Lifecourse epidemiology addresses how the health effects of social, behavioral, clinical or biological exposures at certain times shape health and development in the short- and long-term. Its premise is that there may be life stages when people experience meaningful changes that are particularly relevant to their health. Pregnancy, birth, adolescence and aging have been the main focuses of this research.
Alison Cohen, PhD, MPH, assistant professor of epidemiology and biostatistics at UCSF, is adding early adulthood to this body of research. She co-led a national longitudinal survey of emerging adult college students with Lindsay Hoyt, PhD, of Fordham University, documenting widening health inequities and gendered differences in mental health during the first two years of the COVID-19 pandemic. She was recently awarded an R01 for a five-year research project at two public Hispanic-Serving Institutions of higher education in California.
College is often a time of transition to economic and educational independence. Hispanic-Serving Institutions can serve as vehicles for social mobility for their racially, ethnically and socioeconomically diverse students.
“The health behaviors that you have in emerging adulthood position you for the rest of your life, especially in cardiometabolic health,” Cohen said.
Education and socioeconomic position are significant drivers of health outcomes and can contribute to health inequities across racial and ethnic divides. Identifying potential risks and protective factors for cardiometabolic health among diverse populations in this age range could help inform efforts to promote cardiovascular health and reduce cardiovascular health inequities for people across their lifespans.
Cohen’s study, co-led with Hoyt, is known as the 3E Study (Economic and Educational Contributions to Emerging Adults’ Cardiometabolic Health). It is enrolling first-year students from UC Riverside and California State University, East Bay, to share their academic records, respond to surveys, and participate in campus health visits measuring height, weight and blood pressure. A smaller group of participants will also run a smartphone app that tracks physical activity and sleep. The study also seeks to address another gap in current research on health disparities: a lack of data from Latine and Asian groups. Both campuses have large Latine and Asian student populations, which will result in more robust data to address health disparities for all groups.
These data points will show how financial stressors and educational protective factors affect cardiometabolic health. To capture the full range of college experiences among diverse, lower-income young people, the study will follow these students through their first three years of college education. If they leave college before graduating, they will remain in the study to offer important insights about this particularly understudied population of emerging adults. Cohen and Hoyt also hope to continue following the cohort beyond their early 20s if they can obtain additional grant funding.
“Students are experiencing tradeoffs between education and economics that seem important to document,” she said. “Education is usually a positive social determinant of health, but part of that comes through economic standing, and education is also often accompanied by debt. We hope our research can inform strategies for equitably investing in young people and their futures.”