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I WANT TO

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WELCOME YOU ALL AND THANK YOU

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FOR JOINING US TODAY AS WE BEGIN

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A LARGELY NOVEL RESEARCH

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DIRECTION FOR NIDDK

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UNDERSTANDING THE BIOLOGICAL

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MECHANISMS INFORMATION AND

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MECHANISMS OF RACISM,

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MARGINALIZATION AND

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DISCRIMINATION AND WE HAVE

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VIEWERS TUNING IN VIA NIH

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VIDEOCAST.

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WE HAVE TWO PRIMARY OBJECTIVES

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FOR THIS WORKSHOP.

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WE AIM FIRST TO IDENTIFY

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RESEARCH OPPORTUNITIES TO BETTER

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UNDERSTAND THE BIOLOGICAL

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PATHWAYS THROUGH WHICH RACISM,

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MARGINALIZATION AND

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DISCRIMINATION OR RMD, IN THE

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GOVERNMENT WE HAVE TO HAVE

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ACRONYMS FOR EVERYTHING,

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CONTRIBUTE TO NIDDK DISEASES AND

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THEN SECONDLY, WE'D LIKE TOE

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FOSTER CROSS POLINIZATION AND

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LOOKING AT CAREGIVERS AND BASIC

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SUNE TESTS, EPIDEMIOLOGISTS,

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HEALTH EQUITY RESEARCHERS AND

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MANY MANY OTHERS.

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WE HOPE THAT MANY MUCH YOU WILL

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LEAVE HERE AND LEAVE THIS

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MEETING WITH NEW IDEAS AND NEW

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COLLABORATIONS TO ADVANCE THIS

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TYPE OF SCIENCE WE'LL TAKE A

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MOMENT AND MARGINALIZATION AND

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DISCRIMINATION BASED ON SOCIALLY

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CONSTRUCTED CATEGORIES SUCH AS

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RACE AND ETHNICITY, SEXUAL

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ORIENTATION AND GENDER PRODUCE

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BIOLOGICAL CONSEQUENCES THAT

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CONTRIBUTE TO NEGATIVE HEALTH

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OUTCOMES AND HEALTH DISPARITIES

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IN MANY OF NIDDK'S DISEASES.

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KEY PATHWAYS OF COURSE LIKELY

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INCLUDING EXPOSURE TO ADVERSE

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SOCIAL DETERMINATES OF HEALTH OR

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SOCIAL RISK WHICH CAN STRAIN AND

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MODIFY HEALTH-RELATED BEHAVIOR

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OR AND DIRECT ALTERATIONS OF

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BIOLOGY BY TRIGGER FOR EXAMPLE,

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STRESS PATHWAYS AND MODIFYING

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BIOLOGICAL HOMEOSTASIS AND WHILE

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UNDERSTANDING THE

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PATHOPHYSIOLOGY IS SOMEWHAT

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LIMITED.

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AND THIS ALIGNS WITH KEY

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RECOMMENDATIONS AND

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OPPORTUNITIES FOR ADVANCING

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HEALTH DISPARITIES AND HEALTH

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EQUITY RESEARCH FROM A RECENT

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REPORT PUBLISHED JUST IN MARCH

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OF 2023 ENTITLED PATHWAYS TO

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HEALTH FOR ALL.

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IN PARTICULAR THIS WORKSHOP IS

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THE FIRST STEP IN ADVANCING

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RECOMMENDATION NUMBER 2, SHOWN

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THERE ON THE RIGHT TO ADVANCE

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RESEARCH ON THE MECHANISMS BY

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WHICH BIOLOGICAL, BEHAVIORAL,

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ENVIRONMENTAL AND STRUCTURAL

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FACTORS UNTO ACT TO AFFECT

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HEALTH, DISEASE AND RESILIENCE.

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THIS WORKSHOP DEMONSTRATES

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COMMITMENT TO STRENGTHENING

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COMMUNITY ENGAGEMENT.

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PEOPLE WHO EXPERIENCE

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DISCRIMINATION AND LIVE WITH

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CONDITIONS HAVE BEEN INVOLVED IN

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PLANNING THE WORKSHOP.

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IMMEDIATELY AFTER OUR PLENARY

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PANEL YOU'LL HERE DIRECTLY FROM

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PATIENTS AND THE COMMUNITY

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MEMBERS ON THEIR EXPERIENCE AND

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TRIN THEIR TOPIC.

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AND WE CALL ON ALL OF YOU IN THE

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ROOM TODAY TO SEEK MEANINGFUL

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RESEARCH COMMUNITY MEMBER

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PARTNERSHIPS TO ADVANCE THIS

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RESEARCH FIELD.

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ALSO, ENHANCING COLLABORATIONS

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AS WE BRING TOGETHER THE MANY

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RESEARCH PERSPECTIVES TO ADVANCE

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THESE DISEASES.

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BEFORE I PASS THE MIC BACK OVER

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TO OUR STAFF LEAD, I'D LIKE TO

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THANK THE EXTERNAL PLANNING

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COMMITTEE FOR THEIR THOUGHTFUL

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INPUT ON EVERY ASPECT OF THIS

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WORKSHOP.

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I'D ALSO LIKE TO THANK THE NIH

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INSTITUTES, CENTERS AND OFFICES

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WHO SUPPORTED THE PLANNING WITH

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TIME AND COMMIT.

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THEIR PROGRAM STAFF.

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IN PARTICULAR, I'D LIKE TO I'D

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LIKE TO THANK THE OFFICE OF

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BEHAVIORAL AND SOCIAL SCIENCE

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RESEARCH, OR OBSSR FOR THE NIH

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VIDEOCAST I MENTIONED.

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AND ONE ALL THE SINCERE THANKS

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I'D LIKE TO PASS IT BACK TO RACK

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RAQUEL AND OUR STAFF LEAD.

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THANK YOU.

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THANK YOU, DR. RODGERS FOR THAT

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WONDERFUL INTRODUCTION.

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AND SO TO FOLLOW UP ON -- I WANT

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TO OUTLINE SOME OF THE SPECIFIC

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RESEARCH QUESTIONS WE'LL BE

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ADDRESSING DURING TODAY'S

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WORKSHOP.

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WHAT ARE THE DIRECT MECHANISMS

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AND PATHWAYS UNDERLYING THE

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RELATIONSHIP BETWEEN RACISM,

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MARGINALIZATION AND

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DISCRIMINATION AND NIDDK

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DISEASES AND CONDITIONS AND

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LOOKING AT SEVERAL MECHANISMS OF

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INTEREST WHICH ARE LOOKING

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INCLUDING AT STRESS, ALLOSTATIC

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LOAD AND HOW DO THE MECHANISM OR

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PATHWAYS DIFFER OVERLAPPING OVER

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POPULATIONS EXPERIENCING RACISM,

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MARGINALIZATION AND

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DISCRIMINATION AND ACCOUNT FOR

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INTERSECTIONALITY.

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HOW DO THE BIOLOGICAL MECHANISM

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AND PATHWAYS DIFFER OR OVERLAP

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IN THE CONTEXT OF STRUCTURAL

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VERSUS INTERPERSONAL FORMS OF

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DRMD

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DEF

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ANOTHER QUESTION WE'LL ADDRESS

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IS WHAT BIO, SOCIAL FACTORS

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MITIGATE DISEASE CREATING

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DIFFERENTIAL HEALTH IMPACTS

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WITHIN SUBPOPULATIONS DESPITE

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EXPOSURE TO RMD.

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HOW DO WE IDENTIFY THE

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BIOLOGICAL MARKERS TO DESCRIBE

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THE EXPERIENCE OF RMD.

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DOES RACISM, MARGINALIZATION OR

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DISCRIMINATION CONTRIBUTE TO THE

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POPULATION LEVEL DIFFERS  --

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DIFFERENCES AND WHAT TOOLS IS

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DEVELOPED TO ASSESS THE IMPACT

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OF RMD ON HEALTH OUTCOMES?

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SO WE KNOW THAT DISCRIMINATION

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CONTRIB,

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RACISM AND DISCRIMINATION

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CONTRIBUTE TO DISPARATE POVERTY

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TRACT TO SOCIAL RISK THAT

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CONTRIBUTE TO DIFFERENT SHALL

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IMPACT ON DISEASE AND HEALTH

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OUTCOMES AND WE KNOW

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DISCRIMINATION AND STRUCTURAL

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RACISM AND MARGINALIZATION

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CONTRIBUTE THROUGH BIOLOGICAL

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MECHANISMS TO CONTRIBUTE TO

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HEALTH OUTCOMES AND THAT'S THE

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GOAL OF WHAT WE WANT TO FOCUS ON

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IN TODAY'S WORK SHOP.

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AND SO AS DR. RODGERS ALREADY

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STARTED TO ALLUDE TO WE'LL HAVE

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A PLENARY TALK FROM KEITH NORRIS

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EMPHASIZING THE FIND AND

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PROJECTING THE FUTURE FOR BIO

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MECHANISTIC RESEARCH AND HEAR

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FROM OUR PATIENT AND COMMUNITY

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PANEL ABOUT THEIR EXPERIENCES

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WITH RMD AND WHY THIS THIS

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TOPIC IS SO IMPORTANT AND THEN

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HAVE A LUNCH BREAK AND HAVE

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PANELS DIVING INTO THE BIOLOGIC

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MECHANISMS INCLUDING A PANEL ON

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TELOMERES AND EPIGENETIC

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MECHANISMS, PRENATAL AND FETAL

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MECHANISMS AND ALLOSTATIC LOAD

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AND INFORMATION AND CLOSING

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COMMENTS FROM OUR DEPUTY

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DIRECTOR.

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ON DAY TWO, SO TOMORROW WE'LL

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OPEN UP WITH POSTER SESSIONS AND

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WE ENCOURAGE YOU ALL TO ATTEND

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SINCE SOME OF THESE POSTERS WILL

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BE FROM JUNIOR FACULTY AND

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TRAINEES.

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WE WANT TO ENCOURAGE TO PURSUE

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RESEARCH IN THE SPACE AND THEN

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HAVE A PLENARY PANEL FOCUSSED ON

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UNDERSTANDING DIFFERENTIAL

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IMPACTS ON POPULATIONS AND

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FOLLOWED BY A PANEL ON BIO

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MECHANISMS AND ANOTHER LUNCH

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BREAK AND THE BREAKOUT GROUPS

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WHICH IS THE MEAT OF THIS

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CONFERENCE MEANT TO GUIDE FUTURE

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RESEARCH DIRECTIONS AND THE

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OPPORTUNITIES IN THIS AREA AND

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WANT TO HEAR FROM YOU AND HOPE

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YOU'LL PARTICIPATE IN THOSE

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DISCUSSIONS AND THEN WE CLOSE ON

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THAT LAST DAY.

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BEFORE WE LAUNCH INTO OUR

214
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SESSIONS I WANT TO GO THROUGH

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LOGISTICAL SESSION.

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WE HAVE A PACKED AGENDA AND

217
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WE'RE ALREADY STARTING LATE DUE

218
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TO TECHNICAL ISSUES AND WANT TO

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KEEP THE TALKS ON TIME.

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AND WE HAVE THE BIOS.

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THERE'S COFFEE AND SNACKS

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AVAILABLE FOR PURCHASE FROM THE

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HOTEL RESTAURANT AND WE

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ENCOURAGE YOU TO SIGN UP FOR

225
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DINNER.

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I KNOW MANY OF YOU ARE COMING

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FROM AFAR.

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WE CERTAINLY WANT TO FOSTER

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COLLABORATIONS THROUGH THIS

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CONFERENCE AND SO WE ENCOURAGE

231
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TO YOU SIGN UP FOR DIFFERENT AND

232
00:10:43,242 --> 00:10:46,479
IF YOU HAVE NOT SIGNED UP FOR A

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BREAKOUT GROUP WE ENCOURAGE YOU

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TO.

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>> A COUPLE QUESTIONS.

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[OFF-MIC]

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>> THERE MAY NOT BE -- I'LL

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CONFIRM WITH OUR ORGANIZER.

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THEY MAY BE AVAILABLE ONLINE AND

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00:11:13,406 --> 00:11:15,174
IF YOU GO TO THE WEBSITE THE

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00:11:15,241 --> 00:11:19,145
SPEAKER BIOS ARE LISTED THERE.

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WE DID ORGANIZE WITH THE

243
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RESTAURANT IN ADVANCE TO PROVIDE

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LUNCH BOXES YOU CAN QUICKLY GRAB

245
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A LUNCH BOX, PAY FOR IT AND

246
00:11:29,622 --> 00:11:30,523
REJOIN.

247
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WE DID TRY TO MAKE IT AS

248
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EFFICIENT AS POSSIBLE.

249
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I THINK IT'S THE ROOM NUMBER AND

250
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THEN I THINK WE'LL I'LL FIGURE

251
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OUT THE ONE FOR THE MEETING

252
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CONFERENCE AND CIRCULATE THAT TO

253
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YOU AND GRAB THE WI-FI.

254
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SO IF YOU GO OUT FRONT, THERE'S

255
00:12:21,373 --> 00:12:22,908
PEOPLE TO DIRECT YOU TO THE

256
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RESTROOMS AND EVERYTHING LIKE

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THAT.

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ALL RIGHT, ARE WE GOOD?

259
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ALL RIGHT.

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SO WITH THAT I'M GOING INVITE

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OUR NEXT SPEAKER, KEITH NORRIS

262
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IN THE HEALTH SERVICES RESEARCH

263
00:12:40,226 --> 00:12:42,094
AT UCLA.

264
00:12:42,161 --> 00:12:52,338
THANK YOU.

265
00:12:59,578 --> 00:12:59,678
DEF NOR

266
00:13:09,288 --> 00:13:17,363
>> HI, EVERYBODY.

267
00:13:17,429 --> 00:13:20,633
THANK YOU VERY MUCH, ANY

268
00:13:20,699 --> 00:13:22,334
QUESTION, I'M MORE THAN HAPPY TO

269
00:13:22,401 --> 00:13:22,768
ADDRESS.

270
00:13:22,835 --> 00:13:25,905
I'LL GIVE AN OVERVIEW OF THE

271
00:13:25,971 --> 00:13:27,072
ACTIVITIES FOR THE NEXT TWO DAYS

272
00:13:27,139 --> 00:13:27,940
BUT I WANT TO START OUT FIRST

273
00:13:28,007 --> 00:13:38,284
WITH THIS VIDEO.

274
00:13:45,491 --> 00:13:47,626
>> SO THAT'S REMUNERATION WITH A

275
00:13:47,693 --> 00:13:49,328
BUNCH OF STALLING AND THE

276
00:13:49,395 --> 00:13:51,897
QUESTION IS HOW DO THEY DO THAT

277
00:13:51,964 --> 00:13:52,531
WITHOUT RUNNING INTO EACH OTHER?

278
00:13:52,598 --> 00:13:58,003
ANYBODY.

279
00:13:58,070 --> 00:13:59,104
DO THEY GO TO A PLANNING MEETING

280
00:13:59,171 --> 00:14:09,448
IN THE MORNING?

281
00:14:14,920 --> 00:14:16,655
SOME AWARENESS.

282
00:14:16,722 --> 00:14:17,690
HOW DOES ANYBODY KNOW WHO TO

283
00:14:17,756 --> 00:14:21,493
START AND FOLLOW AND WHEN TO

284
00:14:21,560 --> 00:14:28,734
CHANGE, ETCETERA, ETCETERA?

285
00:14:28,801 --> 00:14:30,569
THIS IS A PHENOMENA.

286
00:14:30,636 --> 00:14:32,438
WE TEND TO CALL IT

287
00:14:32,504 --> 00:14:33,172
SELF-ORGANIZATION BUT WE REALLY

288
00:14:33,239 --> 00:14:33,839
DON'T KNOW.

289
00:14:33,906 --> 00:14:35,374
I THINK THERE'S A LEVEL OF

290
00:14:35,441 --> 00:14:40,312
AWARENESS AND WE THESE TO THINK

291
00:14:40,379 --> 00:14:43,983
ABOUT HOW THAT HAPPENS AND WHAT

292
00:14:44,049 --> 00:14:45,251
LEVEL IT HAPPENS AT.

293
00:14:45,317 --> 00:14:47,219
AS WE TALK OVER THE NEXT COUPLE

294
00:14:47,286 --> 00:14:49,521
DAYS WE NEED TO HAVE A DIFFERENT

295
00:14:49,588 --> 00:14:54,360
LEVEL OF THINKING, A CONCEPTUAL

296
00:14:54,426 --> 00:14:55,794
APPROACH TO SOLVE PROBLEMS TO

297
00:14:55,861 --> 00:14:57,496
TRANSCEND AND WE DO GOOD WORK

298
00:14:57,563 --> 00:14:59,765
AND ARE MAKING SOME LEVEL OF

299
00:14:59,832 --> 00:15:02,868
PROGRESS BUT THE QUESTION IS TO

300
00:15:02,935 --> 00:15:05,871
REALLY TAKE THE NEXT STEP IN

301
00:15:05,938 --> 00:15:10,576
MAKING RESOLUTION

302
00:15:10,643 --> 00:15:17,783
SCIENTIFICALLY, WHAT TYPE OF

303
00:15:17,850 --> 00:15:20,252
APPROACHES DO WE NEED AS

304
00:15:20,319 --> 00:15:30,796
SCIENTISTS TO GET US THERE.

305
00:15:50,082 --> 00:15:52,384
AS WE HEARD EARLIER, THERE'S A

306
00:15:52,451 --> 00:15:57,489
VARIETY OF STRUCTURAL FACTORS

307
00:15:57,556 --> 00:16:00,192
THAT FLOW DOWN STREAM TO THESE

308
00:16:00,259 --> 00:16:02,161
STRUCTURAL FACTORS AND UPSTREAM

309
00:16:02,227 --> 00:16:03,595
FACTORS THAT FLOW DOWN STREAM TO

310
00:16:03,662 --> 00:16:06,298
IMPACT HEALTH OUTCOMES.

311
00:16:06,365 --> 00:16:09,335
IF THOSE ARE NOT EQUITABLY

312
00:16:09,401 --> 00:16:11,603
DISTRIBUTED WE HAVE HEALTH

313
00:16:11,670 --> 00:16:11,904
DISPARITIES.

314
00:16:11,970 --> 00:16:13,972
WHAT WE THINK ABOUT IS NOT ONLY

315
00:16:14,039 --> 00:16:15,974
UP STREAM FACTORS BUT A LITTLE

316
00:16:16,041 --> 00:16:16,608
MORE DETAIL ABOUT THE DOWN

317
00:16:16,675 --> 00:16:20,279
STREAM FACTORS AND WHY WE'RE

318
00:16:20,346 --> 00:16:22,214
LOOKING TO BIOLOGICAL

319
00:16:22,281 --> 00:16:22,548
MECHANISMS.

320
00:16:22,614 --> 00:16:24,783
WE THINK RACISM, MARGINALIZATION

321
00:16:24,850 --> 00:16:27,619
AND DISCRIMINATION ARE STRESSORS

322
00:16:27,686 --> 00:16:28,187
AND THERE'S OTHERS.

323
00:16:28,253 --> 00:16:29,755
SOMETIMES THE STRESS IS NOT GOOD

324
00:16:29,822 --> 00:16:30,756
BUT SOMETIMES THE STRESS CAN

325
00:16:30,823 --> 00:16:32,725
WORK OUT PRETTY WELL.

326
00:16:32,791 --> 00:16:33,659
SO THERE'S BOTH STRESS AND

327
00:16:33,726 --> 00:16:38,430
ADAPTATION TO STRESS.

328
00:16:38,497 --> 00:16:41,900
SO AS WE HEARD EARLIER, TO THE

329
00:16:41,967 --> 00:16:45,104
ONES WE FOCUS ON ARE THOSE THAT

330
00:16:45,170 --> 00:16:47,139
COME FROM THAT WILL SOCIETALLY

331
00:16:47,206 --> 00:16:51,377
GENERATE AND WE THINK THE BIASES

332
00:16:51,443 --> 00:16:53,779
THAT WE HAVE AND STEREOTYPES

333
00:16:53,846 --> 00:16:57,216
PRODUCED, PREJUDICES, PEOPLE

334
00:16:57,282 --> 00:16:57,416
HAVE.

335
00:16:57,483 --> 00:16:59,651
THESE ARE BELIEFS AND THEY CAN

336
00:16:59,718 --> 00:17:02,087
HAVE AN IMPACT AND GREATER

337
00:17:02,154 --> 00:17:06,592
IMPACT WHEN WE HAVE ACTIONS.

338
00:17:06,658 --> 00:17:09,194
MICROAGGRESSIONS AND

339
00:17:09,261 --> 00:17:10,329
DISCRIMINATION THAT OCCURS AND

340
00:17:10,396 --> 00:17:11,864
RACISM IN ITS MULTIPLE FORMS

341
00:17:11,930 --> 00:17:13,899
WE'LL HEAR ABOUT OVER THE NEXT

342
00:17:13,966 --> 00:17:15,000
COUPLE DAYS.

343
00:17:15,067 --> 00:17:16,702
ALL THESE FACTORS LEAD TO STRESS

344
00:17:16,769 --> 00:17:17,770
OR CAN INCREASE STRESS IN THESE

345
00:17:17,836 --> 00:17:22,241
SPACES.

