Neighborhood Violence Research Articles

Examining the Relationship between Anti-Black Racism, Community and Police Violence, and COVID-19 Vaccination

In 2020, the COVID-19 pandemic emerged against a backdrop of long-standing racial inequities that contributed to significant disparities in COVID-19 mortality, morbidity, and eventually, vaccination rates. COVID-19 also converged with two social crises: anti-Black racism and community and police violence. The goal of this study was to examine the associations between community violence, police violence, anti-Black racism, and COVID-19 vaccination. Survey data were collected from a sample of 538 Black residents of Chicago between September 2021 and March 2022. Structural equation modeling was used to test associations between neighborhood violence, police violence, racism, medical mistrust, trust in COVID-related information, depressive symptoms, and having received a COVID-19 vaccination. In line with predictions, neighborhood violence had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor. Additionally, racism had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor, as well as via medical mistrust and trust in COVID-related information from a personal doctor. These findings add to the growing body of literature demonstrating the importance of medical mistrust when examining COVID-19 vaccination disparities. Furthermore, this study highlights the importance of considering how social and structural factors such as violence and racism can influence medical mistrust.

Examining the Relationship between Social Determinants of Health and Adverse Pregnancy Outcomes in Black Women.

Our objective was to examine associations between social determinants of health (cultural, neighborhood, and psychosocial factors) and adverse pregnancy outcomes (gestational age at birth [GAB], preterm birth [PTB], and preeclampsia) in Black women. Cross-sectional data (n = 204) comprised adult Black women aged ≥18 years who delivered between 2013 and 2022 in Milwaukee,Wisconsin. Sequential unadjusted linear and logistic regression models were run to evaluate associations between social determinants of health and pregnancy outcomes. Stepwise regressions with forward selection were run to test the contribution of the social determinants of health to adverse pregnancy outcomes, independent of the contribution of established risk factors. Mean GAB was 37.9 weeks, 19.6% had a PTB and 17.7% had preeclampsia. In all fully adjusted models, education (β0.15, 95% confidence interval [CI]: 0.005, 0.29), nulliparity (β -1.26, 95%CI: -2.08, -0.44), multifetal gestation (β -2.67, 95% CI: -4.29, -1.05), and exposure to neighborhood violence (β -0.13, 95%CI: -0.25, -0.005) were associated with shortened GAB. Education (adjusted odds ratio [aOR]: 0.83, 95%CI: 0.69, 0.99), provider trust (aOR: 0.94, 95%CI: 0.88, 0.99), chance health locus of control (aOR: 0.88, 95%CI: 0.78, 0.99), and anxiety (aOR: 0.81, 95%CI: 0.69, 0.95) were associated with reduced odds of PTB. Powerful others health locus of control (aOR: 1.16, 95%CI: 1.03, 1.32), depression (aOR: 1.17, 95%CI: 1.01, 1.34), nulliparity (aOR: 4.73, 95%CI: 1.79, 12.55), multifetal gestation (aOR: 17.78, 95%CI: 3.49, 90.50), diabetes (aOR: 4.71, 95%CI: 1.17, 19.00), and obstructive sleep apnea (aOR: 44.28, 95%CI: 2.50, 783.12) were associated with increased odds of PTB. Internal health locus of control (aOR: 1.13, 95%CI: 1.01, 1.25), depression (aOR: 1.09, 95%CI: 1.01, 1.17), preeclampsia in a previous pregnancy (aOR: 5.96, 95% CI: 2.22, 16.01), and kidney disease (aOR: 34.27, 95% CI: 1.54, 763.75) were associated with preeclampsia. Provider trust, health locus of control, neighborhood violence, depression, and anxiety were associated with adverse pregnancy outcomes in Black women, independent of demographic and clinical risk factors. · We identified associations between exposure to neighborhood violence and gestational age at birth.. · Trust, locus of control, depression, and anxiety were associated with preterm birth and preeclampsia.. · Future research should focus on interventions that address social and clinical factors..

The Role of Social Determinants of Health in Cardiovascular Diseases: An Umbrella Review.

