Epigenetic Aging and Racialized, Economic, and Environmental Injustice: NIMHD Social Epigenomics Program.

Importance: Epigenetic age acceleration is associated with exposure to social and economic adversity and may increase the risk of premature morbidity and mortality. However, no studies have included measures of structural racism, and few have compared estimates within or across the first and second generation of epigenetic clocks.

Objective: To determine whether epigenetic age acceleration is positively associated with exposures to diverse measures of racialized, economic, and environmental injustice measured at different levels and time periods.

Epigenetic aging & embodying injustice: US and .

Importance: Epigenetic accelerated aging is associated with exposure to social and economic adversity and may increase risk of premature morbidity and mortality. However, no studies have included measures of structural racism and few have compared estimates within or across the 1 and 2 generation of epigenetic clocks (the latter additionally trained on phenotypic data).

Objective: To determine if accelerated epigenetic aging is associated with exposures to diverse measures of racialized, economic, and environmental injustice measured at different levels and time periods.

An epigenome-wide analysis of DNA methylation, racialized and economic inequities, and air pollution.

Importance: DNA methylation (DNAm) provides a plausible mechanism by which adverse exposures become embodied and contribute to health inequities, due to its role in genome regulation and responsiveness to social and biophysical exposures tied to societal context. However, scant epigenome-wide association studies (EWAS) have included structural and lifecourse measures of exposure, especially in relation to structural discrimination.

Objective: Our study tests the hypothesis that DNAm is a mechanism by which racial discrimination, economic adversity, and air pollution become biologically embodied.

Contextualizing Response Rates During the COVID-19 Pandemic: Experiences From a Boston-Based Community Health Centers Study.

Objectives: The focus of this study was to calculate and contextualize response rates for a community-based study conducted during the COVID-19 pandemic, a topic on which scant data exist, and to share lessons learned from recruiting and enrolling for implementation of future studies.

Design: The Life+Health Study, a cross-sectional population-based study designed to advance novel methods to measure and analyze multiple forms of discrimination for population health research.

Setting: The study recruited participants from 3 community health centers in Boston, Massachusetts, between May 2020 and July 2022.

Use of Correct and Incorrect Methods of Accounting for Age in Studies of Epigenetic Accelerated Aging: Implications and Recommendations for Best Practices.

Motivated by our conduct of a literature review on social exposures and accelerated aging as measured by a growing number of epigenetic "clocks" (which estimate age via DNA methylation (DNAm) patterns), we report on 3 different approaches in the epidemiologic literature-1 incorrect and 2 correct-on the treatment of age in these and other studies using other common exposures (i.e., body mass index and alcohol consumption).

The impact of low input DNA on the reliability of DNA methylation as measured by the Illumina Infinium MethylationEPIC BeadChip.

DNA methylation (DNAm) is commonly assayed using the Illumina Infinium MethylationEPIC BeadChip, but there is currently little published evidence to define the lower limits of the amount of DNA that can be used whilst preserving data quality. Such evidence is valuable for analyses utilizing precious or limited DNA sources. We used a single pooled sample of DNA in quadruplicate at three dilutions to define replicability and noise, and an independent population dataset of 328 individuals (from a community-based study including US-born non-Hispanic Black and white persons) to assess the impact of total DNA input on the quality of data generated using the Illumina Infinium MethylationEPIC BeadChip.

Using Implicit Measures of Discrimination: White, Black, and Hispanic Participants Respond Differently to Group-Specific Racial/Ethnic Categories vs. the General Category "People of Color" in the USA.

Recent studies showed that implicit measures are valuable instruments for assessing exposure to discrimination and predicting negative physical conditions. Between March 10, 2020, and April 1, 2020, we conducted three experiments (577 participants) in the USA to evaluate the use of group-specific vs. general race/ethnicity categories in implicit measures of discrimination.

Breast Cancer Incidence, Hormone Receptor Status, Historical Redlining, and Current Neighborhood Characteristics in Massachusetts, 2005-2015.

Background: Scant research has analyzed contemporary US cancer incidence rates in relation to historical redlining (ie, 1930s US federally imposed residential segregation), implemented via the color-coded federal Home Owners' Loan Corporation (HOLC) maps.

Methods: We analyzed Massachusetts Cancer Registry data for all patients with primary invasive breast cancer (BC) diagnosed in 2005-2015 among women in the 28 Massachusetts municipalities with digitized 1930s HOLC maps. Multilevel Poisson regression estimated BC incidence rate ratios (IRR), overall and by tumor estrogen receptor (ER-positive, ER-negative) and progesterone receptor (PR-positive, PR-negative) status, in relation to HOLC grade and contemporary census tract (CT) social characteristics.

Statistical implications of endogeneity induced by residential segregation in small-area modelling of health inequities.

Health inequities are assessed by health departments to identify social groups disproportionately burdened by disease and by academic researchers to understand how social, economic, and environmental inequities manifest as health inequities. To characterize inequities, group-specific small-area health data are often modeled using log-linear generalized linear models (GLM) or generalized linear mixed models (GLMM) with a random intercept. These approaches estimate the same marginal rate ratio comparing disease rates across groups under standard assumptions.