346
00:17:22,307 --> 00:17:27,212
AND WE WANT TO BE AWARE OF

347
00:17:27,279 --> 00:17:27,613
INTERSECTIONALITY.

348
00:17:27,679 --> 00:17:29,948
NONE OF THE STRESSES OCCUR IN

349
00:17:30,015 --> 00:17:30,215
ISOLATION.

350
00:17:30,282 --> 00:17:31,650
WE WANT TO BE THINKING ABOUT

351
00:17:31,717 --> 00:17:35,621
OTHER BIASES AND OTHER

352
00:17:35,687 --> 00:17:36,488
GROUP-LEVEL DISCRIMINATORY

353
00:17:36,555 --> 00:17:38,991
ACTION MAY OCCUR AND THEY'RE ALL

354
00:17:39,057 --> 00:17:40,893
GENERATED BY HAVING THESE

355
00:17:40,959 --> 00:17:42,161
STEREOTYPES OR BIASES AGAINST A

356
00:17:42,227 --> 00:17:43,996
GROUP AND ASSIGNING THAT BIAS TO

357
00:17:44,062 --> 00:17:47,833
EVERY INDIVIDUAL IN THE GROUP.

358
00:17:47,900 --> 00:17:48,867
SO I'VE HIGHLIGHTED A FEW OF

359
00:17:48,934 --> 00:17:51,003
THEM WE WANT TO THINK ABOUT

360
00:17:51,069 --> 00:17:52,438
BECAUSE THIS BECOMES IMPORTANT

361
00:17:52,504 --> 00:17:52,971
WHEN DOING RESEARCH.

362
00:17:53,038 --> 00:17:55,040
HOW DO WE CONTROL FOR THESE AND

363
00:17:55,107 --> 00:17:58,777
ACCOUNT FOR SOME OF THESE.

364
00:17:58,844 --> 00:18:01,380
SO WHAT ABOUT THE CLINICAL

365
00:18:01,447 --> 00:18:07,052
IMPLICATIONS OF RACISM,

366
00:18:07,119 --> 00:18:07,486
MARGINALIZATION AND

367
00:18:07,553 --> 00:18:09,488
DISRIMINATION?

368
00:18:09,555 --> 00:18:20,065
THIS IS FROM THIS IS FROM AND

369
00:18:36,315 --> 00:18:40,652
YOU SEE ALLOSTATIC LOAD AND

370
00:18:40,719 --> 00:18:45,524
OTHERS IMPACTING THE FUNCTION OF

371
00:18:45,591 --> 00:18:47,326
THE KIDNEY AND THE DEVELOPMENT

372
00:18:47,392 --> 00:18:51,964
AND PROGRESSION OF KIDNEY

373
00:18:52,030 --> 00:18:52,197
DISEASE.

374
00:18:52,264 --> 00:18:54,566
AND THERE'S PARALLEL ACTIVITIES

375
00:18:54,633 --> 00:18:59,972
IN OTHER AREAS IN NIDDK IN

376
00:19:00,038 --> 00:19:04,209
DIGESTIVE DISEASES, UROLOGIC AND

377
00:19:04,276 --> 00:19:11,049
METABOLIC DISEASES, ETCETERA.

378
00:19:11,116 --> 00:19:14,019
WHEN I THINK OF THOSE THESE ARE

379
00:19:14,086 --> 00:19:14,353
STRESSES.

380
00:19:14,419 --> 00:19:17,589
AND STRESS IS ONE THING BUT IT'S

381
00:19:17,656 --> 00:19:21,493
THE DESTRESS WHEN IT'S BAD.

382
00:19:21,560 --> 00:19:24,830
YOU GET THE COLD FROM THE

383
00:19:24,897 --> 00:19:26,565
PRESSURE AND THAT LEADS TO POOR

384
00:19:26,632 --> 00:19:28,000
COGNITIVE AND BIOLOGIC

385
00:19:28,066 --> 00:19:30,802
PROCESSING AND MANY OTHER

386
00:19:30,869 --> 00:19:31,136
FACTORS.

387
00:19:31,203 --> 00:19:34,206
SOME OTHER-ISMS, CLASSISM,

388
00:19:34,273 --> 00:19:35,908
POVERTY, SEXISM, ETCETERA, CAN

389
00:19:35,974 --> 00:19:38,243
ALL CONTRIBUTE TO HOW WE AS AN

390
00:19:38,310 --> 00:19:39,778
INDIVIDUAL CAN HANDLE WHATEVER

391
00:19:39,845 --> 00:19:43,448
IT IS WE'RE DOING.

392
00:19:43,515 --> 00:19:45,317
WHATEVER BALLS WE'RE JUGGLING.

393
00:19:45,384 --> 00:19:47,486
WHEN WE THINK ABOUT THE

394
00:19:47,553 --> 00:19:49,154
COGNITIVE PROCESSING AND THE

395
00:19:49,221 --> 00:19:51,290
NEURO LOGIC ASPECTS I THINK

396
00:19:51,356 --> 00:19:53,058
REALIGNMENT OF WHAT'S CALLED THE

397
00:19:53,125 --> 00:19:59,097
GLOBAL WORD SPACE OF THE BRAIN.

398
00:19:59,164 --> 00:20:01,300
WE LACK AT THE IMPACT ON THE

399
00:20:01,366 --> 00:20:02,401
COGNITIVE OR EXECUTIVE FUNCTIONS

400
00:20:02,467 --> 00:20:04,269
AND TWO OF THEM ARE MOST

401
00:20:04,336 --> 00:20:05,203
DRAMATICALLY IMPACTED.

402
00:20:05,270 --> 00:20:08,373
THE ABILITY TO REMEMBER, THE

403
00:20:08,440 --> 00:20:11,310
ABILITY TO IMPLEMENT TASKS.

404
00:20:11,376 --> 00:20:13,512
AND THEN THERE'S BIOLOGICAL

405
00:20:13,579 --> 00:20:16,014
PROCESSING THAT AFFECTS ALL THE

406
00:20:16,081 --> 00:20:19,718
THINGS WE TALKED ABOUT FROM

407
00:20:19,785 --> 00:20:20,385
INFLAMMATION, OXIDATIVE STRESS,

408
00:20:20,452 --> 00:20:25,857
IMMUNE FUNCTION AND MORE.

409
00:20:25,924 --> 00:20:26,858
WE THINK ABOUT PATIENTS AN

410
00:20:26,925 --> 00:20:28,560
STUDENTS AND THINK ABOUT OUR

411
00:20:28,627 --> 00:20:29,828
PATIENTS AND WE TAKE CARE OF A

412
00:20:29,895 --> 00:20:31,597
PATIENT, WE SEE THE PATIENT, WE

413
00:20:31,663 --> 00:20:32,998
WANT OUR PATIENT TO REMEMBER

414
00:20:33,065 --> 00:20:37,202
WHAT WE TOLD THEM AND DO WHAT WE

415
00:20:37,269 --> 00:20:38,070
ASKED THEM DO.

416
00:20:38,136 --> 00:20:42,741
WITH ALL THE STRESSORS, THEY

417
00:20:42,808 --> 00:20:44,810
HAVE AN IMPAIRMENT OF THEIR

418
00:20:44,876 --> 00:20:46,712
COGNITIVE PROCESSING THAT

419
00:20:46,778 --> 00:20:47,512
ACTUALLY IMPACTS THOSE FUNCTIONS

420
00:20:47,579 --> 00:20:50,582
THAT WE WANT THEM TO DO.

421
00:20:50,649 --> 00:20:52,684
WE'RE USUALLY NOT AWARE OF IT.

422
00:20:52,751 --> 00:20:55,420
SO IF WE THINK OF OUR PATIENT,

423
00:20:55,487 --> 00:20:58,690
AND WONDER WHY THEY HAVE

424
00:20:58,757 --> 00:21:01,126
SUBOPTIMAL CLINICAL OUTCOMES AND

425
00:21:01,193 --> 00:21:03,428
INCREASED COMORBIDITIES AND

426
00:21:03,495 --> 00:21:04,730
ADVANCED DISEASE PROGRESSION

427
00:21:04,796 --> 00:21:05,964
THAT MAY BE SUBCLINICAL BECAUSE

428
00:21:06,031 --> 00:21:09,935
OF BOTH THE STRUCTURAL AND

429
00:21:10,002 --> 00:21:15,107
BIOLOGICAL FACTORS THAT ADDRESS

430
00:21:15,173 --> 00:21:17,175
THEIR BIOLOGY AND THEN WE ADD TO

431
00:21:17,242 --> 00:21:20,178
THAT A VARIETY OF FACTORS THAT

432
00:21:20,245 --> 00:21:23,148
WE TYPICALLY SEE IN MARGINALIZED

433
00:21:23,215 --> 00:21:24,583
COMMUNITIES.

434
00:21:24,650 --> 00:21:25,417
INDIVIDUALS WHO HAVE LOWER SOCIO

435
00:21:25,484 --> 00:21:27,019
ECONOMIC STATUS SO THEY'RE

436
00:21:27,085 --> 00:21:32,691
THINKING ABOUT THE COST OF FOOD,

437
00:21:32,758 --> 00:21:34,426
VERSUS THEIR PRESCRIPTIONS AND

438
00:21:34,493 --> 00:21:36,395
OTHER FACTORS.

439
00:21:36,461 --> 00:21:37,796
MISTRUST OF THE PHYSICIAN OF THE

440
00:21:37,863 --> 00:21:40,799
HEALTH SYSTEM, ETCETERA,

441
00:21:40,866 --> 00:21:41,500
ETCETERA.

442
00:21:41,566 --> 00:21:43,368
AND THEN WE ADD TO THAT AN

443
00:21:43,435 --> 00:21:46,905
IMPAIRED ABILITY TO REMEMBER AND

444
00:21:46,972 --> 00:21:50,475
IMPLEMENT TASKS AND WONDER WHY

445
00:21:50,542 --> 00:21:54,579
OUR PATIENT'S OUTCOMES ARE SUB

446
00:21:54,646 --> 00:21:54,813
OPTIMAL.

447
00:21:54,880 --> 00:21:56,648
AND EVERYBODY HERE WILL HEAR HOW

448
00:21:56,715 --> 00:21:59,184
WE ATTENUATE ALL THOSE FACTORS

449
00:21:59,251 --> 00:21:59,818
AND IMPROVE OUR PATIENT

450
00:21:59,885 --> 00:22:10,062
OUTCOMES.

451
00:22:10,929 --> 00:22:13,498
SO ONE ELEMENT THAT WE HEAR

452
00:22:13,565 --> 00:22:16,101
ABOUT OR SORT OF TWO TERMS BUT

453
00:22:16,168 --> 00:22:19,071
ONE IS WEATHERING, THE WEAR AND

454
00:22:19,137 --> 00:22:21,640
TEAR OF EXPOSURES TO STRESS

455
00:22:21,707 --> 00:22:27,579
COINED BY ARLENE GERONOMIS AND

456
00:22:27,646 --> 00:22:31,450
ALLOSTATIC CLOSE WHICH IS THE

457
00:22:31,516 --> 00:22:34,786
CLINICAL AND BIOMARKER

458
00:22:34,853 --> 00:22:37,489
INDICATORS OF CUMULATIVE STRAIN

459
00:22:37,556 --> 00:22:40,959
OR STRESS COINED BY BRUCE

460
00:22:41,026 --> 00:22:41,493
MCEWEN.

461
00:22:41,560 --> 00:22:43,595
THESE FACTORS ARE NOT ONLY

462
00:22:43,662 --> 00:22:45,530
IMPORTANT FOR ALL STRESSES BUT

463
00:22:45,597 --> 00:22:48,533
THERE'S LOTS OF DATA THAT HAVE

464
00:22:48,600 --> 00:22:50,202
SHOWN THEM TO BE ASSOCIATED WITH

465
00:22:50,268 --> 00:22:51,369
VARIOUS FORMS OF DISCRIMINATION

466
00:22:51,436 --> 00:22:54,473
AS SHOWN HERE.

467
00:22:54,539 --> 00:22:56,308
SO WE WANT TO BE COGNIZANT OF

468
00:22:56,374 --> 00:22:57,776
THE FACT THAT DISCRIMINATION SAY

469
00:22:57,843 --> 00:23:00,779
MAJOR MEDIATOR OF THE WEAR AND

470
00:23:00,846 --> 00:23:05,417
TEAR FOR THE WEATHERING OF

471
00:23:05,484 --> 00:23:06,818
ALLOSTATIC LOAD.

472
00:23:06,885 --> 00:23:08,687
THE PAPER THAT LINKED ALLOSTATIC

473
00:23:08,754 --> 00:23:16,061
LOAD TO CLINICAL OUTCOMES WAS BY

474
00:23:16,128 --> 00:23:17,896
THERESA SELMAN WHO LACKED AT A

475
00:23:17,963 --> 00:23:19,431
LITTLE OVER 700 INDIVIDUALS

476
00:23:19,498 --> 00:23:21,666
ABOUT 70 TO 79 YEARS OF AGE AND

477
00:23:21,733 --> 00:23:28,306
FOR THE ED -- FOLLOWED OVER SEVN

478
00:23:28,373 --> 00:23:30,942
YEARS AND HAD A HIGHER RATE OF

479
00:23:31,009 --> 00:23:33,445
MORTALITY IF YOU HAD A HIGHER

480
00:23:33,512 --> 00:23:35,046
ALLOSTATIC LOAD OF 7 TO 10

481
00:23:35,113 --> 00:23:37,816
VERSUS HAVING ONE.

482
00:23:37,883 --> 00:23:40,152
THIS IS 10 MEASURES OF AL OWE

483
00:23:40,218 --> 00:23:47,492
STALT  -- ALLOSTATIC LOAD, TOTAL

484
00:23:47,559 --> 00:23:52,864
CHOLESTEROL AND A VARIETY OF

485
00:23:52,931 --> 00:23:55,367
OTHER STRESSORS AND THAT PUT

486
00:23:55,433 --> 00:23:56,334
ALLOSTATIC LOAD FRONT AND CENTER

487
00:23:56,401 --> 00:23:59,337
AS A MEASURE WE CAN USE TO SORT

488
00:23:59,404 --> 00:24:01,506
OF ASSESS PEOPLE'S CLINICAL

489
00:24:01,573 --> 00:24:06,278
STATUS AND RISK.

490
00:24:06,344 --> 00:24:08,847
BUT WHAT ABOUT LOOKING MORE

491
00:24:08,914 --> 00:24:09,381
SPECIFICALLY AT BIO LODGE

492
00:24:09,447 --> 00:24:15,554
PROCESSES?

493
00:24:15,620 --> 00:24:17,689
SO WE HEARD FROM DR. GRIA

494
00:24:17,756 --> 00:24:20,792
THERE'LL BE A PRESENTATION ON

495
00:24:20,859 --> 00:24:22,494
GENERATIONAL AFFECTS OF RACISM,

496
00:24:22,561 --> 00:24:22,928
MARGINALIZATION AND

497
00:24:22,994 --> 00:24:27,599
DISRIMINATION, SO THIS IS A

498
00:24:27,666 --> 00:24:30,335
STRESSOR, POVERTY, COULD BE

499
00:24:30,402 --> 00:24:31,336
MARGINALIZATION NOT

500
00:24:31,403 --> 00:24:33,338
DISCRIMINATION OR RACISM BUT

501
00:24:33,405 --> 00:24:36,007
IT'S A NATURAL EXPERIMENT SO THE

502
00:24:36,074 --> 00:24:43,415
GREAT CHINESE FAMINE OF IN THE

503
00:24:43,481 --> 00:24:45,550
1959-61.

504
00:24:45,617 --> 00:24:52,123
SOME REMEMBER THAT.

505
00:24:52,190 --> 00:24:52,958
THEY FOLLOWED INDIVIDUALS BORN

506
00:24:53,024 --> 00:24:54,993
AT THAT TIME THE F1 GENERATION

507
00:24:55,060 --> 00:24:56,461
AND THEN THEIR CHILDREN.

508
00:24:56,528 --> 00:24:57,629
AND THEY LOOKED AT INDIVIDUALS

509
00:24:57,696 --> 00:24:59,064
IN CHINA WHO WERE IN THAT AREA

510
00:24:59,130 --> 00:25:01,499
WHERE THE FAMINE WAS AND WHERE

511
00:25:01,566 --> 00:25:02,868
IT WASN'T.

512
00:25:02,934 --> 00:25:04,903
SO THEY FOUND THE FIRST

513
00:25:04,970 --> 00:25:06,605
GENERATION THERE WAS A HIGH

514
00:25:06,671 --> 00:25:09,307
INCREASE IN THE PREVALENCE OF

515
00:25:09,374 --> 00:25:12,711
LOW GFR AND AT THE SAME TIME

516
00:25:12,777 --> 00:25:13,845
HIGH INCREASE IN THE PRESENCE OF

517
00:25:13,912 --> 00:25:14,546
METABOLIC SYNDROME.

518
00:25:14,613 --> 00:25:18,083
IN THE SECOND GENERATION, IT'S

519
00:25:18,149 --> 00:25:21,686
ATTENUATED, IT HASN'T GONE AWAY

520
00:25:21,753 --> 00:25:23,088
TOTALLY BUT WASN'T STATISTICALLY

521
00:25:23,154 --> 00:25:24,789
SIGNIFICANT BUT FOUND THERE WAS

522
00:25:24,856 --> 00:25:33,899
A DEFINED EPIGENETIC PROFILE FOR

523
00:25:33,965 --> 00:25:38,303
INDIVIDUALS THAT WERE EXPOSED --

524
00:25:38,370 --> 00:25:39,204
WHOSE PARENTS WERE EXPOSED TO

525
00:25:39,271 --> 00:25:40,572
THE FAMINE.

526
00:25:40,639 --> 00:25:42,007
EITHER THEY WERE EXPOSED WHEN

527
00:25:42,073 --> 00:25:44,109
THEY WERE YOUNG AND THEN THEIR

528
00:25:44,175 --> 00:25:46,311
CHILDREN, THEY ALSO HAD THAT

529
00:25:46,378 --> 00:25:47,245
EPIGENETIC PROFILE.

530
00:25:47,312 --> 00:25:49,848
WE THINK ABOUT THE EPIGENETIC

531
00:25:49,915 --> 00:25:52,550
CHANGES AND THEY CAN BE

532
00:25:52,617 --> 00:25:56,821
TRANSFERRED EPIGENETICALLY AND

533
00:25:56,888 --> 00:26:00,258
RACISM AND MARGINALIZATION AND

534
00:26:00,325 --> 00:26:01,493
DISCRIMINATION CAN AFFECT THAT

535
00:26:01,559 --> 00:26:02,060
CHANGE.

536
00:26:02,127 --> 00:26:04,763
IF WE SHIFT AND THINK OF THE

537
00:26:04,829 --> 00:26:05,497
RELATIONSHIP BETWEEN

538
00:26:05,563 --> 00:26:08,066
DISCRIMINATION AND TELOMERES OR

539
00:26:08,133 --> 00:26:11,469
MARKERS OF AGING, THIS PAPER BY

540
00:26:11,536 --> 00:26:15,707
DAVID SHAY WHO WILL BE TALKING

541
00:26:15,774 --> 00:26:17,542
TOMORROW, IN PARTICULAR, HAVE AN

542
00:26:17,609 --> 00:26:19,277
INCREASED EXPERIENCES OF RACIAL

543
00:26:19,344 --> 00:26:21,846
DISCRIMINATION ASSOCIATED WITH

544
00:26:21,913 --> 00:26:25,483
FASTER 10 YEAR LEUKOCYTE

545
00:26:25,550 --> 00:26:26,818
TELOMERE LENGTH SHORTENING.

546
00:26:26,885 --> 00:26:28,620
INCREASED DISCRIMINATION AND

547
00:26:28,687 --> 00:26:29,921
SHORTENING OF TELOMERES BAD FOR

548
00:26:29,988 --> 00:26:40,298
OUR AGING PROCESS.

549
00:26:53,011 --> 00:26:56,815
THEY LOOKED AT YOUTH AND AFTER

550
00:26:56,881 --> 00:26:58,950
YEARS REPORTING HIGH UNSTABLE

551
00:26:59,017 --> 00:27:00,952
DISCRIMINATION AND THERE'S AN A

552
00:27:01,019 --> 00:27:04,222
MARKED INCREASE IN THE RATE OF

553
00:27:04,289 --> 00:27:06,658
AGING IF THOSE FAMILIES HAD

554
00:27:06,725 --> 00:27:08,493
LOW -- IF THOSE INDIVIDUALS HAD

555
00:27:08,560 --> 00:27:10,028
LOW FAMILY SUPPORT.

556
00:27:10,095 --> 00:27:11,296
AND IF THEY HAD HIGH FAMILY

557
00:27:11,363 --> 00:27:12,597
SUPPORT, IT ATTENUATED THAT

558
00:27:12,664 --> 00:27:16,167
AGING PROCESS.

559
00:27:16,234 --> 00:27:18,436
SO HERE WE CAN SEE THE

560
00:27:18,503 --> 00:27:20,438
ASSOCIATION WITH AGING,

561
00:27:20,505 --> 00:27:22,674
DISCRIMINATION AND WE ALSO SEE

562
00:27:22,741 --> 00:27:23,475
FACTORS THAT MIGHT MITIGATE IT

563
00:27:23,541 --> 00:27:28,380
WHICH IS VERY IMPORTANT.