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Addressing social determinants of health (SDoH) may be the next forefront of reducing the enormous burden of CVD. SDoH can be defined as any social, economic, or environmental factor that influences a health outcome. Comprehensive evidence of the role of SDoH in CVD is lacking, nevertheless. This umbrella review aims to give a comprehensive overview of the role of SDoH in CVD. We searched systematic reviews (with or without meta-analyses) using 8 databases and included review reference lists. Four themes (economic circumstances, social/community context, early childhood development, and neighbourhood/built environment) and health literacy in the health/health care theme were considered. Seventy reviews were eligible. Despite the quality of the included reviews being low or critically low, there was consistent evidence that factors relating to economic circumstances and early childhood development themes were associated with an increased risk of CVD and CVD mortality. We also found evidence that factors in the social/community context and neighbourhood/built environment themes, such as social isolation, fewer social roles, loneliness, discrimination, ethnicity, neighborhood socioeconomic status, violence, and environmental attributes, had a role in CVD. SDoH factors without (or with minimal) evidence synthesis for CVD were also identified. In sum, this umbrella review offers evidence that SDoH, especially economic circumstance and early childhood development, play a significant role in CVD. This calls for the strengthening of nonmedical interventions that address multiple factors simultaneously and the inclusion of SDoH in future CVD risk prediction models. Registration URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42022346994.

Social Genomics Model of Health Disparities

Social stress such as financial scarcity, childhood trauma, and neighborhood violence has been associated with worse health outcomes. Furthemore, the social stress one experiences is not accidental. Rather, it can be the result of systematic economic and social marginalization through social policies, built environment and neighborhood underdevelopment from structural racism and discrimination. The psychological and physical stress associated with social exposure risk has been identified as possible explanatory variables for the disparities in health outcomes we have previously assigned to “race.” We will use lung cancer as a use case to illustrate a novel model that links social exposure, behavioral risk and the stress response to outcomes.

Neighborhood violence and socioeconomic deprivation influence associations between acute air pollution and temperature on childhood asthma in New York city

Ambient air pollution, temperature, and social stressor exposures are linked with asthma risk, with potential synergistic effects. We examined associations for acute pollution and temperature exposures, with modification by neighborhood violent crime and socioeconomic deprivation, on asthma morbidity among children aged 5–17 years year-round in New York City. Using conditional logistic regression in a time-stratified, case-crossover design, we quantified percent excess risk of asthma event per 10-unit increase in daily, residence-specific exposures to PM2.5, NO2, SO2, O3, and minimum daily temperature (Tmin). Data on 145,834 asthma cases presenting to NYC emergency departments from 2005 to 2011 were obtained from the New York Statewide Planning and Research Cooperative System (SPARCS). Residence- and day-specific spatiotemporal exposures were assigned using the NYC Community Air Survey (NYCCAS) spatial data and daily EPA pollution and NOAA weather data. Point-level NYPD violent crime data for 2009 (study midpoint) was aggregated, and Socioeconomic Deprivation Index (SDI) scores assigned, by census tract. Separate models were fit for each pollutant or temperature exposure for lag days 0–6, controlling for co-exposures and humidity, and mutually-adjusted interactions (modification) by quintile of violent crime and SDI were assessed. We observed stronger main effects for PM2.5 and SO2 in the cold season on lag day 1 [4.90% (95% CI: 3.77–6.04) and 8.57% (5.99–11.21), respectively]; Tmin in the cold season on lag day 0 [2.26% (1.25–3.28)]; and NO2 and O3 in the warm season on lag days 1 [7.86% (6.66–9.07)] and 2 [4.75% (3.53–5.97)], respectively. Violence and SDI modified the main effects in a non-linear manner; contrary to hypotheses, we found stronger associations in lower-violence and -deprivation quintiles. At very high stressor exposures, although asthma exacerbations were highly prevalent, pollution effects were less apparent—suggesting potential saturation effects in socio-environmental synergism.

Multi-Level Influences of Smoke-Free Policies in Subsidized Housing: Applying the COM-B Model and Neighborhood Assessments to Inform Smoke-Free Policies.

Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents' ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.

