Organizations in science and medicine must hold each other accountable for discriminatory practices.

Many organizations persist in working with others that engage in known, remediable structural discrimination. We name this practice interorganizational structural discrimination (ISD) and argue it is a pivotal contributor to inequities in science and medicine. We urge organizations to leverage their relationships and demand progress from collaborators.

Latent Class Analysis of Depressive Symptom Phenotypes Among Black/African American Mothers.

BACKGROUND: Depression is a growing global problem with significant individual and societal costs. Despite their consequences, depressive symptoms are poorly recognized and undertreated because wide variation in symptom presentation limits clinical identification-particularly among African American (AA) women-an understudied population at an increased risk of health inequity. OBJECTIVES: The aims of this study were to explore depressive symptom phenotypes among AA women and examine associations with epigenetic, cardiometabolic, and psychosocial factors. METHODS: This cross-sectional, retrospective analysis included self-reported Black/AA mothers from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (data collected in 2015-2020). Clinical phenotypes were identified using latent class analysis. Bivariate logistic regression examined epigenetic age, cardiometabolic traits (i.e., body mass index ≥ 30 kg/m 2 , hypertension, or diabetes), and psychosocial variables as predictors of class membership. RESULTS: All participants were Black/AA and predominantly non-Hispanic. Over half of the sample had one or more cardiometabolic traits. Two latent classes were identified (low vs. moderate depressive symptoms). Somatic and self-critical symptoms characterized the moderate symptom class. Higher stress overload scores significantly predicted moderate-symptom class membership. DISCUSSION: In this sample of AA women with increased cardiometabolic burden, increased stress was associated with depressive symptoms that standard screening tools may not capture. Research examining the effect of specific stressors and the efficacy of tools to identify at-risk AA women are urgently needed to address disparities and mental health burdens.

Five Strategies Leaders in Academic Medicine Can Implement Now to Enhance Gender Equity.

Abundant disparities for women in medicine contribute to many women physicians considering leaving medicine. There is a strong financial and ethical case for leaders in academic medicine to focus on strategies to improve retention. This article focuses on five immediate actions that leaders can take to enhance gender equity and improve career satisfaction for all members of the workplace.

Depressive Symptoms and Blood Pressure in African American Women: A Secondary Analysis From the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study.

BACKGROUND: Depression is a risk factor for hypertension, yet few studies have been conducted in African American women. OBJECTIVE: We conducted a secondary analysis of depressive symptoms and high blood pressure among African American women from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure longitudinal study (N = 250). METHODS: Logistic regression was used to examine depressive symptoms and blood pressure, adjusting for education, employment, and racism/discrimination. Growth curve modeling was used to investigate longitudinal associations between depressive symptoms and systolic (SBP) and diastolic (DBP) blood pressures at 4 time points (T1-T4). RESULTS: Depressive symptoms at baseline were not prospectively associated with hypertension prevalence. Participants with Beck Depression Inventory scores higher than 10 had higher estimated marginal SBP and DBP over time compared with participants with lower scores. CONCLUSION: Depressive symptoms were not associated with hypertension prevalence at T4, but they were associated with higher estimated marginal SBP and DBP. Future research is needed to elucidate mechanisms and implications for clinical care and prevention.

Experiences of Trauma and DNA Methylation Profiles among African American Mothers and Children.

Potentially traumatic experiences have been associated with chronic diseases. Epigenetic mechanisms, including DNA methylation (DNAm), have been proposed as an explanation for this association. We examined the association of experiences of trauma with epigenome-wide DNAm among African American mothers (n = 236) and their children aged 3-5 years (n = 232; N = 500), using the Life Events Checklist-5 (LEC) and Traumatic Events Screening Inventory-Parent Report Revised (TESI-PRR). We identified no DNAm sites significantly associated with potentially traumatic experience scores in mothers. One CpG site on the ENOX1 gene was methylome-wide-significant in children (FDR-corrected q-value = 0.05) from the TESI-PRR. This protein-coding gene is associated with mental illness, including unipolar depression, bipolar, and schizophrenia. Future research should further examine the associations between childhood trauma, DNAm, and health outcomes among this understudied and high-risk group. Findings from such longitudinal research may inform clinical and translational approaches to prevent adverse health outcomes associated with epigenetic changes.

