Community Child Health Network Research Articles

Examination of Maternal Allostatic Load Among Postpartum Women With Distinct Postpartum Symptom Typologies.

An increased allostatic load (cumulative physiologic wear and tear of the body) can lead to adverse health outcomes. Symptom experiences are known to influence allostatic load. Yet, the relationships between postpartum symptom typologies and maternal allostatic load remain unknown. We used Community Child Health Network data and included participants with allostatic load data at 6, 12, or 24 months postpartum. Bivariate and multivariate analyses were conducted to examine associations between postpartum symptom typologies and (a) overall allostatic load, (b) allostatic load subscales for body systems (neuroendocrine, cardiovascular, metabolic, and inflammatory), and (c) individual biomarkers within the subscale. Overall allostatic load at 12 months postpartum was different by symptom typologies before (p = .042) and after adjusting for confounders (p = .029). Postpartum women in typology 5 (high overall) had the highest adjusted overall allostatic load (M = 4.18, SE = .27). At 12 months, adjusted allostatic load for the cardiovascular subscale was higher in typologies 3 (moderate-high sleep symptoms, M = 1.78, SE = .13) and 5 (high overall, M = 1.80, SE = .17). Within the cardiovascular subscale, those in typology 3 had higher adjusted odds for a clinically significant level of pulse rate (aOR = 2.01, CI = 1.22, 3.31). Postpartum women who experienced high symptom severity across all symptoms (typology 5) at 6 months had higher overall allostatic load at 12 months postpartum. Typologies 3 and 5 had the highest symptom severity in sleep-related symptoms and higher cardiovascular subscale scores. Postpartum symptom management should target symptom burden in an effort to reduce allostatic load thereby improving postpartum women's health outcomes.

Lifetime discrimination in low to middle income mothers and cellular aging: A prospective analysis

BackgroundExperiences of discrimination on the basis of race, ethnicity, and other characteristics are associated with adverse health outcomes, including elevated rates of morbidity in later life and earlier mortality. Acceleration of biological aging is a plausible pathway linking discrimination to disease risk. The objective of this study was to examine the relationship of self-reported lifetime and everyday discrimination to women's telomere length several years after birth of a child in a longitudinal cohort study. MethodsThe Community Child Health Network (CCHN) conducted a community-based participatory research project focused on racial, ethnic, and socioeconomic disparities in maternal and child health. Data for the current substudy are from a longitudinal cohort study in 3 of the 5 project sites. This multi-site community-based longitudinal study was conducted in Lake County, IL north of Chicago, Washington, D.C., and rural North Carolina. Participants were low to middle-income mothers (N = 103) with a primary identity of Hispanic/Latina, Black, or non-Hispanic White who rated their experience of everyday and lifetime discrimination during an at-home interview one-month postpartum. Buccal samples were collected to assay buccal cell telomere length several years later when a consecutive child was 3–5 years of age. Telomere length derived from buccal cells was used as a biomarker indicating cellular aging and a risk factor for age-related disease. ResultsMothers (18–39 years old) who reported higher lifetime discrimination had shorter telomere length an average of 5.6 years later (B = −0.22 [SE = 0.04], p < 0.001). Mother's reports of everyday discrimination were not significantly related to telomere length (0.01[0.01], p = 0.15). ConclusionsThese findings suggest that lifetime exposure to discrimination, but not necessarily current reports of everyday discrimination, may increase biological aging as indicated by shorter buccal cell telomere length, providing evidence of a plausible route through which discrimination contributes to increased risk for earlier onset aging and age-related disease in women.

Subjective social status and allostatic load in mothers 1 year after birth.

Subjective social status (SSS) refers to an individual's perception of relative social rank. We tested associations between SSS and allostatic load, a multisystem index of physiological dysregulation, in a sample of women 1 year after the birth of a child. Participants (n = 1,168) in the Community Child Health Network study were recruited in five sites across the United States shortly after the birth of a child. SSS was assessed at 6 months after birth using the MacArthur Scale of Subjective Social Status. Participants also reported household income and years of education completed. Biomarkers were assessed and allostatic load was calculated by assigning one point for each of 10 biomarkers above clinical cutoffs at a subsequent visit approximately 6 months later. Multiple linear regression analyses tested associations of SSS with allostatic load, adjusting for socioeconomic (SES) indicators of household income, years of education, and other covariates (race/ethnicity, relationship status, maternal age, and study site). We also tested interactions between each of the objective SES measures and SSS. Higher SSS predicted lower subsequent allostatic load independent of household income, education, and other covariates. Associations between SSS and allostatic load were strongest at higher levels of income and education. Study findings demonstrate associations between perceptions of relative social standing and wear-and-tear on multiple physiological systems above and beyond indicators of objective SES, suggesting that psychosocial aspects of lower status may contribute to the gradient between social status and health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Resilience resources in low-income Black, Latino, and White fathers

