Impact of Environment on Disparities

Research Summary

hands, heartbeats, and figure on bed

The Social and Environmental Determinants of Health Equity Group investigates how the physical and social environments influence racial, ethnic, and socioeconomic disparities in cardiometabolic health and wellbeing. In addition to identifying the biological mechanisms by which factors in the physical and social environments affect health and contribute to health inequities, the group is interested in the translation of epidemiologic findings into novel environmental interventions, policies, and practices that address structural, macro-level, as well as individual-level barriers to achieving and maintaining optimal health.

The group, to date, has revealed novel areas for further inquiry and the need to identify the root causes of health inequities or social determinants of health through upstream investigations of, for example, racial/ethnic and socioeconomic disparities in the work-sleep relationship and its downstream health effects. Currently, the group’s major effort involves studying how attributes of neighborhood, housing, and work conditions affect sleep health (insufficient sleep duration and inadequate sleep quality) and cardiometabolic dysfunction (e.g. obesity, type 2 diabetes, cardiovascular disease) in under-resourced populations.

Grounded in the socioecological and biopsychosocial conceptual frameworks, the group’s research centers around answering the following research questions related to the fundamental causes of well-observed inequities in sleep health:

  • What modifiable and non-modifiable factors in the physical and social environments contribute to suboptimal sleep health and subsequent risk of 1) obesity, 2) type 2 diabetes, and 3) cardiovascular disease?
    • Do these factors and the magnitude of their influence differ by race, socioeconomic status, age, and sex? If so, why?
  • How do social determinants (e.g. occupational, housing, and/or educational factors) affect cardiometabolic dysfunction and contribute to racial/ethnic health inequities?
  • Do independent evidence-based improvements in physical and social environments lead to individual-level improvements in sleep health among racial/ethnic minority and low-income adults, children, and infants? Do improvements in sleep health translate into enhanced cardiometabolic health?
  • What environmental interventions are most likely to improve population health and mitigate racial/ethnic and socioeconomic cardiometabolic health inequities in a cost-effective manner?

Group members use observational epidemiology studies and mixed methods research to inform prospective studies and future behavioral interventions. Our ultimate goal is to use these approaches to provide scientific evidence that informs policies and practices designed to improve population health and address unjust and costly health disparities.

Jackson joined the NIEHS Epidemiology Branch as an Earl Stadtman Investigator in 2017, and also holds a secondary appointment at the National Institute of Minority Health and Health Disparities. She earned a M.S. in Cardiovascular Epidemiology from the Harvard T.H. Chan School of Public Health and Ph.D. in Cardiovascular Epidemiology from The Johns Hopkins University Bloomberg School of Public Health. She conducted epidemiologic research as an Alonzo Smythe Yerby postdoctoral fellow at the Harvard T.H. Chan School of Public Health and a Research Associate at the Harvard Catalyst Clinical and Translational Science Center. 

Her research has been presented at national scientific conferences and published in academic journals (e.g., JAMA Internal Medicine, American Journal of Epidemiology), as well as major media outlets (e.g. US News & World Report, The New York Times). Jackson also serves as a member of the editorial board of Sleep Health, the journal of the National Sleep Foundation. She has received merit-based awards at Johns Hopkins and Harvard, including the Charlotte Silverman Award for outstanding commitment to public health, policy, and community outreach, an Outstanding Fellows Award at Harvard, as well as the Novartis Institutes Biomedical Research Postdoctoral Award.  

If you are interested in collaborating or joining the research group, please contact Dr. Jackson via email. Trainee positions are available for postdoctoral fellows, graduate and undergraduate students living in the Research Triangle Park area, as well as summer interns.


Jackson Health Study (JHS)

The Jackson Heart Study is the largest single-site, prospective, epidemiologic investigation of cardiovascular disease among African Americans ever undertaken. It is also the largest study in history to investigate the inherited (genetic) factors that affect high blood pressure, heart disease, strokes, diabetes and other important diseases in African Americans.

Multi-Ethnic Study of Atherosclerosis (MESA)

The Multi-Ethnic Study of Atherosclerosis (MESA) is a study of the characteristics of subclinical cardiovascular disease (disease detected non-invasively before it has produced clinical signs and symptoms) and the risk factors that predict progression to clinically overt cardiovascular disease or progression of the subclinical disease. MESA researchers study a diverse, population-based sample of 6,814 asymptomatic men and women aged 45-84. Approximately 38 percent of the recruited participants are white, 28 percent African-American, 22 percent Hispanic, and 12 percent Asian, predominantly of Chinese descent.

Study of Environment, Lifestyle & Fibroids (SELF)

The Study of Environment, Lifestyle and Fibroids (SELF) seeks to identify risk factors for uterine fibroid development. The study has enrolled a cohort of 1,696 African-American women, ages 23-34, from the Detroit, Michigan area. In addition to data related to uterine fibroids, risk factor and symptom data, physical measurements, as well as blood, urine, and vaginal swab specimens have been collected at enrollment. Specimens and questionnaire data are being collected at each follow-up visit.

The Sister Study 

The Sister Study prospectively examines environmental and familial risk factors for breast cancer and other diseases in a cohort of 50,000 sisters of women who have had breast cancer. Breast cancer-free participants aged 35-74 from across the U.S. territories who had a sister diagnosed with breast cancer enrolled from 2003-2009 by providing questionnaire data about life-time exposures and completing home exams including collection of biological samples. Participants are being followed with brief annual updates and periodic comprehensive questionnaires.