Wendy Demark-Wahnefried, PhD UAB		Lucio Miele, MD, PhD LSU		Arnita Norwood, PhD, MPH UMC		Isabel Scarinci, PhD, MPH UAB

The Research Core aims to advance the understanding of how Social Determinants of Health (SDH) generate and sustain health disparities, with a specific focus on pathways to obesity and chronic illness and mechanisms connecting these pathways throughout the life-course.  This is being pursued in two ways, by:

1. Developing and testing interventions in “critical periods” in the life course, such as pregnancy, early childhood, and old age; and
2. Conducting retrospective studies to identify the contemporaneous, delayed, or cumulative effect of specific social determinants on biological and behavioral mechanisms that produce health disparities.

 
The life-course approach pinpoints critical periods when social context is especially important to health in a person’s life course. The focus is on the relationship between social factors and health during these critical periods, using a variety of cross-sectional analyses; at the same time, promote longitudinal studies that can reveal lagged, cumulative, and contemporaneous effects of SDH over a person’s life span. To conduct longitudinal epidemiological studies with biomarkers, existing cohorts established by the participating institutions are utilized, with appropriate measures of both socioeconomic status and physiological data, such as:
 

1. The Jackson Heart Study – a large, community-based observational study with 5,301 participants were recruited from among the non-institutionalized African American adults in the Jackson, MS, metropolitan statistical area to investigate the causes of cardiovascular disease in African Americans
2. The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study – an ongoing national observational study of risk factors for stroke in adults 45 years or older, with 30,239 participants; the study PI, as well as the statistical and data coordinating center, the survey research unit, and the outcomes unit are housed at UAB; Dr. George Howard, co-PI of REGARDS, is a Mid-South TCC consultant.
3. The UAB Study of Aging – a prospective study at UAB of an ethnically and geographically (urban/rural) diverse population-based cohort of 1,000 community-dwelling Medicare beneficiaries, age 65 years and older.

All of the above cohort studies have been or are being conducted in our Mid-South TCC consortium institutions. The datasets from these cohorts include baseline and follow-up health and risk data, dietary data, health status, and biospecimen samples from our Mid-South TCC population.
 
Consistent with the life-course approach, the work of the Mid-South TCC address obesity, a risk factor for chronic diseases, during three critical time points across the lifespan: pregnancy, early childhood, and old age. At each of these time points, the prevalence of obesity is higher in African Americans than in Caucasians and poses a greater threat to health and well-being. Obesity as a risk factor for chronic disease during pregnancy and in childhood is addressed with the two collaborative sub-projects.