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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:
- Developing and testing interventions in “critical periods” in the life course, such as pregnancy, early childhood, and old age; and
- 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:
- 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
- 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.
- 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.