Linked emergence of racial disparities in mental health and epigenetic biological aging across childhood and adolescence.

Marginalization due to structural racism may confer an increased risk for aging-related diseases - in part - via effects on people's mental health. Here we leverage a prospective birth cohort study to examine whether the emergence of racial disparities in mental health and DNA-methylation measures of biological aging (i.e., DunedinPACE, GrimAge Acceleration, PhenoAge Acceleration) are linked across childhood and adolescence. We further consider to what extent racial disparities are statistically accounted for by perinatal and postnatal factors in preregistered analyses of N=4,898 participants from the Future of Families & Child Wellbeing Study, of which N=2,039 had repeated saliva DNA methylation at ages 9 and 15 years. We find that racially marginalized children had higher levels of externalizing and internalizing behaviors and diverging longitudinal internalizing slopes. Black compared to White identifying children, children living in more racially segregated neighborhoods, and racially marginalized children more affected by colorism tended to have higher age-9 levels of biological aging and more biological age acceleration over adolescence. Notably, longitudinal increases in internalizing and externalizing behavior were correlated with longitudinal increases in biological aging. While racial and ethnic disparities in mental health were largely statistically accounted for by socioeconomic variables, racial differences in biological aging were often still visible beyond covariate controls. Our findings indicate that racial disparities in mental health and biological aging are linked and emerge early in life. Programs promoting racial health equity must address the psychological and physical impacts of structural racism in children. Comprehensive measures of racism are lacking in current population cohorts.

Structural racism in primary schools and changes in epigenetic age acceleration among Black and White youth.

Structural racism generates racial inequities in U.S. primary education, including segregated schools, inequitable funding and resources, racial disparities in discipline and achievement, and hostile racial climates, which are risk factors for adverse youth health and development. Black youth are disproportionately exposed to adverse school contexts that may become biologically embedded via stress-mediated epigenetic pathways. This study examined whether childhood exposure to adverse school contexts is associated with changes in epigenetic aging during adolescent development. DNA methylation-based epigenetic clocks were calculated from saliva samples at ages 9 and 15 among Black (n = 774) and White (n = 287) youth in the Future of Families and Child Wellbeing Study (2009-2015). We performed latent class analyses to identify race-specific primary school contexts using administrative data on segregation, discipline, achievement, resources, economic disadvantage, and racial harassment. We then estimated change in epigenetic age acceleration from childhood to adolescence across school typologies using GrimAge, PhenoAge, and DunedinPACE epigenetic clocks. Three distinct school contexts were identified for Black youth: segregated and highly-disadvantaged (17.0%), segregated and moderately-disadvantaged (52.1%), and integrated and moderately-disadvantaged (30.8%). Two school contexts emerged for White youth: integrated and unequal (46.5%) and predominantly White & advantaged (53.5%). At age 15, Black youth who attended segregated and highly-disadvantaged primary schools experienced increases in their speed of epigenetic aging with GrimAge and DunedinPACE. Slowed epigenetic aging with GrimAge was observed for Black youth who attended integrated and moderately-disadvantaged schools. School contexts were not associated with changes in epigenetic age acceleration for White youth. Our findings suggest that manifestations of structural racism in primary school contexts are associated with early-life epigenetic age acceleration and may forecast future health inequities.

Discrimination and Inflammation in Adolescents of Color.

Background: This study examined how experiences with discrimination relate to inflammation, a key biological pathway in mental and physical illnesses, and whether associations are moderated by gender across two samples of adolescents of color. Methods: Study 1 was a longitudinal study of 419 African American adolescents assessed on discrimination (ages 19-20), with trajectories of biomarkers of low-grade inflammation (C-reactive protein and soluble urokinase plasminogen activator receptor) measured from ages 25 to 29. Study 2 was a cross-sectional study of 201 eighth graders of color assessed on discrimination and mechanistic indicators of a proinflammatory phenotype: 1) in vitro studies of immune cells' inflammatory cytokine responses to stimuli; 2) in vitro studies of cells' sensitivity to anti-inflammatory agents; 3) circulating numbers of classical monocytes, key cellular drivers of low-grade inflammation; and 4) a composite of six biomarkers of low-grade inflammation. Results: Interactions of discrimination by gender were found across both studies. In study 1, African American males experiencing high discrimination showed increasing trajectories of soluble urokinase plasminogen activator receptor over time (p < .001). In study 2, adolescent boys of color experiencing greater discrimination evinced a more proinflammatory phenotype: larger cytokine responses to stimuli (p = .003), lower sensitivity to anti-inflammatory agents (p = .003), higher numbers of classical monocytes (p = .008), and more low-grade inflammation (p = .003). No such associations were found in females. Conclusions: Discrimination is a pressing societal issue that will need to be addressed in efforts to promote health equity. This study suggests that adolescent males of color may be particularly vulnerable to its effects on mental health-relevant inflammatory processes.