Abstract 370: Corticosterone-mediated Associations Between Neighborhood Environment Perceptions and Lysosomal Acid Lipase Levels - Data From The Washington, D.C. Cardiovascular Health and Needs Assessment

Experiences of adverse social determinants of health (SDoH), like less favorable neighborhood environment perceptions, are associated with cardiovascular disease (CVD). Lysosomal acid lipase (LAL) plays an important role in lipid metabolism, and genetic LAL deficiency has been linked to CVD risk. We aimed to determine the potential relationship between neighborhood perceptions and LAL and to evaluate stress-related biomarkers as mediators of this relationship in the D.C. Cardiovascular Health and Needs Assessment cohort (60 African American participants, mean age 61yr, 93% female), biomarkers were measured using ELISA, and perceptions of neighborhood violence, physical and social environment, social cohesion, and safety were determined using validated questionnaires with higher scores indicating more favorable perceptions. We explored neighborhood perceptions-LAL relationships with regression models adjusted for BMI and ASCVD risk score and stratified by hyperlipidemia due to the potential confounding role of LDL. Mediation analysis was used to evaluate cortisol and corticosterone as potential mediators of the neighborhood perceptions-LAL relationship. Of the neighborhood perceptions measured, more favorable perceptions of physical and social environment associated with greater LAL (β=0.23, p=0.09); this association persisted only among participants without hyperlipidemia (β=0.42, p=0.04). Only corticosterone associated with both perceived physical and social environment and LAL (Figure); corticosterone mediated 73.1% of this relationship in all participants and 89.9% of this relationship in participants without hyperlipidemia. Our data highlight the relationship between perceived physical and social environment and LAL mediated by corticosterone. Results also emphasize the importance of future interdisciplinary work to better understand mechanisms by which SDoH and associated biomarkers contribute to CVD disparities.

Staying Power: Strategies for Weathering Criminal Violence in Marginal Neighborhoods of Medellín and Monterrey

AbstractCriminal violence in Latin American cities is increasing. Meanwhile, with urbanization, greater numbers of people are moving to cities and into the crossfire. What self-protection strategies do residents adopt to keep safe in violent cities? Drawing on qualitative data from Medellín, Colombia, and Monterrey, Mexico, we document the strategies residents use to stay safe. We synthesize insights from studies of civil war, criminal governance, and urban violence to construct an analytical framework to systematically catalog and name these strategies. We posit that the type of violence residents face—indiscriminate or targeted—influences the strategies they pursue. Responding to either the indiscriminate or targeted form, residents employ survival strategies to avoid, withstand, or confront violence. Our research underscores the centrality of agency for residents’ “staying power” amid urban violence.

"But I Live Here Too": Social-structural stressors, racial discrimination, and resiliency among urban dwelling black emerging adult men.

For many Black emerging adult men in the United States, social-structural stressors rooted in racial discrimination are daily experiences that place them at greater risk for poor health. Emerging adulthood is a critical life course period marked by greater experimentation with health risk behaviors. Although Black men's health vulnerabilities during this period are connected to their social-structural environments, investigations of these factors among noncollege sampled Black men remain limited. We conduced thirty semi-structured in-depth interviews to examine associations between social-structural challenges and social-structural resources for resiliency. Interviews were audio-recorded, transcribed verbatim, and coded using Dedoose web-based qualitative software. Through open coding, emergent concepts were connected across interviews and major themes were identified. We found three core social-structural stressors: (1) Racial profiling, (2) neighborhood violence, and (3) lack of economic opportunities, and three resilience factors: (1) Positive social networks, (2) community-based resources, and (3) safe environments that foster a sense of community. Collectively, these findings provide insight into developing structural- and community-level interventions tailored to bolster resiliency across multiple levels and counteract the social-structural challenges that young Black men face.

