Intergenerational health impacts of interpersonal and community-based violence: From childbirth to childbearing

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Project Summary This proposal outlines a 3-year post-doctoral training fellowship, designed to prepare the trainee for a career as an independent researcher at a major research university. The research and training plan are based on the applicant's interest in studying social determinants of health and how violence and social stress are structured and embodied in ways that can perpetuate health inequities across generations. Her career before graduate school involved applied mixed method research and public policy advocacy for minority populations experiencing disenfranchisement and human rights violations in Southeast Asia. During her graduate training she gained advanced training in epidemiologic, demographic, and social research methods in order to study structural causes of population health disparities. For her dissertation, she designed and completed her own survey at the Thai-Myanmar border among refugees, migrants, and local residents in order to better evaluate how maternal and child health is shaped by maternal life histories related to armed conflict, racism, military and police surveillance, and other forms of violence. She recruited over 800 mother-child pairs, 520 of which completed each survey component: in depth mother interviews, anthropometry, and hair sample collections. The post-doctoral research and training that she proposes uses data she has already collected, along with complementary datasets from Southeast Asia and the US, that allow her to examine more closely how violence can influence maternal and child health, through social chains of risk and related biological mechanisms. She will model maternal chains of risk triggered by violence and potentially leading to adverse birth outcomes, from childbirth to childbearing, as they are indicated in life event histories collected among conflict- and displacement-affected populations at the Thai-Myanmar border (Aim 1) and as they have been measured prospectively in a US-representative cohort at the peak of family formation (Aim 2). She will focus in more closely on maternal biological stress as a mediator of past violence and adverse birth outcomes by examining how childhood and adolescent violence shape adult biological markers of stress and chronic inflammation among mothers before and during pregnancy based on cohort data from the Philippines (Aim 3). The proposed training plan involves the study of human biological and psychological models of stress and health physiology, along with practical training in the bioassays and analysis of stress biomarker data, in order to complete the proposed aims and prepare for an independent research career. Specific training goals include: (1) Deepen understanding of stress physiology and biosocial pathways of embodiment; (2) Broaden expertise with field-based longitudinal survey data collection and analysis; (3) Learn field-based stress data and biospecimen collection and related lab techniques and analyses; and (4) Establish publication record, prepare for faculty position, and write grants for future research.