The Cumulative Influence of Perceived Discrimination, Stress, and Coping Responses on Symptoms of Depression Among Young African American Mothers.

BACKGROUND: African American women have an elevated risk for experiencing depressive symptoms, and discrimination, stress, and coping contribute to symptoms of depression. AIMS: We aimed to examine the associations between discrimination, stress, and coping on symptoms of depression among young African American mothers. METHODS: In this retrospective study, we utilized a hierarchical linear regression to explore the effects of perceived racial discrimination, stress, and general and discrimination-related coping responses on depressive symptoms in a sample of African American mothers (N = 250). The data were drawn from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (InterGEN), a study conducted between 2014 and 2019 and based in Connecticut. RESULTS: After accounting for maternal age, level of education, and income, greater perceived racial discrimination (p = .03), higher levels of stress (p < .001), greater engagement in avoidance coping (p < .001), and use of passive coping responses to discrimination (p = .04) were uniquely associated with increased depressive symptoms. Other forms of coping, specifically, problem-solving and support seeking, did not appear to influence depressive symptoms in this sample. CONCLUSION: The findings highlight the negative impact of discrimination, heightened stress, and maladaptive coping on the emotional health of young African American mothers.

The Association Between Neighborhood Social Vulnerability and Cardiovascular Health Risk Among Black/African American Women in the InterGEN Study.

BACKGROUND: Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States. OBJECTIVES: The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women. METHODS: We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants' addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention's Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships. RESULTS: Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk. DISCUSSION: We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.

Examining Mother-Reported Poor Sleep and Blood Pressure in Black/African American Mother-Child Dyads.

BACKGROUND: Poor sleep is a confirmed risk factor for hypertension (HTN), and Black/African American (AA) women have among the highest rates of HTN in the United States. OBJECTIVE: We examined the relationship between sleep and blood pressure (BP) among Black/AA mother-child dyads using data from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study. METHODS: Data for this study were derived from 250 Black/AA mother-child dyads from low-income neighborhoods, collected via 4 home visits over 2 years. Mothers reported poor sleep, including reports of sleeping worse than usual and nighttime awakenings. Recordings of BP were obtained for mother and child. Mother BP was scored as normal (<120/<80 mm Hg), elevated (120-129/<80 mm Hg), stage 1 HTN (130-139/80-89 mm Hg), or stage 2 HTN (systolic ≥140 or diastolic ≥90 mm Hg). Generalized linear models examined the relationships between mother-reported poor sleep variables and both mother and child BP. Adjusted models examining mother BP controlled for the mother's age, education, marital status, smoking, body mass index, and depression symptoms. RESULTS: In adjusted models, nighttime awakenings were associated with stage 2 HTN (b = 2.70, 95% confidence interval [CI], 0.54-4.86, P < .05). Compared with children whose mother who had normal BP, children whose mother had elevated BP had higher diastolic BP (b = 0.37; 95% CI, 0.19-0.54; P < .001). Mother elevated BP was associated with both child systolic BP (b = 2.49; 95% CI, 0.44-4.53; P < .05) and diastolic BP (b = 2.07; 95% CI, 0.39-3.76; P < .05). Mother stage 1 HTN was associated with both child systolic BP (b = 2.16; 95% CI, 0.29-4.03; P < .05) and diastolic BP (b = 3.91; 95% CI, 2.40-5.42; P < .001). We detected a significant interaction between mother stage 2 HTN and mother nighttime awakenings in predicting higher child diastolic BP (b = 8.16; 95% CI, 0.65-15.68; P < .05). CONCLUSIONS: We found evidence for an association between mothers' nighttime awakenings and very high BP. Our study also illuminated a strong relationship between high mother BP and high child BP. Finally, our study found preliminary support for the potentially mediating role of mothers' nighttime awakenings in predicting the relationship between mother stage 2 HTN and child BP.