“I Can’t Vote if I Don’t Leave My Apartment”: The Problem of Neighborhood Violence and its Impact on the Political Behavior of Black American Women Living Below the Poverty Line

Prior research examining political behavior outside of the United States, has shown that violence can have a mixed impact on political engagement. Building on that work, this research examines whether violence shapes the political lives of poor Black women within the United States. I argue, neighborhood violence in the United States can and often does, shape the political behavior of Black women living below the poverty line in public housing. I use ethnographic data to parse out a conceptual framework which articulates connections between residential violence experienced by Black women living in poverty and their politics. Ultimately, my analysis shows violence can cause isolation and harm, and in doing so dampen political engagement. When residents experienced high levels of violence and did not feel a sense of belonging or connection to their neighborhood, they rarely engage d in visible political behaviors. However, residents who expressed a sense of connection to their neighborhood continued to engage in politics. Those residents who had interpersonal relationships within their residential neighborhood, frequently maintained and sometimes further developed their individual politics, despite and sometimes in response to, personal experiences with residential violence.

Adverse Childhood Experiences Are Associated With Seizures in Children: A Cross-sectional Analysis.

To assess the relationship between adverse childhood experiences (ACE/ACEs) and epilepsy. We performed a cross-sectional retrospective cohort analysis using population-based data from the 2018 and 2019 National Survey of Children's Health to examine caregiver-reported ACE exposures and their relationship to caregiver-reported physician diagnoses of epilepsy or seizure disorder in children. ACEs elicited in the survey included questions about experience of violence, household dysfunction, and food and housing insecurity. Adjusting for age, race, and income level, we used logistic regression to test the relationships between cumulative ACE score and current seizure disorder or epilepsy diagnosis and to examine which specific ACEs were individually associated with current seizure disorder or epilepsy diagnosis. The study population consisted of 59,963 participants; 52.2% were female, and 47.8% were male. Participant ages ranged from 0 to 17 years. A current diagnosis of epilepsy or seizure disorder was reported in 377 (0.63%) participants, and 22,749 (37.9%) participants had one or more ACE exposures. As the number of ACEs increased, odds of current epilepsy or seizure disorder diagnosis increased by 1.14 (95% confidence interval 1.07-1.22). Five ACE exposures demonstrated a high association with a current diagnosis of epilepsy or seizure disorder: food/housing insecurity, witnessing domestic violence, household mental illness, neighborhood violence, and parent/guardian incarceration. Multiple ACE exposures were individually associated with reporting a diagnosis of epilepsy or seizure disorder. An increase in cumulative ACE exposures increased odds of having current diagnosis of epilepsy or seizure disorder.

Association of Adverse Childhood Experiences with Heart Conditions in Children: Insight from the 2019-2020 National Survey of Children's Health.

We evaluated the associations between ACEs and heart diseases among children in the United States. Data on children ages 0 to 17 years reported by parents/guardians to have current heart conditions were analyzed. Using Stata version 17 software, descriptive statistics were generated for the demographic characteristics and the various health outcomes using the chi-square of independence. Multivariate logistic regression models were employed to determine the associations between ACEs and heart conditions, the severity of heart conditions, and overall health status. There were 826 children with current heart conditions from a total of 68,753 surveyed children. This corresponded to an estimated 780,000 (1.13%) children living with heart conditions in the U.S. On multivariate logistic models, several ACEs, including household economic hardship, parental/guardian's alcohol/drug abuse, severe mental health illness of parents/guardians, racial/ethnic discrimination, exposure to neighborhood violence, and accumulation of two or more ACEs, were significantly associated with heart diseases among children. Though the accumulation of two or more ACEs did not have a significant association with the severity of heart condition, it was significantly associated with caregiver reports of undesirable overall health status. ACEs are significantly associated with heart conditions among children and contribute to unfavorable overall health status among children with heart conditions in the U.S. There is a need for policies and programs that will promptly identify ACEs and mitigate their negative impact on children.