564
00:27:28,446 --> 00:27:30,648
SIMILARLY IN ANOTHER PAPER THEY

565
00:27:30,715 --> 00:27:34,085
LOOKED AT THE RELATIONSHIP

566
00:27:34,152 --> 00:27:34,919
BETWEEN DISCRIMINATION AND

567
00:27:34,986 --> 00:27:36,921
INFLAMMATION AND WHAT THEY

568
00:27:36,988 --> 00:27:38,223
REPORTED HERE IS AGAIN WITH LOW

569
00:27:38,289 --> 00:27:39,758
LEVELS OF DISCRIMINATION VERSUS

570
00:27:39,824 --> 00:27:45,897
HIGH LEVELS OF DISCRIMINATION,

571
00:27:45,964 --> 00:27:49,000
WHAT YOU SEE IS AFTER SEVERAL

572
00:27:49,067 --> 00:27:52,570
YEARS FOLLOW UP REPORTING HIGH

573
00:27:52,637 --> 00:27:53,805
LEVELS OF EXPOSURE OR EXPERIENCE

574
00:27:53,872 --> 00:27:55,707
WITH DISCRIMINATION A SLIGHT

575
00:27:55,774 --> 00:27:57,509
INCREASE WITH THE GROUP WITH

576
00:27:57,575 --> 00:27:59,010
POSITIVE RACIAL IDENTITY, THEY

577
00:27:59,077 --> 00:28:00,211
HAVE A POSITIVE SELF-IDENTITY

578
00:28:00,278 --> 00:28:03,948
ABOUT BEING A MEMBER OF A

579
00:28:04,015 --> 00:28:06,351
MARGINALIZED RACIAL GROUP VERSUS

580
00:28:06,418 --> 00:28:08,753
THOSE WITH A NEGATIVE

581
00:28:08,820 --> 00:28:09,087
SELF-IDENTITY.

582
00:28:09,154 --> 00:28:12,023
AND THOSE WITH THE NEGATIVE

583
00:28:12,090 --> 00:28:15,427
SELF-IDENTIFY HAVE A MARKED IN

584
00:28:15,493 --> 00:28:15,860
SELF-IDENTIFICATION.

585
00:28:15,927 --> 00:28:17,228
LOOKING AT THE FACTORS THAT MAY

586
00:28:17,295 --> 00:28:18,696
BE PROTECTIVE.

587
00:28:18,763 --> 00:28:23,735
AND AGAIN OTHER FACTORS SUCH AS

588
00:28:23,802 --> 00:28:25,403
PERCEIVED CONTROL HERE HAVE

589
00:28:25,470 --> 00:28:27,939
HIGHLIGHTED THE IMPACT OF

590
00:28:28,006 --> 00:28:28,973
PERCEIVED CONTROL AS ANOTHER

591
00:28:29,040 --> 00:28:32,043
POTENTIAL MODULATOR PARTICULARLY

592
00:28:32,110 --> 00:28:35,814
ON THE EXPRESSION OF CV ACTIVE

593
00:28:35,880 --> 00:28:38,083
PROTEIN AS A DOWN STREAM

594
00:28:38,149 --> 00:28:40,952
MEDIATOR FROM EVERYDAY

595
00:28:41,019 --> 00:28:45,023
DISCRIMINATION.

596
00:28:45,090 --> 00:28:46,324
I WANT TO HIGHLIGHT THIS STUDY

597
00:28:46,391 --> 00:28:48,927
AS WE THINK OF RESEARCH IN THE

598
00:28:48,993 --> 00:28:51,062
FUTURE FROM APRIL THAMES AND

599
00:28:51,129 --> 00:28:52,163
STEVE COLE IN COLLEAGUES IN

600
00:28:52,230 --> 00:28:53,498
INDIVIDUALS WITH HIV, BLACK AND

601
00:28:53,565 --> 00:28:58,570
WHITE AND WHAT'S SHOWN HERE IS

602
00:28:58,636 --> 00:29:01,806
DATA ON THE RELATIVE INCREASE IN

603
00:29:01,873 --> 00:29:03,675
A VARIETY OF OR RELATIVE CHANGE

604
00:29:03,741 --> 00:29:07,112
IN A VARIETY OF MARKERS BETWEEN

605
00:29:07,178 --> 00:29:10,582
BLACK AND WHITE INDIVIDUALS,

606
00:29:10,648 --> 00:29:13,485
PROINFLAMMATORY AT THE TOP WITH

607
00:29:13,551 --> 00:29:19,691
ACTIVATOR PROTEIN ONE NF KAPPA B

608
00:29:19,757 --> 00:29:25,230
A

609
00:29:25,296 --> 00:29:26,831
AND THIS IS IMPORTANT BECAUSE WE

610
00:29:26,898 --> 00:29:29,834
HAVE THE TOTAL ASSOCIATION AND

611
00:29:29,901 --> 00:29:33,271
THE BOTTOM PANEL IS CONTROLLED

612
00:29:33,338 --> 00:29:34,205
FOR DISCRIMINATION.

613
00:29:34,272 --> 00:29:36,774
IF YOU LOOK AT THE

614
00:29:36,841 --> 00:29:37,509
PRO-INFLAMMATORY MARKERS WHICH

615
00:29:37,575 --> 00:29:41,779
ARE INCREASED IN THE BLACK

616
00:29:41,846 --> 00:29:45,750
COHORT, WHEN YOU CONTROL FOR

617
00:29:45,817 --> 00:29:48,453
DISCRIMINATION, THEY NO LONGER

618
00:29:48,520 --> 00:29:50,321
EXIST.

619
00:29:50,388 --> 00:29:52,724
AGAIN, SO EMPHASIZING THAT IT'S

620
00:29:52,790 --> 00:29:54,459
NOT REY RACE PER SE BUT FACTORS

621
00:29:54,526 --> 00:29:56,161
THAT ARE OPERATING THROUGH RACE

622
00:29:56,227 --> 00:29:59,831
AND HERE RACISM THAT MAKES THE

623
00:29:59,898 --> 00:30:00,131
DIFFERENCE.

624
00:30:00,198 --> 00:30:01,699
WHAT'S ALSO IMPORTANT IS WHEN WE

625
00:30:01,766 --> 00:30:04,402
THINK BE THE RESEARCH, WHEN YOU

626
00:30:04,469 --> 00:30:05,670
CONTROL FOR DISCRIMINATION, THAT

627
00:30:05,737 --> 00:30:09,908
DID NOT ACCOUNT FOR THE CHANGES

628
00:30:09,974 --> 00:30:10,942
IN THE STRESS RESPONSIVE

629
00:30:11,009 --> 00:30:12,076
SIGNALLING PATHWAYS.

630
00:30:12,143 --> 00:30:13,244
AND SO THERE'S SOME OTHER

631
00:30:13,311 --> 00:30:15,313
FACTORS THAT ARE HAPPENING

632
00:30:15,380 --> 00:30:15,513
THERE.

633
00:30:15,580 --> 00:30:16,948
WE HAVE TO BE COGNITIVE OF THE

634
00:30:17,015 --> 00:30:19,918
FACT THAT NOT ALL OF AS THE

635
00:30:19,984 --> 00:30:22,587
BIOMARKERS CHANGE THE SAME IN

636
00:30:22,654 --> 00:30:23,888
EVERY SETTING OR RELATED TO

637
00:30:23,955 --> 00:30:25,290
EVERY TYPE OF STRESS

638
00:30:25,356 --> 00:30:25,657
REPRESENTATION.

639
00:30:25,723 --> 00:30:29,394
-- RESPONSE.

640
00:30:29,460 --> 00:30:33,998
SO JUST TO SORT OF SUMMARIZE

641
00:30:34,065 --> 00:30:38,203
THAT SO WE HAVE

642
00:30:38,269 --> 00:30:39,370
INSTITUTIONALIZED, RACISM,

643
00:30:39,437 --> 00:30:41,639
BIASES, DISCRIMINATION, ETCETERA

644
00:30:41,706 --> 00:30:46,211
THAT CAN HAVE AN IMPACT ON

645
00:30:46,277 --> 00:30:48,479
FACTORS LIKE RESIDENTIAL

646
00:30:48,546 --> 00:30:52,617
SEGREGATION, LOW OR UNDER

647
00:30:52,684 --> 00:30:54,018
EMPLOYMENT, HOUSING, INSURANCE

648
00:30:54,085 --> 00:30:56,821
STATUS, WHEN THESE COME TOGETHER

649
00:30:56,888 --> 00:31:01,392
AND CAN LEAD TO STRESS AND

650
00:31:01,459 --> 00:31:02,694
MALADAPTIVE COPING BEHAVIORS AND

651
00:31:02,760 --> 00:31:06,531
THEN THEY ALL COME TOGETHER TO

652
00:31:06,598 --> 00:31:08,166
IMPACT WHERE WE'RE FOCUSSING ON

653
00:31:08,233 --> 00:31:12,503
TODAY ARE THE BIOLOGICAL

654
00:31:12,570 --> 00:31:12,837
CONSEQUENCES.

655
00:31:12,904 --> 00:31:16,207
THE CHRONIC INFLAMMATION AND

656
00:31:16,274 --> 00:31:17,642
DYSFUNCTION, IMMUNE REGULATION,

657
00:31:17,709 --> 00:31:19,344
EPIGENETIC CHANGES AND MORE AND

658
00:31:19,410 --> 00:31:20,345
ULTIMATELY WHAT WE SEE IS THE

659
00:31:20,411 --> 00:31:23,481
INCREASE IN WEATHERING OR

660
00:31:23,548 --> 00:31:25,483
ALLOSTATIC LOAD REDUCED TELOMERE

661
00:31:25,550 --> 00:31:30,555
LENGTH AND POORER OUTCOMES, MORE

662
00:31:30,622 --> 00:31:30,822
DISEASE.

663
00:31:30,888 --> 00:31:34,158
THE KEY FACTORS WE SAW IN THE

664
00:31:34,225 --> 00:31:36,127
PAPER OR SLIDES I SHOWED WAS

665
00:31:36,194 --> 00:31:38,129
POSITIVELY RACIAL IDENTITY OR A

666
00:31:38,196 --> 00:31:41,132
SENSE OF SELF-WORTH CAN HELP

667
00:31:41,199 --> 00:31:43,968
ATTENUATE THE BIOLOGICAL

668
00:31:44,035 --> 00:31:45,803
CONSEQUENCES OF STRESS, RATE OF

669
00:31:45,870 --> 00:31:49,907
FAMILY SUPPORT OR CONNECTEDNESS,

670
00:31:49,974 --> 00:31:52,644
RIGHT, WE TALK ABOUT

671
00:31:52,710 --> 00:31:53,444
CONNECTEDNESS BEING IMPORTANT

672
00:31:53,511 --> 00:31:56,014
FOR HEALTH AND GREATER PERCEIVED

673
00:31:56,080 --> 00:31:56,447
CONTROL.

674
00:31:56,514 --> 00:31:58,483
SO, WE ALSO WANT TO BE THINKING

675
00:31:58,549 --> 00:32:00,018
ABOUT AND COGNITIVE OF THOSE

676
00:32:00,084 --> 00:32:02,854
FACTORS AND HOW THEY'RE BEING

677
00:32:02,920 --> 00:32:03,688
INCLUDED OR ASSESSED WHEN WE ARE

678
00:32:03,755 --> 00:32:10,228
DOING RESEARCH IN THIS SPACE.

679
00:32:10,295 --> 00:32:11,796
SO I WANT TO PROJECT THE FUTURE

680
00:32:11,863 --> 00:32:13,231
OR AT LEAST MY THOUGHTS FOR

681
00:32:13,298 --> 00:32:14,365
THINGS WE NEED TO BE THINK ABOUT

682
00:32:14,432 --> 00:32:15,066
WHEN WE'RE DOING RESEARCH IN

683
00:32:15,133 --> 00:32:19,904
THIS SPACE.

684
00:32:19,971 --> 00:32:22,640
SO AGAIN, I WANT US TO BE THINK

685
00:32:22,707 --> 00:32:28,579
ABOUT HOW WE NEED TO THINK OR

686
00:32:28,646 --> 00:32:29,714
WHERE WE KNENEED TO COME FROM.

687
00:32:29,781 --> 00:32:37,522
WHAT IS THAT A PICTURE OF?

688
00:32:37,588 --> 00:32:41,025
SOME SAY GLASS HALF FULL, SOME

689
00:32:41,092 --> 00:32:41,959
SAY GLASS HALF EMPTY.

690
00:32:42,026 --> 00:32:44,796
WATER IN THE GLASS.

691
00:32:44,862 --> 00:32:49,233
COULD BE A PICTURE OF A GLASS

692
00:32:49,300 --> 00:32:52,770
HALFWAY ON ITS WAY TO BEING FULL

693
00:32:52,837 --> 00:32:54,172
OR EMPTY.

694
00:32:54,238 --> 00:32:55,873
COULD BE WATER AND AIR.

695
00:32:55,940 --> 00:32:59,477
COULD BE ENERGY.

696
00:32:59,544 --> 00:33:04,716
IT'S A PICTURE OF A GLASS.

697
00:33:04,782 --> 00:33:09,253
WE SAY IT'S A GLASS AND IT'S NOT

698
00:33:09,320 --> 00:33:09,587
UNREASONABLE.

699
00:33:09,654 --> 00:33:10,688
WAS THAT ALWAYS A GLASS?

700
00:33:10,755 --> 00:33:12,824
WAS IT ALWAYS A GLASS?

701
00:33:12,890 --> 00:33:15,093
AND WILL IT ALWAYS BE A GLASS?

702
00:33:15,159 --> 00:33:17,028
SO IT'S ON IT'S WAY FROM

703
00:33:17,095 --> 00:33:19,497
SOMEWHERE TO SOMEWHERE ELSE.

704
00:33:19,564 --> 00:33:21,132
WE HAPPEN TO HAVE CAUGHT IT

705
00:33:21,199 --> 00:33:25,069
WHILE IT'S A GLASS.

706
00:33:25,136 --> 00:33:31,476
WE HAVE TO HAVE THAT SAME LEVEL

707
00:33:31,542 --> 00:33:36,314
OF INTROSPECTION WHEN WE THINK

708
00:33:36,381 --> 00:33:38,983
OF THE RESEARCH WE'RE DOING AND

709
00:33:39,050 --> 00:33:40,017
THE INTERPRETATION AND THAT'S

710
00:33:40,084 --> 00:33:40,852
GOING TO BE IMPORTANT IN THE

711
00:33:40,918 --> 00:33:45,356
SPACE AS WE START GETTING DOWN

712
00:33:45,423 --> 00:33:48,259
TO SOME OF THE BIOMARKERS AND

713
00:33:48,326 --> 00:33:49,961
CELL-LEVEL ACTIVITIES, WE WANT

714
00:33:50,027 --> 00:33:54,232
TO BE THINKING ABOUT HOW WE CAN

715
00:33:54,298 --> 00:33:56,067
ADVANCE THE WORK WE'RE DOING TO

716
00:33:56,134 --> 00:33:58,870
HAVE AN EVEN GREATER IMPACT THAN

717
00:33:58,936 --> 00:34:07,011
WHAT WE'VE BEEN DOING TO DATE.

718
00:34:07,078 --> 00:34:10,448
I'LL LET EVERYBODY THINK ABOUT

719
00:34:10,515 --> 00:34:14,252
THAT ALONE UNIN INFLUENCED AND

720
00:34:14,318 --> 00:34:15,520
UNENCUMBERED BY A CONDITION

721
00:34:15,586 --> 00:34:16,654
VOICE AND THAT'S IMPORTANT FOR

722
00:34:16,721 --> 00:34:17,255
RESEARCHERS AND IT WILL BE

723
00:34:17,321 --> 00:34:18,823
IMPORTANT FOR OUR PATIENTS IF WE

724
00:34:18,890 --> 00:34:20,958
WANT THEM TO BE ABLE TO ACHIEVE

725
00:34:21,025 --> 00:34:22,493
THEIR OPTED MALL HEALTH.

726
00:34:22,560 --> 00:34:24,629
-- OPTIMAL HEALTH.

727
00:34:24,695 --> 00:34:26,164
SO SOME THINGS WE WANT TO BE

728
00:34:26,230 --> 00:34:29,100
THINKING ABOUT FOR

729
00:34:29,167 --> 00:34:34,138
INTERVENTIONS.

730
00:34:34,205 --> 00:34:40,845
NUTRITION AND WE FOCUS ON PLEA

731
00:34:40,912 --> 00:34:41,979
-- NUTRITION, LIFESTYLE

732
00:34:42,046 --> 00:34:44,248
CHANGES, PRACTICES.

733
00:34:44,315 --> 00:34:46,083
ARE THERE WAYS WE CAN GIVE

734
00:34:46,150 --> 00:34:49,821
PEOPLE THE TOOLS THAT ARE NOT

735
00:34:49,887 --> 00:34:52,824
EXPENSIVE THAT CAN ATTENUATE OR

736
00:34:52,890 --> 00:34:54,058
MITIGATE THE DOWN STREAM

737
00:34:54,125 --> 00:34:55,226
CONSEQUENCES OF THE STRUCTURAL

738
00:34:55,293 --> 00:34:56,027
AND PSYCHOLOGICAL INSULTS

739
00:34:56,093 --> 00:35:02,033
THEY'RE DEALING WITH.

740
00:35:02,099 --> 00:35:05,503
WE TALKED ABOUT CONNECTEDNESS.

741
00:35:05,570 --> 00:35:06,771
WE'RE SEEING A LOT OF ARTIFICIAL

742
00:35:06,838 --> 00:35:07,872
INTELLIGENCE AND SOCIAL MEDIA.

743
00:35:07,939 --> 00:35:09,040
SOME PEOPLE ARE MOVING TO THAT

744
00:35:09,106 --> 00:35:10,141
FOR THEIR CONNECTIONS.

745
00:35:10,208 --> 00:35:13,277
IS THAT CONNECTEDNESS THE SAME

746
00:35:13,344 --> 00:35:16,280
AS HAVING ACTUAL REAL, PHYSICAL

747
00:35:16,347 --> 00:35:17,081
CONNECTIONS WITH OTHER PEOPLE?

748
00:35:17,148 --> 00:35:27,391
I DON'T KNOW.

749
00:35:33,464 --> 00:35:36,934
SOMEBODY NEEDS TO DO THAT

750
00:35:37,001 --> 00:35:40,204
RESEARCH ON THE PATHWAYS WE SEE

751
00:35:40,271 --> 00:35:43,574
THAT HAVE BECOME ABNORMAL IN THE

752
00:35:43,641 --> 00:35:46,844
SETTING OF MARGINALIZATION AND

753
00:35:46,911 --> 00:35:47,945
DISCRIMINATION.

754
00:35:48,012 --> 00:35:53,184
ANTI-INFLAMMATORY MARKERS FOR

755
00:35:53,251 --> 00:35:57,355
OXIDATIVE STRESS AND CYTOKINE

756
00:35:57,421 --> 00:35:59,190
INHIBITORS, ETCETERA.

757
00:35:59,257 --> 00:36:01,492
THIS IS AN OPPORTUNITY FOR

758
00:36:01,559 --> 00:36:02,527
PHARMACOLOGIC DEVELOPMENT OF

759
00:36:02,593 --> 00:36:06,464
TOOLS THAT CAN BE HELPFUL.

760
00:36:06,531 --> 00:36:08,866
WEARABLE SENSORS FOR STRESS

761
00:36:08,933 --> 00:36:09,133
RESPONSE.

762
00:36:09,200 --> 00:36:13,271
I'LL TALK ABOUT THAT IN A

763
00:36:13,337 --> 00:36:14,572
SECOND.

764
00:36:14,639 --> 00:36:15,706
R&D IN THE MICROBIND.

765
00:36:15,773 --> 00:36:17,675
THERE'S A LOT GOING ON THERE AND

766
00:36:17,742 --> 00:36:20,711
FOR HOW WE INTERPRET THINGS DO

767
00:36:20,778 --> 00:36:23,114
WE EVEN KNOW TALKING ABOUT

768
00:36:23,180 --> 00:36:24,415
DISCRIMINATION AND

769
00:36:24,482 --> 00:36:29,020
MARGINALIZATION WE HAVE TO

770
00:36:29,086 --> 00:36:32,623
UNDERSTAND HOW METHODLOGICALLY

771
00:36:32,690 --> 00:36:34,625
WE SHOULD NOT USE RACE LOOKING

772
00:36:34,692 --> 00:36:37,495
AT DIFFERENCES IN HEALTH SYSTEM

773
00:36:37,562 --> 00:36:40,731
WORK AND PUBLIC HEALTH WORK

774
00:36:40,798 --> 00:36:41,265
VERSUS INDIVIDUAL LEVEL

775
00:36:41,332 --> 00:36:47,138
ALGORITHMS, ETCETERA.

776
00:36:47,204 --> 00:36:50,007
SO, WHEN I THINK OF

777
00:36:50,074 --> 00:36:50,708
MARGINALIZATION I THINK OF

778
00:36:50,775 --> 00:36:52,109
CONDITIONED THOUGHTS.