Socially Stratified Epigenetic Profiles Are Associated With Cognitive Functioning in Children and Adolescents.

Children's cognitive functioning and educational performance are socially stratified. Social inequality, including classism and racism, may operate partly via epigenetic mechanisms that modulate neurocognitive development. Following preregistered analyses of data from 1,183 participants, ages 8 to 19 years, from the Texas Twin Project, we found that children growing up in more socioeconomically disadvantaged families and neighborhoods and children from marginalized racial/ethnic groups exhibit DNA methylation profiles that, in previous studies of adults, were indicative of higher chronic inflammation, lower cognitive functioning, and a faster pace of biological aging. Furthermore, children's salivary DNA methylation profiles were associated with their performance on in-laboratory tests of cognitive and academic skills, including processing speed, general executive function, perceptual reasoning, verbal comprehension, reading, and math. Given that the DNA methylation measures that we examined were originally developed in adults, our results suggest that children show molecular signatures that reflect the early life social determinants of lifelong disparities in health and cognition.

Debt Stress, College Stress: Implications for Black and Latinx Students' Mental Health.

Educational debt is an economic stressor that is harmful to mental health and disproportionately experienced by African American and Latinx youth. In this paper, we use a daily diary design to explore the link between mental health, context specific factors like "college stress" and time use, and educational debt stress, or stress incurred from thinking about educational debt and college affordability. This paper utilizes data from a sample of predominately African American and Latinx college students who provided over 1,000 unique time observations. Results show that debt-induced stress is predictive of greater self-reported hostility, guilt, sadness, fatigue, and general negative emotion. Moreover, the relationship may be partly mediated by "college stress" reflecting course loads and post-graduation job expectations. For enrolled students then, educational debt may influence mental health directly through concerns over affordability, or indirectly by shaping facets of college life. The window that our granular data provides into college experiences suggest that the consequences of student debt are manifest and immediate. Further, the documented day-to-day mental health burden for minority students may contribute to downstream processes like matriculation.

Do trait psychological characteristics moderate sympathetic arousal to racial discrimination exposure in a natural setting?

Personality and psychological traits are known to influence how individuals react to and cope with stress, and thus, have downstream health and aging consequences. However, research considering psychological health traits as individual-level difference factors moderating the links been racism-related stress and health for racial and ethnic minorities in the United States is rare. Using intensive daily diaries and a wearable sensor that continuously recorded sympathetic nervous system arousal in a sample of racial and ethnic minority college students (80% African American, first-generation Black, or African; 20% Latinx), we linked arousal to racism-related experiences dynamically throughout the day as participants naturally went about their lives. Findings suggest that multiple traits are associated with increased arousal in real time when interpersonal discrimination is perceived, but that only anger and anxiety also predicted increased arousal during moments of rumination and reflection on race-related inequities. Vicarious discrimination exposure moments were also linked to suppressed arousal in general, but particularly for more anxious individuals. We use a stress appraisal and coping framework to elucidate the ways in which individual psychological differences may inform physiological responses to race-related stress. The biopsychosocial pathways by which cognitive appraisal and interpersonal race-related stress contribute to racial health disparities are also discussed.

Intimate partner violence, circulating glucose, and non-communicable Disease: Adding insult to injury?

Analyzing data from the 2015-2016 Indian Demographic and Health Survey (N = 41,768), we investigate how women's circulating glucose varies with the severity of intimate partner violence (IPV) they have experienced in the last year and how their likelihoods of corresponding noncommunicable diseases vary with IPV severity in their lifetime. Consistent with a physiological stress response, women who have recently experienced severe IPV exhibit higher glucose levels and are more likely to have extremely high levels-forewarning of disease development-than women who have not experienced IPV. Correspondingly, women who have ever experienced severe IPV in their lifetime have 33%-200% higher probabilities of diabetes, heart disease, thyroid disorders, and cancer and are 70% more likely to have any of these diseases and 175% more likely to have multiple than women who have experienced none.

In the Flow of Life: Capturing Affective Socializing Dynamics Using a Wearable Sensor and Intensive Daily Diaries.