Associations between social determinants of health, perceived discrimination, and body mass index on symptoms of depression among young African American mothers.

PURPOSE: The association between symptoms of depression and risks for cardiovascular disease (CVD) remains equivocal for African American (AA) mothers. We examined the association between social determinants of health (perceived discrimination), and cardiovascular risk (BMI) on symptoms of depression in a sample of young AA mothers. METHODS: Secondary data from 219 adult AA mothers between the ages of 21 and 46 with an average BMI of 29.8 and yearly family income of $14,999 were analyzed using a latent growth model that evaluated four time points to assess changes in symptoms of depression. RESULTS: Initial BMI was significantly associated with initial symptoms of depression (b = 0.12, p = .019). Perceived discrimination (unfair treatment) was associated with higher initial symptoms of depression (b = 1.14, p = .017). CONCLUSION: The findings suggest that elevated BMI and perceived discrimination are associated with higher reported symptoms of depression among young, socioeconomically disadvantaged AA mothers. These results advance the scientific understanding of young AA mothers' risk for symptoms of depression and CVD by elucidating the impact of perceived discrimination and social experiences on mental health. Further studies of SDoH and CVD risk factors and perceived racism and depression are needed to shed light on the long-term mental health impact on AA mothers and their children.

High blood pressure in pregnancy, DNA methylation, and later blood pressure in African American women enrolled in the InterGEN Study.

BACKGROUND: Few studies have examined the effects of high blood pressure (BP) in pregnancy, preeclampsia, or eclampsia on later BP, and the epigenetics of this phenomenon is similarly poorly understood, especially among African Americans. The purpose of this study was to examine the association between high BP in pregnancy, epigenomics, and later BP in African American women in the InterGEN Study (n = 250). METHODS: In cross-sectional analyses, regression and linear mixed-effects models were employed to examine the effects of high BP in pregnancy on: (a) epigenetic associations (DNA methylation) and (b) BP 3-5 years after birth. The 850K Illumina EPIC BeadChip was used for evaluating epigenome-wide DNA methylation. High BP in pregnancy, preeclampsia, or eclampsia was self-reported by women, and BP was measured 3-5 years after birth, per JNC-7 guidelines. DNA methylation and clinical BP were the main outcomes. RESULTS: Mean age of enrolled women was 31.2 years, 21.8% were smokers, 58% had some college or higher education, 46.6% reported an annual income <$15 000, and 13.6% reported high BP in pregnancy. After adjustment for obesity, smoking, and age, women with a history of high BP in pregnancy had significantly higher BP than those who did not report this complication (5.39 ± 2.4 mm Hg, P = .030). Epigenome-wide analysis revealed no significant sites after multiple testing correction. CONCLUSIONS: We observed a small, but clinically significant, increase in BP in women who reported high BP in pregnancy 3-5 years after that pregnancy. Future studies with larger sample sizes should examine epigenetic contributions to this finding.

Association of Obesity with DNA Methylation Age Acceleration in African American Mothers from the InterGEN Study.

African American women are affected by earlier onset of age-associated health deteriorations and obesity disproportionally, but little is known about the mechanism linking body mass index (BMI) and biological aging among this population. DNA methylation age acceleration (DNAm AA), measuring the difference between DNA methylation age and chronological age, is a novel biomarker of the biological aging process, and predicts aging-related disease outcomes. The present study estimated cross-tissue DNA methylation age acceleration using saliva samples from 232 African American mothers. Cross-sectional regression analyses were performed to assess the association of BMI with DNAm AA. The average chronological age and DNA methylation age were 31.67 years, and 28.79 years, respectively. After adjusting for smoking, hypertension diagnosis history, and socioeconomic factors (education, marital status, household income), a 1 kg/m2 increase in BMI is associated with 0.14 years increment of DNAm AA (95% CI: (0.08, 0.21)). The conclusion: in African American women, high BMI is independently associated with saliva-based DNA methylation age acceleration, after adjusting for smoking, hypertension, and socioeconomic status. This finding supports that high BMI accelerates biological aging, and plays a key role in age-related disease outcomes among African American women.