779
00:36:52,176 --> 00:36:57,448
ALL THE FACTORS CONSPIRE TO

780
00:36:57,515 --> 00:36:59,784
INFLUENCE OUR CONDITION THOUGHTS

781
00:36:59,850 --> 00:37:03,354
AND BEHAVIORS AND ACTIVATION.

782
00:37:03,421 --> 00:37:05,489
THIS HAS RACISM, DISCRIMINATION

783
00:37:05,556 --> 00:37:08,492
IS LINKED TO THE STRUCTURAL

784
00:37:08,559 --> 00:37:09,460
DRIVERS OF HEALTH.

785
00:37:09,527 --> 00:37:13,497
THAT LEADS TO BIOLOGICAL STRESS

786
00:37:13,564 --> 00:37:16,467
PROCESS IMPACT ALL DISEASE

787
00:37:16,534 --> 00:37:18,569
SYSTEMS BUT OF IMPORTANCE TO

788
00:37:18,636 --> 00:37:19,136
DATE, NIDDK RELATED DISEASE

789
00:37:19,203 --> 00:37:23,074
SYSTEMS.

790
00:37:23,140 --> 00:37:25,676
SO WE THINK ABOUT INTERVENTIONS

791
00:37:25,743 --> 00:37:27,945
AND HAVE TO THINK OF SOCIAL

792
00:37:28,012 --> 00:37:34,151
CHANGE BUT FOR THE MORE BIOLOGIC

793
00:37:34,218 --> 00:37:36,887
RELATED PATHWAYS WE THINK

794
00:37:36,954 --> 00:37:37,888
PRECISION NUTRITION AND NOVEL

795
00:37:37,955 --> 00:37:38,522
THERAPEUTICS TO TRY TO ADDRESS

796
00:37:38,589 --> 00:37:41,325
THE PATHWAYS.

797
00:37:41,392 --> 00:37:46,564
EVEN MORE BROADLY, PRECISION

798
00:37:46,631 --> 00:37:47,398
NUTRITION OR MORE SPECIFICALLY

799
00:37:47,465 --> 00:37:55,239
WITH NOVEL THERAPEUTICS.

800
00:37:55,306 --> 00:37:59,510
WHERE ARE THE SENSORS?

801
00:37:59,577 --> 00:38:01,412
OTHERS HAVE WORK COMING OUT OF

802
00:38:01,479 --> 00:38:04,949
WEARABLE SENSORS WHERE THEY CAN

803
00:38:05,016 --> 00:38:07,385
MEASURE C REACTIVE PROTEIN AND

804
00:38:07,451 --> 00:38:08,686
OTHER INFLAMMATORY MARKERS AS

805
00:38:08,753 --> 00:38:13,324
WELL AS OTHER CLINICAL

806
00:38:13,391 --> 00:38:13,891
BIOMARKERS.

807
00:38:13,958 --> 00:38:15,893
SO THOSE ARE ADVANCING AND

808
00:38:15,960 --> 00:38:18,129
COMING ALONG NOW AND WILL BE

809
00:38:18,195 --> 00:38:20,564
WAYS TO MEASURE OVER TIME WHAT'S

810
00:38:20,631 --> 00:38:22,433
GOING ON WITH A PARTICULAR

811
00:38:22,500 --> 00:38:25,269
PATIENT OR COHORT WE'RE LOOKING

812
00:38:25,336 --> 00:38:29,173
AT AND LINK IT MORE SPECIFICALLY

813
00:38:29,240 --> 00:38:33,477
TO EXPERIENCES OR EXPOSURES THEY

814
00:38:33,544 --> 00:38:34,345
MAY HAVE.

815
00:38:34,412 --> 00:38:41,152
THE MICROBIOME AND THEY RECENTLY

816
00:38:41,218 --> 00:38:45,156
PROVIDED A MODEL LINKING THE

817
00:38:45,222 --> 00:38:45,790
BRAIN-GUT MICROBIOME TO

818
00:38:45,856 --> 00:38:47,158
DISCRIMINATION AND CLINICAL

819
00:38:47,224 --> 00:38:47,458
OUTCOMES.

820
00:38:47,525 --> 00:38:50,861
AGAIN, SOMETHING WE WANT TO BE

821
00:38:50,928 --> 00:38:52,530
THINKING ABOUT BECAUSE THERE'S

822
00:38:52,596 --> 00:38:55,433
SO MUCH GOING ON IN THE

823
00:38:55,499 --> 00:38:56,701
MICROBIOME NOW AND BEING

824
00:38:56,767 --> 00:38:58,402
COGNIZANT OF THAT WHEN DOING OUR

825
00:38:58,469 --> 00:39:01,505
WORK OR MAY TAKE THAT AS A

826
00:39:01,572 --> 00:39:06,077
PRIMARY PATH FOR RESEARCH.

827
00:39:06,143 --> 00:39:08,045
A LOT OF TIMES WE TEND TO STUDY

828
00:39:08,112 --> 00:39:13,084
PEOPLE WHOSE POMP -- POPULATIONS

829
00:39:13,150 --> 00:39:14,952
WE LOOK AT WITH THE DISEASE AND

830
00:39:15,019 --> 00:39:17,054
DON'T LOOK ENOUGH AT PEOPLE WHO

831
00:39:17,121 --> 00:39:20,324
ARE WELL DESPITE THE FACT THEY

832
00:39:20,391 --> 00:39:21,625
SHOULD HAVE DISEASE BECAUSE

833
00:39:21,692 --> 00:39:23,160
THERE'S A LOT TO LEARN WHY

834
00:39:23,227 --> 00:39:24,562
SOMEBODY IS DOING SO WELL

835
00:39:24,628 --> 00:39:25,596
DESPITE ALL THE REASONS THEY

836
00:39:25,663 --> 00:39:28,666
SHOULD BE STICK FOR A PARTICULAR

837
00:39:28,733 --> 00:39:28,966
CONDITION.

838
00:39:29,033 --> 00:39:31,135
WE'LL NEED NEW METHODS TO

839
00:39:31,202 --> 00:39:32,937
MEASURE EVERY DAY DISCRIMINATION

840
00:39:33,003 --> 00:39:34,271
TO HAVE SOCIAL MEDIA, CYBER

841
00:39:34,338 --> 00:39:36,807
BULLYING AND MAYBE THINKING

842
00:39:36,874 --> 00:39:40,211
ABOUT INTERSECTIONALITY MORE,

843
00:39:40,277 --> 00:39:40,945
CONNECTEDNESS, SELF-WORTH AND

844
00:39:41,011 --> 00:39:45,049
HOW DO THEY ALL IMPACT THE

845
00:39:45,116 --> 00:39:46,050
STRESS BIOMARKERS AND WHICH ONES

846
00:39:46,117 --> 00:39:48,219
DO THEY ALL IMPACT THE SAME

847
00:39:48,285 --> 00:39:48,519
BIOMARKERS.

848
00:39:48,586 --> 00:39:55,359
WE DON'T KNOW.

849
00:39:55,426 --> 00:39:55,760
INTERSECTIONALITY.

850
00:39:55,826 --> 00:39:58,829
WE WANT TO BE COGNIZANT OF THAT

851
00:39:58,896 --> 00:40:02,133
AND WHAT ARE THE MAJOR/MINOR

852
00:40:02,199 --> 00:40:04,802
PATHWAYS FOR AS POTENTIAL

853
00:40:04,869 --> 00:40:09,473
APPLICANTS OR EXISTING GRANTEES

854
00:40:09,540 --> 00:40:12,109
AT NIDDK FOR WHATEVER ORGAN,

855
00:40:12,176 --> 00:40:13,377
ORGAN SYSTEM OR CELL SYSTEM

856
00:40:13,444 --> 00:40:16,080
YOU'RE FOCUSSING ON OR MIGHT BE

857
00:40:16,147 --> 00:40:17,782
FOCUSSING ON, WHAT ARE THE MAJOR

858
00:40:17,848 --> 00:40:20,351
AND MINOR PATHWAYS THAT MAY BE

859
00:40:20,417 --> 00:40:27,124
IMPORTANT FOR YOUR ORGAN SYSTEM

860
00:40:27,191 --> 00:40:29,393
AND WHAT STRESS MEDIATORS MAY BE

861
00:40:29,460 --> 00:40:30,861
MORE IMPORTANT FOR YOUR SYSTEM

862
00:40:30,928 --> 00:40:32,129
THAN IN OTHER SYSTEMS.

863
00:40:32,196 --> 00:40:34,532
SO WE WANT TO BE THINKING ABOUT

864
00:40:34,598 --> 00:40:34,732
THAT.

865
00:40:34,799 --> 00:40:36,233
SO FOR EVERYBODY HERE, AS YOU

866
00:40:36,300 --> 00:40:37,134
PUT THAT ALL TOGETHER, YOU'RE

867
00:40:37,201 --> 00:40:41,105
GOING TO COME UP WITH YOUR

868
00:40:41,172 --> 00:40:43,073
TAILORED INTERVENTIONS THAT ARE

869
00:40:43,140 --> 00:40:47,144
GOING TO LEAD TO ADVANCES IN

870
00:40:47,211 --> 00:40:51,782
ADDRESSING HEALTH DISPARITIES

871
00:40:51,849 --> 00:40:53,317
AND ACHIEVING HEALTH EQUITY IN

872
00:40:53,384 --> 00:40:54,185
NIDDK SPACES BEFORE ANY OTHER

873
00:40:54,251 --> 00:40:57,288
INSTITUTE.

874
00:40:57,354 --> 00:40:58,989
THAT'S THE GOAL HERE, RIGHT.

875
00:40:59,056 --> 00:41:01,592
WE WANT TO BRING ALL THE OTHER

876
00:41:01,659 --> 00:41:02,693
INSTITUTES ALONG WHERE YOUR GOAL

877
00:41:02,760 --> 00:41:06,397
IS TO BE LEADERS HERE.

878
00:41:06,463 --> 00:41:08,532
SO WHAT ABOUT AT THE CELLULAR

879
00:41:08,599 --> 00:41:08,799
LEVEL.

880
00:41:08,866 --> 00:41:09,967
I DIDN'T MENTION MUCH ABOUT

881
00:41:10,034 --> 00:41:10,801
INSIDE THE CELL.

882
00:41:10,868 --> 00:41:14,505
A LOT OF WORK HAS BEEN DONE ON

883
00:41:14,572 --> 00:41:19,076
MITOCHONDRIAL DYSFUNCTION AND

884
00:41:19,143 --> 00:41:22,446
MITOCHONDRIAL ALLOSTATIC LOAD

885
00:41:22,513 --> 00:41:25,716
AND ALL THE ORGANELLES IN THE

886
00:41:25,783 --> 00:41:25,916
CELL.

887
00:41:25,983 --> 00:41:27,451
WHEN WE LOOK AT CLINICALLY WHEN

888
00:41:27,518 --> 00:41:30,988
WE LOOK AT COMMUNITY-LEVEL

889
00:41:31,055 --> 00:41:33,490
FACTORS, WE DO GEOGRAPHIC

890
00:41:33,557 --> 00:41:37,261
INFORMATION SYSTEMS TO PULL

891
00:41:37,328 --> 00:41:38,429
TOGETHER DIFFERENT STRUCTURAL

892
00:41:38,495 --> 00:41:41,699
SOCIAL FACTOR MAY BE HIGHER OR

893
00:41:41,765 --> 00:41:43,367
LOWER IN PREVALENCE THAN AN

894
00:41:43,434 --> 00:41:44,068
INDIVIDUAL COMMUNITY.

895
00:41:44,134 --> 00:41:48,372
WHO IS DOING G.I.S. WORK WITHIN

896
00:41:48,439 --> 00:41:49,206
A CELL?

897
00:41:49,273 --> 00:41:50,741
DO YOU THINK IF ORGANELLES IN

898
00:41:50,808 --> 00:41:52,476
THE CELL ARE ARRANGED

899
00:41:52,543 --> 00:42:00,417
DIFFERENTLY IT ACTS THE SAME?

900
00:42:00,484 --> 00:42:06,023
THERE'S SOME THAT ARE LINKED TO

901
00:42:06,090 --> 00:42:07,191
EYE DIFFERENTIAL ORGANELLE IN

902
00:42:07,258 --> 00:42:07,825
THE CELL.

903
00:42:07,892 --> 00:42:09,493
THERE'S LIMITED WORK IN THAT

904
00:42:09,560 --> 00:42:11,362
SPACE AND OPEN TO LOOK AT FOR

905
00:42:11,428 --> 00:42:13,097
QUITE A WHILE.

906
00:42:13,163 --> 00:42:17,668
IF WE THINK ABOUT RACE, WE SAW

907
00:42:17,735 --> 00:42:19,904
THE ENUMERATION.

908
00:42:19,970 --> 00:42:23,474
IF WE THINK ABOUT CELLULAR

909
00:42:23,540 --> 00:42:25,643
COMMUNICATION, THERE'S DATA ON

910
00:42:25,709 --> 00:42:27,478
QUANTUM COHERENCE AS IT RELATES

911
00:42:27,544 --> 00:42:30,414
TO LIGHT BUT WE DON'T YEEL DO

912
00:42:30,481 --> 00:42:32,016
MUCH OF THAT IN MEDICINE BUT TO

913
00:42:32,082 --> 00:42:35,219
THINK QUANTUM COHERENCE IN THE

914
00:42:35,286 --> 00:42:40,424
WAY THAT FUNCTIONING WOULD NOT

915
00:42:40,491 --> 00:42:42,726
BE RELEVANT TO WHAT'S HAPPENING

916
00:42:42,793 --> 00:42:45,262
IN OUR CELLS AND BODY I THINK

917
00:42:45,329 --> 00:42:47,197
WE'RE NAIVE TO THINK IT'S NOT

918
00:42:47,264 --> 00:42:50,501
HAPPENING.

919
00:42:50,567 --> 00:42:56,206
SO, I THINK I'LL WIND UP WITH

920
00:42:56,273 --> 00:42:59,910
THIS SLIDE FROM BALMER AND

921
00:42:59,977 --> 00:43:01,478
COLLEAGUES WHICH GIVES A NICE

922
00:43:01,545 --> 00:43:04,982
INTEGRATION HOW WE CAN THINK OF

923
00:43:05,049 --> 00:43:07,418
THINGS.

924
00:43:07,484 --> 00:43:09,119
COMMUNITY-ENGAGED COLLABORATIVE

925
00:43:09,186 --> 00:43:10,821
TEAMS LOOKING AT THE SOCIAL

926
00:43:10,888 --> 00:43:13,123
DETERMINATES OF HEALTH, LOOKING

927
00:43:13,190 --> 00:43:15,926
AT STRESS REDUCTION ELEMENTS,

928
00:43:15,993 --> 00:43:19,797
SLEEP, I DIDN'T MENTION SLEEP.

929
00:43:19,863 --> 00:43:22,666
IF YOU HAVE STRESS OR NOT

930
00:43:22,733 --> 00:43:23,534
SLEEPING THAT'S IMPORTANT FOR

931
00:43:23,600 --> 00:43:26,036
BEING CONTROLLED AND WHAT IMPACT

932
00:43:26,103 --> 00:43:31,308
DOES THAT HAVE AND THEN HOW

933
00:43:31,375 --> 00:43:34,011
THOSE INTERVENTIONS ARE LINKED

934
00:43:34,078 --> 00:43:40,718
TO THESE BIOLOGIC FACTORS.

935
00:43:40,784 --> 00:43:43,754
AND TRANSCRIPTOMICS AND MORE AND

936
00:43:43,821 --> 00:43:45,990
IN CERTAIN INSTANCES WHETHER

937
00:43:46,056 --> 00:43:47,791
PEOPLE CAN LOOK WITHIN THE CELLS

938
00:43:47,858 --> 00:43:50,794
AND LOOK AT CELL RECEPTORS AND

939
00:43:50,861 --> 00:43:53,230
SO RECEPTORS WITH THEIR

940
00:43:53,297 --> 00:43:57,468
MODIFICATIONS IN SOME RESPECT

941
00:43:57,534 --> 00:44:01,071
FOR EXPRESSION AND IS IT DUE TO

942
00:44:01,138 --> 00:44:04,008
NUMBERS OR CO-LOCATION WITH

943
00:44:04,074 --> 00:44:04,708
ORGANELLES.

944
00:44:04,775 --> 00:44:07,578
THINGS WE NEED TO THINK OF AND

945
00:44:07,644 --> 00:44:18,155
END WITH THIS FROM DANIEL BO

946
00:44:20,124 --> 00:44:20,791
BOORSTIN.

947
00:44:20,858 --> 00:44:22,393
THE GREATEST OBSTACLE TO

948
00:44:22,459 --> 00:44:25,062
DISCOVERY IS NOT IG NOERNSZ BUT

949
00:44:25,129 --> 00:44:25,662
THE ILLUSION OF KNOWLEDGE.

950
00:44:30,200 --> 00:44:33,504
IG

951
00:44:45,516 --> 00:44:48,318
>> SEEING NOBODY ELSE LINE UP IN

952
00:44:48,385 --> 00:44:49,820
THE ROOM I GOT SEVERAL QUESTIONS

953
00:44:49,887 --> 00:44:50,220
VIA ZOOM.

954
00:44:50,287 --> 00:44:52,089
>> I WAS GOING TO ASK ABOUT

955
00:44:52,156 --> 00:44:53,357
THAT.

956
00:44:53,424 --> 00:44:55,659
>> I'LL GO AHEAD AND ALLOW YOU

957
00:44:55,726 --> 00:44:58,495
TO ENTERTAIN A FEW OF THESE.

958
00:44:58,562 --> 00:45:00,064
SO THE FIRST QUESTION IS DIRECT.

959
00:45:00,130 --> 00:45:02,866
IF THE STUDY WHICH DEMONSTRATED

960
00:45:02,933 --> 00:45:04,601
ADJUSTING FOR DISCRIMINATION AND

961
00:45:04,668 --> 00:45:08,705
INFLAMMATION AND RACE, HOW WAS

962
00:45:08,772 --> 00:45:10,274
WAS INFORMATION COLLECTED?

963
00:45:10,340 --> 00:45:11,341
BY SELF-REPORT?

964
00:45:11,408 --> 00:45:12,476
>> YES, SELF-REPORT.

965
00:45:12,543 --> 00:45:14,244
>> THAT WAS AN EASY ONE.

966
00:45:14,311 --> 00:45:16,146
THE NEXT ONE IS A LITTLE MORE

967
00:45:16,213 --> 00:45:17,247
COMPLICATE ABOUT MEASUREMENT AND

968
00:45:17,314 --> 00:45:19,383
I'LL COMBINE A COUPLE QUESTIONS.

969
00:45:19,450 --> 00:45:22,252
THERE WERE QUESTIONS ABOUT HOW

970
00:45:22,319 --> 00:45:24,354
WE CAN BEST MEASURE STRUCTURAL

971
00:45:24,421 --> 00:45:26,423
RACISM AND HOW WE CAN QUANTIFY

972
00:45:26,490 --> 00:45:28,058
THE STRESS RESPONSE THAT MIGHT

973
00:45:28,125 --> 00:45:30,527
BE UNIQUE TO EXPERIENCING

974
00:45:30,594 --> 00:45:32,796
RACISM, MARGINALIZATION AND

975
00:45:32,863 --> 00:45:35,299
DISCRIMINATION VERSUS ANY OTHER

976
00:45:35,365 --> 00:45:37,334
CHRONIC STRESSORS SUCH AS FAMINE

977
00:45:37,401 --> 00:45:40,204
OR OTHER CHRONIC STRESSORS AND

978
00:45:40,270 --> 00:45:42,139
IS THAT STRESS EXPERIENCED FROM

979
00:45:42,206 --> 00:45:50,147
RACISM, MARGINALIZATION AND IS

980
00:45:50,214 --> 00:45:54,952
IT MULTIPLICLATIVE.

981
00:45:55,018 --> 00:45:56,386
>> SOME OF THE RESEARCH THAT

982
00:45:56,453 --> 00:45:59,323
COMES FROM THE JUNIOR FACULTY

983
00:45:59,389 --> 00:46:01,658
HERE AND POSTDOCS AND GRADUATE

984
00:46:01,725 --> 00:46:03,327
STUDENTS BECAUSE THOSE ARE

985
00:46:03,393 --> 00:46:04,461
IMPORTANT QUESTIONS.

986
00:46:04,528 --> 00:46:06,897
FIRST, HOW DO WE MEASURE THE

987
00:46:06,964 --> 00:46:09,733
IMPACT OF STRUCTURAL RACISM.

988
00:46:09,800 --> 00:46:13,170
THERE'S MULTIPLE STRUCTURES IN A

989
00:46:13,237 --> 00:46:15,172
GIVEN COMMUNITY THAT IMPACTS

990
00:46:15,239 --> 00:46:17,274
EACH PERSON DIFFERENTLY.

991
00:46:17,341 --> 00:46:19,276
EACH PERSON IS NOT EXPOSED TO

992
00:46:19,343 --> 00:46:19,910
EACH STRUCTURE IN THAT COMMUNITY

993
00:46:19,977 --> 00:46:22,513
EQUALLY.

994
00:46:22,579 --> 00:46:26,550
AND THEN WE HAVE TO THINK ABOUT

995
00:46:26,617 --> 00:46:28,085
DIFFERENT PEOPLE HAVE DIFFERENT

996
00:46:28,152 --> 00:46:29,319
PROTECTIVE FACTORS.