Interpersonal socializing is important to many sociological outcomes, but assessing the affective dynamics within interactional contexts is extremely challenging methodologically. As a first step toward capturing socializing and affective outcomes concurrently, this pilot study (n = 118) combines intensive daily surveys with a wearable sensor that tracked affective arousal. This approach allowed the operationalization of affect along its two primary dimensions, valence and arousal, which were then linked to periods socializing with a romantic partner, a best friend, and/or a group of friends. Although socializing predicted positive and negative affective valence concurrently in time, only socializing with groups of friends consistently predicted increased affective arousal. Findings for romantic partners and/or socializing with a close friend suggest that low arousal "downtime" with close intimates may also provide important social functions. This work demonstrates a new biosignaling approach to affective dynamics broadly relevant to emotion-related sociological research.

Race and ethnic variation in college students' allostatic regulation of racism-related stress.

Racism-related stress is thought to contribute to widespread race/ethnic health inequities via negative emotion and allostatic stress process up-regulation. Although prior studies document race-related stress and health correlations, due to methodological and technical limitations, they have been unable to directly test the stress-reactivity hypothesis in situ. Guided by theories of constructed emotion and allostasis, we developed a protocol using wearable sensors and daily surveys that allowed us to operationalize and time-couple self-reported racism-related experiences, negative emotions, and an independent biosignal of emotional arousal. We used data from 100 diverse young adults at a predominantly White college campus to assess racism-related stress reactivity using electrodermal activity (EDA), a biosignal of sympathetic nervous system activity. We find that racism-related experiences predict both increased negative emotion risk and heightened EDA, consistent with the proposed allostatic model of health and disease. Specific patterns varied across race/ethnic groups. For example, discrimination and rumination were associated with negative emotion for African American students, but only interpersonal discrimination predicted increased arousal via EDA. The pattern of results was more general for Latinx students, for whom interpersonal discrimination, vicarious racism exposure, and rumination significantly modulated arousal. As with Latinx students, African students were particularly responsive to vicarious racism while 1.5 generation Black students were generally not responsive to racism-related experiences. Overall, these findings provide support for allostasis-based theories of mental and physical health via a naturalistic assessment of the emotional and sympathetic nervous system responding to real-life social experiences.

Race moderates the association of perceived everyday discrimination and hair cortisol concentration.

The influence of discrimination on hypothalamic-pituitary-adrenal (HPA) axis function is considered to be more pronounced for racial minority versus majority groups, although empirical support for this argument is not strong. This study examined whether the association of perceived discrimination was more strongly associated with long-term, retrospective cortisol output (as measured by hair cortisol concentration [HCC]) among African American compared to White adults. Participants included 141 community-dwelling adults (72 White, 69 African American; mean age 45.8 years; 67% females). The Everyday Discrimination Scale assessed perceived discrimination. The first 3 cm of proximal scalp hair was analyzed for HCC using enzyme-linked immunoassay. Associations between race, perceived discrimination and HCC were examined using hierarchical multiple regression. African Americans had higher HCC than Whites, but both groups reported perceived discrimination with similar frequency. Race moderated the association between perceived discrimination and HCC (R2 interaction = 0.03, p = 0.007) such that perceived discrimination was positively associated with HCC among African Americans (ß = 0.28, p = 0.007), but not Whites (ß = -0.11, p = 0.274). Perceived discrimination did not mediate the association between race and HCC (ß for indirect effect = 0.025, 95% CI [-.003, 0.087]). Although perceived discrimination did not differ between races, perceived discrimination was positively associated with retrospective levels of cortisol in scalp hair among African Americans but not Whites. This may suggest that characteristics of discrimination other than frequency are particularly salient to HPA axis function among African Americans (e.g. attribution, severity, historical context).LAY SUMMARYThis study found that greater perceived discrimination frequency was associated with greater long-term cortisol secretion (i.e. hair cortisol concentration) among African American compared to White adults. Both groups reported similar discrimination frequency, so the uniqueness of African Americans' experience with discrimination may be salient to HPA axis upregulation for this population.

Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study.

Racial discrimination is a social stressor harmful to mental health. In this paper, we explore the links between mental health and interpersonal discrimination-related social events, exposure to vicarious racism via social media, and rumination on racial injustices using a daily diary design. We utilize data from a racially diverse sample of 149 college students with 1,489 unique time observations at a large predominantly White university. Results show that interpersonal discrimination-related social events predicted greater self-reported anger, anxiety, depressive symptoms, and loneliness both daily and on average over time. Vicarious racism from day-to- day was associated with increased anxiety symptoms. In contrast, rumination was not associated with negative mental health outcomes. These findings document an increased day-to-day mental health burden for minority students arising from frustrating and alienating social encounters experienced individually or learned about vicariously.

