Connecting the social and built environment to health and health inequalities

Margaret Hicken

Research Assistant Professor, Survey Research Center, Institute for Social Research

Research Assistant Professor, Division of Nephrology, Department of Internal Medicine, Michigan Medicine

Faculty Associate, Population Studies Center, Institute for Social Research

Director, RacismLab

Director, Americans’ Changing Lives, Wave 6

Through my entire research program, I am committed to clarifying the social causes and biological mechanisms linking racial group membership to renal and cardiovascular disease inequalities. The major hallmark of my research is the integration of scientific knowledge from diverse disciplines, as this transdisciplinary approach to research allows for creative and innovative insights into the root causes and mechanisms of the seemingly intractable racial health inequalities. A significant portion of my research program falls at the intersection of sociology, geography, and environmental toxicology, examining the interrelated roles of racial residential segregation, neighborhood disadvantage, environmental hazards, and racial health inequalities.

Research Projects

  • Racial Inequalities in Health Throughout Adulthood: The Cumulative Impact of Neighborhood Chemical and Non-chemical Stressors on Epigenomic Pathways

    (NIH/NIMHD 5R01MD013299)
    Racial inequalities in healthy aging have been well-documented. Compared to White Americans, Black Americans experience illness and death at early ages and show steeper age-related declines in health. Our neighborhoods, as the site of where we live, learn, play, and pray, may serve as a powerful source of these racial inequalities. Racial residential segregation (which is the sorting of different racial groups into different neighborhoods through historical and current discriminatory policies and practices) has resulted in a racially unequal American neighborhood landscape. Neighborhoods with mostly Black residents experience more poverty, civic and commercial disinvestment, and more exposure to environmental hazards compared to neighborhoods with mostly White residents. While more researchers are documenting the role of neighborhoods in health inequalities, we may actually be underestimating the true impact of neighborhood context, because we often focus on specific health outcomes, such as cardiovascular disease or diabetes. However, there are likely shared biological mechanisms within the body that drive many of these diseases – and one such mechanism may be changes to our genomic structure, called epigenomics. While our genes do not change, the environment can have an impact on whether our genes are actually “expressed”. We will determine whether the accumulation of adulthood lived experience in racially-segregated neighborhoods is related to epigenomic patterns called DNA methylation. We will also specifically determine whether the accumulation of adulthood exposure to neighborhood industrial air pollution and disadvantage together are related to these patterns of DNA methylation. Finally, we will determine whether the DNA methylation patterns we see are related to racial inequalities in healthy aging. We hypothesize that racially-segregation Black neighborhoods, with their greater levels of industrial air pollution and social disadvantage, will be related to the types of patterns in DNA methylation that have been shown to be related to chronic diseases in molecular studies. In fact, we further hypothesize that these patterns in DNA methylation will be related to racial inequalities in cognitive function and the number of chronic diseases one has had. Clarifying the role of neighborhood context in racial inequalities in healthy aging is critical, as neighborhoods are not naturally- occurring. They develop and change through policies and are amenable to intervention. Identifying the role of DNA methylation that likely underlies many chronic diseases, will clarify the importance of neighborhoods and point to potential effective interventions.

  • DNA methylation in context: Racial inequities in social adversity and vulnerability to the health impact of air pollution

    (NIH/NIA; R01 AG074887)
    Black-White inequities in healthy aging are well-known with Black adults experiencing greater risk of developing and earlier onset of chronic conditions such as cardiovascular disease (CVD), hypertension, and diabetes compared to White adults. Neighborhood context has emerged as a potentially powerful determinant of racial inequities in aging-related health conditions, including cognitive decline, and may be a key intervention site. Neighborhoods include both social and environmental exposures important for healthy aging. Evidence indicates stark racial inequities in exposure to segregated, under-resourced but over-surveilled and polluted neighborhoods. Pollution and aspects of social adversity are often correlated and may operate cumulatively to result in racial health inequities. Importantly, however, these chemical (i.e. pollution) and non-chemical (i.e., social adversity) stressors may act synergistically, whereby exposure to social adversity can heighten vulnerability to the deleterious health impact of even low levels of pollution. Yet, the environmental and social science literatures – even the environmental and social epidemiology literatures – are largely separate. There is a pressing need to integrate the study of these exposures given their likely cumulative and synergistic effects on racial health inequities in order to direct effective interventions and policies. In addition to the gaps in our knowledge about the combined impact of chemical and non-chemical stressors on racial inequities in healthy aging, there is a need to focus on outcomes that may serve as biological pathways to numerous diseases. Research on either pollution or social adversity has tended to focus on specific health outcomes. Focus on a single disease may underestimate the overall health impact of these racially unequal exposures. It is critical to clarify the shared biological mechanisms that underlie numerous chronic diseases to understand the full impact of pollution and social adversity on racial health inequities. A growing literature points to the importance of epigenetic factors, particularly DNA methylation, linking socioenvironmental context to health. Indeed, it may be that epigenetic processes are an important mechanism through which inequities in both air pollution and social adversity are embodied. Our objective is to identify underlying DNA methylation mechanisms linking neighborhood segregation and ambient and industrial air pollution and social adversity to measures of healthy aging. Clarifying the role of neighborhood in racial health inequities is critical, as neighborhoods are amenable to intervention. Identifying the role of DNA methylation patterns reflecting racial segregation, including chemical and non-chemical stressors, can point to specific disease etiologies and causal mechanisms effective interventions to eliminate racial inequities in healthy aging.

    Selected Articles

  • Hicken MT, Hing A, Lee H. The weight of racism: Vigilance and racial inequalities in weight-related measures. Social Science and Medicine. 2018. 199:157-166.
  • Hicken MT, Kravitz-Wirtz N, Durkee M, Jackson JS. Racial inequalities in health: Framing future research. Social Science and Medicine. 2018. 199:11-18.
  • Hicken MT. Fundamental causes, social context, and modifiable risk factors in the racial/ethnic inequalities in blood pressure and hypertension: Invited commentary. American Journal of Epidemiololgy 2015. 182(4):354-357.
  • Hicken MT. Measurement and modeling of race and health in Brazil: Continuing the discussion. Cadernos Saude Publica 2017. 33(Suppl 1). doi:10.1590/0102-311×00084216.
  • Hicken MT, Dvonch JT, Schulz AJ, Mentz G, Max P. Psychosocial stress and vulnerability to the cardiovascular effects of fine particulate matter air pollution in Detroit. Environmental Research 2014. 133:195-203.
  • Hicken MT, Gragg R, Hu H. How cumulative risks warrant a shift in our approach to racial health disparities: The case of lead, stress, and hypertension. Health Affairs 2011. 30(10):1895-1901.

Curriculum Vitae (Word)

Email Margaret Hicken

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