Blacks have the highest infant mortality rate of any racial or ethnic group in the United States. And the disparities are stark. Black pregnant people in the U.S. experience preterm birth at rates approximately 2 times that of White pregnant people and Black infants are twice as likely to die within the first year. In this episode, we are joined by University of Minnesota health equity researchers Drs. Rachel Hardeman and Tongtan (Bert) Chantarat who are working to change that pattern and advance reproductive health equity. By exploring replicable and theoretically sound measures of structural racism, these researchers hope to reveal evidence of its harm to maternal-child health and thereby identify pathways for intervention.   References 1.     Hardeman RR, Homan PA, Chantarat T, Davis BA, Brown TH. Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy, Health Affairs. February 2022 2.     Chantarat T, Van Riper DC, Hardeman RR, Multidimensional structural racism predicts birth outcomesfor Black and White Minnesotans, Health Services Research. June 2022 3.     Multidimensional Measurement of Structural Racism: Learnings from an Interview with Dr. Tongtan (Bert) Chantarat, Evidence for Action Blog. August 2022 4.     Hardeman RR, Chantarat T, Smith ML, et al. Association of Residence in High–Police Contact Neighborhoods With Preterm Birth Among Black and White Individuals in Minneapolis, JAMA Network Open. December 2021

Structural racism is a core cause of health inequities. Providing evidence of that relationship requires a reliable method to measure structural racism. Frequently, measurements of racism are too simplistic and feed the false narrative that race, rather than racism, is the cause of racial health inequities. In this episode, Dr. Roland J. Thorpe, Jr., a gerontologist and social epidemiologist at the Johns Hopkins Bloomberg School of Public Health, joins podcast hosts Drs. Szanton and Crews to discuss a framework for assessing structural racial discrimination across contexts, geography, and the life course with the aim of dismantling structural racism and advancing health equity. References: Thorpe RJ, Szanton SL, LaFave SE. Structural Racial Discrimination and Structural Resilience: Measurement Precedes Change. The Journals of Gerontology. February 2022 LaFave SE, Bandeen-Roche K, Gee G, Thorpe RJ, Li Q, Crews D, Samuel L, Cooke A, Hladek M, Szanton SL. Quantifying Older Black Americans’ Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim? Journal of Urban Health. April 2022 Dean LT, Thorpe RJ. What Structural Racism Is (or Is Not) and How to Measure It: Clarity for Public Health and Medical Researchers. American Journal of Epidemiology. September 2022

Drs. Sarah Szanton and Deidra Crews kick off Aging Fast & Slow Season 2 with guest Dr. Paris "AJ" Adkins-Jackson, Assistant Professor in the Departments of Epidemiology and Sociomedical Sciences at Columbia University Mailman School of Public Health. One big question for health researchers is how to measure structural racism in different places and systems. Dr. Adkins-Jackson is among the leading number of scientists working in this area. She joins us to discuss her research on the health impact of structural racism and to provide recommendations for how epidemiologists and other health researchers can measure structural racism, including approaches taken by other fields.  References: 1.      Adkins-Jackson PB, Incollingo Rodriguez AC. Methodological approaches for studying structural racism and its biopsychosocial impact on health. Nursing Outlook. September 2022 2.      Adkins-Jackson PB, Chantarat T, Bailey ZD, Ponce NA. Measuring Structural Racism: A Guide for Epidemiologists and Other Health Researchers. American Journal of Epidemiology. April 2022 3.      Adkins-Jackson PB, Jackson-Preston PA, Hairston T. “The only way out”: How self-care is conceptualized by Black women. Ethnicity & Health. 2022

Tune in as we interview cutting-edge scientists, policy experts, and innovators as we seek to understand structural discrimination, and resilience across the lifecourse and the impact on health inequities with aging. Podcast guests will speak about their research or work, ‘aha’ moments, and next topics for exploration.

Wrapping up Season 1, Dr. Lisa Cooper stresses the importance of trust as a key ingredient for the patient-physician relationship, community engagement, and crisis response. Podcast References: Race, Gender, and Partnership in the Patient-Physician Relationship Unmasking and Addressing COVID-19’s Toll on Diverse Populations A Game Plan to Help the Most Vulnerable COVID-19 and Health Equity – A New Kind of “Herd Immunity” Twitter: @LisaCooperMD, @JHhealthequity, @JHUrbanHealth Continue the Conversation: Twitter: @agingcenter Email: [email protected] Episode 5 Transcript

Episode 4 of Aging Fast & Slow highlights how business collaborations drive systems change to achieve social impact. Guest Stephen Johnston describes how Aging2.0 accelerates innovation through its global community and collective intelligence platform to improve the lives of older adults. Podcast References: Aging2.0 Connect with your local Aging2.0 Chapter The Collective Aging2.0’s COVID-19 Request for Critical Topics and Innovations Twitter: @sdbj, @Aging20, @TheA2Collective Continue the Conversation: Twitter: @agingcenter Email: [email protected] Aging Fast & Slow Episode 4 Transcript

Even amid the COVID-19 outbreak, chronic conditions don't take a break. In honor of National Kidney Month, we talk to Aging Fast & Slow’s own Dr. Deidra Crews, a nephrologist at Johns Hopkins. She tells us how kidney health inequities impact us all and how common they are. Dr. Crews also helps us understand what epidemiology and intervention research are, how they differ, and how she uses both in her work. Podcast References: 5 Plus Nuts & Beans for Kidneys Study Johns Hopkins Center for Health Equity Twitter: @DrDeidraCrews Continue the Conversation: Twitter: @agingcenter Email: [email protected] Episode 3 Transcript

Summary: Dr. Keith Whitfield, an expert in aging among African Americans and the Provost at Wayne State University, joins hosts Dr. Sarah Szanton and Dr. Deidra Crews for the second episode of Aging Fast & Slow. Together they discuss the impact of desegregation on cognition by looking at stress and longevity within and among African American families. Podcast References: Publications Education in Time: Cohort Differences in Educational Attainment in African-American Twins Education Desegregation and Cognitive Change in African American Older Adults Book recommendations Handbook of Minority Aging by Keith Whitfield and Tamara Baker Continue the Conversation:Twitter:@agingcenter Email: [email protected] Episode 2 Transcript

Episode Summary: Hosts Dr. Sarah Szanton and Dr. Deidra Crews kick off Aging Fast & Slow with guest Dr. Elissa Epel, professor of psychiatry at UCSF. Dr. Epel’s research seeks to understand the root of health disparities, and the role of chronic stress within aging. Together they unpack her recent work which reveals how the impact of systemic oppression is transmitted intergenerationally. Podcast References:Sign up: UCSF’s Aging, Metabolism, & Emotional Research newsletter Publications: Accelerated telomere shortening in response to life stress Racial discrimination and telomere shortening among African Americans: The Coronary Artery Risk Development in Young Adults (CARDIA) Study Can Childhood Adversity Affect Telomeres of the Next Generation? Possible Mechanisms, Implications, and Next-Generation Research More than a feeling: A unified view of stress measurement for population science. Continue the Conversation:Twitter: @agingcenter [email protected] AgingFast & Slow Episode 1 Transcript

Some people age faster than others, but why? Our podcast hosts Dr. Sarah Szanton, a nurse practitioner with a research degree, and Dr. Deidra Crews, a nephrologist, will seek to answer this question. They will talk to scientists, policy experts, and innovators to better understand aging across the life course, and also differences in aging - due to societal structures, community factors, and even our own cells. Learn More: https://nursing.jhu.edu/agingfastandslow