Background and aimResilience resources are associated with positive mental and physical health outcomes. However, we know little about protective factors in low-income or racially or ethnically diverse populations of men. This study examined socioeconomic status and racial/ethnic differences in resilience resources among low-income Black, Latino, and White fathers of infants. MethodsThe Community Child Health Network conducted a cohort study of mothers and fathers in five sites across the U.S. A sample of fathers who identified as Black, Latino/Hispanic, or non-Hispanic White were recruited and interviewed at home on three occasions during the first year of parenting (n = 597). Several resilience resources were assessed: mastery, self-esteem, dispositional optimism, approach-oriented coping style, positive affect, social support, and spirituality. The first five resources were interrelated and scored as a composite. ResultsMultivariate analyses adjusted for covariates indicated that Black fathers had higher scores on the resilience resources composite compared to White and Latino fathers. Black fathers were also highest in spirituality, followed by Latino fathers who were higher than White fathers. There were significant interactions between race/ethnicity with income and education in predicting optimism, spirituality, and self-esteem. Higher education was associated with higher scores on the resilience resources composite and spirituality in Black fathers, and higher education was associated with higher self-esteem in Black and Latino fathers. Higher income was associated with higher optimism in White fathers. ConclusionThese results indicate that levels of individual resilience factors are patterned by income, education, and race/ethnicity in low-income fathers, with many possible implications for research and policy.

Neighbourhood-level deprivation indices and postpartum women\u2019s health: results from the Community Child Health Network (CCHN) multi-site study

BackgroundArea-level socioeconomic characteristics have been shown to be related to health status and mortality however, little is known about the association between residential community characteristics in relation to postpartum women’s health.MethodsData from the longitudinal, multi-site Community Child Health Network (CCHN) study were used. Postpartum women (n = 2510), aged 18–40 were recruited from 2008 to 2012 within a month of delivery. Socioeconomic data was used to create deprivation indices. Census data were analysed using principal components analysis (PCA) and logistic regression to assess the association between deprivation indices (DIs) and various health indicators.ResultsPCA resulted in two unique DIs that accounted for 67.5% of the total variance of the combined all-site area deprivation. The first DI was comprised of variables representing a high percentage of Hispanic or Latina, foreign-born individuals, dense households (more than one person per room of residence), with less than a high-school education, and who spent more than 30% of their income on housing costs. The second DI was comprised of a high percentage of African-Americans, single mothers, and high levels of unemployment. In a multivariate logistic regression model, using the quartiles of each DI, women who reside in the geographic area of Q4-Q2 of the second DI, were almost twice as likely to have more than three adverse health conditions compared to those who resided in the least deprived areas. (Q2vs.Q1:OR = 2.09,P = 0.001,Q3vs.Q1:OR = 1.89,P = 0.006,Q4vs.Q1:OR = 1.95,P = 0.004 respectively).ConclusionsOur results support the utility of examining deprivation indices as predictors of maternal postpartum health.

Maternal postpartum stress and toddler developmental delays: Results from a multisite study of racially diverse families.

Maternal psychosocial stress during pregnancy can adversely influence child development, but few studies have investigated psychosocial stress during the postpartum period and its association with risk of toddler developmental delays. Moreover, given the expanding diversity of the U.S. population, and well-documented health and stress disparities for racial and ethnic minorities, research examining the effect of postpartum stress on risk of developmental delays in diverse populations is of critical importance. In this study, data from the Community Child Health Network provided the opportunity to test maternal postpartum stress as a predictor of toddler risk of developmental delay in a sample of African American, Latina and non-Hispanic White women and their toddlers (N=1537) recruited in urban, suburban, and rural communities. Postpartum maternal stress over 1 year was operationalized as perceived stress, life events, and negative impact of life events. Regression results revealed higher risk of developmental delays in toddlers whose mothers experienced more negative life events, greater negative impact of events, and higher perceived stress over the year. Prenatal stress, pregnancy/birth complications, and postpartum depression did not explain these associations. Maternal postpartum stress may contribute to increased risk for developmental delays and is an important target for psychosocial intervention.

Association of weight discrimination during pregnancy and postpartum with maternal postpartum health.

