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

In collaboration with U-M’s renowned Graham Sustainability Institute, we implemented this comprehensive study designed to assess sustainability knowledge, behaviors, and attitudes across U-M students, faculty, and staff over time. This groundbreaking effort, known as the Sustainability Cultural Indicators Program (SCIP), is designed to inform educational programs and campus operations at the University, and is an outgrowth of the Community Awareness goal area of the U-M Campus Sustainability Integrated Assessment.

Building on information gleaned from focus groups, questionnaires were designed and administered to samples of university students, faculty, and staff in 2012, 2013,2014, 2015, 2018, and 2021. In addition to the Ann Arbor campus, the 2021 survey was extended to  cover U-M’s Flint and Dearborn campuses. . The web surveys yielded responses from more than 3,500 students and 1,500 faculty and staff members each year. Questions cover travel and transportation, waste prevention and conservation, the natural environment, climate change, food, and engagement, awareness, and ratings of campus sustainability initiatives. Survey data are supplemented with geographic data covering campus buildings where respondents live, work and study. Current plans call for repeating the survey again in fall 2024.  

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.

Poor muscle function is a pressing public health problem: half of all U.S. older adults meet criteria for muscle weakness. Poor muscle function, defined by low muscle strength and power, is a major risk factor for a host of negative health outcomes, including functional limitations, disability, and multimorbidity. Neighborhood characteristics predict functional limitations, disability, and death, but we do not understand the biologic mechanisms.

Muscle function and its underlying physiology, including mitochondrial bioenergetics, are a biologically promising, but unexplored mechanism linking neighborhoods and disability. While previous research has examined neighborhood effects on disability, almost no prior work has explored neighborhood effects on muscle function and no research has evaluated connections with skeletal muscle mitochondria.

Neighborhood factors represent an untapped opportunity in musculoskeletal health research to assess the interplay among environmental, sociocultural, behavioral, and biological determinants to understand and prevent disease while exploring the relationship among mitochondrial biogenesis and musculoskeletal function. Understanding how neighborhood characteristics get under the skin and contribute to poor muscle function, reduced physical activity, and alter mitochondrial bioenergetics will enhance our understanding of what social and biologic risk factors matter most for muscle function and could be targets for interventions.

This study proposal leverages data from two well-characterized datasets, the Health and Retirement Study (HRS) and the Study of Muscle Mobility and Aging (SOMMA) to identify which features of the neighborhood environment are related to muscle function, physical activity and mitochondrial health in older adults. We will assess which predictors of the neighborhood environment affect muscle function in older adults, examine the relationship between the neighborhood environment and skeletal muscle mitochondrial bioenergetics, and test the hypothesis that mitochondrial bioenergetics and physical activity mediate the link between the neighborhood environment and muscle function.

Complementing this research is a detailed training plan that will build on the applicants prior training in social and clinical epidemiology to include (1) neighborhood research on planning/design; (2) the assessment of skeletal muscle mitochondrial bioenergetics, and; (3) causal mediation analysis. This integrated sociobiologic training will prepare the applicant for a successful independent research career focused on incorporating the social determinants of health into the study of musculoskeletal research. Findings from this project will provide critical insights into understanding the complex, multifactorial social and biologic contributors of poor muscle function in older 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.

This project supports the analysis of existing social and epigenetic data for three countries and the development of longitudinal epigenetic data for three countries: the United States, Ireland, and the United Kingdome (Northern Ireland, specifically). The project will answer basic questions about how life circumstances in both childhood and adulthood affect epigenetic change and how that change is associated with health after age 50. Researchers in the three countries have a set of integrated aims and analyses using data from three national studies of aging in the family of Health and Retirement Studies: the US Health and Retirement Study (HRS), the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA), and the Irish Longitudinal Study of Aging (TILDA).

We will examine the links between lifetime social, economic, psychological, environmental and behavioral circumstances, and epigenetic markers related to aging and health, and subsequent health. Epigenetic modification is one of the hallmarks of aging, i.e. an underlying physiological change that can speedup or delay aging-related health outcomes. Faster aging is characteristic of people in adverse social circumstances. Epigenetic change, particularly DNA methylation (DNAm), appears to be especially influenced by adverse social circumstances, both at early ages and at later ages.

This project is unique in evaluating how a variety of social circumstances. Low levels of education and income, minority group membership, adverse childhood experiences, adult traumas, risky health behaviors, psychological states, and chronic stress, are associated with epigenetic markers in three different countries. These factors have somewhat different historical, social, and behavioral characteristics and operate in different health policy regimes. These differences allow for both replication where effects are hypothesized to be similar and differentiation where they are hypothesized to differ (e.g., where risk characteristics are differentially patterned by SES).