The impact of social exclusion on anticipatory attentional processing.

The importance of understanding how we anticipate and prepare for social rejection is underscored by the mental and physical toll of continual social vigilance. In this study, we investigate the impact of social rejection on anticipatory attentional processes using the well-known Cyberball task, a paradigm in which participants engage in a game of catch with virtual avatars who after an initial period of fair-play (inclusion condition) then exclude the participant from the game (exclusion condition). The degree of anticipatory attention allocated by subjects towards the avatars was assessed by measuring P3b responses towards the avatars' preparatory actions (i.e. the phase preceding their exclusionary actions) using high density EEG. The results of the study show that relative to the inclusion, participants exhibit elevated levels of anticipatory attentional allocation towards the avatars during the exclusion block. This shift was however significantly moderated by participants' self-reported cognitive regulation tendencies. Participants with higher levels of self-reported cognitive reappraisal tendencies showed larger anticipatory P3b increases from the inclusion to exclusion block relative to participants with reduced levels of reappraisal tendencies. These results highlight the impact of social exclusion on anticipatory neural processing and the moderating role of cognitive reappraisal on these effects.

Stress-Related Biosocial Mechanisms of Discrimination and African American Health Inequities.

This review describes stress-related biological mechanisms linking interpersonal racism to life course health trajectories among African Americans. Interpersonal racism, a form of social exclusion enacted via discrimination, remains a salient issue in the lives of African Americans, and it triggers a cascade of biological processes originating as perceived social exclusion and registering as social pain. Exposure to discrimination increases sympathetic nervous system activation and upregulates the HPA axis, increasing physiological wear and tear and elevating the risks of cardiometabolic conditions. Consequently, discrimination is associated with morbidities including low birth weight, hypertension, abdominal obesity, and cardiovascular disease. Biological measures can provide important analytic tools to study the interactions between social experiences such as racial discrimination and health outcomes over the life course. We make future recommendations for the study of discrimination and health outcomes, including the integration of neuroscience, genomics, and new health technologies; interdisciplinary engagement; and the diversification of scholars engaged in biosocial inequities research.

Grandparents' Education and Infant Health: Pathways across Generations.

Using data from the Fragile Families and Child Wellbeing survey linked to respondents' medical records (N=2,870), this study examines the association between grandparents' education and birth outcomes and explores potential pathways underlying this relationship. Results show that having a grandfather with less than a high school education was associated with a 93 gram reduction in birthweight, a 59% increase in the odds of low birthweight, and a 136% increase in the odds of a neonatal health condition, compared to having a grandfather with a high school education or more. These associations were partially accounted for by mother's educational attainment and marital status, as well as by prenatal history of depression, hypertension, and prenatal health behaviors, depending on the specific outcome. The findings from this study call for heightened attention to the multigenerational influences of educational attainment for infant health.

Do adolescent risk behaviors mediate health and school bullying? Testing the stress process and general strain frameworks.

Adolescent bullying is a significant public health issue in the United States. The health consequences of bullying may vary, however, according to the social position and characteristics of victims and bullies within the bullying subculture. For example, research suggests that bully involved youth are more likely to engage in risky health behaviors, including social withdrawal, tobacco, and alcohol use. Yet, the extent to which health outcomes are shaped by involvements in bullying or the risk behaviors associated with bullying remains unclear. In this study we assess the extent to which risk behaviors mediate the links between health outcomes of bully-involved youth using data from the Health Behavior of School Aged Children 2005-2006 Study (N = 8066). School-level fixed-effects regression models assessed whether risk behaviors mediate relationships between bullying statuses and somatic and depressive symptoms. Results show that mediational risk behavior pathways vary across outcomes for youth situated differently in the bullying subculture, with substantially more mediation for bullies than victims. This study advances the current bullying and health research by accounting for risk behavior pathways linking bullying and health.

Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender.

We examine four life course models as they relate to adolescent SES, adult SES, and cardiovascular risk--the sensitive period, pathways, accumulation, and social mobility models. Accounting for race/ethnic and gender differences in life course processes, we analyzed Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of individuals enrolled in grades 7-12 when they were first interviewed in 1994/5. We restricted our sample to whites, blacks, and Latinos who were interviewed in Waves I and IV and provided biomarker data (n = 11,397). The cardiovascular risk score at Wave IV combined waist circumference, blood pressure, hemoglobin A1c, and C-reactive protein. We found evidence for each of the four life course models for white women, whereas the sensitive period was indicated for white men. Upward mobility was also associated with higher CVD risk among white men as compared to those who were socio-economically advantaged at both time points. The pathway model was significant for Latino women. No life course models were significant for black men or women or Latino men. Our findings demonstrate the importance of applying an intersectional lens to understanding CVD risk over the life course.

