies, or electronic health records at various levels of geography. We will work with the COVID-19 Consortium Coordination Center to identify and create key neighborhood metrics that are priorities for research teams in the Consortium, including a set of common data elements (CDEs) on the social, behavioral and economic indicators of the COVID-19 pandemic at the neighborhood level. We will also develop new metrics of longitudinal neighborhood change in the decades preceding the pandemic, which can inform community risk and resilience since the pandemic.

The Child Development Supplement (CDS) is an integral and on-going component of the Panel Study of Income Dynamics (PSID), a longitudinal survey of a nationally representative sample of U.S. families that began in 1968. With data collected on the same families and their descendants for 41 waves over 52 years (as of 2020), PSID is a cornerstone for empirical social science research in the U.S. Through its long-term measures of economic and social wellbeing, and based on its weighted representative sample of U.S. families that now includes two major immigrant refresher samples, the study has advanced research on the dynamics of social, economic, demographic, and health processes and their interrelationships. Five waves of CDS have been conducted: three on the original cohort of children born between 1985 and 1997 (in 1997, 2002/2003, and 2007/2008) and two waves (in 2014 and 2019) on the next generation of PSID children who were born between 1997 and 2019.

This project has two specific aims. The first is to design and field a follow-up wave of CDS in 2021, collecting re-interview data on children aged 2-17 years who participated in CDS-19, through interviews with primary caregivers and older children aged 12-17 years. The second specific aim is to process, document, and distribute the new CDS-21 data, with scale composites, generated variables, and individual-level links to detailed school data from the National Center for Education Statistics. The 2021 wave of CDS will, in conjunction with data from CDS-14 and CDS-19, provide unique and valuable prospective panel data to study the effects of the Covid-19 pandemic, lockdown, and recession. The study will provide comprehensive and rich information on a large, nationally representative sample of children that includes an over-sample of African Americans and a new refresher sample of children in immigrant families. These data will be available free of charge through the PSID Online Data Center, which provides customized extracts and codebooks, detailed study documentation, and comprehensive user education and support.

High-intensity drinking (consuming 10+ drinks in a row) among young adults has recently been acknowledged as a serious health problem that requires urgent research attention. We have previously documented prevalence, predictors, and developmental change in recollection of any past 2-week high-intensity drinking from ages 18 to 30 through secondary data analysis of the national Monitoring the Future (MTF) study.

We are now collecting intensive longitudinal data to examine occasion-specific predictors and consequences of binge and high-intensity drinking at the period of the lifespan (ages 19-22) where alcohol use is the greatest. Information on occasion-specific predictors and short- and long-term consequences of binge and high-intensity drinking is needed to identify the motives, contexts, and public health impacts that differentiate these heavy levels of alcohol consumption. Building on our recent findings that used biennial data from the nationally representative Monitoring the Future (MTF) study, we plan to conduct new primary longitudinal data collection from a national sample of high school students followed into young adulthood. We will select participants from the 2018 MTF 12th-grade baseline surveys (with an oversample of high school binge drinkers) for a 4-year web-based measurement burst study – a shorter term study within a longitudinal study – across the transition into young adulthood.

We will collect up to 56 days of data per respondent using four annual data collection bursts (14 consecutive days of daily surveys per year at ages 19, 20, 21, and 22). Specific aims are to examine:

1. When and for whom high-intensity drinking is most likely to occur. We will focus on occasion-level predictors (e.g., affect, motives for drinking, drinking contexts, and other substance use) and time-varying developmental predictors (e.g., college attendance, employment, living with parents) of gender-specific rates of high-intensity drinking (8+/10+ drinks for women/men), compared to binge (4-7 for women, 5-9 for men) or moderate (1-3 for women, 1-4 for men) drinking occasions;
2. Whether acute consequences (e.g., blackouts, injury, aggressive behavior, sexual risk, and negative interpersonal consequences) associated with high-intensity (compared to moderate and binge) drinking differ across days and based on developmental and sociodemographic characteristics; and
3. Longer- term patterns of alcohol-related consequences (ages 18-22) and whether they differ by gender and social roles including educational experiences (e.g., 2-year and 4-year college).

The project will be the first national study of both college attenders and non-attenders to identify occasion-level predictors and occasion-level consequences of specific occasions of binge and high-intensity drinking. This will provide critical information for health promotion and intervention efforts targeting high-risk alcohol behaviors among young adults.

A growing literature documents Black-White inequalities in sleep deficiencies with Black adults experiencing less sleep and lower sleep quality compared to White adults. Because sleep hygiene is tightly linked to health, racial inequalities in sleep deficiencies may be a key determinant of racial inequalities in health.

Racial inequalities in work-related stress may be a crucial, but understudied driver of sleep inequalities and ultimately, health inequalities. As with all racial groups, the majority of Black men and women are in the labor force; however, compared to White adults, Black adults spend more time in the workplace, are more likely to hold multiple jobs, and twice as likely to hold two full-time jobs. Further compared to White adults, Black adults tend to be in occupations that are objectively more stressful, where they have less control and greater physical and emotional demands, and to report greater levels of stress at work.

