Cardiovascular disease (CVD) is the leading cause of adult mortality in the United States. Preclinical signs of CVD begin to emerge within the first decades of life and, as a result, CVD is increasingly being understood as a lifecourse disease. From a public health perspective, there is therefore a large need to understand the experiential and biobehavioral antecedents of CVD in early life. With this in mind, recent reports have identified youth violence exposure as a risk factor for lifetime CVD risk. Between 25% and 42% of youth in the U.S. are exposed to violence, and emerging evidence is beginning to suggest the hypothesis that violence exposure in early life instantiates biological processes that can have long-term consequences for mortality and morbidity from CVD. Importantly, however, very little is known about the specific biobehavioral mechanisms that underlie the association between violence exposure and CVD risk. A mechanistic understanding of this kind is particularly important in adolescence, a period in which the atherosclerotic process begins. Adolescence is also a time during which other factors that are relevant to health such as self-control and health behaviors?putative mechanisms that may link violence to CVD risk?are still developing. Given the limited amount of prior research, the question of whether self-control and health behaviors are mechanisms that explain the association between violence and CVD risk is not known. There has also been little research comparing the effects of indirect or ?vicarious? exposure to community violence with the effects of direct violence exposure (victimization/witnessing) on CVD risk. To address these gaps in the literature, the proposed research studies aim to 1) test whether direct violence exposure and indirect violence exposure (community-level violence and crime) in adolescence are uniquely and prospectively associated with pro-inflammatory activity and cardiometabolic risk across adolescence; 2) to test whether self-control and poor health behaviors statistically mediate the associations between direct and indirect violence exposure and inflammatory and cardiometabolic processes across adolescence; and 3) to test prospective associations between direct and indirect violence exposure, self- control, health behavior in adolescence and inflammatory and cardiometabolic endpoints in young adulthood. This proposed program of research utilizes two data sources to test these aims. The proposed research is part of a broader post-doctoral training program, whose goal is to prepare the applicant for a career as a PI at a major research university, focused on understanding early life stress processes related to CVD pathogenesis. In addition to the research outlined above, the applicant will complete coursework on the pathophysiology of CVD and statistical methods, gain technical experience in the collection and measurement of inflammatory and cardiometabolic biomarkers relevant to CVD, and obtain expertise presenting and publishing research in the realm of cardiovascular behavioral medicine.
Cardiovascular disease (CVD) is the leading cause of adult mortality in the United States and it originates in the early decades of life. Adolescents who are exposed to violence (either directly victimized/witnesses to violence or who are indirectly exposed to community violence) are at higher risk of developing physical health problems that can promote lifetime risk for CVD, although very little is known about the specific biobehavioral mechanisms that underlie these associations. The proposed program of research tests the extent to which self-control and health behaviors are mechanisms that explain the association between violence exposure and inflammatory and cardiometabolic health in adolescence and young adulthood.