Abstract P160: Sex-Differences in Physical Activity-Mediated Associations of Perceived Neighborhood Environments With Severity of Metabolic Syndrome Among Jackson Heart Study Participants

Introduction: Metabolic syndrome (MetS) can lead to harmful effects on cardiovascular health. Assessing whether links between perceived neighborhood social environment (PNSE) and MetS are mediated by physical activity (PA) levels will inform interventions to reduce population-level mortality attributed to MetS. Hypothesis: PNSE will be both directly and indirectly related to MetS severity via PA. Methods: This study utilized baseline data from the Jackson Heart Study, a prospective, community-based cohort of African American adults in Jackson, MS (total sample=3082; mean age 53.3 years; 64% female). PNSE variables included neighborhood violence, problems (higher value=more violence or problems), and social cohesion (higher value=more cohesion). MetS severity Z-score was the outcome (higher score indicates worse MetS). Validated self-reported total PA, based on active living, sports, and home/yard indices, was tested as the mediator. Linear regressions with bootstrap-generated 95% bias-corrected confidence intervals ( BC CIs ) were estimated to test for significant unstandardized indirect effects, controlling for covariates (age, education, smoking status, alcohol consumption, and diet). All analyses were stratified by sex. Results: In women, neighborhood violence, problems, and social cohesion were indirectly related to MetS via PA (B for indirect effects=.04, 95% BC CI =.01, .08; .03, 95% BC CI =.01, .06; and -.03, 95% BC CI =-.07, -.01, respectively). That is, higher violence and problems were related to lower PA (B=-1.06, 95%CI=-1.76, -.36; B=-.79, 95%CI=-1.26, -.32, respectively), while higher social cohesion was associated with higher PA (B=.86, 95%CI=.15, 1.58). In turn, higher PA was associated with lower MetS. All PNSE factors were directly related to MetS (p<.05). In men, neighborhood violence, problems, and social cohesion were indirectly related to MetS via PA (B for indirect effects=.06, 95% BC CI =.02, .12; .04, 95% BC CI =.01, .08; and -.06, 95% BC CI =-.11, -.02, respectively). Again, higher violence and problems were related to lower PA (B=-1.65, 95%CI=-2.58, -.71; B=-1.02, 95%CI=-1.64, -.40, respectively), while higher social cohesion was associated with higher PA (B=1.58, 95%CI=.64, 2.52). In turn, higher PA was associated with lower MetS. No PNSEs were directly related to MetS. Conclusions: Consistent with what we expected, higher perceived neighborhood violence and problems were positively related to MetS, and vice versa for social cohesion. These associations may be explained in part by PA levels. The data showed that indirect effects by PA were more pronounced in men than women. Future interventions to reduce MetS attributed to neighborhood issues should consider PA promotion tailored to women and men in conjunction with community efforts to reduce neighborhood violence and problems and encourage cohesive neighborhoods.

Abstract 04: Neighborhood Social Vulnerability Associated With Increased Hypertension and Cardiovascular Disease in Port-au-Prince: Findings From the Haiti Cardiovascular Disease Cohort Study

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in low-income countries (LICs). Neighborhood social vulnerability has been associated with increased CVD risk in high-income countries, but the relationship is unknown in LICs. Our objective was to determine the association between neighborhood social vulnerability and prevalent CVD in urban Haiti. Hypothesis: We hypothesize that adults living in neighborhoods with increased social vulnerability will have a greater prevalence of hypertension (HTN) and CVD. Methods: We used cross-sectional enrollment data from the Haiti CVD Cohort study, a population-based cohort of adults ≥18 years living in Port-au-Prince distributed across 97 census blocks. To quantify vulnerability, we created a Haiti-specific Neighborhood Social Vulnerability Index (NSVI) based on the US CDC Social Vulnerability Index. The NSVI included three socioeconomic variables (income, sex, education), two household variables (single parent household, household with child <18 years), and six neighborhood stress and well-being variables (neighborhood cohesion, neighborhood violence, perceived stress, food insecurity, depression, social support). Each variable was determined using validated questionnaires. NSVI was calculated for each census block, which were stratified into quartiles. HTN was defined as SBP ≥140 mmHg, DBP ≥90, or on antihypertensive medications; CVD included heart failure, stroke, myocardial infarction, and angina, defined using adjudicated criteria. HTN and CVD prevalence were calculated for each NSVI quartile. Associations between NSVI quartile and HTN or CVD were quantified using individual-level multivariate logistic regression to adjust for confounders. Results: Among 2932 participants, median age was 40 years (IQR 28-55) and 58% were female. Age-standardized prevalence of HTN and CVD was 32.3% and 13.8%, respectively. The age-standardized prevalence of HTN and CVD was 35.7% and 17.3% across 4 th NSVI quartile blocks, compared to 29.1% and 14.1% across 1 st quartile NSVI blocks (p < 0.001). After adjusting for age, BMI, smoking, and alcohol use, participants living in 4 th NSVI quartile blocks had a greater risk of HTN (Adjusted Odds Ratio (aOR) 1.42; 95% CI 1.07-1.88; p-value 0.01) and CVD (aOR 1.36; CI: 0.99-1.88; p-value 0.06) compared to participants in the 1 st NSVI quartile blocks. NSVI was significantly associated with HTN in males but not females; conversely, NSVI was significantly associated with CVD in females and not males. Conclusions: Individuals living in neighborhoods with the greatest social vulnerability had a higher prevalence of HTN and CVD. Even in a setting of severe poverty such as urban Haiti, gradients in social vulnerabilities are associated with CVD disparities. Screening for social vulnerabilities should be incorporated into CVD prevention and treatment interventions in LICs.

