Jerica Berge, PhD, MPH, LMFT, CFLE, along with her interdisciplinary team of co-investigators Alicia Kunin-Batson, PhD, LP (Pediatrics), Rachel Hardeman, PhD, MPH (Health Policy & Management), Angie Fertig, PhD (Humphrey School of Public Affairs), David Van Riper, MA (MN Population Center), Allan Tate, PhD, MPH (University of Georgia), and Grace Bagwell Adams, PhD, MPA (University of Georgia), were awarded $3,249,455 under the R01 mechanism on behalf of the National Center for Complementary & Integrative Health (NCCIH) (NIH) for their grant entitled "Multi-level predictors of structural racism and discrimination and associations with health and well-being across the life course in diverse families."

Amanda Trofholz is the project director of the study, and the study team is composed of undergraduate, graduate, and postdoctoral students, community members, and staff from the University of Minnesota who were part of the submission and will also help to implement the study and disseminate the findings. The pre-award staff who submitted the grant were Kendall Choate and Urszula Parfieniuk. The post-award accountant who will be managing the award is Tim Sanford.

While some studies have shown associations between discrimination and negative health outcomes in adults (e.g., cardiometabolic disease, depression), less is known about the impact of structural racism and discrimination (SRD) on whole-person health (i.e., physical, mental, behavioral, and social) of individuals and families across the life course. Before interventions can be developed to mitigate structural racism and discrimination, a comprehensive understanding of the multiple levels of structural racism and discrimination (i.e., individual, neighborhood, institutional, societal/policy) is needed to fill gaps in our understanding about the relationship between structural racism and discrimination and whole-person health.

The proposed study is built on a prospective longitudinal cohort study of 627 racially/ethnically diverse families (i.e., African American, Hispanic, Native American, Immigrant/Refugee, white) that span the life course (childhood, adolescence, adulthood/parenthood) and are from urban settings (i.e., Minneapolis, St. Paul). The parent R01 already has three time-points of mixed-methods data (i.e., ecological momentary assessment (EMA), Geographic Information Sysytem (GIS), survey) that includes discrimination and neighborhood segregation measures and physical, mental, and behavioral health outcomes. The funded grant allows for adding an additional study site in Georgia. A sample of 300 racially/ethnically diverse families from rural Georgia (i.e., outside of Athens) will be added to compare structural racism and disrimination experiences in urban versus rural settings. In addition, cardiometabolic and stress biomarker data (i.e., heart rate, blood pressure, waist circumference, hair cortisol) and multi-level measures of structural racism (i.e., individual, neighborhood, institutional, societal/policy) will be added at two time points, 18 months apart.

The proposed study will be one of the first to prospectively measure multiple levels of structural racism and discrimination using mixed-methods across two sites and associations with whole-person health across the life course in diverse families. Results of the study will inform the development of an intervention targeting multi-level structural racism and discrimination factors to promote health equity.

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