Structural Racism and Adverse Birth Outcomes in the US South: A Multigenerational Perspective (Diversity Supplement)

ABSTRACT Candidate: The candidate is an epidemiologist with expertise in environmental influences on maternal and child health (MCH). She is applying for the NIMHD supplement to promote diversity in health-related research (diversity supplement) under parent grant, “Structural racism and adverse birth outcomes in the US South: A

multigenerational perspective” (1R01MD016046-01). The candidate seeks specialized training in social epidemiology, environmental justice advocacy and statistical modeling methods to support her development into an independent researcher who examines relationships between social and environmental drivers of

adverse birth outcomes. Her goals are to use an interdisciplinary approach to improve understanding of the complex factors and the resulting pathways that contribute to health disparities and ultimately, partner with communities to advocate for research-informed environmental justice solutions to address drivers of MCH

health disparities. Research context: This work extends the scope of the parent grant by examining racial differences in associations between multi-generational air pollution exposure, which may in part result from discriminatory practices stemming from structural racism, and adverse birth outcomes. Structural racism is

reported to be a key driver of the uneven distribution of air pollution and may play a role in observed racial and ethnic disparities in adverse birth outcomes. Policies such as redlining, an outdated policy used to classify neighborhoods and subsequently used as an investment eligibility measure by lenders, may be a driving factor

in the hypothesized air pollution and adverse birth outcomes relationship. Although redlining ended in 1968, its impact has persisted and is evidenced by associations between redlined neighborhoods and the siting of pollution sources such as industrial facilities and roadways. Research objectives: This work will complement

the parent grant by adding another measure of structural racism and allow for a broader understanding of its contributions to disparities in adverse birth outcomes. Research plan: Data from the parent study (South Carolina multigenerational linked birth data from 1989-2020) will be used to generate census tract level

prenatal air pollution data for grandmothers and mothers to examine associations between multi-generational air pollution exposure and adverse birth outcomes among Non-Hispanic White and Non-Hispanic Black families. Career development goals: Through didactic and experiential activities, this work will enable the

candidate to acquire specialized skills in social epidemiology, environmental justice and statistical modeling methods to support her development. Environment: The candidate will conduct the proposed activities in a setting supported by eminent leaders in social epidemiology, environmental epidemiology, and biostatistics.

Exceptional resources at the University of Michigan and the School of Public Health ensure that the candidate can successfully implement the proposed work and lay the foundation to acquire future R01 funding to conduct independent research on environmental and social drivers of disparities in adverse birth outcomes.