THE INFLUENCE OF RACIAL VIOLENCE IN NEIGHBORHOODS AND SCHOOLS ON THE PSYCHO-BEHAVIORAL OUTCOMES IN ADOLESCENCE

Racism in all its manifestations is violence. This study examines the effect of discrimination-based racial violence in neighborhoods and schools on adolescent psychological and behavioral outcomes, while also testing the moderating influence of civic engagement. Researchers used a cross-sectional survey design to measure neighborhood and school-based racial discrimination, civic engagement, racial identity development, racism-based stress, and aggressive behaviors in a sample of 167 13 - 23 year old adolescents and emerging adults. Participants were recruited through a cluster randomized trial to test the impact of blight remediation in preventing youth violence. Study researchers hypothesized a direct effect of racial discrimination on adolescents’ racism-based stress and aggressive behaviors and a buffering effect of civic engagement on these relationships. Researchers also examined these relationships in participants with higher-than-average racial identity development scores. Multivariate regression models revealed a significant direct effect of both neighborhood and school discrimination on adolescents’ aggressive behaviors. Civic engagement had a positive buffering effect in the relationship between neighborhood discrimination and aggressive behaviors. Similar relationships were observed among adolescents with a high racial identity with stronger effect. Study findings have implications for understanding the behavioral impact of racial violence and investing in civic engagement to mitigate its impact in adolescence and emerging adulthood.

Exposure to neighborhood violence and child-parent conflict among a longitudinal sample of Dutch adolescents

An extensive body of research has documented the deleterious effects of community violence on adolescent development and behavior. Much of this research focuses on how exposure to violence structures social interaction, and, ultimately, how it motivates youth to engage in troublesome behavior. This study builds upon this body of research to demonstrate how exposure to community violence strains relationships between adolescents and their caregivers, resulting in higher levels of interpersonal conflict. Drawing on five waves of longitudinal panel data (n = 778; observations = 3458; 55 % female), combined with police records of violent crime in Utrecht, the Netherlands, a hybrid tobit regression documents how exposure to local and nearby violence affects child-parent conflict. The results indicate that youth who experience high levels of neighborhood violence report higher levels of conflict with parents than youth with low exposure to neighborhood violence. These results are consistent across different levels of neighborhood aggregation.

Would Caring Teachers Buffer the Link Between Violence Victimization and Early Sexual Initiation? Comparing Heterosexual and Non-Heterosexual African American Youth.

This study investigated the relationship between youth violence exposures (i.e., peer and neighborhood) and early sexual initiation. It also explored whether caring relationships with teachers might moderate this relationship and whether results differed for heterosexual versus non-heterosexual African American youth. The study sample (N = 580) comprised 475 heterosexual and 105 non-heterosexual youths, 319 female and 261 male, ages 13 to 24years (M age = 15.8). Students were assessed for peer and neighborhood violence, relationship with teachers, early sexual initiation, sexual orientation, and socioeconomic status. Major results indicated a positive relationship between exposure to peer and neighborhood violence and early sexual initiation for heterosexual youth but not those who identified as non-heterosexual. Further, identifying as female (vs. male) was significantly associated with later sexual initiation for both heterosexual and non-heterosexual youth. In addition, caring teachers moderated the relationship between exposure to peer violence and age of sexual initiation among non-heterosexual youth. Programs and interventions to curtail violence sequelae would need to consider the unique effects of various types of youth violence exposures and the significance of sexual orientation.