997
00:46:29,386 --> 00:46:32,923
IF YOU THINK ABOUT EARLY ADVERSE

998
00:46:32,990 --> 00:46:35,459
EVENTS IN CHILDREN AND ADVERSE

999
00:46:35,526 --> 00:46:37,761
EVENTS, YOU HAVE A MARKED

1000
00:46:37,828 --> 00:46:38,962
INCREASE IN THE RISK OF MANY

1001
00:46:39,029 --> 00:46:41,165
CHRONIC DISEASES.

1002
00:46:41,231 --> 00:46:42,432
THE ONE MEDIATING FACTOR FOR

1003
00:46:42,499 --> 00:46:44,468
THAT IS IF YOU HAVE ONE PERSON

1004
00:46:44,535 --> 00:46:46,036
IN YOUR FAMILY LOVED YOU AND

1005
00:46:46,103 --> 00:46:47,838
CARED FOR YOU, THAT TENDS TO

1006
00:46:47,905 --> 00:46:50,340
HAVE A SIGNIFICANT PROTECTIVE

1007
00:46:50,407 --> 00:46:55,812
EFFECT AGAINST ALL THESE OTHER

1008
00:46:55,879 --> 00:46:56,246
ADVERSE EVENTS.

1009
00:46:56,313 --> 00:46:59,983
SO AND IT'S NOT WELL KNOWN AND

1010
00:47:00,050 --> 00:47:03,387
SO THERE'S PEOPLE OUT THERE AND

1011
00:47:03,453 --> 00:47:09,493
THEY'RE WAITING FOR THE PAPERS

1012
00:47:09,560 --> 00:47:11,628
AND GRANT PROPOSALS.

1013
00:47:11,695 --> 00:47:13,864
>> GREAT ANSWER TO THAT QUESTION

1014
00:47:13,931 --> 00:47:15,165
AND EXCELLENT TALK WHICH I

1015
00:47:15,232 --> 00:47:16,166
PROBABLY SHOULD HAVE STARTED

1016
00:47:16,233 --> 00:47:17,834
WITH WHEN I WALKED UP.

1017
00:47:17,901 --> 00:47:20,304
I SEE WE'RE A LITTLE BEHIND

1018
00:47:20,370 --> 00:47:20,704
TIME.

1019
00:47:20,771 --> 00:47:22,306
I THINK IF EVERYBODY COULD JUST

1020
00:47:22,372 --> 00:47:23,574
GIVE ONE MORE ROUND OF

1021
00:47:23,640 --> 00:47:27,077
APPLAUSE -- THANK YOU.

1022
00:47:27,144 --> 00:47:29,446
AND I BELIEVE WE'RE INVITING UP

1023
00:47:29,513 --> 00:47:33,483
OUR PATIENT AND COMMUNITY PANEL

1024
00:47:33,550 --> 00:47:35,953
TO THE STAGE.

1025
00:47:36,019 --> 00:47:38,488
HELLO, I'M PLEASED TO BE

1026
00:47:38,555 --> 00:47:39,756
CO-MODERATING TODAY'S SESSION

1027
00:47:39,823 --> 00:47:44,294
OUR PATIENT AND COMMUNITY PANEL.

1028
00:47:44,361 --> 00:47:54,905
MY NAME IS SHEENA MARTENIES AND

1029
00:47:55,405 --> 00:47:59,409
JOINED BY OUR CO-MODERATOR VIA

1030
00:47:59,476 --> 00:48:02,079
ZOOM JOINED WITH PHYLLIS HARRIS,

1031
00:48:02,145 --> 00:48:04,081
NICOLE WIESEN AND BOBBY HOWARD

1032
00:48:04,147 --> 00:48:05,215
AND CLAUDIA CAMACHO.

1033
00:48:05,282 --> 00:48:10,020
THE GOALS FOR THE SESSION ARE

1034
00:48:10,087 --> 00:48:10,320
T

1035
00:48:10,387 --> 00:48:10,554
TWOFOLD.

1036
00:48:10,621 --> 00:48:12,623
FIRST IS SET THE STAGE FOR THE

1037
00:48:12,689 --> 00:48:13,190
WORKSHOP AND EMPHASIZE THE

1038
00:48:13,257 --> 00:48:14,591
IMPORTANCE OF THE TOPIC.

1039
00:48:14,658 --> 00:48:16,627
MANY OF US ARE COMING FROM A

1040
00:48:16,693 --> 00:48:19,429
RESEARCH AND PRACTICE

1041
00:48:19,496 --> 00:48:21,565
PERSPECTIVE AND IT'S IMPORTANT

1042
00:48:21,632 --> 00:48:22,466
TO UNDERSTAND THE PATIENT AND

1043
00:48:22,532 --> 00:48:23,433
COMMUNITY PERSPECTIVE AS WE

1044
00:48:23,500 --> 00:48:24,534
PURSUE OUR WORK.

1045
00:48:24,601 --> 00:48:27,404
IT'S ALSO A REMINDER FOR US TO

1046
00:48:27,471 --> 00:48:29,673
ALL TAILOR OUR DISCUSSIONS TO BE

1047
00:48:29,740 --> 00:48:31,775
INCLUSIVE THE PATIENTS AND

1048
00:48:31,842 --> 00:48:34,911
OTHERS AT RISK FOR

1049
00:48:34,978 --> 00:48:36,013
NIDDK-FOCUSSED DISEASES WHO ARE

1050
00:48:36,079 --> 00:48:37,814
ALSO IN ATTENDANCE IN THE

1051
00:48:37,881 --> 00:48:45,722
WORKSHOP TODAY AND TOMORROW.

1052
00:48:45,789 --> 00:48:47,591
WITH THAT I'D LOVE OUR PANELISTS

1053
00:48:47,658 --> 00:48:49,259
TO INTRODUCE THEMSELVES AND

1054
00:48:49,326 --> 00:48:50,160
OFFER INFORMATION ON THE

1055
00:48:50,227 --> 00:48:51,928
IDENTITIES AND PERSPECTIVES

1056
00:48:51,995 --> 00:48:54,031
YOU'RE BRINGING TO THIS

1057
00:48:54,097 --> 00:48:58,402
DISCUSSION AND THEN OUR

1058
00:48:58,468 --> 00:49:03,907
COMODERATOR, GLENDA WILL

1059
00:49:03,974 --> 00:49:04,775
INTRODUCE HERSELF.

1060
00:49:04,841 --> 00:49:08,478
>> MY NAME IS PHYLLIS HARRIS.

1061
00:49:08,545 --> 00:49:11,615
I COME FROM CLEVELAND, OHIO.

1062
00:49:11,682 --> 00:49:15,319
I HAVE PARTICIPATED IN THE LAST

1063
00:49:15,385 --> 00:49:17,154
SEVERAL MONTHS AS AN ORGANIZER.

1064
00:49:17,220 --> 00:49:17,821
I THINK THAT'S WHAT I GET CREDIT

1065
00:49:17,888 --> 00:49:25,996
FOR.

1066
00:49:26,063 --> 00:49:30,000
I FELT EXCITED THOUGH I WAS

1067
00:49:30,067 --> 00:49:31,535
ZOOMS ON SCIENTISTS AND A LOT OF

1068
00:49:31,601 --> 00:49:32,602
WHAT I WAS HEARING I DIDN'T

1069
00:49:32,669 --> 00:49:38,075
QUITE UNDERSTAND.

1070
00:49:38,141 --> 00:49:41,244
I KNOW ENOUGH ABOUT MY WORK OF

1071
00:49:41,311 --> 00:49:44,481
AN EXECUTIVE DIRECTOR IN TERMS

1072
00:49:44,548 --> 00:49:46,917
OF AN LGBTQ DIRECTOR RELATED TO

1073
00:49:46,983 --> 00:49:47,751
MINORITY STRESS.

1074
00:49:47,818 --> 00:49:49,720
KNOW A LOT ABOUT MY OWN PERSONAL

1075
00:49:49,786 --> 00:49:54,825
EXPERIENCE AS A BLACK LESBIAN AS

1076
00:49:54,891 --> 00:49:58,428
A MOM AND NON-PROFIT EXECUTIVE

1077
00:49:58,495 --> 00:50:00,397
RAISED BY A WORKING CLASS SINGLE

1078
00:50:00,464 --> 00:50:02,566
MOM WHO WORKED IN A FACTORY FOR

1079
00:50:02,632 --> 00:50:07,804
30 YEARS AND NOW WE'RE DEALING

1080
00:50:07,871 --> 00:50:10,107
WITH THE CHALLENGES THAT HAS

1081
00:50:10,173 --> 00:50:11,041
BROUGHT AROUND HER HEALTH.

1082
00:50:11,108 --> 00:50:17,047
I LOVE THE OPENING REMARKS AND

1083
00:50:17,114 --> 00:50:27,624
WHAT I LEARNED THERE I'M HERE

1084
00:50:28,058 --> 00:50:29,626
REPRESENTING MYSELF AND I'M

1085
00:50:29,693 --> 00:50:30,260
ALMOST 60.

1086
00:50:30,327 --> 00:50:36,666
I FIGURED OUT TWO YEARS AGO --

1087
00:50:36,733 --> 00:50:38,301
THREE YEARS AGO IF I COULD BE

1088
00:50:38,368 --> 00:50:39,703
THE PERSON TO HELP HER REDUCE

1089
00:50:39,770 --> 00:50:41,405
THE STRESS IN HER LIFE, I COULD

1090
00:50:41,471 --> 00:50:43,874
HELP HER DELAY THE PROGRESSION

1091
00:50:43,940 --> 00:50:46,910
OF HER DISEASE.

1092
00:50:46,977 --> 00:50:54,885
SO YOU'RE UP HERE TALK TO A ROOM

1093
00:50:54,951 --> 00:50:56,286
OF SMART PEOPLE AND SCIENTISTS

1094
00:50:56,353 --> 00:50:59,990
AND YOU'RE SPEAKING MY LIFE.

1095
00:51:00,056 --> 00:51:01,558
IT DIDN'T TAKE ME BEING HERE TO

1096
00:51:01,625 --> 00:51:05,962
UNDERSTAND WHAT YOU WERE SAYING

1097
00:51:06,029 --> 00:51:07,397
TO SEE IT PLAY OUT IN REAL TIME

1098
00:51:07,464 --> 00:51:18,008
WITH MY MOM AND HOW IT'S WORKING

1099
00:51:23,880 --> 00:51:26,316
TO MIKE ENOUGH MONEY TO HELP HER

1100
00:51:26,383 --> 00:51:28,752
AND KEEP HER IN HER HOME AND

1101
00:51:28,819 --> 00:51:30,587
THAT'S ALL SHE HAS TO SHOW FOR

1102
00:51:30,654 --> 00:51:32,589
THE 30 YEARS OF WORK IN A

1103
00:51:32,656 --> 00:51:34,858
FACTORY AND TELL ME AND MY

1104
00:51:34,925 --> 00:51:35,959
BROTHER I'M DOING THIS SO YOU

1105
00:51:36,026 --> 00:51:39,529
DON'T HAVE TO AND BE HERE TO

1106
00:51:39,596 --> 00:51:40,130
REPRESENT CHANGES IN THE

1107
00:51:40,197 --> 00:51:41,698
NARRATIVE IN TERMS OF WHAT A

1108
00:51:41,765 --> 00:51:45,669
WANT TO DO AS A BLACK WOMAN, AS

1109
00:51:45,735 --> 00:51:46,937
SOMEONE WHO IS PROUD TO BE

1110
00:51:47,003 --> 00:51:49,973
BLACK, PROUD TO BE OUT AND A

1111
00:51:50,040 --> 00:51:55,912
LESBIAN AND MOM AND FOR OUR

1112
00:51:55,979 --> 00:52:01,685
FAMILIES.

1113
00:52:01,751 --> 00:52:05,689
FOR THE GENERATIONAL STRESS AND

1114
00:52:05,755 --> 00:52:06,656
WITH THIS AND MORE MY KIDS WILL

1115
00:52:06,723 --> 00:52:07,023
BE BETTER.

1116
00:52:07,090 --> 00:52:08,091
I THINK THERE'S A WAY TO CHANGE

1117
00:52:08,158 --> 00:52:15,365
THE NARRATIVE.

1118
00:52:15,432 --> 00:52:19,903
I THINK YOU ARE ALL ARE A PART

1119
00:52:19,970 --> 00:52:27,444
OF THAT SO THANK YOU.

1120
00:52:27,511 --> 00:52:29,112
>> GOOD MORNING.

1121
00:52:29,179 --> 00:52:33,016
MY NAME IS CLAUDIA CAMACHO.

1122
00:52:33,083 --> 00:52:37,988
I'M FROM DENVER.

1123
00:52:38,054 --> 00:52:45,028
WE CAME TO THE STATES BACK IN

1124
00:52:45,095 --> 00:52:49,633
THE LATE '80s.

1125
00:52:49,699 --> 00:52:52,335
CAN YOU HEAR ME NOW?

1126
00:52:52,402 --> 00:52:55,205
SO I WORK AT THE UNIVERSITY OF

1127
00:52:55,272 --> 00:53:01,978
COLORADO RIGHT NOW WITH DR

1128
00:53:02,045 --> 00:53:06,616
DR. CERVANTES AS A PATIENT

1129
00:53:06,683 --> 00:53:11,888
NAVIGATOR AND DIALYSIS

1130
00:53:11,955 --> 00:53:18,628
PATIENTS -- UM, THE REASON WHEN

1131
00:53:18,695 --> 00:53:22,532
SHE POSTED THE SHOW I -- THE

1132
00:53:22,599 --> 00:53:24,367
FIRST THING I THOUGHT ABOUT WAS

1133
00:53:24,434 --> 00:53:27,237
KIDNEY DISEASE.

1134
00:53:27,304 --> 00:53:30,307
MY DAD WAS DIAGNOSED END STAGE

1135
00:53:30,373 --> 00:53:32,876
KIDNEY DISEASE BACK IN THE EARLY

1136
00:53:32,943 --> 00:53:35,946
2000s AND WE TRIED TO NAVIGATE

1137
00:53:36,012 --> 00:53:40,116
THE SYSTEM.

1138
00:53:40,183 --> 00:53:40,984
IT WAS DIFFICULT.

1139
00:53:41,051 --> 00:53:45,388
IF I KNEW WHAT I KNOW NOW IS

1140
00:53:45,455 --> 00:53:46,990
AVAILABLE MY DAD WOULD PROBABLY

1141
00:53:47,057 --> 00:53:55,565
BE ALIVE AT THIS POINT.

1142
00:53:55,632 --> 00:53:57,267
WE WERE NOT OFFERING A LOT OF

1143
00:53:57,334 --> 00:54:03,873
STUFF.

1144
00:54:03,940 --> 00:54:05,742
I WAS A SPANISH INTERPRETER AT

1145
00:54:05,809 --> 00:54:06,776
THAT TIME AND THOUGHT I THROUGH

1146
00:54:06,843 --> 00:54:11,615
WHAT WE NEEDED TO DO AT THE END

1147
00:54:11,681 --> 00:54:13,416
WE LACKED A LOT OF INFORMATION.

1148
00:54:13,483 --> 00:54:24,027
I WANTED TO SAY SOMETHING ABOUT

1149
00:54:24,461 --> 00:54:26,930
I WANT TO TALK ABOUT THE

1150
00:54:26,997 --> 00:54:29,332
MOTIVATION AND CREATION AND I

1151
00:54:29,399 --> 00:54:31,968
KNOW BASED ON THE STUDIES, BASED

1152
00:54:32,035 --> 00:54:35,038
ON THE WORK SHE HAS DONE THEY

1153
00:54:35,105 --> 00:54:39,275
HAVE KNOWN A LOT OF PEOPLE, A

1154
00:54:39,342 --> 00:54:40,744
LOT OF COMMUNITY, LATINO

1155
00:54:40,810 --> 00:54:45,782
COMMUNITY THAT STRUGGLE EVERY

1156
00:54:45,849 --> 00:54:51,788
DAY WITH RESOURCES ESPECIALLY

1157
00:54:51,855 --> 00:54:58,528
WITH THE MIGRANCY SITUATION

1158
00:54:58,595 --> 00:55:01,197
WAITING FOR THE PAPERS AND NOT

1159
00:55:01,264 --> 00:55:03,466
LEGAL AND SOMETIMES WE'RE IN THE

1160
00:55:03,533 --> 00:55:03,733
SHADOWS.

1161
00:55:03,800 --> 00:55:05,068
WE DON'T WANT GO TO THE

1162
00:55:05,135 --> 00:55:06,469
HOSPITALS BECAUSE WE'RE AFRAID

1163
00:55:06,536 --> 00:55:09,706
THEY'RE GOING TO DEPORT US OR

1164
00:55:09,773 --> 00:55:11,608
GET SEPARATED FROM OUR KIDS AND

1165
00:55:11,675 --> 00:55:11,841
FAMILY.

1166
00:55:11,908 --> 00:55:15,111
THAT'S WHAT HAPPENED TO MANY

1167
00:55:15,178 --> 00:55:16,813
PATIENTS IN DENVER WHEN THEY

1168
00:55:16,880 --> 00:55:18,415
WERE GETTING DIALYSIS.

1169
00:55:18,481 --> 00:55:28,992
THEY WENT TO THE HOSPITAL AND

1170
00:55:32,062 --> 00:55:35,965
YOU WERE TOLD GO BACK TO YOUR

1171
00:55:36,032 --> 00:55:37,300
COUNTRY BECAUSE YOU DON'T HAVE

1172
00:55:37,367 --> 00:55:37,734
MEDICAL INSURANCE.

1173
00:55:37,801 --> 00:55:40,970
I KNOW IT'S STILL HAPPENING

1174
00:55:41,037 --> 00:55:43,573
THOUGH IN COLORADO, EMERGENCY

1175
00:55:43,640 --> 00:55:45,842
MEDICAID COVERS IN-CENTER

1176
00:55:45,909 --> 00:55:46,676
DIALYSIS I STILL HEAR PEOPLE

1177
00:55:46,743 --> 00:55:48,678
SAYING I WENT TO THE HOSPITAL

1178
00:55:48,745 --> 00:55:49,446
AND THEY TOLD ME TO GO BACK TO

1179
00:55:49,512 --> 00:55:55,585
MY COUNTRY.

1180
00:55:55,652 --> 00:55:58,688
THAT'S A GROUP WHERE I'M IN A

1181
00:55:58,755 --> 00:55:59,923
PRIVILEGED POSITION BECAUSE I'M

1182
00:55:59,989 --> 00:56:02,025
WORKING WITH THE DOCTOR AND

1183
00:56:02,092 --> 00:56:04,327
WE'RE TRYING TO DO BETTER SYSTEM

1184
00:56:04,394 --> 00:56:07,597
FOR THE LATINO COMMUNITY.

1185
00:56:07,664 --> 00:56:09,733
THERE WAS A LOT OF STUFF THAT

1186
00:56:09,799 --> 00:56:10,266
RESONATED WITH ME ON YOUR

1187
00:56:10,333 --> 00:56:12,268
PRESENTATION.

1188
00:56:12,335 --> 00:56:15,905
KIDS CAN, I WANT TO DO THIS FOR

1189
00:56:15,972 --> 00:56:19,442
MY KIDS TOO.

1190
00:56:19,509 --> 00:56:22,679
LIKE HER.

1191
00:56:22,746 --> 00:56:23,346
THERE'S MORE AWARENESS OF WHAT'S

1192
00:56:23,413 --> 00:56:28,952
HAPPENING.

1193
00:56:29,018 --> 00:56:29,819
SOMETIMES BEING IN THE SHADOWS

1194
00:56:29,886 --> 00:56:35,291
OR IN THE COUNTRY BECAUSE WE

1195
00:56:35,358 --> 00:56:45,935
DON'T HAVE PAPERS AND AN

1196
00:56:49,172 --> 00:56:50,340
EMERGENCY BECAUSE WE'RE GETTING

1197
00:56:50,406 --> 00:56:52,876
SICK AND WE THINK THAT'S ENOUGH.

1198
00:56:52,942 --> 00:56:54,577
I THINK I DON'T HAVE A RIGHT TO

1199
00:56:54,644 --> 00:56:55,478
BE HERE SO WHATEVER THEY'LL GIVE

1200
00:56:55,545 --> 00:57:05,855
ME WILL BE ENOUGH.

1201
00:57:08,057 --> 00:57:09,192
AND WITH HEALTH CARE WE WORK

1202
00:57:09,259 --> 00:57:10,760
HARD, LATINOS WORK HARD.

1203
00:57:10,827 --> 00:57:16,332
YOU CAN SEE PEOPLE IN THE FIELDS

1204
00:57:16,399 --> 00:57:19,035
AND WITH THE FIRES AND WE WORK

1205
00:57:19,102 --> 00:57:19,669
REALLY HARD AND CONTRIBUTE TO

1206
00:57:19,736 --> 00:57:21,171
THE ECONOMY.

1207
00:57:21,237 --> 00:57:25,308
WE DON'T GET MANY BACK BUT WE

1208
00:57:25,375 --> 00:57:25,608
CONTRIBUTE.

1209
00:57:25,675 --> 00:57:26,976
WE JUST NEED A LITTLE BIT OF

1210
00:57:27,043 --> 00:57:28,845
WORK AND WE'LL BE OKAY.

