Midlife Health Inequities in the Rural South

Project Description

This study builds on the Great Smoky Mountains Study (GSMS), a study originating at Duke, and now currently following participants in the Great Smoky Mounties Study of Rural Aging (GSMS-RA). This study, Midlife Health Inequities in the Rural South (HIRS) aims to create a new consortium of samples for the study of midlife health inequalities, focused on residents in the Black Belt counties of North Carolina. As in GSMS-RA, this proposal does not focus on specific research questions but on creating a resource to be drawn from related to rural health and aging.

Project Goals

  1. HIRS will identify, recruit, and consent a sample of 350 African American (AA) adults and 350 non-African American adults and administer a harmonized data collection protocol from the GSMS-RA that covers health, health risk, cognition, and social and economic functioning in midlife, as well as bio-measure collection. In addition, this protocol will include assessments of racial identity, discrimination (including experiences of racism at individual and structural levels) and stigmatization as factors that may drive midlife rural health. Individual data will be supplemented with administrative data that reflect geographic-contextual social/economic risk/resilience factors.
  2. HIRS will evaluate everyday life and the rural context of adults in eastern North Carolina by following participants for 6 months with
    1. an Ecological Momentary Assessment (EMA) protocol assessing within-subject variability in health, wellness, economic, and social functioning,
    2. actigraphy to assess physical activity and sleep (three 1-week observations), and
    3. geospatial movement using GPS monitoring to assess activity space. This in-depth individual information will be coupled with community and neighborhood profiles assessed via Census data linkage to block groups/census tracts, systematic social observations of neighborhoods, and participant/neighborhood surveys on collective efficacy (i.e., social cohesion and informal social control).
  3. Data collection will facilitate urban/rural and local/national comparisons by harmonizing measures of core constructs to maximize overlap with key aging studies, creating cross-walked codebooks between HIRS and key studies, and constructing multi-study model datasets.
  4. HIRS will have a comprehensive data-sharing program to maximize access and use of HIRS for scientists and potential collaborators.

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