Multidimensional structural racism and moderating role of psychosocial resources on cancer-control behaviors in African Americans

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Project Summary Cancer disparities impacting African Americans are deeply rooted in historical social injustices such as structural racism, housing discrimination and redlining, struggling educational systems, and concentrated poverty. It is well-established that the neighborhood where a person lives can have a considerable impact on their health and health behaviors. This includes cancer control behaviors, a primary driver of cancer incidence and mortality. Our preliminary data suggests that neighborhood characteristics contribute uniquely to cancer control behaviors beyond individual factors in African Americans. However, little is known about multi-level and longitudinal influences of structural racism and discrimination in predicting cancer control behaviors, and the potential role of protective psychosocial resources. This is particularly true among African Americans, who suffer a disproportionate cancer burden. The proposed study will quantitatively measure SRD, evaluate its longitudinal role in cancer control behaviors, and examine the moderating role of psychosocial resources in African American adults. In Aim 1, we will construct an index of structural racism and discrimination from publicly available data for use in the Aims 2 and 3 analysis. In Aim 2, we will evaluate the relative contributions of the impact of historical, long-term, and current place-based exposure to structural racism and discrimination on cancer control behaviors (e.g., diet, smoking, physical activity, screening) in probability samples of African Americans from four focal states (N=5000) via a multilevel analysis. In Aim 3, we will test the moderating role of psychosocial resources in the relationship between exposure to SRD and cancer control behaviors in African Americans. Study findings will have important implications for policy and community interventions to eliminate persistent cancer disparities that disproportionately impact African Americans.