BUILD: The Role of Environment on Stress Physiology in Minority Young Adults

It is estimated that by 2050, traditionally under-represented minority groups will compose well over half of the California population, highlighting the critical priority for assessing cardiometabolic health risk in these populations. As example of these high health risks, Latinx specifically have a 50% lifetime risk of developing type 2 diabetes and other chronic diseases, a result of a complex mixture of predisposition, health behaviors, and environmental factors. Furthermore, earlier disease onset extends the burden of the disease on the individual as well as the potential for increases in societal health care expenditures. Data show that minority populations are much less likely to obtain adequate preventive screenings and care; therefore, early and comprehensive detection methods of preventable chronic disease, such as type 2 diabetes, are essential. A stress-associated physiological mechanism related to chronic diseases is allostatic overload, which is a failure to maintain homeostasis during times of persistent stress. An allostatic load index can be calculated by summation of various high cardiometabolic biomarker and anthropometric measures, where higher allostatic load index scores represent an increasing risk for cardiometabolic disease. In existing literature, allostatic load scores have been shown to be higher in racial/ethnic groups, namely Black and Latinx populations in comparison to White populations. In addition, ample evidence supports a role of psychosocial stressors on allostatic load, however the role of environmental on allostatic load has been sparse. A modest body of evidence from our group has shown that physical environmental exposures during early life may impact neurological, metabolic and/or inflammatory processes that may increase T2D vulnerability; therefore the overarching aim of this proposal is to characterize allostatic load (the result of cumulative stressors on physiology via alterations in brain or nervous system physiology) associated with high environmental burdens that have likely results from imposed (environmental) racial discrimination in minority youth. We will continue recruitment of an existing pilot study of Los Angeles area minority young adults (18-24 years old) and examine an evidence-based allostatic load index to determine the role of racism, alongside other salient predictors of allostatic load. This on-going study consists of minority young adults (any racial ethnic background except European White) with a family history of type 2 diabetes. Data collection consists of various biospecimens (saliva, hair, urine) for determination of allostatic load indices. A comprehensive panel of eleven allostatic load makers will be utilized representing neuroendocrine, cardiovascular and metabolic components, markers that were specifically selected based on existing literature on allostatic load and knowledge on pathophysiology associated with type 2 diabetes risk in minority youth. Our main predictor is measured by a cumulative score of environmental burden (as determined by CalEnviroScreen Tool 3.0, developed by the California Office of Environmental Health Hazard Assessment). Other measures include psychosocial stressors, health history, and health behaviors (diet, physical activity, smoking, and sleep). To our knowledge, this will be the first study in minority young adults specifically designed to test the role of high environmental burdens on allostatic load. This interdisciplinary research will provide a better understanding of the relationship between social determinants and biological mechanisms during the period of late adolescence/young adulthood. This pilot study of minority youth was designed to determine the role of environmental discrimination in biological stress responses (i.e., allostatic load). Targeted research can support structural changes in environmental protections and public awareness. Preventive measures in cardiometabolic diseases targeted at minority youth will reduce disease and suffering and will reduce the public burden of disease.