Kudos to Jewel Scott and her advisor Leigh Ann Simmons for their NIH NRSA application entitled “The Effects of Resilience Factors and Childhood Adversity on Cardiovascular Disease Risk in Young Black Women.” This proposal requests funding for a two-year period with a start date of July 1, 2018.
Despite two decades of research on the disproportionate cardiovascular (CV) disease prevalence in Black Americans, there has been little improvement in the CV-related morbidity and mortality in Black women. Black women continue to have the highest prevalence of hypertension than all other racial and ethnic groups in the United States. For Black women, chronic stress, including adversity in childhood, is a psychosocial determinant of CV disease risk. Adverse childhood experiences (ACEs), such as child abuse or parental mental illness, are examples of chronic stress, which independently double the odds of CV disease even after controlling for traditional risk behaviors. Most studies endorse that women report more childhood adversity than men, and research suggests this toxic level of adversity may preferentially affect CV disease risk in women more than men. Moreover, for Black women, ambient stressors, such as discrimination and neighborhood violence, in combination with ACEs may amplify CV disease risk. However, chronic stress does not uniformly raise CV disease risk, as not all women who have experienced chronic stress have CV disease. Thus, there may be critical time periods in childhood to counteract the up-regulated stress response. However, little research has determined whether young adulthood, a period of transition and instability, is also a sensitive window to dampen the effects of chronic stress. In addition, resilience factors at the individual, interpersonal, and community levels may counter the effects of chronic stress and promote low CV disease risk. A novel, strengths based approach will examine intrinsic and extrinsic resilience factors over time. Few studies have used this life course approach to examine resilience factors such as social connectedness in early childhood, adolescence and early adulthood. To fill this gap, the overall goal of this descriptive, correlational study is to examine the influence of ACEs and ambient stressors (discrimination and neighborhood violence) on CV disease risk, and determine the extent to which resilience factors counter the effects of adversity in 700 young Black women, ages 24-32, using 14 years of follow-up data from the National Longitudinal Study of Adolescent to Adult Health.
The specific aims are:
Aim 1: Determine the influence of severity of adversity, as measured by ACEs and/or ambient stressors, on CV disease risk in young black women convarying for socioeconomic position, depression and physical activity.
Aim 2: Identify individual (personality, spirituality), interpersonal (parental warmth), and community (adolescent and adult social connectedness) resilience factors that moderate the effects of severity of adversity on CV health convaying for socioeconomic position, depression and physical activity.
Findings from this research will increase our knowledge of contextual factors that contribute to physical resilience in the form of positive CV health and inform both the timing and the content of future interventions to prevent or mitigate future CV disease in young black women.