Connecting the social and built environment to health and health inequalities

Grace Noppert

Research Assistant Professor, Social Environment and Health Program

As a social and infectious disease epidemiologist, my work examines the inequitable distribution of infections in the population and the consequences for the aging of the immune system across the life course. My work lies at the intersection of infectious disease, social epidemiology, and aging. I am particularly interested in how social processes such as racism, sexism, and socioeconomic status accelerate patterns of biological aging, particularly through the wear and tear of the immune compartment. Additionally, a significant portion of my research involves utilizing surveillance data from state and local health departments to understand long-standing disparities in infectious diseases in the U.S. I received my PhD in Epidemiology at the University of Michigan in 2016. I currently work on a NIA-funded project examining life course social disadvantage and immune aging using data from the Health and Retirement Study, the National Longitudinal Study of Adolescent to Adult Health, and the Detroit Neighborhood Study.

Research Projects

Immunosenescence, socioeconomic disadvantage and dementia in the US aging population

(NIH/NIA R01 AG075719)

Many questions remain regarding the role of immunity in the etiology of cognitive decline and Alzheimer’s Disease and related dementias (ADRD). Using the Health and Retirement Study (HRS), we will examine associations between peripheral immunosenescence and cognitive function, decline, and incident ADRD, with specific attention to social inequalities in these processes.

Social Disadvantage and Its Impact on Pathogen Burden and Immune Dysfunction Across the Life Course

(NIH/NIA R00 AG062749)

Disparities in aging persist despite robust efforts to ameliorate them. Sociobiological processes beginning in childhood are increasingly being examined as critical drivers of these disparities. This project seeks to explore the impact of early life experiences of poverty and stress on later life inflammation and immune dysfunction, with a specific focus on infectious burden as a key mediator of these processes.

Examining how the Social and Physical Neighborhood Environment Shapes the Distribution of SARS-CoV-2 Infections in the U.S.

(NIH/NIA; R24 045061; Pilot Grant)

The burden of COVID-19 in the U.S. has not been equitable at either the individual- or neighborhood-level. Yet, a lack of fine-scale, spatially-referenced SARS-CoV-2 infection data is not available for the U.S. as a whole, impeding our ability to further investigate these trends. Such data would allow for the accurate identification of who is at risk for COVID-19, both individuals and communities, and why and how the burden has shifted across time and space. While SARS-Co-V-2 infections have been differentially distributed across neighborhoods, the mechanisms through which the neighborhood social and physical environment shape the burden of COVID-19 remain unknown. Thus, the long-term goal of this research is to identify neighborhoods that will likely have lasting social and economic consequences from the COVID-19 pandemic so that we can then begin to under-stand the implications for population health trends going forward, and particularly age-related decline and dis-ease trends. Our long-term hypotheses are that there are hidden, fine-scale, spatial inequalities in the distribu-tion of SARS-CoV-2 infections, and those differences a) are related to pre-pandemic neighborhood conditions, b) influence the neighborhood demographic shifts that have occurred as a result of the pandemic, and c) will have lasting consequences for population health trends post-pandemic. Using fine-resolution, spatially-referenced data, we can better determine which aspects of the neighborhood context drive the observed dis-ease trends, something that is not possible using only the state- or county-level data currently available.

A National Neighborhood Data Resource to Understand Inequities in the Health and Socioeconomic Impacts of COVID-19 in the United States

(NIH/NINR; U01NR020556)

The consequences of the COVID-19 pandemic have been unequally felt by individuals and communities across the United States. To understand these patterns, we will create, integrate, and share data on neighborhood characteristics, both before and since the pandemic, that can be readily linked to existing survey or cohort studies at various levels of geography. This national neighborhood data (NANDA) resource will support the scientific community in understanding the mechanisms that may convey risk and resilience, particularly in underserved and vulnerable populations, and will allow us to more effectively prepare for the next public health emergency.

Key Publications

  • GA Noppert & L Zalla. “Who Counts and Who Gets Counted? Health Equity in Infectious Disease Surveillance.” American Journal of Public Health. 2021 (in press).
  • Duchowny K & Noppert GA. “Examining the Association between Cytomegalovirus and Disability by Race/Ethnicity and Gender: Results from the Health and Retirement Study.” American Journal of Epidemiology. 2021.
  • GA Noppert, L Gaydosh, KM Harris, A Goodwin, & RA Hummer. “Is Educational Attainment Associated with Young Adult Cardiometabolic Health?” SSM-Population Health. 2021; 100752.
  • RC Stebbins, GA Noppert, YC Yang, JB Dowd, A Simanek, & AE Aiello. “Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study.” American Journal of Epidemiology; 2021 (in press).
  • Zalla L, Martin C, Edwards JK, Gartner D, & Noppert GA. “A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States.” American Journal of Epidemiology. 2021.
  • GA Noppert, RC Stebbins, JB Dowd, RA Hummer, & AE Aiello. “Life Course Socioeconomic Disadvantage and the Aging Immune System: Findings from the Health and Retirement Study.” The Journals of Gerontology: Series B. 2020.
  • N Snyder-Mackler, JR Burger, L Gaydosh, DW Belsky, GA Noppert, FA Campos, A Bartolomucci, YC Yang, AE Aiello, A O’Rand, KM Harris, CA Shively, SC Alberts, & J Tung. “Social Determinants of Health and Survival in Humans and Other Animals.” Science. 2020; 368 (6493).