Birth weight, early life course BMI, and body size change: Chains of risk to adult inflammation?

This paper examines how body size changes over the early life course to predict high sensitivity C-reactive protein in a U.S. based sample. Using three waves of the National Longitudinal Study of Adolescent Health (Add Health), we test the chronic disease epidemiological models of fetal origins, sensitive periods, and chains of risk from birth into adulthood. Few studies link birth weight and changes in obesity status over adolescence and early adulthood to adult obesity and inflammation. Consistent with fetal origins and sensitive periods hypotheses, body size and obesity status at each developmental period, along with increasing body size between periods, are highly correlated with adult CRP. However, the predictive power of earlier life course periods is mediated by body size and body size change at later periods in a pattern consistent with the chains of risk model. Adult increases in obesity had effect sizes of nearly 0.3 sd, and effect sizes from overweight to the largest obesity categories were between 0.3 and 1 sd. There was also evidence that risk can be offset by weight loss, which suggests that interventions can reduce inflammation and cardiovascular risk, that females are more sensitive to body size changes, and that body size trajectories over the early life course account for African American- and Hispanic-white disparities in adult inflammation.

Teen Alcohol Use and Social Networks: The Contributions of Friend Influence and Friendship Selection.

BACKGROUND: We evaluated the contributions of teen alcohol use to the formation and continuation of new and existing friendships while in turn estimating the influence of friend drinking on individuals' regular use and heavy drinking. METHOD: Longitudinal network analysis was used to assess the mutual influences between teen drinking and social networks among adolescents in two large Add Health schools where full network data was collected three times. Friendship processes were disaggregated into the formation of new friendships and the continuation of existing friendships in a joint model isolating friendship selection and friend influences. RESULTS: Friends have a modest influence on one another when selection is controlled. Selection is more complicated than prior studies suggest, and is only related to new friendships and not their duration in the largest school. Alcohol use predicts decreasing popularity in some cases, and popularity does not predict alcohol consumption. CONCLUSION: Intervention efforts should continue pursuing strategies that mitigate negative peer influences. The development of socializing opportunities that facilitate relationship opportunities to select on healthy behaviors also appears promising. Future work preventing teen substance use should incorporate longitudinal network assessments to determine whether programs promote protective peer relationships in addition to how treatment effects diffuse through social networks.

Hard Times and Heart Break: Linking Economic Hardship and Relationship Distress.

We used the Fragile Families and Child Well-Being Study to examine an integrated mediational model linking economic hardship to relationship distress. Depressive symptoms, partner's discord, parenting stress, and coparenting are combined into a joint model linking economic hardship to relationship distress among mothers and fathers in intimate relationships. Although economic hardship is significantly associated with each mediating factor, only discord is associated with both relationship distress and dissolution in the full model. Moreover, comparisons using multigroup structural equation modeling indicate that while economic hardship is associated with higher discord among both mothers and fathers, the influence is substantially larger among fathers. We suggest that the link between hardship and relationship distress is largely contingent on interactional processes (i.e., discord) and how mothers perceive their child's father in the midst of economic hard times.

Perceived discrimination and markers of cardiovascular risk among low-income African American youth.

OBJECTIVES: Our study examines the relationship between perceived discrimination and levels of C-reactive protein and blood pressure in low-income youth ages 10-15 years old. METHODS: Data were collected from 10 to 15 year old focal children and their mothers. Face-to-face interviews were implemented to collect data on stressors including experiences of everyday discrimination from youth. High sensitivity CRP in dried blood spot samples and diastolic and systolic blood pressure were also collected at the time of the interview. RESULTS: Perceived discrimination among youth was significantly associated with higher levels of CRP, systolic, and diastolic blood pressure. CRP, systolic, and diastolic blood pressure remained significant after controlling for age-adjusted BMI, waist circumference, and other factors. CONCLUSIONS: Discrimination is a salient risk factor for inflammation and cardiovascular health. Early life course inflammation and cardiovascular reactivity are important candidate pathways through which the repeated exposure to discrimination for minority group members contributes to racial and economic health inequities in adulthood.