Community Cohort Of African Americans Research Articles

Neighborhood socioeconomic deprivation and individual-level socioeconomic status are associated with dopamine-mediated changes to monocyte subset CCR2 expression via a cAMP-dependent pathway

Social determinants of health (SDoH) include socioeconomic, environmental, and psychological factors that impact health. Neighborhood socioeconomic deprivation (NSD) and low individual-level socioeconomic status (SES) are SDoH that associate with incident heart failure, stroke, and cardiovascular mortality, but the underlying biological mechanisms are not well understood. Previous research has demonstrated an association between NSD, in particular, and key components of the neural-hematopoietic-axis including amygdala activity as a marker of chronic stress, bone marrow activity, and arterial inflammation. Our study further characterizes the role of NSD and SES as potential sources of chronic stress related to downstream immunological factors in this stress-associated biologic pathway. We investigated how NSD, SES, and catecholamine levels (as proxy for sympathetic nervous system activation) may influence monocytes which are known to play a significant role in atherogenesis. First, in an ex vivo approach, we treated healthy donor monocytes with biobanked serum from a community cohort of African Americans at risk for CVD. Subsequently, the treated monocytes were subjected to flow cytometry for characterization of monocyte subsets and receptor expression. We determined that NSD and serum catecholamines (namely dopamine [DA] and norepinephrine [NE]) associated with monocyte C–C chemokine receptor type 2 (CCR2) expression (p < 0.05), a receptor known to facilitate recruitment of monocytes towards arterial plaques. Additionally, NSD associated with catecholamine levels, especially DA in individuals of low SES. To further explore the potential role of NSD and the effects of catecholamines on monocytes, monocytes were treated in vitro with epinephrine [EPI], NE, or DA. Only DA increased CCR2 expression in a dose-dependent manner (p < 0.01), especially on non-classical monocytes (NCM). Furthermore, linear regression analysis between D2-like receptor surface expression and surface CCR2 expression suggested D2-like receptor signaling in NCM. Indicative of D2-signaling, cAMP levels were found to be lower in DA-treated monocytes compared to untreated controls (control 29.78 pmol/ml vs DA 22.97 pmol/ml; p = 0.038) and the impact of DA on NCM CCR2 expression was abrogated by co-treatment with 8-CPT, a cAMP analog. Furthermore, Filamin A (FLNA), a prominent actin-crosslinking protein, that is known to regulate CCR2 recycling, significantly decreased in DA-treated NCM (p < 0.05), indicating a reduction of CCR2 recycling. Overall, we provide a novel immunological mechanism, driven by DA signaling and CCR2, for how NSD may contribute to atherogenesis. Future studies should investigate the importance of DA in CVD development and progression in populations disproportionately experiencing chronic stress due to SDoH.

Long-term Consequences of Criminal Justice System Intervention: The Impact of Young Adult Arrest on Midlife Health Behaviors.

While there is a growing literature on the relationship between incarceration and health, few studies have expanded the investigation of criminal justice system involvement and health to include the more common intervention of arrest. This study uses a quasi-experimental design to evaluate the long-term effect of arrest in young adulthood on health behaviors in midlife for African Americans. We use propensity score matching methods and gender-specific multivariate regression analyses to equate those who did and did not incur an arrest in young adulthood from a subsample (n = 683) of the Woodlawn cohort, an African American community cohort followed from childhood into midlife. The results suggest that, for men, having been arrested in young adulthood has a direct effect on smoking, daily drinking, and risky sexual behaviors into midlife while young adult arrest does not seem to impact midlife health risk behaviors for women. This study adds health risk behaviors to the growing list of detrimental outcomes, such as crime, drug use, education, and mental health that are related to criminal justice contact for African American men, in particular.

Examining the Consequences of the “Prevalent Life Events” of Arrest and Incarceration among an Urban African-American Cohort

The life course perspective has traditionally examined prevalent adult life events, such as marriage and employment, and their potential to redirect offending trajectories. However, for African-Americans, the life events of arrest and incarceration are becoming equally prevalent in young adulthood. Therefore, it is critical to understand how these “standard” criminal justice practices, which are designed to deter as well as punish, affect deviance among this population. This study evaluates the long-term consequences of criminal justice intervention on substance use and offending into midlife among an African-American community cohort using propensity score matching and multivariate regression analyses. The results largely point to a criminogenic effect of criminal justice intervention on midlife deviance with a particularly strong effect of young adult arrest on rates of violent and property arrest counts into midlife. The theoretical and policy implications of the findings are discussed.

Taking a life course approach to studying substance use treatment among a community cohort of African American substance users

BackgroundLife course theory emphasizes the need to examine a wide variety of distal factors along with proximal factors, longitudinally. Yet research on who obtains substance use treatment is generally cross-sectional and limited to examining developmentally proximal factors (e.g., substance use severity) and demographic factors. MethodsTo investigate treatment within a life-course framework, we studied 522 drug and/or alcohol users from a community cohort of African Americans followed prospectively from age 6. Developmentally distal factors of childhood and adolescent social behavior, family environment, academic achievement, mental health, and substance use along with the key proximal factors of substance use severity and socioeconomic status were examined using regression analyses to assess their impact on obtaining adult substance use treatment. ResultsOne-fifth of the study population obtained treatment for substance use by age 32 (20.5%). Although adult socioeconomic status was not associated with substance use treatment in adulthood in the multivariable model, the proximal factor of substance use severity was a strong predictor of obtaining substance use treatment, as expected. After including several developmentally distal factors in the model, childhood aggression also had an independent effect on adult substance use treatment, above and beyond substance use severity. ConclusionsThese findings emphasize the importance of using a life course framework when exploring predictors of treatment; early life characteristics are important influences beyond the more proximal factors in adulthood. Research should continue to take a life course approach to better understand pathways to substance use treatment.