While work-related stress has been linked to sleep deficiencies, there is a need to examine more racially-salient forms of stress such as vigilance, or the thoughts and behaviors in which Black Americans may engage in order to navigate everyday spaces such as the workplace. A substantial qualitative literature indicates that Black adults regularly anticipate and worry about potential encounters in everyday life such as being followed in stores or having assumptions made about their intellect or character. Vigilance may be particularly important for sleep inequalities because it captures a racially-salient and prevalent form of stress with characteristics that interfere with sleep quality and duration, including: (a) anticipatory stress, which predicts increased biological stress even in the absence of a stressful event; and (b) ruminative stress, which can transform acute situations into chronic sources of stress.

Using both real world and laboratory settings, we are collecting data from 500 Black men and women to capture both momentary work-related stressful experiences and chronic work-related stress. We are examining the linkages between racially-salient, work-related stress, captured through ecological momentary assessments, and sleep deficiencies, captured through self-report and actigraphy. The workplace is particularly relevant for racial inequalities in health due to focus on economic upward mobility among Black Americans and the growth of diversity, equity, and inclusion initiatives that may widen inequalities due to the need for vigilance as Black workers join predominantly White workplaces.

Due to rapid population aging and more frequent and heavier drinking among the baby boom generation, we expect an alarming rise in the number of older adults with alcohol-related problems. At the same time, more than 50% of adults over age 55 in the U.S. have hypertension and cardiovascular disease remains the nation’s leading cause of death. Alcohol use is strongly related to hypertension and cardiovascular disease, and moderation of alcohol is key for preventing and managing hypertension in older adults. Although low levels of alcohol use can have cardioprotective effects, physiological changes, chronic illnesses, and medication use can make even small amounts of alcohol detrimental for cardiovascular health among older individuals.

Marriage is a critical context for examining alcohol use and its effects on cardiovascular health. Over 60% of older adults are married and couples often engage in similar drinking behaviors that can benefit marital quality, potentially establishing or maintaining problematic drinking patterns. Further, it is well established that cardiovascular diseases and their biological risk factors are moderately to highly heritable (20%-75%), indicating that they are influenced by genetics.  However, we know little about how alcohol use changes among couples as they age together or the marital and genetic factors that may make individuals and couples more resilient or vulnerable to cardiovascular disease.

We use nationally representative longitudinal data from one of the largest studies of older couples (N = 8,545 married/cohabiting couples; 17,090 individuals) to address the following aims:

• Identify alcohol use patterns among older couples over time and the demographic and contextual predictors of those patterns,
• Determine the implications of individual and partner alcohol use for cardiovascular health and mortality among older couples over time,
• Identify genetic and marital risk and protective factors linked to alcohol-related cardiovascular health and mortality among older couples, and
• Develop and validate an innovative prognostic model to identify individuals and couples at high risk for poor cardiovascular health and mortality.

Identifying individuals and couples who are most at risk or resilient to alcohol-related cardiovascular health problems and development of new prognostic models will generate key insights for designing and testing interventions to reduce these major public health threats among the growing population of aging adults.

Although the majority of Americans with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) live independently, the neighborhood contexts in which they develop and navigate cognitive decline and impairment are largely ignored. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for AD/ADRD. However, with the onset of the COVID-19 pandemic, many neighborhood resources that are critical sources of socialization, stimulation, and activity are closed or tightly restricted. Avoiding crowded places, isolating, limiting travel, and permanent business closures likely have profound consequences for cognitive impairment and AD/ADRD risk due to disruptions in daily life, impacts on mental health, and loss of opportunities for social, intellectual, and physical activities.

This research addresses a critical knowledge gap on neighborhood contexts of cognitive decline before and after the pandemic onset. This is one of few studies to utilize both qualitative and quantitative data from the nationally representative Health and Retirement Study (HRS) of US adults aged 50+. Our first objective is to identify the neighborhood features associated with cognitive trajectories in the HRS before the pandemic onset. Our second objective is to use an advanced mixed-methods approach and novel HRS experimental module to investigate how the collective trauma of COVID-19 has fundamentally changed neighborhood landscapes and ways of aging in place. This will inform where to focus our third objective: analyses to identify which neighborhood features present the greatest risk and resiliency for cognitive impairment among older adults after the March 2020 pandemic onset.

Findings from this research will build evidence for a new concept of ‘cognability’, an innovative theoretical approach to indicate how supportive a geographic area is to cognitive health for aging residents through specific neighborhood resources and amenities.

The fellowship aspect of this project will facilitate Dr. Jessica Finlay’s career development and future as a successful independent health researcher. It extends her expertise in environmental gerontology, mixed-methods, and cognitive function with advanced training in longitudinal analysis, cognitive decline and AD/ADRD, and acute illness among aging adults. A strong interdisciplinary mentorship team and supportive training environment at the University of Michigan provide a foundation for Dr. Finlay to fill an important scientific niche on neighborhood vulnerability and resilience for cognitive decline and AD/ADRD. She has a unique vantage point to advance research on social determinants of AD/ADRD, identify neighborhood features that affect health and well-being, and inform public health policy and health services. Her long-term goal is to establish an R01-funded, mixed-methods research program that informs neighborhood interventions and community services to support the needs, health, and well-being of older adults aging in place.