Risk and Protective Factors for Alcohol, Marijuana, and Cocaine Use Among Child Welfare-Involved Youth.

Youth involved in child welfare services (CWS) are at elevated risk for substance use. CWS involvement may provide an opportunity for intervention to prevent subsequent use; however, little is known about mitigating substance use risk in this population. Using data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), the present study examined individual, psychological, and contextual risk factors (e.g., prior substance use, depression, posttraumatic stress, maltreatment experiences) and protective factors (e.g., caregiver monitoring, peer relationships) following CWS involvement (Wave 1) in relation to alcohol, marijuana, and cocaine use 36 months later (Wave 3). The nationally-representative sample of CWS-involved youth was restricted to individuals who were aged 11 years or older at Wave 1 and had at least a partial interview at Wave 3 (N = 763). Three logistic regression models showed that Wave 1 substance use increased the likelihood of marijuana and cocaine use at Wave 3 [marijuana OR = 1.41 (1.19-1.68); cocaine OR = 1.26 (1.07-1.50)] but not binge alcohol use [OR = 1.44 (0.95-2.19)]. Other risk and protective factors had limited predictive value for Wave 3 substance use. The present findings suggest that initiating substance use prior to or at the time of CWS involvement is a critical risk factor for later substance use. Substance use screening and referral to treatment is imperative for CWS-involved youth.

Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial.

BACKGROUND: Human immunodeficiency virus (HIV) disproportionately impacts minority youth. Interventions to decrease HIV sexual risk are needed. OBJECTIVE: We hypothesized that an engaging theory-based digital health intervention in the form of an interactive video game would improve sexual health outcomes in adolescents. METHODS: Participants aged 11 to 14 years from 12 community afterschool, school, and summer programs were randomized 1:1 to play up to 16 hours of an experimental video game or control video games over 6 weeks. Assessments were conducted at 6 weeks and at 3, 6, and 12 months. Primary outcome was delay of initiation of vaginal/anal intercourse. Secondary outcomes included sexual health attitudes, knowledge, and intentions. We examined outcomes by gender and age. RESULTS: A total of 333 participants were randomized to play the intervention (n=166) or control games (n=167): 295 (88.6%) were racial/ethnic minorities, 177 (53.2%) were boys, and the mean age was 12.9 (1.1) years. At 12 months, for the 258 (84.6%) participants with available data, 94.6% (122/129) in the intervention group versus 95.4% (123/129) in the control group delayed initiation of intercourse (relative risk=0.99, 95% CI 0.94-1.05, P=.77). Over 12 months, the intervention group demonstrated improved sexual health attitudes overall compared to the control group (least squares means [LS means] difference 0.37, 95% CI 0.01-0.72, P=.04). This improvement was observed in boys (LS means difference 0.67, P=.008), but not girls (LS means difference 0.06, P=.81), and in younger (LS means difference 0.71, P=.005), but not older participants (LS means difference 0.03, P=.92). The intervention group also demonstrated increased sexual health knowledge overall (LS means difference 1.13, 95% CI 0.64-1.61, P<.001), in girls (LS means difference 1.16, P=.001), boys (LS means difference 1.10, P=.001), younger (LS means difference 1.18, P=.001), and older (LS means difference=1.08, P=.002) participants. There were no differences in intentions to delay the initiation of intercourse between the two groups (LS means difference 0.10, P=.56). CONCLUSIONS: An interactive video game intervention improves sexual health attitudes and knowledge in minority adolescents for at least 12 months. TRIAL REGISTRATION: Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6syumc9C0).

The Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study (InterGEN): Design and Methods for Recruitment and Psychological Measures.

BACKGROUND: Although studies show that genomics and environmental stressors affect blood pressure, few studies have examined their combined effects, especially in African Americans. OBJECTIVE: We present the recruitment methods and psychological measures of the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (InterGEN) study, which seeks to investigate the individual and combined effects of genetic (G) and environmental (E) (psychological) stressors on blood pressure in African American mother-child dyads. Genetic methods are presented elsewhere, but here we present the recruitment methods, psychological measures, and analysis plan for these environmental stressors. METHODS: This longitudinal study will enroll 250 mother-child dyads (N = 500). Study participation is restricted to women who (a) are ≤21 years of age, (b) self-identify as African American or Black, (c) speak English, (d) do not have an identified mental illness or cognitive impairment, and (e) have a biological child between 3 and 5 years old. The primary environmental stressors assessed are parenting stress, perceived racism and discrimination, and maternal mental health. Covariates include age, cigarette smoking (for mothers), and gender (for children). The study outcome variables are systolic and diastolic blood pressure. ANALYSIS: The main analytic outcome is genetic-by-environment interaction analyses (G × E); however, main effects (G) and (E) will be individually assessed first. Genetic (G) and interaction analyses (G × E) are described in a companion paper and will include laboratory procedures. Statistical modeling of environmental stressors on blood pressure will be done using descriptive statistics and generalized estimating equation models. IMPLICATIONS: The methodology presented here includes the study rationale, community engagement and recruitment protocol, psychological variable measurement, and analysis plan for assessing the association of environmental stressors and blood pressure. This study may provide the foundation for other studies and development of interventions to reduce the risk for hypertension and to propose targeted health promotion programs for this high-risk population.

Reflections on a Community Psychology Setting and the Future of the Field.

The 50th anniversary of the Swampscott Conference offers an opportunity to reflect on a community psychology setting, The Consultation Center at Yale, that was formed in response to the 1963 Community Mental Health Act and the 1965 Swampscott Conference. The Center has flourished as a community psychology setting for practice, research, and training for 39 of the 50 years since Swampscott. Its creation and existence over this period offers an opportunity for reflection on the types of settings needed to sustain the field into the future.

Health, emergency department use, and early identification of young children exposed to trauma.

BACKGROUND: Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency departments (EDs) are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters). STUDY OBJECTIVES: Describe the prevalence of physical health symptoms, ED use, and health-related problems in young children (birth through 5 years) affected by trauma, and to predict whether or not children experiencing trauma are more likely to be affected by health-related problems. METHODS: Community-based, cross-sectional survey of 208 young children. Traumatic events were assessed by the Traumatic Events Screening Inventory - Parent Report Revised. Child health symptoms and health-related problems were measured using the Caregiver Information Questionnaire, developed by ORC Macro (Atlanta, GA). RESULTS: Seventy-two percent of children had experienced at least one type of traumatic event. Children exposed to trauma were also experiencing recent health-related events, including visits to the ED (32.2%) and the doctor (76.9%) for physical health symptoms, and recurring physical health problems (40.4%). Children previously exposed to high levels of trauma (four or more types of events) were 2.9 times more likely to report having had recently visited the ED for health purposes. CONCLUSIONS: Preventing recurrent trauma or recognizing early trauma exposure is difficult, but essential if long-term negative consequences are to be mitigated or prevented. Within EDs, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury, and mortality.

Preventing Sexual Harassment in Higher Education: A Framework for Prevention Science Program Development.

