Impact of the Neighborhood-Level Exposome on Waking Cortisol and Diurnal Slope. (September 2021) - Stephens, A.I.
Abstract : Background: The exposome is a metric of structural racism, connecting ecological context with environmental exposure and includes variables revealing resource-allocation legacy effects stemming from segregation, such as neighborhood safety (NS). There is a need to dismantle structural racism by understanding how NS disproportionately affects people of color. Methods: We collected salivary cortisol and examined perceptions of neighborhood safety (NS) on waking cortisol levels (WCL) and diurnal cortisol slopes (DCS) (n=127 Blacks, 148 Whites). Regression analyses on the interaction between race, WCL, DCS, and NS probed structural racism effects. Results: In unsafe neighborhoods, Blacks trended toward lower WCL (B=-.127, p=.056). Participants in unsafe neighborhoods (Black=13, White=16) trended toward higher WCL (B=.17, p=.068). A significant race interaction (B=-.279, p=.005) showed Blacks had blunted DCS (B=.286, p<.001) in unsafe neighborhoods. There was no difference in DCS for Blacks and Whites in safe neighborhoods. Conclusion: Beyond race, exposomal NS affects WCL. Though the exposure to NS was not different by race, unsafe perception impacted Blacks differently than Whites, indicating race-based structural implications.