1211
00:57:28,912 --> 00:57:32,982
I WANT PEOPLE TO KNOW LATINOS WE

1212
00:57:33,049 --> 00:57:35,585
CAN EXPECT MORE FROM THE SYSTEM

1213
00:57:35,652 --> 00:57:44,761
ESPECIALLY KEEPING US HEALTHY.

1214
00:57:44,828 --> 00:57:47,964
>> GOOD MORNING, MY NAME IS

1215
00:57:48,031 --> 00:57:48,898
BOBBY HOWARD.

1216
00:57:48,965 --> 00:57:55,939
I BRING YOU GREETINGS FROM THE

1217
00:57:56,005 --> 00:57:57,273
GREAT STATE OF GEORGIA.

1218
00:57:57,340 --> 00:58:00,009
I RECEIVED A KIDNEY AND OCTOBER

1219
00:58:00,076 --> 00:58:00,844
WILL BE 30 YEAR.

1220
00:58:00,910 --> 00:58:05,515
MY BACKGROUND PRIOR TO THAT IS

1221
00:58:05,582 --> 00:58:05,715
SMALL.

1222
00:58:05,782 --> 00:58:07,851
I WAS A FORMER RUNNING BACK WITH

1223
00:58:07,917 --> 00:58:09,252
THE TB BUCCANEERS AND

1224
00:58:09,319 --> 00:58:11,521
PHILADELPHIA EAGLES AND THE

1225
00:58:11,588 --> 00:58:15,058
GREEN BAY PACKERS AND I

1226
00:58:15,124 --> 00:58:16,359
CONTRACTED END STAGE RENAL

1227
00:58:16,426 --> 00:58:17,493
DISEASE RIGHT AFTER I RETIRED

1228
00:58:17,560 --> 00:58:19,295
FROM THE NFL AND MY WHOLE

1229
00:58:19,362 --> 00:58:22,599
JOURNEY WITH THAT AND THE WORK I

1230
00:58:22,665 --> 00:58:26,035
DO, I WORK NOW AS A DIRECTOR OF

1231
00:58:26,102 --> 00:58:31,140
OUR MULTI-CULTURAL PROGRAM WE

1232
00:58:31,207 --> 00:58:32,876
RECOVER ALL THE ORGANS IN THE

1233
00:58:32,942 --> 00:58:35,545
STATE FOR TRANSPLANT AND THROUGH

1234
00:58:35,612 --> 00:58:36,813
MY JOURNEY I SAW THE NEED FOR MY

1235
00:58:36,880 --> 00:58:38,982
VOICE AND WHO I WAS AND MY

1236
00:58:39,048 --> 00:58:41,084
DIALYSIS AND TRANSPLANT JOURNEY

1237
00:58:41,150 --> 00:58:42,919
WASN'T AS STRINGENT AND TOUGH AS

1238
00:58:42,986 --> 00:58:44,520
OTHER PEOPLE I SAW ON DIALYSIS.

1239
00:58:44,587 --> 00:58:46,789
SO I WANTED TO USE MY VOICE TO

1240
00:58:46,856 --> 00:58:49,359
BE AN ADVOCATE FOR PEOPLE WHO

1241
00:58:49,425 --> 00:58:51,194
WERE SUFFERING BECAUSE I FELT MY

1242
00:58:51,261 --> 00:58:54,197
BACKGROUND LENDED ME THAT

1243
00:58:54,264 --> 00:58:56,466
CREDIBILITY TO SAY I PLAY

1244
00:58:56,532 --> 00:58:57,767
FOOTBALL AND I CAN CHANGE THE

1245
00:58:57,834 --> 00:58:58,601
SUBJECT MATTER AND TALK ABOUT

1246
00:58:58,668 --> 00:59:00,703
WHAT I REALLY WANT TO TALK

1247
00:59:00,770 --> 00:59:01,070
ABOUT.

1248
00:59:01,137 --> 00:59:07,277
I HAVE REALLY USED THAT IN MY

1249
00:59:07,343 --> 00:59:11,247
CAREER NOW TO HELP PEOPLE

1250
00:59:11,314 --> 00:59:12,682
NAVIGATE THE SYSTEM AND NAVIGATE

1251
00:59:12,749 --> 00:59:14,550
THE COMORBIDITIES AND THE WORK

1252
00:59:14,617 --> 00:59:18,321
WITH THE HEALTH CARE SYSTEM TO

1253
00:59:18,388 --> 00:59:19,088
SAY BECAUSE YOU'RE DIFFERENT

1254
00:59:19,155 --> 00:59:21,824
THEN NORM, YOU CAN STILL HAVE

1255
00:59:21,891 --> 00:59:23,459
THE SAME TREATMENT AS THE NORM.

1256
00:59:23,526 --> 00:59:29,165
AND WORKING THROUGH THE WHOLE

1257
00:59:29,232 --> 00:59:31,000
PROCESS GOES WAY BACK.

1258
00:59:31,067 --> 00:59:34,737
MY MOTHER RECEIVED A KIDNEY

1259
00:59:34,804 --> 00:59:37,807
TRANSPLANT BUT DIED PASSED WHEN

1260
00:59:37,874 --> 00:59:45,248
I WAS 13 YEARS OLD MAKING THE

1261
00:59:45,315 --> 00:59:48,384
TRANSITION AND HOPEFULLY WHAT I

1262
00:59:48,451 --> 00:59:50,119
CAN BRING IS WITHOUT HAVING

1263
00:59:50,186 --> 00:59:51,654
COMMUNITY PARTNERS INVOLVED IN

1264
00:59:51,721 --> 00:59:54,891
DECISION MAKING, I TRULY BELIEVE

1265
00:59:54,958 --> 00:59:55,959
YOU'RE GOING DOWN THE WRONG ROAD

1266
00:59:56,025 --> 00:59:59,028
AND BRINGING COMMUNITY PARTNERS

1267
00:59:59,095 --> 01:00:00,163
TO HEAR WHAT THE COMMUNITY NEEDS

1268
01:00:00,229 --> 01:00:02,732
WE CAN ALL GO DOWN THE SAME ROAD

1269
01:00:02,799 --> 01:00:03,833
AND HOPE TO HAVE BETTER

1270
01:00:03,900 --> 01:00:04,133
OUTCOMES.

1271
01:00:04,200 --> 01:00:05,868
THANK YOU FOR ALLOWING ME TO BE

1272
01:00:05,935 --> 01:00:07,303
HERE AND GIVE SOME INSIGHT FROM

1273
01:00:07,370 --> 01:00:13,376
MY PERSPECTIVE.

1274
01:00:13,443 --> 01:00:14,978
>> I'D LIKE TO THANK ALL THREE

1275
01:00:15,044 --> 01:00:16,813
OF MY PANELISTS.

1276
01:00:16,879 --> 01:00:17,780
TO THE WERE VERY MOVING

1277
01:00:17,847 --> 01:00:18,648
COMMENTS.

1278
01:00:18,715 --> 01:00:21,651
MY NAME IS GLENDA ROBERTS.

1279
01:00:21,718 --> 01:00:23,920
I'M AN AFRICAN AMERICAN

1280
01:00:23,987 --> 01:00:27,457
HETEROSEXUAL TRANSPLANT

1281
01:00:27,523 --> 01:00:28,091
RECIPIENT WITH -- CAN YOU HEAR

1282
01:00:28,157 --> 01:00:32,462
ME?

1283
01:00:32,528 --> 01:00:34,430
I'M PROUD TO HAVE AN OPPORTUNITY

1284
01:00:34,497 --> 01:00:36,566
TO INTERFACE WITH THIS PANEL.

1285
01:00:36,632 --> 01:00:38,568
YOU GUYS HAVE DONE A GREAT JOB

1286
01:00:38,634 --> 01:00:41,537
OF ADDRESSING OUR PRIMARY

1287
01:00:41,604 --> 01:00:44,841
QUESTION WAS TO ASK YOU ABOUT

1288
01:00:44,907 --> 01:00:46,409
YOUR EXPERIENCES WITH RACISM,

1289
01:00:46,476 --> 01:00:47,944
MARGINALIZATION AND

1290
01:00:48,011 --> 01:00:53,349
DISCRIMINATION -- OKAY.

1291
01:00:53,416 --> 01:00:55,952
TELL ME WHEN YOU WANT ME TO

1292
01:00:56,019 --> 01:01:06,129
START.

1293
01:01:33,022 --> 01:01:34,690
YOU CAN HEAR ME ONLINE BUT NOT

1294
01:01:34,757 --> 01:01:35,158
IN THE ROOM.

1295
01:01:35,224 --> 01:01:38,494
>> YOU CAN HEAR US BUT WE CAN'T

1296
01:01:38,561 --> 01:01:40,863
HEAR YOU AND THEY'RE TO FIX THE

1297
01:01:40,930 --> 01:01:43,266
AUDIO COMING INTO THE ROOM.

1298
01:01:43,332 --> 01:01:47,970
IF YOU CAN CHECK YOUR MIC AND

1299
01:01:48,037 --> 01:01:58,581
MAKE SURE -- CAN YOU HEAR ME IN

1300
01:02:54,604 --> 01:03:04,780
THE ROOM NOW?

1301
01:03:08,718 --> 01:03:11,020
I HAVE A REQUEST -- ARE THOSE

1302
01:03:11,087 --> 01:03:15,024
ONLINE ALSO IN THE ROOM, COULD

1303
01:03:15,091 --> 01:03:16,959
YOU ASK SHEENA TO GO AHEAD WITH

1304
01:03:17,026 --> 01:03:22,231
THE QUESTIONS.

1305
01:03:22,298 --> 01:03:25,668
>> THANK YOU, GLENDA.

1306
01:03:25,735 --> 01:03:27,203
HOPEFULLY WE CAN HEAR FROM YOU

1307
01:03:27,270 --> 01:03:27,937
IN THE RAM.

1308
01:03:28,004 --> 01:03:31,941
I'LL PROCEED WITH OUR FIRST

1309
01:03:32,008 --> 01:03:42,185
QUESTIONS.

1310
01:03:45,721 --> 01:03:50,860
CAN YOU SHARE WITH US WHAT YOU

1311
01:03:50,927 --> 01:03:56,966
SEE IN THE COMMUNITY.

1312
01:03:57,033 --> 01:04:07,176
>> OKAY.

1313
01:04:15,851 --> 01:04:17,887
I JUST WANT TO -- I CAN START.

1314
01:04:17,954 --> 01:04:20,823
IS THAT OKAY?

1315
01:04:20,890 --> 01:04:21,023
OKAY.

1316
01:04:21,090 --> 01:04:23,125
SO THINKING ABOUT THE QUESTIONS

1317
01:04:23,192 --> 01:04:27,230
AND WHAT I LEARNED LIKE I SAID

1318
01:04:27,296 --> 01:04:31,934
MY DAD WAS DIAGNOSED END STAGE

1319
01:04:32,001 --> 01:04:35,771
RENAL DISEASE I THOUGHT WE WERE

1320
01:04:35,838 --> 01:04:37,473
PRIVILEGED SITUATION OR PLACE

1321
01:04:37,540 --> 01:04:39,175
BECAUSE I KNEW THE SYSTEM,

1322
01:04:39,242 --> 01:04:40,042
RIGHT.

1323
01:04:40,109 --> 01:04:50,286
I WAS A SPANISH INTERPRETER.

1324
01:04:50,353 --> 01:04:58,728
S THEY DIDN'T OFFER US ANYTHING

1325
01:04:58,794 --> 01:05:05,368
AND I USED TO ENCOURAGE HIM LIKE

1326
01:05:05,434 --> 01:05:11,407
WE SHOULD BE THANKFUL AND YOU

1327
01:05:11,474 --> 01:05:16,812
ARE IN THE POSITION YOU CAN GET

1328
01:05:16,879 --> 01:05:21,751
BENEFITS AND A CENTER TO GET

1329
01:05:21,817 --> 01:05:23,986
DIALYSIS AND INTERPRETING FOR

1330
01:05:24,053 --> 01:05:24,820
INDIVIDUALS AT THE HOSPITAL THAT

1331
01:05:24,887 --> 01:05:27,390
WERE REAL SICK AND COULDN'T GET

1332
01:05:27,456 --> 01:05:29,825
DIALYSIS BECAUSE THEIR POTASSIUM

1333
01:05:29,892 --> 01:05:36,365
WAS LOW OR WASN'T HIGH ENOUGH.

1334
01:05:36,432 --> 01:05:39,468
I USED TO TELL MY DAD, WE'RE

1335
01:05:39,535 --> 01:05:40,903
LUCKY, WE CAN GO TO A CENTER AND

1336
01:05:40,970 --> 01:05:46,375
THERE'S PEOPLE THAT CAN'T.

1337
01:05:46,442 --> 01:05:52,148
THAT'S WHAT I THINK THEN I START

1338
01:05:52,214 --> 01:05:55,151
WORKING WITH THE PATIENTS AFTER

1339
01:05:55,217 --> 01:06:00,756
MY DAD PASSED AWAY AND THEY

1340
01:06:00,823 --> 01:06:11,500
DECLINED FAST ER AND THE PEOPLE

1341
01:06:12,101 --> 01:06:16,772
THAT WAS HERE WORKING TRYING TO

1342
01:06:16,839 --> 01:06:19,008
SURVIVE FOR FAMILIES WERE AT THE

1343
01:06:19,075 --> 01:06:20,343
HOSPITAL EVERY WEEK AND THEIR

1344
01:06:20,409 --> 01:06:25,481
LIFE CHANGES.

1345
01:06:25,548 --> 01:06:30,152
AND THERE'S NO SAFETY NET AND

1346
01:06:30,219 --> 01:06:31,721
CAN GO TO THE CENTER BUT THEY

1347
01:06:31,787 --> 01:06:33,356
DON'T HAVE TRANSPORTATION, THEY

1348
01:06:33,422 --> 01:06:39,362
DON'T HAVE A RESOURCES LIKE FOOD

1349
01:06:39,428 --> 01:06:40,796
STAMPS.

1350
01:06:40,863 --> 01:06:43,799
THERE'S PANTRIES AVAILABLE BUT

1351
01:06:43,866 --> 01:06:45,134
DON'T HAVE TRANSPORTATION AND

1352
01:06:45,201 --> 01:06:52,441
THE PATIENTS DECLINE.

1353
01:06:52,508 --> 01:06:57,546
AND I SAW THE PEOPLE THAT DIDN'T

1354
01:06:57,613 --> 01:06:58,848
HAVE AND COMPARED TO PEOPLE THAT

1355
01:06:58,914 --> 01:07:00,816
HAVE FAMILY SUPPORT AND HERE

1356
01:07:00,883 --> 01:07:05,621
LIVING BY THEMSELVES BECAUSE

1357
01:07:05,688 --> 01:07:10,226
THEY CAME HERE FROM THEIR

1358
01:07:10,292 --> 01:07:10,626
COUNTRY.

1359
01:07:10,693 --> 01:07:12,762
THEY DIDN'T HAVE SUPPORT OR

1360
01:07:12,828 --> 01:07:14,330
ANYTHING AND BECAUSE THE

1361
01:07:14,397 --> 01:07:16,198
ILLEGALS, THEY DON'T HAVE

1362
01:07:16,265 --> 01:07:17,333
PAPERS, I'LL SAY THAT, THEY'RE

1363
01:07:17,400 --> 01:07:27,843
NOT ELIGIBLE FOR ANYTHING.

1364
01:07:32,114 --> 01:07:37,119
>> I THINK I'LL START WITH

1365
01:07:37,186 --> 01:07:39,655
THINKING ABOUT WHEN I FIRST

1366
01:07:39,722 --> 01:07:45,728
BECAME ACQUIRE  -- AWARE AND

1367
01:07:45,795 --> 01:07:47,930
STARTED WITH FIND AS A LESBIAN

1368
01:07:47,997 --> 01:07:50,332
IN OUR COMMUNITY WE NEEDED TO

1369
01:07:50,399 --> 01:07:52,301
FIND PLACE TO GO AND GET MEDICAL

1370
01:07:52,368 --> 01:07:54,603
CARE AND IN MY COMMUNITY THAT

1371
01:07:54,670 --> 01:07:57,740
WAS A PLANNED PARENTHOOD.

1372
01:07:57,807 --> 01:08:01,143
IT WAS KNOWN AND IN MY EARLY 20s

1373
01:08:01,210 --> 01:08:05,815
IT WAS KNOWN AROUND MY NETWORK

1374
01:08:05,881 --> 01:08:08,217
OF LESBIAN FEMINISTS IN

1375
01:08:08,284 --> 01:08:09,652
CLEVELAND, PLANNED PARENTHOOD IS

1376
01:08:09,718 --> 01:08:11,954
A PLACE YOU COULD GO AND BE

1377
01:08:12,021 --> 01:08:15,357
RESPECTED AND BE OUT AND SAY I'M

1378
01:08:15,424 --> 01:08:25,301
A LESBIAN AND I DON'T HAVE SEX

1379
01:08:25,367 --> 01:08:27,603
LIKE THIS BUT LIKE THAT AND I

1380
01:08:27,670 --> 01:08:30,039
WAS REFERRED TO ANOTHER

1381
01:08:30,105 --> 01:08:32,975
GYNECOLOGIST BECAUSE THE NURSE

1382
01:08:33,042 --> 01:08:34,276
TOLD ME I MAY HAVE FIBROIDS.

1383
01:08:34,343 --> 01:08:36,946
I DIDN'T KNOW WHAT THEY WERE BUT

1384
01:08:37,012 --> 01:08:39,248
SENT ME OVER AND SAID GET

1385
01:08:39,315 --> 01:08:40,216
ANOTHER DOCTOR AND GO CHECK

1386
01:08:40,282 --> 01:08:41,550
THESE OUT AND A DID AND FOUND

1387
01:08:41,617 --> 01:08:43,652
OUT SHE WAS RIGHT AND SO I WAS

1388
01:08:43,719 --> 01:08:44,820
HAPPY FOR THAT INTERVENTION AND

1389
01:08:44,887 --> 01:08:46,956
I LEARNED ALL ABOUT FIBROIDS.

1390
01:08:47,022 --> 01:08:51,227
I WAS PARTNERED AT THE TIME AND

1391
01:08:51,293 --> 01:08:53,229
WE HAD PLANS TO HAVE CHILDREN

1392
01:08:53,295 --> 01:08:56,866
AND I WAS PLANNING TO BE THE

1393
01:08:56,932 --> 01:08:59,568
BIRTH MOM AND I SAW THE

1394
01:08:59,635 --> 01:09:00,736
GYNECOLOGIST AND BASICALLY SHE

1395
01:09:00,803 --> 01:09:07,943
CAME TO TALK TO US BOTH AND LET

1396
01:09:08,010 --> 01:09:11,280
ME KNOW AT 27 I WOULD NEED TO

1397
01:09:11,347 --> 01:09:13,949
HAVE A HYSTERECTOMY AND MY THEN

1398
01:09:14,016 --> 01:09:15,551
PARTNER WHO WAS WHITE AND THIS

1399
01:09:15,618 --> 01:09:18,220
IS ABOUT MY PROXIMITY TO

1400
01:09:18,287 --> 01:09:20,756
WHITENESS AND THINK IT SUPPORTED

1401
01:09:20,823 --> 01:09:23,492
ME AROUND GETTING BETTER CARE,

1402
01:09:23,559 --> 01:09:25,761
SAID, OH, NO, WE DON'T WANT TO

1403
01:09:25,828 --> 01:09:28,330
HAVE A HYSTERECTOMY, TALKING

1404
01:09:28,397 --> 01:09:29,031
ABOUT ME.

1405
01:09:29,098 --> 01:09:33,736
WE DIDN'T BUT WE WANT TO HAVE

1406
01:09:33,802 --> 01:09:35,437
CHILDREN AND THE WHITE PHYSICIAN

1407
01:09:35,504 --> 01:09:37,006
SAID TO US, THEN YOU HAVE THE

1408
01:09:37,072 --> 01:09:40,109
BABY AND POINTED TO HER AND SHE

1409
01:09:40,175 --> 01:09:41,844
SAID IT'S NOT GOING TO COME OUT

1410
01:09:41,911 --> 01:09:47,950
OF MY BODY, THIS ABOUT HER AND I

1411
01:09:48,017 --> 01:09:57,526
LEARNED ABOUT MYOMECTOMY AND I

1412
01:09:57,593 --> 01:09:59,895
DON'T THINK IF I HADN'T BEEN

1413
01:09:59,962 --> 01:10:06,402
WITH AMY MY CO-PARENTING PARTNER

1414
01:10:06,468 --> 01:10:08,404
QUESTIONING IT I THINK IT STARTS

1415
01:10:08,470 --> 01:10:08,604
THERE.

1416
01:10:08,671 --> 01:10:11,941
FAST FORWARD MY EXPERIENCE WITH

1417
01:10:12,007 --> 01:10:16,712
MEDICAL CARE AFTER I HAD A

1418
01:10:16,779 --> 01:10:19,214
PREMATURE CHILD BY THIS TIME I'M

1419
01:10:19,281 --> 01:10:21,784
32.