The researchers are uniquely placed with their collaborative resources to explore how socioeconomic experiences across the life course alter epigenetic profiles to influence health outcomes such as frailty, disability, chronic disease, and premature mortality. The three data sets have been highly harmonized for information collection from the beginning of the studies and were designed to encourage comparative analysis. They have been harmonized in the survey information and the development of the epigenetic data in the three countries. Each country has strong independent research teams who bring unique expertise and resources and a history of collaboration to this collaborative proposal.

The homes of millions of older Americans do not provide adequate protection from extreme temperatures, due in large part to ‘energy poverty.’ Modifications to homes that increase energy efficiency and improve indoor temperatures may reduce the adverse neuropsychological health impacts of extreme temperatures.

Indoor temperatures may impact sleep quality and short-term cognitive function, and high utility bills may exacerbate the psychosocial stress of financial worry. Some of the health benefits of weatherization include reductions in emergency department visits related to asthma. We propose to evaluate the health and financial impacts of low-cost and higher-cost weatherization programs, considering the novel or under-studied outcomes of financial worry, cognitive function, and sleep quality and duration. We propose to enroll three categories of participants: those of a low-cost weatherization program in a cold climate (Detroit, MI), those of a high-cost weatherization program in a cold climate (Madison, WI), and those of a high- cost weatherization program in a warm climate (Memphis, TN).

In a longitudinal study with multiple surveys and sub-hourly indoor temperature and humidity monitoring per person over one year of participation, we will characterize  the associations of indoor temperatures with cognitive function and sleep quality/ duration and the associations of low- and high-cost weatherization programs with indoor environmental parameters (temperature, humidity) and financial worry. We will also characterize the monetized health impacts of low- and high-cost weatherization programs in terms of both community-wide air pollution benefits (related to reduced energy consumption) and recipient-specific health. This research will advance our long-term objectives of reducing the health impacts of extreme weather, characterizing the health impacts of the home environment, and reducing disparities in the health impacts of energy generation and use. Our results will inform policies for energy efficiency and weatherization subsidies, considering that medical savings from expenditures on housing upgrades would potentially reduce state- or federally-subsidized healthcare expenditures. Such interventions may improve the health of older adults via improvements to indoor temperatures and reductions in utility costs and help households both mitigate (through decreased energy usage) and adapt to extreme weather.

Racial inequalities in healthy aging have been well-documented. Compared to White Americans, Black Americans experience illness and death at early ages and show steeper age-related declines in health. Our neighborhoods, as the site of where we live, learn, play, and pray, may serve as a powerful source of these racial inequalities. Racial residential segregation (which is the sorting of different racial groups into different neighborhoods through historical and current discriminatory policies and practices) has resulted in a racially unequal American neighborhood landscape. Neighborhoods with mostly Black residents experience more poverty, civic and commercial disinvestment, and more exposure to environmental hazards compared to neighborhoods with mostly White residents. While more researchers are documenting the role of neighborhoods in health inequalities, we may actually be underestimating the true impact of neighborhood context, because we often focus on specific health outcomes, such as cardiovascular disease or diabetes. However, there are likely shared biological mechanisms within the body that drive many of these diseases — and one such mechanism may be changes to our genomic structure, called epigenomics. While our genes do not change, the environment can have an impact on whether our genes are actually expressed. We will determine whether the accumulation of adulthood lived experience in racially-segregated neighborhoods is related to epigenomic patterns called DNA methylation. We will also specifically determine whether the accumulation of adulthood exposure to neighborhood industrial air pollution and disadvantage together are related to these patterns of DNA methylation. Finally, we will determine whether the DNA methylation patterns we see are related to racial inequalities in healthy aging. We hypothesize that racially-segregation Black neighborhoods, with their greater levels of industrial air pollution and social disadvantage, will be related to the types of patterns in DNA methylation that have been shown to be related to chronic diseases in molecular studies. In fact, we further hypothesize that these patterns in DNA methylation will be related to racial inequalities in cognitive function and the number of chronic diseases one has had. Clarifying the role of neighborhood context in racial inequalities in healthy aging is critical, as neighborhoods are not naturally-occurring. They develop and change through policies and are amenable to intervention. Identifying the role of DNA methylation that likely underlies many chronic diseases, will clarify the importance of neighborhoods and point to potential effective interventions.

This project will include investigators at five Michigan institutions and will focus on three primary aims:

AIM 1: To investigate the effects of persistent organic pollutants (POPs) and heavy metals, assessed across two generations, on ECHO outcomes.

AIM 2: To assess the effect of maternal nutritional/weight status in pregnancy on ECHO outcomes.

AIM 3: To assess effects of pregnancy infection and inflammation (assessed in maternal blood, placenta and newborn blood spots) on ECHO outcomes.