Examining maternal lifetime exposure to structural racism and metabolomics in neonatal dried blood

Henry Ford Health + Michigan State University Health Sciences, East Lansing MI

Investigators

Abstract

Structural racism (SR) denotes the multidimensional and systemic oppression of Black individuals in the US. Residential segregation is a central component of SR. According to experts, race-based residential segregation is a fundamental determinant of racial disparities in health through neighborhood disadvantage leading to high rates of chronic disease and lower life expectancy in these communities. According to the concept of “weathering”, cumulative exposure to racial injustices (including segregation) over the life course wear at the physical and mental health of minoritized communities. Spatial manifestations of SR have been linked to stress responses, immune dysregulation, and heightened chronic inflammation among US Black individuals. Transfer of a propensity toward chronic inflammation from mother to infant can create an intergenerational cycle of disadvantage and poor health, leading to the health inequities observed today. We posit that maternal exposure to SR is linked to observed evidence of initial stages of disease processes in their offspring. We propose to examine the association between maternal lifetime exposure to SR and the presence of inflammatory markers in the child’s neonatal dried blood spots (DBS) using a cohort of women who have delivered a child at Henry Ford Health (HFH), a Detroit-based health care organization serving a diverse population with respect to race and socioeconomic status. DBS are routinely collected at birth and stored by the State of Michigan. Our plan to define the proposed exposure, SR, builds on existing literature and the expertise of our team. We will characterize neighborhoods in the Detroit metropolitan area and assign a “Neighborhood SR Score” using existing spatial measures of SR (e.g., racial inequities in the domains of housing, education, employment, etc.). Aim 1 is to create a cumulative Lifetime SR Exposure Score for each participant based on their lifetime residential history. Aim 2 is to associate the Lifetime SR Exposure Score to the levels of inflammatory markers measured in the DBS of participant offspring using an untargeted metabolomics platform. We have the investigator expertise needed to achieve our aims, including epidemiology, biostatistics, untargeted metabolomics, and urban planning, and we have access to the targeted population. This R21 will assess the feasibility of creating exposure and outcome measures as well recruitment and data collection. Our work includes the domains of influence reflective of SR from the National Minority Health and Health Disparities Research Framework and will inform a larger study. Empirical evidence of how SR can initiate processes in early life that manifest in adult disease is an invaluable step in eliminating health inequities.