1420
01:10:21,850 --> 01:10:24,253
BY THE THAT TIME MY SON IS NOW

1421
01:10:24,320 --> 01:10:27,189
36 AND GETTING MARRIED IN AUGUST

1422
01:10:27,256 --> 01:10:32,161
WAS BORN TWO POUNDS 14 OUNCES IN

1423
01:10:32,227 --> 01:10:36,565
A HOSPITAL RIGHT IN THE HOOD AND

1424
01:10:36,632 --> 01:10:38,167
LIVED IN A SUBURB BUT THAT'S

1425
01:10:38,233 --> 01:10:40,703
WHERE MY DOCTOR PRACTICED OUT OF

1426
01:10:40,769 --> 01:10:42,538
AND WHERE I DELIVERED.

1427
01:10:42,605 --> 01:10:44,974
THE EXPERIENCE OF ANTI-BLACK

1428
01:10:45,040 --> 01:10:46,842
BIAS I KNOW OF NOW, I KNEW TO

1429
01:10:46,909 --> 01:10:50,346
CALL IT THERE AND THE MICRO

1430
01:10:50,412 --> 01:10:52,214
AGGRESSIONS BUT I WAS FIERCE AND

1431
01:10:52,281 --> 01:10:54,383
HAD A BABY COMPLETELY HEALTHY

1432
01:10:54,450 --> 01:10:56,619
BUT TINY.

1433
01:10:56,685 --> 01:10:58,887
THROUGHOUT MY PREGNANCY I'M A

1434
01:10:58,954 --> 01:11:04,460
BIG CURVY WOMAN, I WOULD BE

1435
01:11:04,526 --> 01:11:08,030
ASKED IF I MAYBE USED DRUGS

1436
01:11:08,097 --> 01:11:12,835
BECAUSE I WAS GAINING WEIGHT AND

1437
01:11:12,901 --> 01:11:18,374
I WAS VEGETARIAN AND MY MAMA WAS

1438
01:11:18,440 --> 01:11:23,646
BLACK AND SAID EAT SOME MEAT AND

1439
01:11:23,712 --> 01:11:26,782
I DEALT WITH THOUGHT OF LITERACY

1440
01:11:26,849 --> 01:11:32,788
AND DIDN'T THINK THAT I COULD

1441
01:11:32,855 --> 01:11:35,724
READ AND I KNOW THAT IS AN

1442
01:11:35,791 --> 01:11:38,594
PROBLEM IN THAT AREA AND IT WAS

1443
01:11:38,661 --> 01:11:39,762
INFURIATING AND I HAD THIS KID

1444
01:11:39,828 --> 01:11:41,697
AND IN THE HOSPITAL AND THEY'RE

1445
01:11:41,764 --> 01:11:45,334
NOT TREATING ME RIGHT AND IT WAS

1446
01:11:45,401 --> 01:11:46,835
ANTI-BLACK BIAS AND RACISM.

1447
01:11:46,902 --> 01:11:48,671
THAT WAS MY FIRST EXPERIENCE OF

1448
01:11:48,737 --> 01:11:53,475
IT.

1449
01:11:53,542 --> 01:11:59,181
SO COMING IN INTO THE INTERACIAL

1450
01:11:59,248 --> 01:12:01,317
RELATIONSHIP AND LESBIANS AND

1451
01:12:01,383 --> 01:12:04,753
OUT AND FAST FORWARD QUICKLY, IF

1452
01:12:04,820 --> 01:12:06,455
THAT'S POSSIBLE I GET TO A PLACE

1453
01:12:06,522 --> 01:12:07,589
WHERE I'M AN ADULT.

1454
01:12:07,656 --> 01:12:09,158
MY KID IS FINE.

1455
01:12:09,224 --> 01:12:12,261
I BIRTHED MY SON AND CAUGHT MY

1456
01:12:12,327 --> 01:12:12,528
DAUGHTER.

1457
01:12:12,594 --> 01:12:15,864
MY CO-PARENTING PARTNER HAD OUR

1458
01:12:15,931 --> 01:12:20,235
DAUGHTER AND THEY'RE 26 AND 18.

1459
01:12:20,302 --> 01:12:23,072
AND YOU WOULD LOVE INTERACTING

1460
01:12:23,138 --> 01:12:23,372
WITH THEM.

1461
01:12:23,439 --> 01:12:26,642
I'M DOING MY THING.

1462
01:12:26,709 --> 01:12:29,344
I'M NOW 56, 57, SOMETHING LIKE

1463
01:12:29,411 --> 01:12:39,922
THAT, CO-PARENTING PARTNER WE

1464
01:12:41,323 --> 01:12:44,960
FIGURED IT OUT AND I GET SICK.

1465
01:12:45,027 --> 01:12:50,232
FOR THREE MONTHS I'M REALLY SICK

1466
01:12:50,299 --> 01:12:51,834
WITH FATIGUE, I'M LOSING WEIGHT.

1467
01:12:51,900 --> 01:12:57,406
I CAN BARELY WALK FROM HERE TO

1468
01:12:57,473 --> 01:13:06,014
THERE AND DRINKING PROTEIN TO

1469
01:13:06,081 --> 01:13:06,749
GIVE ME SOME ENERGY.

1470
01:13:06,815 --> 01:13:09,017
I'M CONNECTED TO A HEALTH

1471
01:13:09,084 --> 01:13:10,152
SYSTEM.

1472
01:13:10,219 --> 01:13:14,156
I'VE GONE THROUGH EVERY

1473
01:13:14,223 --> 01:13:17,159
DEPARTMENT LIKE FROM THEY'RE

1474
01:13:17,226 --> 01:13:21,764
TESTING EVERYTHING LIKE THEY

1475
01:13:21,830 --> 01:13:23,799
THOUGHT I HAD LYME'S DISEASE AND

1476
01:13:23,866 --> 01:13:26,301
ASKING ME QUESTIONS AND GET TO

1477
01:13:26,368 --> 01:13:30,672
THE GYNECOLOGIST AND I'M IN

1478
01:13:30,739 --> 01:13:31,340
THERE.

1479
01:13:31,406 --> 01:13:32,074
HE ALREADY DOESN'T THINK THAT

1480
01:13:32,141 --> 01:13:34,910
WHATEVER IS GOING ON WITH ME HAS

1481
01:13:34,977 --> 01:13:36,745
ANYTHING TO DO HOW HE COULD CARE

1482
01:13:36,812 --> 01:13:37,613
FOR ME.

1483
01:13:37,679 --> 01:13:47,890
AND I REMEMBER BEING IN THE

1484
01:13:47,956 --> 01:13:52,861
DOCTORS OFFICE AND SAYING I

1485
01:13:52,928 --> 01:13:57,833
DON'T WANT TO BE I DON'T WANT

1486
01:13:57,900 --> 01:13:59,234
YOU TO DISMISS WHAT I'M SAYING

1487
01:13:59,301 --> 01:14:06,041
AROUND WHAT'S GOING ON WITH ME.

1488
01:14:06,108 --> 01:14:07,609
YOUR NOT LISTENING TO ME.

1489
01:14:07,676 --> 01:14:09,311
YOU ALREADY LET ME KNOW BY YOUR

1490
01:14:09,378 --> 01:14:14,383
ATTITUDE YOU DON'T THINK I CAN

1491
01:14:14,449 --> 01:14:16,718
HELP AND I DON'T UNDERSTAND THAT

1492
01:14:16,785 --> 01:14:18,153
AND KNEW HOW TO ADVOCATE FOR

1493
01:14:18,220 --> 01:14:22,124
MYSELF AND HAD THE WORSE BIOPSY.

1494
01:14:22,191 --> 01:14:23,926
IT WAS THE WORSE EXPERIENCE I'VE

1495
01:14:23,992 --> 01:14:29,498
EVER HAD IN TERMS OF A

1496
01:14:29,565 --> 01:14:30,098
GYNECOLOGICAL EXPERIENCE AND

1497
01:14:30,165 --> 01:14:31,967
CAME OUT OF THERE AND WROTE A

1498
01:14:32,034 --> 01:14:39,942
LETTER QUICKLY ON THE MY CHART

1499
01:14:40,008 --> 01:14:46,014
SITUATION AND IF THIS PERSON

1500
01:14:46,081 --> 01:14:47,749
RESPECTED ME MORE AND GIVEN ME

1501
01:14:47,816 --> 01:14:49,751
MORE CARE AND LISTENED TO ME I

1502
01:14:49,818 --> 01:14:50,886
THINK SOMETHING BETTER COULD

1503
01:14:50,953 --> 01:14:51,587
HAVE HAPPENED.

1504
01:14:51,653 --> 01:14:52,988
I BELIEVE THAT SITUATION AND NOW

1505
01:14:53,055 --> 01:14:55,824
I'M ON TO ONTOLOGY.

1506
01:14:55,891 --> 01:14:57,960
THEY CAN'T FIGURE OUT WHAT'S

1507
01:14:58,026 --> 01:14:58,760
GOING ON.

1508
01:14:58,827 --> 01:15:01,663
MY WHITE BLOOD COUNT IS CRAZY.

1509
01:15:01,730 --> 01:15:05,634
I'M NOT GETTING ANY BETTER.

1510
01:15:05,701 --> 01:15:07,269
IT'S THE CANCER STUFF, ONCOLOGY

1511
01:15:07,336 --> 01:15:08,904
AND THEY'RE LOOKING AT THAT AND

1512
01:15:08,971 --> 01:15:10,305
TAKING MY BLOOD OUT AND PUTTING

1513
01:15:10,372 --> 01:15:14,409
IT BACK IN AND DOING ALL THIS

1514
01:15:14,476 --> 01:15:19,615
CRAZY STUFF LIKE WILD.

1515
01:15:19,681 --> 01:15:22,017
I GO ON SOCIAL MEDIA AND SAY I

1516
01:15:22,084 --> 01:15:24,853
NEED HELP AND I HAVE SOME

1517
01:15:24,920 --> 01:15:26,288
PRIVILEGE AND GET KNOW SOMEONE

1518
01:15:26,355 --> 01:15:27,422
IN A DIFFERENT HOSPITAL SYSTEM

1519
01:15:27,489 --> 01:15:28,724
TO CALL SOMEONE IN ANOTHER

1520
01:15:28,790 --> 01:15:30,259
HOSPITAL SYSTEM TO SEE IF I CAN

1521
01:15:30,325 --> 01:15:31,393
GET IN TO SEE A DIFFERENT

1522
01:15:31,460 --> 01:15:33,095
DOCTOR.

1523
01:15:33,161 --> 01:15:43,672
LONG STORY SHORT, I HAD I HAD

1524
01:15:44,873 --> 01:15:49,778
THE MYOECTOMY AND SIT CALCIFIED

1525
01:15:49,845 --> 01:15:52,881
WHEN IT GETS OLD FIBROIDS THAT

1526
01:15:52,948 --> 01:16:03,492
WERE MISSED IN ALL OF THE OF ALL

1527
01:16:11,333 --> 01:16:13,802
THE X-RAYS AND A TEAM OF WOMEN,

1528
01:16:13,869 --> 01:16:18,073
WHICH I LOVE AS A FEMINIST, IF

1529
01:16:18,140 --> 01:16:20,709
YOU KNOW, YOU KNOW.

1530
01:16:20,776 --> 01:16:22,477
I'M IN THE EMERGENCY ROOM AND

1531
01:16:22,544 --> 01:16:24,279
EXHAUSTED AND BARELY BREATHE.

1532
01:16:24,346 --> 01:16:26,615
YOU ALL ARE SCIENTISTS.

1533
01:16:26,682 --> 01:16:31,853
IT WAS GROSS.

1534
01:16:31,920 --> 01:16:33,221
THEY WALK IN AND SHE'S EXHAUSTED

1535
01:16:33,288 --> 01:16:39,294
AND SIT ON THE SIDE ON THE

1536
01:16:39,361 --> 01:16:48,036
LITTLE STOOL AND THAT'S WHO PAID

1537
01:16:48,103 --> 01:16:50,405
ATTENTION TO ME AND LISTENED TO

1538
01:16:50,472 --> 01:16:51,773
ME BUT I TOOK ALMOST THREE

1539
01:16:51,840 --> 01:16:55,577
MONTHS AND NO ONE WOULD TREAT ME

1540
01:16:55,644 --> 01:16:56,378
BECAUSE THEY COULDN'T FIND THE

1541
01:16:56,445 --> 01:17:06,822
SOURCE OF MY ILLNESS.

1542
01:17:11,626 --> 01:17:15,063
AND PEOPLE DIDN'T BELIEVE HOW

1543
01:17:15,130 --> 01:17:17,432
SICK AND WAS IT BECAUSE I WAS

1544
01:17:17,499 --> 01:17:17,632
BLACK?

1545
01:17:17,699 --> 01:17:18,900
BECAUSE I WAS LESBIAN OR BECAUSE

1546
01:17:18,967 --> 01:17:21,737
I CHOSE TO USE THE PUBLIC

1547
01:17:21,803 --> 01:17:25,173
HOSPITAL I TRUSTED?

1548
01:17:25,240 --> 01:17:27,142
I GOT BETTER CARE THERE THAN THE

1549
01:17:27,209 --> 01:17:29,745
OTHER ONES INITIALLY BY SOME

1550
01:17:29,811 --> 01:17:32,581
DOCTORS BUT IT WAS MADDENING.

1551
01:17:32,647 --> 01:17:37,285
IF I TALK ABOUT IN TODAY'S TERM

1552
01:17:37,352 --> 01:17:42,357
AR  OR WHEN I TALK ABOUT MY MOM

1553
01:17:42,424 --> 01:17:43,792
AND THE CHALLENGES AROUND I'M

1554
01:17:43,859 --> 01:17:46,361
THE OLDEST OF GEN X BUT I FEEL

1555
01:17:46,428 --> 01:17:48,230
MORE LIKE A BOOMER BECAUSE MY

1556
01:17:48,296 --> 01:17:50,766
BROTHER AND MOM ARE BOOMERS AND

1557
01:17:50,832 --> 01:17:51,933
RAISED IN A HOUSEHOLD AND SORT

1558
01:17:52,000 --> 01:17:53,435
OF HAVE BOOMER VALUES, DON'T

1559
01:17:53,502 --> 01:17:56,038
TELL THE YOUNG PEERM.

1560
01:17:56,104 --> 01:17:57,005
-- PEOPLE.

1561
01:17:57,072 --> 01:17:59,941
I KNOW IT'S IMPORTANT WE

1562
01:18:00,008 --> 01:18:01,143
ADVOCATE FOR OURSELVES I KNOW

1563
01:18:01,209 --> 01:18:03,145
ABOUT MARGINALIZATION AND

1564
01:18:03,211 --> 01:18:06,715
DISCRIMINATION AND ANTI-BLACK

1565
01:18:06,782 --> 01:18:09,918
BIAS THAT'S WORLDWIDE AND ALL

1566
01:18:09,985 --> 01:18:10,952
THOSE THINGS AND HOW IT'S WITHIN

1567
01:18:11,019 --> 01:18:13,255
OUR SYSTEMS AND KNOW ABOUT

1568
01:18:13,321 --> 01:18:13,855
INTERNALIZED OPPRESSION AND

1569
01:18:13,922 --> 01:18:15,791
THAT'S WHAT I SEE IN MY MOM.

1570
01:18:15,857 --> 01:18:18,093
WHEN I'M IN THE ROOM WITH HER,

1571
01:18:18,160 --> 01:18:20,195
LETTING FOLKS KNOW SHE HAS

1572
01:18:20,262 --> 01:18:22,030
PEOPLE, ME AND MY BROTHER.

1573
01:18:22,097 --> 01:18:23,732
SHE HAS FOLKS TO ADVOCATE FOR

1574
01:18:23,799 --> 01:18:26,902
HER.

1575
01:18:26,968 --> 01:18:30,338
I ARGUE WITH HER ABOUT ALLOWING

1576
01:18:30,405 --> 01:18:33,308
ME TO ADVOCATE BECAUSE OF THE

1577
01:18:33,375 --> 01:18:35,710
DIFFERENCE OF RESPECTABILITY AND

1578
01:18:35,777 --> 01:18:38,847
POLITICS AND DOCTORS KNOW MORE

1579
01:18:38,914 --> 01:18:40,816
AND I SAY, MOM, THEY KNOW MORE

1580
01:18:40,882 --> 01:18:42,918
ABOUT SCIENCE BUT DON'T KNOW HOW

1581
01:18:42,984 --> 01:18:46,354
BLACK PEOPLE ARE TREATED AND HOW

1582
01:18:46,421 --> 01:18:51,960
WE EXPERIENCE RACISM AND SEXISM

1583
01:18:52,027 --> 01:18:55,063
AND CLASSISM AND WHAT HAPPENS

1584
01:18:55,130 --> 01:18:57,432
WHEN YOU HAVE INTERSECTING

1585
01:18:57,499 --> 01:18:57,732
IDENTITIES.

1586
01:18:57,799 --> 01:18:58,900
I'M FIRED UP ABOUT THIS AND

1587
01:18:58,967 --> 01:19:01,036
THINKING BIT IN TERMS OF MYSELF

1588
01:19:01,103 --> 01:19:02,604
AND MY OWN EXPERIENCES BUT AS

1589
01:19:02,671 --> 01:19:04,973
THAT PERSON WHO WILL BE THERE

1590
01:19:05,040 --> 01:19:08,710
FOR MY MOM TO HELP HER LIVE

1591
01:19:08,777 --> 01:19:09,177
PASSED 78.

1592
01:19:09,244 --> 01:19:19,588
SHE'S 78 THIS YEAR.

1593
01:19:24,626 --> 01:19:26,795
>> IN THE STATEMENT OF GEORGIA

1594
01:19:26,862 --> 01:19:28,263
THERE'S A LACK OF INFORMATION

1595
01:19:28,330 --> 01:19:29,331
AND HEALTH CARE FOR PEOPLE OF

1596
01:19:29,397 --> 01:19:32,868
COLOR IN THE STATE.

1597
01:19:32,934 --> 01:19:34,870
AND FOR ME PERSONALLY I DON'T

1598
01:19:34,936 --> 01:19:36,738
THINK I HAVE TOO MUCH

1599
01:19:36,805 --> 01:19:38,573
DISCRIMINATION AND AM VERY VOCAL

1600
01:19:38,640 --> 01:19:40,242
AND KNOW HOW TO FIGHT FOR ME BUT

1601
01:19:40,308 --> 01:19:41,543
WHEN IT'S DONE TO OTHERS AND SEE

1602
01:19:41,610 --> 01:19:46,414
IT HOW CAN YOU SIT AND ALLOW IT

1603
01:19:46,481 --> 01:19:47,649
TO HAPPEN?

1604
01:19:47,716 --> 01:19:49,117
WHEN I SEE PEOPLE NOT BEING

1605
01:19:49,184 --> 01:19:51,353
TREATED FAIRLY IS WHEN I TRY TO

1606
01:19:51,419 --> 01:19:53,922
STEP IN AND USE MY ABILITIES AND

1607
01:19:53,989 --> 01:19:55,323
MY KNOWLEDGE TO GIVE THEM

1608
01:19:55,390 --> 01:19:59,895
INSIGHT ON MAYBE QUESTIONS TO

1609
01:19:59,961 --> 01:20:01,296
ASK TELLING THEM DON'T GO TO THE

1610
01:20:01,363 --> 01:20:02,898
DOCTOR BY YOURSELF.

1611
01:20:02,964 --> 01:20:09,971
TAKE A BUDDY WITH YOU.

1612
01:20:10,038 --> 01:20:11,139
SOMETIMES WHEN YOU GET

1613
01:20:11,206 --> 01:20:12,007
INFORMATION FROM HEALTH CARE

1614
01:20:12,073 --> 01:20:13,141
PROFESSIONALS I BELIEVE IN THE

1615
01:20:13,208 --> 01:20:17,512
BLACK COMMUNITY ANYTIME YOU WEAR

1616
01:20:17,579 --> 01:20:19,781
A WHITE COAT YOU WEAR

1617
01:20:19,848 --> 01:20:20,916
EVERYTHING.

1618
01:20:20,982 --> 01:20:24,519
THEY SAY IT'S PRACTICING

1619
01:20:24,586 --> 01:20:26,221
MEDICINE BUT I BELIEVE THEY'RE

1620
01:20:26,288 --> 01:20:27,756
PRACTICING SO THEY DON'T KNOW

1621
01:20:27,822 --> 01:20:28,890
EITHER AND WHEN YOU ASK A LOT OF

1622
01:20:28,957 --> 01:20:30,592
QUESTIONS AND HAVE A BUDDY WITH

1623
01:20:30,659 --> 01:20:32,994
YOU AND WHEN YOU GET THE

1624
01:20:33,061 --> 01:20:35,730
INFORMATION YOU HEAR SOMETHING

1625
01:20:35,797 --> 01:20:36,865
NEGATIVE YOU HAVEN'T HEARD

1626
01:20:36,932 --> 01:20:40,702
ANYTHING ELSE THE DOCTOR OR

1627
01:20:40,769 --> 01:20:43,405
NURSE OR ANYONE SAID BUT WHEN

1628
01:20:43,471 --> 01:20:44,573
YOU HAVE A BUDDY TO HELP YOU

1629
01:20:44,639 --> 01:20:47,075
UNDERSTAND WHAT WAS STATED BUT

1630
01:20:47,142 --> 01:20:49,411
IT'S SO SAD WHEN YOU'RE GIVEN

1631
01:20:49,477 --> 01:20:51,112
SOME INFORMATION AND IT'S NOT

1632
01:20:51,179 --> 01:20:53,348
CORRECT OR IT'S INFORMATION THAT

1633
01:20:53,415 --> 01:20:54,950
YOU'RE GIVE JON JUST TO GET OUT

1634
01:20:55,016 --> 01:20:55,951
OUT OF THE WAY.

