Life Course Socioeconomics, Acculturation, & Type-2 Diabetes Risk Among Latinos

In the United States, Latinos are disproportionately burdened by type-2 diabetes. This study follows 500 adult biological offspring of the original participants in the Sacramento Area Latino Study on Aging (SALSA) as well as additional family members of the current study participants. Taking advantage of a unique and large epidemiologic cohort, this study examines life course determinants of type-2 diabetes across generations of US Latinos, an understudied ethnic minority group. We hypothesize that the disparities in type-2 diabetes among Latinos reflect the combined effect of intergenerational transmission of socioeconomic position, culture, behavior, biology, and other risk factors that accumulate over the life course. The findings from this study will have important public health implications, providing an unprecedented opportunity to identify targets for intervention and supporting our long-term goal of reducing disparities in type-2 diabetes among Latinos in the US. More broadly, the proposed research may uncover crucial life course socioeconomic and cultural patterning of risk or health-promoting factors that may benefit other racial/ethnic minorities suffering from type-2 diabetes.

Infectious Links Between Psychosocial Stress and Aging

Accelerated biological aging has been proposed as an explanation for socioeconomic differences in disease, but the specific mechanisms linking the social environment and stress to aging are not well understood. This study seeks to improve scientific understanding of how the social environment and psychosocial stress accelerate the aging process by bringing together research on two pathways that have been linked to both socioeconomic status and psychosocial stress: the role of latent pathogens in age-related immunosenescence and the role of telomere shortening in cellular aging. This study takes advantage of both immunological and molecular level studies to provide evidence for pathways through which psychosocial stress might be related to accelerated aging. This study proposes to add pathogen data to a unique sub-sample of the Whitehall II epidemiological cohort, including pathogen seropositivity and antibody levels, complementing the rich data on social factors, psychosocial stress, stress response, and telomeres already in this dataset. Identifying associations and interactions between psychosocial stress, immune function, and telomere length, this study could lead to novel areas of prevention and intervention in chronic diseases of aging.

Ecological stressors, PTSD, and drug use in Detroit

The Detroit Neighborhood Health Study (DNHS) is a prospective, representative longitudinal cohort study of predominantly African American adults living in Detroit, Michigan. Although recent work has shown that stressors at multiple levels may be important determinants of psychopathology and behavior, there has been very little systematic effort to understand the contributions of ecologic stressors to the risk of incident post-traumatic stress disorder (PTSD) or drug abuse/dependence while concurrently accounting for individual stressors. The overall goal of the DNHS is to determine whether ecologic stressors (concentrated disadvantage, income distribution, residential segregation, quality of the built environment) influence the risk of PTSD and drug abuse/dependence. Our central hypothesis is that exposure to ecologic factors is a fundamental determinant of population mental health, particularly in the urban context. Additionally, we will begin to assess the relationship between exposure to ecologic stressors, PTSD, and specific immune and inflammatory responses in order to elucidate the potential biological pathways underlying the relationship between psychosocial stress, PTSD, and consequent physical morbidity. This study combines multiple waves of interviews, ecological assessments, and blood samples from 1500 residents from Detroit’s 54 neighborhoods. Bringing together a team with expertise in urban health, survey research, epidemiology and psychoneuroimmunology, this study stands to make a substantial contribution to our understanding of the etiology of PTSD, drug abuse/dependence, and their consequences. 


A Randomized Study of Exclusion Criteria in a University Population

Community transmission of seasonal and pandemic influenza occurs most often in younger individuals, in part because of their susceptibility, but also because of their social interaction patterns. This study assesses the impact of varying periods of voluntary isolation on risk of influenza in university residence halls to evaluate the acceptability and magnitude of effect that can be expected from such an intervention, and to determine the number of days that sequestration should be practiced. In this study, 590 students living in six residence halls on a university campus were randomized to either a three-day isolation intervention group or a control group. Participants were asked to respond to weekly surveys on health behaviors, social interactions with other participants, and symptoms of influenza-like illness (ILI). Following onset of ILI (cough plus fever/feverishness and body aches or chills), participants in the intervention group were asked to adhere to a three-day isolation period. ILI case-patients reported on their isolation behavior during illness and provided throat and nasal swab specimens at illness onset, day three, and day six of illness. A subsample of individuals also participated in a pilot study of a novel smartphone application, iEpi, which collected sensor and contextually-dependent survey data about social interactions between participants. We hypothesize that individuals in close physical proximity to cases are protected given sequestration, and that friends/social contacts residing further from the index case also have lowered risk. The findings from this study will have important public health implications, including identification of critical periods of illness transmission that may account for outbreaks in the school setting. The results of this study may be used for setting specific national mitigation strategies where social distancing is a major component.

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