A longitudinal study of substance use and violent victimization in adulthood among a cohort of urban African Americans

This paper examines the effects of experiencing violent victimization in young adulthood on pathways of substance use from adolescence to mid-adulthood. Data come from four assessments of an African American community cohort followed longitudinally from age 6 to 42 years. The cohort lived in the urban, disadvantaged Woodlawn neighborhood of Chicago in 1966. All first graders from the public and parochial schools were asked to participate (n = 1242). Dependent variables-alcohol, marijuana and cocaine use-came from self-reports at age 42. Young adult violent victimization was reported at age 32, as were acts of violence, substance use, social integration and socio-economic resources. First grade risk factors came from mothers' and teachers' reports; adolescent substance use was self-reported. Structural equation models indicate a pathway from adolescent substance use to young adult violent victimization for females and those who did not grow up in extreme poverty (betas ranging from 0.15 to 0.20, P < 0.05). In turn, experiencing violent victimization in young adulthood increased alcohol, marijuana and cocaine use, yet results varied by gender and early poverty status (betas ranging from 0.12 to 0.15, P < 0.05). Violent victimization appears to play an important role in perpetuating substance use among the African American population. However, within-group variations are evident, identifying those who are not raised in extreme poverty as the most negatively affected by violence.

Social integration in young adulthood and the subsequent onset of substance use and disorders among a community population of urban African Americans

This paper examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design Data come from a community cohort of African Americans followed longitudinally from age 6-42 years with four assessment periods. The cohort all lived in the Woodlawn neighborhood of Chicago in 1966, an urban disadvantaged setting. All Woodlawn first graders in 1966 were asked to participate; 13 families declined (n = 1242). Substance use was measured via interview at age 42 and includes the onset of alcohol and drug use disorders and the onset of cocaine/heroin use between ages 32 and 42 years. Social integration measures were assessed via interview at age 32 and include social roles (employee, spouse, parent), participation in religious and social organizations and a measure of overall social integration. Control variables were measured in childhood and later in the life course. Multivariate regression analyses suggest that unemployment, being unmarried, infrequent religious service attendance and lower overall social integration in young adulthood predict later adult-onset drug use disorders, but not alcohol use disorders once confounders are taken into consideration. Unemployment and lower overall social integration predict onset of cocaine/heroin use later in adulthood. Results show meaningful onset of drug use and substance use disorders during mid-adulthood and that social integration in young adulthood seems to play a role in later onset of drug use and drug disorders, but not alcohol disorders.

Life Stage, Substance Use and Health Decline in a Community Cohort of Urban African Americans

This longitudinal study analyzed chronic health effects, predominantly somatic, resulting from substance use in a homogeneously urban African American community cohort (n = 411). Individual and collective effects of eight licit and illicit substances on change in perceived health (index of reported health conditions formulated as regressed change scores) were tested as the cohort matured into young adulthood. Ten additional measures of health behavior, social attainment and social networks were introduced to control against spurious causal attribution. Gender differences in direct and intercorrelated drug effects and their timing processes were observed. Substance use explained a larger share of the variance in men's health than in women's. In absolute numbers of health problems, however, substance use had a greater effect on women's health.

Changing HIV infection rates and risk in an African-American community cohort

This longitudinal study of a homogeneously urban African-American community cohort drawn from the metropolitan New York area (USA) analyzed three-year change in HIV-1 antibody prevalence and self-reported risk practices separately for men and women. Specifically, risk practices reported on personal interviews and results from blood sero-assay in 1989-1990 were compared to similar interview reports of risk practices and HIV assay from saliva samples in 1993. Results showed: (1) women's infection rates increased more than men's, resulting in a male to female infection ratio of 1.5:1; (2) heterosexual transmission accounted for most of women's new infection; (3) in multivariate analysis, multiple partners was a significant heterosexual risk indicator for both men and women, increasing infection odds five-fold; and (4) buying sex also increased heterosexual men's infection odds approximately five-fold. Results document increasing rates of African-American HIV infection linked largely to heterosexual exposure risk, that the African-American male-female infection ratio resembles the global rather than North American one, and also the utility of an expanded classification of heterosexual exposure risk.

HIV-1 seroprevalence and risk behaviors in an urban African-American community cohort.

Previous attempts at obtaining population estimates of human immunodeficiency virus type 1 (HIV-1) seroprevalence have been beset by problems of cooperation bias. As part of the fourth round of study with an urban African-American community cohort, the following investigation was aimed at assessing HIV-1 prevalence and the relative importance of sex and drug injection as risk factors in infection. Personal interviews were conducted in the home with 364 respondents, followed by voluntary blood sample collection from 287 of these individuals. Blood assays showed a point prevalence of 8.4% HIV-1 seropositivity in this community cross section, with a higher female-to-male ratio than appears among acquired immunodeficiency syndrome (AIDS) case reports. Most infected persons were unaware and unsuspecting of their infection. First, findings underscore the need to focus on risk behaviors rather than on risk groups. Second, the smaller than 2:1 ratio of infected men to women suggests that current AIDS case reports seriously underestimate HIV-1 infection among certain cohorts of African-American women. Finally, widespread ignorance of own infected status and inaccurate risk assessment signal the substantial task for community health educators in reaching inner-city African-American men and women at risk.