Weight stigma adversely affects the health of the general population, but almost no studies have examined possible negative consequences of weight stigma in the context of pregnancy. The present study tested whether experiencing weight stigma in pregnancy is inversely related to mental and physical health in mothers during the first postpartum year. This study examined associations between weight-related experiences of discrimination in everyday life, measured at 1 month after the birth of a child, and physical and mental health outcomes measured concurrently and at 6 months and 1 year postpartum in a sample of 214 women in the Community Child Health Network study. Outcomes of interest were postpartum depressive symptoms, pregnancy weight gain, postpartum weight retention, and two biomarkers of maternal stress (blood pressure and salivary cortisol). After adjusting for covariates including race/ethnicity and prepregnancy body mass index, weight-related everyday discrimination was associated with greater postpartum depressive symptoms at 1 month postpartum. Weight-related everyday discrimination was also associated with greater pregnancy weight gain and greater weight gain in excess of the recommendations set by the Institute of Medicine. Additionally, weight-related discrimination prospectively predicted greater postpartum depressive symptoms and weight retention at 1 year postpartum. Weight-related everyday discrimination was not associated with blood pressure or cortisol. These findings offer novel evidence that experiencing weight stigma during pregnancy and in the early postpartum period is prospectively associated with adverse mental and physical health outcomes for women after birth, implicating weight stigma as a potential maternal health threat. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cardiovascular and Metabolic Risk in Women in the First Year Postpartum: Allostatic Load as a Function of Race, Ethnicity, and Poverty Status.

Allostatic load (AL) represents multisystem physiological "wear-and-tear" reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.

Mastery, self-esteem, and optimism mediate the link between religiousness and spirituality and postpartum depression.

Religious and spiritual beliefs and behaviors are powerful influences in the everyday lives of people worldwide and are especially salient for women and families around the birth of a child. A growing body of research indicates that aspects of religiousness and spirituality are associated with mental health including lower risk of postpartum depression, a disorder that affects as many as 1 in 5 women after birth. The mechanisms, however, are not well understood. In this study, psychosocial resources (mastery, self-esteem, and optimism) was tested as a mechanism linking religiousness and spirituality with depressive symptoms in 2399 postpartum women from the Community Child Health Network. Results indicated that religiousness and spirituality each predicted lower depressive symptoms throughout the first year postpartum. Psychosocial resources mediated these associations. Our findings contribute to existing knowledge by establishing psychological resources as mechanisms explaining how religiousness and spirituality influence mental health in women postpartum.

Psychosocial and demographic predictors of postpartum physical activity.

Physical activity promotes better health outcomes across the lifespan, and provides physical and mental health benefits for women who have recently given birth. However, research has not adequately characterized physical activity levels or risk factors for inadequate physical activity during the postpartum period. The objective of the present study was to describe levels and correlates of physical activity at 6months postpartum in mothers of diverse race/ethnicity (55% African American, 23% White, 22% Hispanic/Latina), with the majority living in or near poverty. We analyzed data collected by the five-site Community Child Health Network study. Women (n = 1581) were recruited shortly after the birth of a child. Multinomial logistic regression models tested associations of demographic factors and self-reported stress in several life domains with total physical activity levels at 6-9months postpartum, including activities done at work, at home, for transportation, and leisure. Thirty-five percent of participants in this sample reported low levels of physical activity. African American race, Latina ethnicity, and living in a rural area were associated with low levels of physical activity, whereas working outside the home was associated with high physical activity. Contrary to hypotheses, chronic stress was not associated with physical activity with the exception of financial stress, which predicted greater likelihood of being highly physically active. These findings suggest that optimal postpartum care should integrate physical activity promotion, and that African American, Latina, and rural-dwelling women may benefit most from efforts to promote activity following birth.

The Impact of Prenatal and Postpartum Partner Violence on Maternal Mental Health: Results from the Community Child Health Network Multisite Study

Abstract Background: Intimate partner violence (IPV) negatively impacts maternal and infant health, yet few studies assess violence at multiple time points during the childbearing year. Methods: Using data on 2018 women from the multisite Community Child Health Network (CCHN), this study assesses the relationship between past-year IPV (reported at 1 and 12 months postpartum) and maternal depression and perceived stress measured 1 year postpartum. Past-year IPV was measured using a modified version of the HITS (Hurts, Insults, Threatens, and Screams) assessment; depression was assessed using the Edinburgh Postnatal Depression Scale; perceived stress was assessed by the Perceived Stress Scale. Multivariable logistic regression models estimated risk for depression and estimated stress scores among women reporting exposure to IPV at one or both time points compared to those unexposed to IPV, adjusting for maternal age and household income. Results: At 1 month postpartum, 36% of participants reported past-year...

