CancerisaleadingcauseofmorbidityandmortalityamongBlackwomenwithasubstantialburdendueto alcoholuse,smoking,andobesity.Despitegrowingevidenceoftheimportanceofearlylifeadverse experiencesonlong-termhealth,littleisknownabouthowchronicexposuretoadverseexperiencesacrossthe lifecourseinfluencescancerriskfactorsorriskbehaviorsamongBlackwomen.AfricanAmericanwomenare particularlyvulnerabletoahigherburdenofadverseexperiences.Duetohighlevelsofracialresidential segregationintheUnitedStates,AfricanAmericanwomenarealsomorelikelythanwomenofotherracesto liveinpoor,segregatedneighborhoodsirrespectiveofindividualeducationandincome.Neighborhoodcontext mayexacerbateeffectsofindividualleveladverseexperiences.Thereissomeevidencesuggestingthat modifyingtheneighborhoodmayattenuatetheeffectsofadverseexperiencesinearlylife.Wehypothesize thatadverseexperiencesacrossthelifecourse,compoundedbylivinginahighlyraciallysegregated neighborhoodinadulthoodwillresultinahigherriskofunhealthycopingbehaviors.UsingtheBlackWomen?s HealthStudy,acohortof59,000AfricanAmericanwomen(followedfrom1995-present),weaimto1)examine theassociationbetweentrajectoriesofadverseexperiencesinchildhood,adolescence,andadulthoodand adultalcoholuse,smoking,andbodysizeinAfricanAmericanwomenand2)determineiftheassociationof adverseexperienceswithadultalcoholuse,smoking,andbodysizeismodifiedbyneighborhoodracial segregationandsocioeconomicstatus. Thisstudywillfillacriticalgapinunderstandingtheinfluenceofearlylifeadverseexperiencesoncancerrisk factorsamongBlackwomen.Identifyingcriticalperiodsandinterveningearlierinthelifecoursewillyield greatergainsinreducingcancerdisparitiesinthispopulation.Theproposedresearchincorporatesseveral innovativeelements:1)Weareusingalarge,wellpowereddatasetthatwasexclusivedesignedtoelucidate thedriversofamultitudeofhealthoutcomesamongBlackwomen;?2)byincorporatingatrajectoryapproach weareabletoassesshowthetimingandcontinuityofadverseexperiencesinfluencehealthbehaviors;?3)By employingmultilevelmodelswecanexaminetheinfluenceofmultilevel(bothindividualandneighborhood) stressorsonhealthbehaviorsinthispopulation;?4)weareexaminingmultiplemeasuresofbodysizeincluding waist-to-hipratio(WHR)andBMI.Theinterdisciplinarytrainingenvironmentforthisproposalwillprovidethe applicantanopportunitytoenhancemethodologicalskills,buildresearchcompetency,andenhancecontent expertise,inordertobecomeanexpertintheintersectionofcancerandsocialepidemiology.
CancerisaleadingcauseofmorbidityandmortalityamongBlackwomen.Despitegrowing evidenceoftheimportanceofearlylifeadverseexperiencesonlong-termcancer-relatedhealth behaviorsandcancerincidence,littleisknownaboutchronicexposuretoadverseexperiences acrossthelifecourseandtheadditionaleffectoflivinginhighlyraciallysegregated neighborhoodsamongAfricanAmericanwomen.Thisprojectistosupportdissertationresearch usingtheBlackWomen?sHealthStudytoevaluatehowadverseexperiencesinchildhoodor adulthoodinteractwithresidenceinraciallysegregatedneighborhoodstoshapecancerrisk behaviors.
