Increases in anti-immigrant policy and rhetoric occurring since 2017, coupled with the Covid-19 pandemic, raise serious public health concerns regarding the large and growing Latinx youth population. Family and biological stress processes are key mechanisms through which immigration changes and the ongoing pandemic may compromise a range of health outcomes from adolescence through the transition to adulthood. Family stress processes such as perceived financial strain, maternal depression, and parent-youth conflict elevate risks to youth?s health outcomes directly and indirectly through biological stress processes and ineffective parenting. Cortisol is a key biological mechanism explaining how adversity during adolescence is harmful to later mental and physical health. Chronic, frequent, and/or severe exposure to stress can lead to over- and/or repeated stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and a release of cortisol. Over time, this process may lead to either heightened or reduced overall cortisol levels, as well as flatter diurnal slopes in daily cortisol output, a process harmful for a range of health outcomes. Serious research gaps limit our understanding of pathways linking adversity, stress processes, and indicators of health for Latinx adolescents and young adults. The main goal of this application is to expand Pathways to Health/Caminos Al Bienestar (Caminos), an ongoing study collecting 8 time points of data over a period of 4 years for 547 Latinx adolescents and, for 50% of them, their mothers. Building on the investigative team?s initial set of compelling findings, we propose to (1) collect 4 additional annual time points of data; (2) assess diurnal cortisol slopes and overall cortisol levels using, respectively, saliva and hair cortisol samples; and (3) assess youth?s chronic disease risks. The resulting 12 time points of data following youth from ages 11-14 through ages 18-22 will advance knowledge regarding family and biological stress processes explaining how adversity during adolescence influences Latinx mental health, substance use, social functioning, and chronic disease risk through the transition to adulthood. We will use multi-level Structural Equation Modeling to test the hypothesis that family and biological stress processes mediate associations between immigrant- and Covid-19 related adversity during early and middle adolescence and health during the transition to adulthood. Tests of moderated mediation will identify community-, family-, and individual-level strengths buffering negative impacts of (a) adversity on stress processes and (b) family stress processes on youth outcomes. Sex as a biological variable is examined as a key modifier. The use of culturally informed theory, multi-level data, and multiple mediation models, coupled with evidence of high retention in the ongoing study strengthen significance, innovation, and scientific rigor. There is a pressing need to identify how U.S. policies, communities, and schools may best prevent health problems for Latinx youth as they prepare to enter adulthood. Our findings will address immediate needs to inform policy and intervention and will have lasting utility for research and practice addressing health inequities among the Latinx population.
George Washington University
09/23/2021 to 05/31/2023