Chronic Stress and C-Reactive Protein in Mothers During the First Postpartum Year.

Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year. We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum. Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index. In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.

Allostatic Load During the Interconception Period in Women Who Had Gestational Diabetes Mellitus [14C

INTRODUCTION: Gestational diabetes mellitus (GDM) is a condition disproportionately affecting racial/ethnic minorities, but the reasons for this disparity remain unclear. GDM in one pregnancy also greatly predicts GDM in future pregnancies. Allostatic load (AL) measures cumulative effects of physical and psychological stress on multiple body systems. Directly measuring and monitoring AL presents a novel way of assessing health risk biomarkers in mothers. We aim to determine the relationship between maternal AL and GDM in the interconception period. METHODS: Data collection occurred through the 5-site NIH Community Child Health Network. AL was analyzed as an absolute value plus individual indices to determine associations to GDM at both 6 and 12 months postpartum. ANOVAs were performed to assess relationships between AL, stress, and resiliency in women with and without GDM. RESULTS: There are significant differences in AL between the GDM (N=61) and non-GDM (N=1421) groups at 6 and 12 months (P &lt; .001), particularly in the African-American group at both time points (P &lt; .001). There was no significant change in AL from 6 to 12 months postpartum for either group. There were no significant differences between the groups for self-reported measures of stress and resiliency. Total chronic life stress is significantly correlated with AL at both times for both groups (P &lt; .01). CONCLUSION: Differences in AL between mothers with and without GDM highlights a worse picture of health postpartum for women with GDM, especially African-American women. Women with increased AL and GDM need more rigorous and focused interconception care in order to prevent GDM and improve overall health.

Adverse Perinatal Outcomes and Postpartum Multi-Systemic Dysregulation: Adding Vitamin D Deficiency to the Allostatic Load Index

Background Allostatic load (AL) is an index of multi-system physiological "wear-and-tear," operationalizing emergent chronic disease risk and predicting morbidity and mortality. AL has been proposed as an organizing framework for studying pregnancy outcomes and additional AL biomarkers for the study of maternal health would be valuable. Objectives To test whether adverse perinatal outcomes are associated with postpartum AL and if including vitamin D deficiency (serum 25(OH)D < 20ng/ml) as an additional marker of postpartum AL increases the association. Methods The Community Child Health Network is a community-based participatory research network that enrolled women at birth and followed them for 2years measuring ten biomarkers (body mass index, waist: hip ratio, pulse, systolic and diastolic blood pressures, cortisol slope, c-reactive protein, hgbA1c, HDL, and total cholesterol) at 6 and 12months postpartum. A composite of four adverse perinatal outcomes (low birth weight, preterm birth, preeclampsia, and gestational diabetes) was collected from medical charts in a sample of 164 women from one site and serum 25(OH)D status was measured 24-39weeks postpartum in this cohort. Results Twenty-nine percent experienced one or more of the four adverse perinatal outcomes. Serum 25(OH)D was significantly inversely correlated with the AL index (Spearman's r = -0.247, p = 0.002). Logistic regression results adjusting for maternal age and race showed that adverse outcome was significantly associated with higher postpartum AL (OR 1.53 for a 1-unit increase in AL, 95% CI 1.24-1.89). Adding 25(OH)D deficiency as an 11th component to the AL index improved the model fit (Delta (-2LogL) = 3.955, p = 0.047), and improved the Akaike information criterion (180.32 vs. 184.27). Conclusion Women with adverse perinatal outcomes have higher postpartum AL and adding vitamin D deficiency to the AL index strengthens this association.

The Impact of Prenatal and Postpartum Partner Violence on Maternal Mental Health: Results from the Community Child Health Network Multisite Study

The Impact of Prenatal and Postpartum Partner Violence on Maternal Mental Health: Results from the Community Child Health Network Multisite Study

Explaining racial and ethnic inequalities in postpartum allostatic load: Results from a multisite study of low to middle income woment