Comparing denominator sources for real-time disease incidence modeling: American Community Survey and WorldPop.

Across the United States public health community in 2020, in the midst of a pandemic and increased concern regarding racial/ethnic health disparities, there is widespread concern about our ability to accurately estimate small-area disease incidence rates due to the absence of a recent census to obtain reliable population denominators. 2010 decennial census data are likely outdated, and intercensal population estimates from the Census Bureau, which are less temporally misaligned with real-time disease incidence data, are not recommended for use with small areas. Machine learning-based population estimates are an attractive option but have not been validated for use in epidemiologic studies.

The target/perpetrator brief-implicit association test (B-IAT): an implicit instrument for efficiently measuring discrimination based on race/ethnicity, sex, gender identity, sexual orientation, weight, and age.

Background: To date, research assessing discrimination has employed primarily explicit measures (i.e., self-reports), which can be subject to intentional and social desirability processes.

Impact of Differential Privacy and Census Tract Data Source (Decennial Census Versus American Community Survey) for Monitoring Health Inequities.

To investigate how census tract (CT) estimates of mortality rates and inequities are affected by (1) differential privacy (DP), whereby the public decennial census (DC) data are injected with statistical "noise" to protect individual privacy, and (2) uncertainty arising from the small number of different persons surveyed each year in a given CT for the American Community Survey (ACS). We compared estimates of the 2008-2012 average annual premature mortality rate (death before age 65 years) in Massachusetts using CT data from the 2010 DC, 2010 DC with DP, and 2008-2012 ACS 5-year estimate data. For these 3 denominator sources, the age-standardized premature mortality rates (per 100 000) for the total population respectively equaled 166.

A Structural Model of Social Determinants of the Metabolic Syndrome.

Objectives: The metabolic syndrome (MetS) refers to a cluster of interrelated physiological characteristics that are associated with an increased risk of cardiovascular disease and diabetes. While the clinical usefulness of the MetS has been the subject of controversy for years, increasingly sophisticated methods are being used to measure the concept.

Participants: Study of community health center patients who were not diabetic; study group was evenly divided between Black and White adults.

Cancer Incidence and Multilevel Measures of Residential Economic and Racial Segregation for Cancer Registries.

Background: The handful of studies (<30) on cancer and residential segregation have focused on racial segregation, primarily at the city/town level. We tested a priori hypotheses about choice of measure and level by extending use of the Index of Concentration at the Extremes (ICE) to quantify both economic and racial residential segregation, singly and combined, and conducted analyses for the total population and stratified by race/ethnicity.

Methods: Outcomes comprised Massachusetts incidence rates (2010-2014) for invasive breast, cervical, and lung cancer, analyzed in relation to census tract and city/town ICE measures for income, race/ethnicity, race/ethnicity + income, and the federal poverty line.

Using the Index of Concentration at the Extremes at multiple geographical levels to monitor health inequities in an era of growing spatial social polarization: Massachusetts, USA (2010-14).

Background: Metrics that quantify economic and social spatial polarization at multiple geographical levels are not routinely used by health agencies, despite rising inequalities.

Methods: We employed the Index of Concentration at the Extremes (ICE), which quantifies how persons in a specified area are concentrated into the top vs bottom of a specified societal distribution, to examine associations with Massachusetts mortality data (2010-14). Our a priori hypotheses were that these associations would: be greater at the local [census tract (CT)] compared with city/town level; vary by race/ethnicity but not gender; and be greatest for our new ICE for racialized economic segregation.

Feasibility of analyzing DNA copy number variation in breast cancer tumor specimens from 1950 to 2010: how old is too old?

Purpose: The purpose of the study was to assess the feasibility of quantifying long-term trends in breast tumor DNA copy number variation (CNV) profiles.

Methods: We evaluated CNV profiles in formalin-fixed paraffin-embedded (FFPE) tumor specimens from 30 randomly selected Kaiser Permanente Northern California health plan women members diagnosed with breast cancer from 1950 to 2010. Assays were conducted for five cases per decade who had available tumor blocks and pathology reports.

Breast Cancer Estrogen Receptor Status According to Biological Generation: US Black and White Women Born 1915-1979.

Evidence suggests that contemporary population distributions of estrogen-receptor (ER) status among breast cancer patients may be shaped by earlier major societal events, such as the 1965 abolition of legal racial discrimination in the United States (state and local "Jim Crow" laws) and the Great Famine in China (1959-1961). We analyzed changes in ER status in relation to Jim Crow birthplace among the 46,417 black and 339,830 white US-born, non-Hispanic women in the Surveillance, Epidemiology, and End Results (SEER) 13 Registry Group who were born between 1915 and 1979 and diagnosed (ages 25-84 years, inclusive) during 1992-2012. We grouped the cases according to birth cohort and quantified the rate of change using the haldane (which scales change in relation to biological generation).