Sexual harassment is an intractable problem that harms the students, community, culture, and success of institutes of higher education (IHEs). The alarming prevalence of sexual harassment at IHEs highlights the urgent need for effective prevention programs. However, there are few empirically supported preventive interventions that effectively target the factors that most impact the determinants, trajectory, and short- and intermediate-term effects of sexual harassment. In this paper, we overview the problem of sexual harassment and propose an organizing framework to help IHEs develop effective interventions to prevent sexual harassment. Guided by prevention science, we propose a framework-modified from SAMHSA's (2019) guidelines for prevention practitioners-that underscores the criticality of trauma- and equity-informed characteristics in prevention programs. We offer a discussion on how IHEs must consider and evaluate the empirical evidence of effectiveness, flexibility, cultural competency, and sustainability when developing and adapting prevention programs to reduce and-ultimately-ameliorate sexual harassment. We conclude with recommendations that can provide a roadmap for higher education stakeholders and researchers to prevent this urgent public health concern.

Exposure to traumatic events and health-related quality of life in preschool-aged children.

PURPOSE: To examine the association of lifetime exposure to traumatic events with health-related quality of life (HRQOL) and psychosocial health in children aged 3 through 5 years. METHODS: This study is a community-based, cross-sectional survey of 170 children and their parents. Traumatic events were assessed by the Traumatic Events Screening Inventory-Parent Report Revised using criteria for potentially traumatic events in young childhood outlined by the Zero to Three working group. HRQOL of young children was measured using the 97-item Infant/Toddler Quality of Life Questionnaire, and psychosocial health was measured using the Child Behavior Checklist 1.5-5. RESULTS: One hundred and twenty-three (72 %) of children had experienced at least one type of trauma event. Children who had been exposed to 1-3 types of trauma and those exposed to 4 or more types of trauma had significantly worse HRQOL and psychosocial health than children not exposed to trauma. Significant effect sizes between children exposed to low levels or high levels of traumatic events and children not exposed to trauma ranged from small to large. CONCLUSIONS: Exposure to traumatic events in early childhood is associated with less positive HRQOL and psychosocial health. Cumulative trauma exposure led to significant effects in outcome variables in this population. Interventions to decrease trauma exposure and to reduce significant stress in early childhood associated with exposure to trauma may be appropriate strategies for preventing negative health conditions throughout the life span.

The role of parenting stress in young children's mental health functioning after exposure to family violence.

This study evaluates the associations of young children's exposure to family violence events, parenting stress, and children's mental health functioning. Caregivers provided data for 188 children ages 3 to 5 years attending Head Start programming. Caregivers reported 75% of children had experienced at least 1 type of trauma event, and 27% of children had experienced a family violence event. Child mental health functioning was significantly associated with family violence exposure after controlling for children's age, gender, household income, and other trauma exposure (ß = .14, p = .033). Stress in the parenting role partially mediated the relationship between family violence exposure and young children's mental health functioning (ß = .12, p = .015, 95% confidence interval [0.02, 0.21]). Interventions for young children exposed to family violence should address the needs of the child, as well as the caregiver while also building healthy parent-child relationships to facilitate positive outcomes in children faced with trauma.

Associations between Paternal Co-residence and Child Health among African American Children.

We investigated the associations between paternal co-residence and asthma, obesity, and blood pressure among children aged 3-5 years. Mother/child dyads (N = 250) self-identified as African American or Black. Mothers reported on father's co-residence and child's asthma diagnosis. Height, weight, and blood pressure were measured. Regression models were used to examine paternal co-residence with child health outcomes (i.e., asthma, obesity, and blood pressure). Confounders included maternal and child age, child sex, maternal smoking, and insurance status. Children who lived with their fathers were less likely to have asthma (OR = 0.39, 95% CI 0.18-0.79), though this association was not significant after adjustment for confounders (aOR = 0.47, 95% CI 0.22-1.01). Paternal co-residence was not significantly associated with child obesity (aOR = 0.78, 95% CI 0.35-1.73), systolic (ß = 0.57, SE = 1.2, p = .64), or diastolic (ß = 1.91, SE = 1.0, p = .07) blood pressure. More research is necessary to understand the diversity of family living situations and how they affect child health.