BackgroundRacial and ethnic inequalities in women's health are widely documented, but not for the postpartum period, and few studies examine whether neighborhood, psychosocial, and biological factors explain these gaps in women's health. MethodsUsing prospective longitudinal data collected from 1766 low to middle income women between 2008 and 2012 by the Community Child Health Network (CCHN), we tested the extent to which adjustment for neighborhood, economic, psychological, and medical conditions following a birth explained differences between African American, Latina, and White women in an indicator of physiological dysregulation allostatic load (AL), at one year postpartum as measured by 10 biomarkers: Body Mass Index, Waist Hip Ratio, systolic and diastolic blood pressure, high sensitivity C-reactive protein, Hemoglobin A1c, high-density lipoprotein and cholesterol ratio, and diurnal cortisol. ResultsMean postpartum AL scores were 4.65 for African American, 4.57 for Latina and 3.86 for White women. Unadjusted regression estimates for high AL for African American women (with White as the reference) were 0.80 (SD = 0.11) and 0.53 (SD = 0.15) for Latina women. Adjustment for household poverty, neighborhood, stress, and resilience variables resulted in a reduction of 36% of the excess risk in high AL for African Americans versus Whites and 42% of the excess risk for Latinas compared to Whites. ConclusionsRacial and ethnic inequalities in AL were accounted for largely by household poverty with additional contributions by psychological, economic, neighbourhood and medical variables. There remained a significant inequality between African American, and Latina women as compared to Whites even after adjustment for this set of variables. Future research into health inequalities among women should include a fuller consideration of the social determinants of health including employment, housing and prepregnancy medical conditions.

Postpartum Depressive Symptoms Following Consecutive Pregnancies

Postpartum depression is a major mental health issue for women and society. We examined stability and change in symptoms of depression over two consecutive pregnancies and tested life stress as a potential mechanism. The Community Child Health Network followed an ethnically/racially diverse sample from one month after a birth for two years. A subset of 228 women had a second birth. Interview measures of depression symptoms (EPDS) and life stress (life events, perceived stress, chronic stress, interpersonal aggression) were obtained during home visits. Three-quarters of the sample showed intra-individual stability in depressive symptoms from one postpartum period to the next, and 24% of the sample had clinically significant symptoms after at least one pregnancy (9% first, 7.5% second, 3.5% both). Each of the four life stressors significantly mediated the association between depressive symptoms across two postpartum periods. Stress between pregnancies for women may be an important mechanism perpetuating postpartum depression.

Issues and Solutions for Collecting Biological Specimen in Longitudinal Studies: Experience from the Community Child Health Network Research Network.

The inclusion of biomarkers in studies of stress and health outcomes is of growing interest, including for community-based participatory research (CBPR) studies. Yet the perspectives of participants and communities have been infrequently consulted to inform the biomarker collection process. The objective of this paper is to describe the process and outcomes of using CBPR in framing biomarker collection in a study of allostatic load in a maternal and child health population. Through analysis of focus group data, we identify aspects of CBPR that facilitate increased community trust and endorsement related to collecting biological samples, and also provide a community perspective that is often overlooked in the literature. We found that a CBPR approach facilitated greater understanding among community members about the importance of biomarkers, while simultaneously informing the design of a biomarker data collection protocol that was responsive to the desired scope and data collection procedures that reflected community priorities.

Diurnal salivary cortisol patterns prior to pregnancy predict infant birth weight.

Elevated maternal psychosocial stress during pregnancy and accompanying changes in stress hormones may contribute to risk of adverse birth outcomes such as low birth weight and preterm birth. Relatedly, research on fetal programming demonstrates intriguing associations between maternal stress processes during pregnancy and outcomes in offspring that extend into adulthood. The purpose of this study was to test whether hypothalamic-pituitary-adrenal (HPA) patterns in mothers during the period between 2 pregnancies (i.e., the interpregnancy interval) and during the subsequent pregnancy predict infant birth weight, a key birth outcome. This study sampled salivary cortisol before and during pregnancy in a diverse community sample of 142 women enrolled in the Community Child Health Network study. Using multilevel modeling, we found that flatter diurnal cortisol slopes in mothers during the interval between one birth and a subsequent pregnancy predicted lower infant birth weight of the subsequent child. This interpregnancy cortisol pattern in mothers also correlated with significantly shorter interpregnancy intervals, such that women with flatter cortisol slopes had more closely spaced pregnancies. After adding demographic covariates of household income, cohabitation with partner, and maternal race to the model, these results were unchanged. For participants who provided both interpregnancy and pregnancy cortisol data (n = 73), we found that interpregnancy cortisol slopes predicted infant birth weight independent of pregnancy cortisol slopes. These novel findings on interpregnancy HPA axis function and subsequent pregnancy outcomes strongly support life course health approaches and underscore the importance of maternal stress physiology between pregnancies. (PsycINFO Database Record

The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research

ABSTRACTBackground and Objectives: Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Design and Methods: Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Results: Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. Conclusions: This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.