The power of family? Family social capital and the risk of externalising behaviours among youth with multiple childhood adversities.

Externalising behaviour problems (EBP), or aggressive and delinquent behaviours, among youth pose a significant problem for their peers, parents, teachers and society. Many types of childhood adversities increase the risk of EBP, including maltreatment, physical punishment, domestic violence, family poverty and living in violent neighbourhoods. This study asks, to what extent do children who face multiple adversities during childhood suffer an increased risk of EBP and is family social capital (FSC) associated with a lower risk? Using seven waves of panel data from the Longitudinal Studies of Child Abuse and Neglect, I examine the accumulation of adversities associated with greater risk of EBP among youth and investigate whether FSC-family network, support and cohesion-in early childhood is associated with a reduction in EBP risk. Experiencing early and multiple adversities resulted in the worst EBP trajectories throughout childhood. Although, among youth with the highest adversities, if early family support was also high, their EBP trajectories are more favourable than their disadvantaged peers with less support. FSC may protect against EBP when multiple childhood adversities are experienced. The need for early EBP interventions and bolstering FSC are discussed.

"The Fight is Two Times as Hard": A Qualitative Examination of a Violence Syndemic Among Young Black Sexual Minority Men.

Young Black men who have sex with men (YBMSM) are disproportionately impacted by violence, including violence rooted in anti-Black racism, sexual identity bullying, and neighborhood violence rooted in structural racism and inequities. These multiple forms of violence are frequently co-occurring and interactive creating syndemic conditions that can negatively impact HIV care. This qualitative study is based on in-depth interviews with 31 YBMSM, aged 16-30 years, living with HIV in Chicago, IL, to examine how violence has impacted their lives. Using thematic analysis, we identified five themes that reflect how YBMSM experience violence at the intersection of racism, homonegativity, socioeconomic status, and HIV status: (a) the experience of intersectional violence; (b) long histories of violence contributed to hypervigilance, lack of safety, and lack of trust; (c) making meaning of violence and the importance of strength; (d) normalizing violence for survival; and (e) the cyclical nature of violence. Our study highlights how multiple forms of violence can accumulate across an individual's life and contribute to social and contextual situations that further contribute to violence and negatively impact mental health and HIV care.

Distinct Associations of Deprivation and Threat With Alterations in Brain Structure in Early Childhood

The dimensional model of adversity and psychopathology hypothesizes deprivation and threat impact distinct neurobiological pathways, such as brain structure. This hypothesis has not been examined longitudinally or in young children. This study tested longitudinal associations between threat and deprivation measured in preschool and brain structure in childhood. It was hypothesized that threat would be associated with amygdala and hippocampal subcortical volume and deprivation would be associated with cortical thickness in association cortex. The study included T1-weighted scans from 72 children (5-10 years old, 54.2% female participants). Threat was measured by the presence of domestic violence, sexual abuse, physical abuse, or neighborhood violence. Deprivation was measured by the presence of neglect. Associations of deprivation or threat with brain structure were examined controlling for other dimension (deprivation or threat) and nuisance covariates using whole-brain vertex-wise analyses. Subcortical volume was extracted, and the same associations were examined using multiple regression. Threat was associated with widespread decreases in cortical surface area across the prefrontal cortex and other regions. Threat was not associated with amygdala or hippocampal volume. Deprivation was associated with increased thickness in occipital cortex, insula, and cingulate. Results suggest distinct associations of deprivation and threat on brain structure in early childhood. Threat is associated with widespread differences in surface area, and deprivation is associated with differences in cortical thickness. These observations are consistent with work in adolescence and adulthood and reflect how dimensions of adversity differentially impact neural structure.