1635
01:20:56,017 --> 01:21:00,922
THAT'S WHAT THE COMMUNITY

1636
01:21:00,989 --> 01:21:02,591
BELIEVES.

1637
01:21:02,657 --> 01:21:05,227
WHEN YOU LOOK AT DISCRIMINATION

1638
01:21:05,293 --> 01:21:07,062
IT ALWAYS SEEM TO BE TO PEOPLE

1639
01:21:07,128 --> 01:21:08,930
OF COLOR AND SEE HOSPITALS

1640
01:21:08,997 --> 01:21:09,864
CLOSING UP ONLY IN COMMUNITIES

1641
01:21:09,931 --> 01:21:11,399
OF COLOR.

1642
01:21:11,466 --> 01:21:12,968
WHEN YOU SEE HEALTH CARE SYSTEMS

1643
01:21:13,034 --> 01:21:14,002
MOVING OUT AND YOU'RE SAYING IF

1644
01:21:14,069 --> 01:21:18,406
SOMETHING HAPPENS YOU HAVE TO

1645
01:21:18,473 --> 01:21:19,541
DRIVE OVER AN HOUR TO GET

1646
01:21:19,608 --> 01:21:21,076
TREATMENT AND THE MINUTE CLINICS

1647
01:21:21,142 --> 01:21:21,776
JUST DON'T DO IT.

1648
01:21:21,843 --> 01:21:27,382
WHEN YOU LLOOK YOU LOOK AT THOS

1649
01:21:27,449 --> 01:21:29,351
THINGS YOU HAVE TO SEE WHY IT'S

1650
01:21:29,417 --> 01:21:31,386
HAPPENING AND THE HISTORY AND

1651
01:21:31,453 --> 01:21:32,787
VOLUME OF INEQUITY AND UNFAIR

1652
01:21:32,854 --> 01:21:34,155
TREATMENT TO PEOPLE OF COLOR AND

1653
01:21:34,222 --> 01:21:35,190
NOW YOU LOOK AT THE HEALTH CARE

1654
01:21:35,257 --> 01:21:37,158
SYSTEM AND IT'S THE SAME THING.

1655
01:21:37,225 --> 01:21:39,461
YOU JUST HAVE A BIGGER FIGHT

1656
01:21:39,527 --> 01:21:40,695
BECAUSE NOW WE'RE FIGHTING ABOUT

1657
01:21:40,762 --> 01:21:42,163
MY LIFE, NOT THE SOCIAL NEEDS

1658
01:21:42,230 --> 01:21:52,674
BUT MY HEALTH AND MY LIFE.

1659
01:21:54,509 --> 01:21:55,543
FORMING GROUPS AND COMMUNITY

1660
01:21:55,610 --> 01:21:56,911
VOICES FOR THE VOICELESS IS WHAT

1661
01:21:56,978 --> 01:21:58,747
I SEE ON A DAILY BASIS

1662
01:21:58,813 --> 01:22:09,357
THROUGHOUT THE STATE OF GEORGIA.

1663
01:22:20,402 --> 01:22:21,536
>> THANK YOU.

1664
01:22:21,603 --> 01:22:23,672
TO BRING THIS SESSION TO A CLOSE

1665
01:22:23,738 --> 01:22:25,774
TO HAVE TIME FOR YOUR RESPONSES,

1666
01:22:25,840 --> 01:22:28,810
I WOULD ASK WHAT ADVICE YOU

1667
01:22:28,877 --> 01:22:33,515
COULD GIVE TO THE RESEARCH

1668
01:22:33,581 --> 01:22:35,083
COMMUNITY HOW DISCRIMINATION

1669
01:22:35,150 --> 01:22:35,750
IMPACTS HEALTH?

1670
01:22:35,817 --> 01:22:39,921
ARE THERE AREAS OR TOPICS YOU

1671
01:22:39,988 --> 01:22:41,156
IDENTIFY AS A PRIORITY IN THE

1672
01:22:41,222 --> 01:22:43,925
SPACE FOR RESEARCHERS TO WORK

1673
01:22:43,992 --> 01:22:50,265
ON?

1674
01:22:50,332 --> 01:22:53,668
>> WHAT A WOULD LIKE TO SEE IS

1675
01:22:53,735 --> 01:22:54,703
MORE PEOPLE LIKE US A PART OF

1676
01:22:54,769 --> 01:22:56,371
YOUR RESEARCH STUDIES.

1677
01:22:56,438 --> 01:23:00,108
I THINK SOMETIMES WHEN THERE'S

1678
01:23:00,175 --> 01:23:03,945
GROUPS PUT TOGETHER WE GO FOR

1679
01:23:04,012 --> 01:23:06,481
THE HIGH PEOPLE NOT THE MEDIUM

1680
01:23:06,548 --> 01:23:07,382
OR LOW PEOPLE AND SOMETIMES

1681
01:23:07,449 --> 01:23:11,953
DON'T VALUE OR THINK THEY'RE

1682
01:23:12,020 --> 01:23:15,857
PIN -- OPINION IS WHAT WE REALLY

1683
01:23:15,924 --> 01:23:16,124
WANT.

1684
01:23:16,191 --> 01:23:17,726
IF YOU THINK ABOUT WHO YOU

1685
01:23:17,792 --> 01:23:20,495
REALLY NEED AT THE TABLE IT'S

1686
01:23:20,562 --> 01:23:22,230
THE PEOPLE WHO YOUR RESEARCH IS

1687
01:23:22,297 --> 01:23:23,098
GOING TO AFFECT.

1688
01:23:23,164 --> 01:23:28,470
SO YOU MUST HAVE THAT OPINION

1689
01:23:28,536 --> 01:23:34,509
FROM THE HEALTHY PEOPLE THEIR

1690
01:23:34,576 --> 01:23:35,910
OPINION IS DIFFERENT THAN MINE.

1691
01:23:35,977 --> 01:23:37,612
I TELL MY FRIENDS ON A DAILY

1692
01:23:37,679 --> 01:23:39,647
BASIS, I SAY YOU GOT TO GO TO

1693
01:23:39,714 --> 01:23:41,649
THE DOCTOR AND I SAY I KNOW

1694
01:23:41,716 --> 01:23:43,918
WHAT'S WRONG WITH ME BECAUSE GO

1695
01:23:43,985 --> 01:23:45,453
TO THE DOCTOR BUT YOU DON'T KNOW

1696
01:23:45,520 --> 01:23:46,454
WHAT'S WRONG WITH YOU BECAUSE

1697
01:23:46,521 --> 01:23:47,989
YOU DON'T KNOW.

1698
01:23:48,056 --> 01:23:49,424
SOMETIMES WE GET OPINIONS

1699
01:23:49,491 --> 01:23:50,592
INTEREST PEOPLE WHO WILL JUST

1700
01:23:50,658 --> 01:23:52,961
GIVE THEIR OPINION TO BE A PART

1701
01:23:53,027 --> 01:23:54,662
OF SOMETHING.

1702
01:23:54,729 --> 01:23:55,930
IF THERE'S ANY FIELD OR RESEARCH

1703
01:23:55,997 --> 01:24:01,269
THAT I WOULD LIKE TO SEE IT'S

1704
01:24:01,336 --> 01:24:06,808
RESEARCH ON WHEN IT COMES TO

1705
01:24:06,875 --> 01:24:10,445
HEALTH IS WHAT CAN HAPPEN IF

1706
01:24:10,512 --> 01:24:11,613
YOUR COMMUNITY PLAYED A BIGGER

1707
01:24:11,679 --> 01:24:12,881
ROLE AND WHAT DOES YOUR

1708
01:24:12,947 --> 01:24:14,516
COMMUNITY NEED TO MAKE A

1709
01:24:14,582 --> 01:24:19,587
DIFFERENCE IN YOUR OVER ALL

1710
01:24:19,654 --> 01:24:21,322
HEALTH THAT'S WHAT I WOULD LIKE

1711
01:24:21,389 --> 01:24:22,891
TO SEE HAPPEN BECAUSE DON'T

1712
01:24:22,957 --> 01:24:23,825
THINK THE QUESTION'S BEING ASKED

1713
01:24:23,892 --> 01:24:25,527
OF THE COMMUNITIES WHO ARE

1714
01:24:25,593 --> 01:24:26,094
SUFFERING.

1715
01:24:26,161 --> 01:24:30,832
I THINK IF WE DO SOME OF

1716
01:24:30,899 --> 01:24:32,367
RESEARCH AND ASK WHAT DOES YOUR

1717
01:24:32,434 --> 01:24:33,067
COMMUNITY NEED?

1718
01:24:33,134 --> 01:24:34,502
WE THINK WE NEED A LOT OF IT BUT

1719
01:24:34,569 --> 01:24:35,670
IT'S THE FINE LINE THINGS WE

1720
01:24:35,737 --> 01:24:36,337
DON'T KNOW ABOUT.

1721
01:24:36,404 --> 01:24:38,540
THAT'S WHAT I WOULD LIKE TO SEE.

1722
01:24:38,606 --> 01:24:48,783
THANK YOU.

1723
01:24:53,254 --> 01:24:56,291
>> I HAVE SOME EMPATHY OR WANT

1724
01:24:56,357 --> 01:24:59,527
TO GIVE GRACE TO MEDICAL

1725
01:24:59,594 --> 01:25:03,932
PROFESSIONALS IN SOME WAYS I

1726
01:25:03,998 --> 01:25:05,967
THINK INFORMATION RACISM IS AN

1727
01:25:06,034 --> 01:25:07,535
ANTI-BLACK BIAS AND

1728
01:25:07,602 --> 01:25:08,803
MARGINALIZATION OF PEOPLE AND

1729
01:25:08,870 --> 01:25:11,239
UNDERSTANDING DOMINANT CULTURAL

1730
01:25:11,306 --> 01:25:12,807
RULES AROUND POWER IS SOMETHING

1731
01:25:12,874 --> 01:25:18,213
IS AN ONGOING JOURNEY OF

1732
01:25:18,279 --> 01:25:19,180
LEARNING AND CHALLENGE AND

1733
01:25:19,247 --> 01:25:21,049
STRETCHING YOURSELF AND BEING

1734
01:25:21,115 --> 01:25:26,554
UNCOMFORTABLE AND THEN I THINK

1735
01:25:26,621 --> 01:25:30,291
OF WHAT I IMAGINE THE PACE OF

1736
01:25:30,358 --> 01:25:32,560
BEING A MEDICAL PROFESSIONAL, WE

1737
01:25:32,627 --> 01:25:34,963
SEE IT IN DOCTOR'S OFFICE WHEN

1738
01:25:35,029 --> 01:25:35,830
WE'RE HANDED SOMETHING TO GET US

1739
01:25:35,897 --> 01:25:38,366
OUT.

1740
01:25:38,433 --> 01:25:40,635
WE'RE NOT DUMB.

1741
01:25:40,702 --> 01:25:40,935
WE KNOW.

1742
01:25:41,002 --> 01:25:43,071
WE KNOW WHAT'S HAPPENING.

1743
01:25:43,137 --> 01:25:43,905
WE SEE THE RUSH.

1744
01:25:43,972 --> 01:25:46,207
SOMEBODY -- A DOCTOR WHO WAS

1745
01:25:46,274 --> 01:25:50,445
TELLING US AFTER WE WAITED THREE

1746
01:25:50,512 --> 01:25:52,914
HOURS FROM MY MOM'S OUT PATIENT

1747
01:25:52,981 --> 01:25:55,016
SURGERY TO BE CANCELLED WHEN I

1748
01:25:55,083 --> 01:25:57,452
SAID IT'S NOT GOING TO BE HARD

1749
01:25:57,519 --> 01:25:59,254
FOR US TO RESCHEDULE BECAUSE I'M

1750
01:25:59,320 --> 01:26:00,221
HER PERSON AROUND TRANSPORTATION

1751
01:26:00,288 --> 01:26:07,929
AND I'M LEAVING FOR A

1752
01:26:07,996 --> 01:26:12,400
CONFERENCE.

1753
01:26:12,467 --> 01:26:17,705
HE SAW MY MOM TRYING TO

1754
01:26:17,772 --> 01:26:19,340
ACQUIESCE AND ME ADVOCATING AND

1755
01:26:19,407 --> 01:26:21,676
PATTING HER ON THE HEAD, Y'ALL.

1756
01:26:21,743 --> 01:26:24,746
IN MY CASE IT READ IF THIS

1757
01:26:24,812 --> 01:26:26,614
PHYSICIAN DOESN'T KNOW THAT

1758
01:26:26,681 --> 01:26:30,885
PLACATING MY MOTHER BY DOING

1759
01:26:30,952 --> 01:26:34,222
THAT AND DOESN'T UNDERSTAND THAT

1760
01:26:34,289 --> 01:26:36,391
BLACK PEOPLE SPECIFICALLY BLACK

1761
01:26:36,457 --> 01:26:41,462
WOMEN ARE NOT BELIEVED ABOUT OUR

1762
01:26:41,529 --> 01:26:48,736
PAIN AND HE NEEDS MORE TRAINING.

1763
01:26:48,803 --> 01:26:50,038
DON'T FIGHT US.

1764
01:26:50,104 --> 01:26:51,906
DON'T DISMISS US ABOUT WHAT

1765
01:26:51,973 --> 01:26:53,308
WE'RE SAYING AND NEED.

1766
01:26:53,374 --> 01:26:54,609
FIGHT INSURANCE COMPANIES.

1767
01:26:54,676 --> 01:26:58,413
FIGHT WHAT YOU ARE HEARING ABOUT

1768
01:26:58,479 --> 01:27:00,682
ROLLING BACK TRAINING FOR

1769
01:27:00,748 --> 01:27:01,482
DIVERSITY, EQUITY, INCLUSION AND

1770
01:27:01,549 --> 01:27:10,091
BELONGING AND ACCESS.

1771
01:27:10,158 --> 01:27:10,959
WITH YOUR DIRECT SERVICE AND

1772
01:27:11,025 --> 01:27:18,499
RESEARCH AND ALL THAT, WE ALL

1773
01:27:18,566 --> 01:27:21,336
SOME HAVE POWERS ABOUT YOU ALL

1774
01:27:21,402 --> 01:27:24,872
BEING GREAT AND TAKING CARE OF

1775
01:27:24,939 --> 01:27:26,140
ALL TEAM BECAUSE THAT'S WHAT YOU

1776
01:27:26,207 --> 01:27:27,875
WANT TO DO.

1777
01:27:27,942 --> 01:27:35,984
I SAW A GLASS HALF FULL.

1778
01:27:36,050 --> 01:27:38,219
TARGETINGIOR MOTHER OR ADVOCACY

1779
01:27:38,286 --> 01:27:45,493
AROUND NOT FIGHTING AGAINST

1780
01:27:45,560 --> 01:27:47,095
INSURANCE AND WHAT MAKES YOU

1781
01:27:47,161 --> 01:27:49,097
TREAT US LIKE WIDGETS, OPPOSED

1782
01:27:49,163 --> 01:27:59,273
TO PEOPLE, FIX IT.

1783
01:27:59,340 --> 01:28:00,708
>> I'M GOING MIRROR BOBBY.

1784
01:28:00,775 --> 01:28:02,577
WE NEED MORE PEOPLE LIKE US IN

1785
01:28:02,644 --> 01:28:07,682
THE RESEARCH SPACE.

1786
01:28:07,749 --> 01:28:11,953
DOING RESEARCH MYSELF NOW WITH

1787
01:28:12,020 --> 01:28:14,389
DR. CERVANTES I RESONATE WITH

1788
01:28:14,455 --> 01:28:16,491
PEOPLE AND WE IDENTIFY.

1789
01:28:16,557 --> 01:28:21,229
CULTURALLY HAVE MORE PEOPLE ON

1790
01:28:21,295 --> 01:28:26,634
YOUR TEAM CULTURALLY APPROPRIATE

1791
01:28:26,701 --> 01:28:30,571
AND LATINOS ARE BIG ON RELIGION

1792
01:28:30,638 --> 01:28:33,141
AND GOD AND INFORM YOURSELF.

1793
01:28:33,207 --> 01:28:34,542
GET THE CULTURED PIECE ON YOUR

1794
01:28:34,609 --> 01:28:36,277
RESEARCH.

1795
01:28:36,344 --> 01:28:42,817
THAT'S GOING TO HELP YOU A LOT.

1796
01:28:42,884 --> 01:28:43,918
SPEAK THE LANGUAGE.

1797
01:28:43,985 --> 01:28:44,619
THAT'S VERY IMPORTANT.

1798
01:28:44,686 --> 01:28:49,357
DON'T HAVE SOMEBODY THAT WENT TO

1799
01:28:49,424 --> 01:28:51,659
GUATEMALA ONE YEAR AND LEARNED

1800
01:28:51,726 --> 01:28:55,029
SPANISH.

1801
01:28:55,096 --> 01:28:58,433
SPEAK THE LANGUAGE, THE LANGUAGE

1802
01:28:58,499 --> 01:28:59,801
CULTURALLY SO YOU CAN

1803
01:28:59,867 --> 01:29:00,101
COMMUNICATE.

1804
01:29:00,168 --> 01:29:02,570
IT'S FUNNY, RIGHT NOW WE'RE

1805
01:29:02,637 --> 01:29:05,873
DOING SOME INTERVIEWS AND WE'RE

1806
01:29:05,940 --> 01:29:07,375
ASKING PATIENTS IN DIALYSIS WHAT

1807
01:29:07,442 --> 01:29:14,682
WORKS IN RESEARCH.

1808
01:29:14,749 --> 01:29:16,084
RIGHT NOW THEY HAVE NO

1809
01:29:16,150 --> 01:29:17,218
EXPERIENCE WITH RESEARCH.

1810
01:29:17,285 --> 01:29:20,354
NOBODY'S APPROACHING THEM TO ASK

1811
01:29:20,421 --> 01:29:23,925
DO YOU WANT TO BE PART OF THE

1812
01:29:23,991 --> 01:29:26,227
STUDY.

1813
01:29:26,294 --> 01:29:28,329
IF THEY DO, THEY DON'T DO A GOOD

1814
01:29:28,396 --> 01:29:30,732
JOB EXPLAINING.

1815
01:29:30,798 --> 01:29:32,467
I HAD A PATIENT IN THE TRIAL AND

1816
01:29:32,533 --> 01:29:36,170
IT WAS A NEW MEDICATION FOR

1817
01:29:36,237 --> 01:29:38,005
PHOSPHORUS THE POWDER, SHE

1818
01:29:38,072 --> 01:29:46,681
DOESN'T KNOW WHAT IT WAS FOR.

1819
01:29:46,748 --> 01:29:48,816
AND ANOTHER PATIENT WHO ASKED

1820
01:29:48,883 --> 01:29:50,485
EVERY TIME ARE YOU TAKING THE

1821
01:29:50,551 --> 01:29:51,819
MEDICINE AND SHE WASN'T TAKING

1822
01:29:51,886 --> 01:29:53,921
IT AND SHE COULDN'T ASK.

1823
01:29:53,988 --> 01:29:55,757
THE RESEARCH ASSISTANT WASN'T

1824
01:29:55,823 --> 01:29:56,324
SPEAKING THE LANGUAGE.

1825
01:29:56,390 --> 01:29:59,427
THEY WERE LIKE, HERE, I DON'T

1826
01:29:59,494 --> 01:29:59,627
KNOW.

1827
01:29:59,694 --> 01:30:02,330
IF YOU WANT TO INCLUDE THE

1828
01:30:02,396 --> 01:30:05,032
ATLANTA COMMUNITY HAVE SPANISH

1829
01:30:05,099 --> 01:30:12,340
SPEAKERS NATIVES IF YOU CAN.

1830
01:30:12,406 --> 01:30:19,080
SPEAK THE LANGUAGE AND GIVING

1831
01:30:19,147 --> 01:30:20,248
RESULTS AND I HEARD PEOPLE

1832
01:30:20,314 --> 01:30:21,816
SAYING I PARTICIPATED IN THIS

1833
01:30:21,883 --> 01:30:24,619
BUT I DON'T KNOW WHAT HAPPENED

1834
01:30:24,685 --> 01:30:24,819
AFTER.

1835
01:30:24,886 --> 01:30:25,153
WHAT HAPPENED?

1836
01:30:25,219 --> 01:30:30,124
DID I HELP SOMEBODY?

1837
01:30:30,191 --> 01:30:34,896
GIVE THEM RESULTS.

1838
01:30:34,962 --> 01:30:37,431
THINGS TO LOOK FORWARD TO AND WE

1839
01:30:37,498 --> 01:30:39,934
HELP WITH THE MISTRUST.

1840
01:30:40,001 --> 01:30:41,903
LATINOS DON'T LIKE TO

1841
01:30:41,969 --> 01:30:43,304
PARTICIPATE BECAUSE DON'T WANT

1842
01:30:43,371 --> 01:30:46,808
TO BE THE GUINEA PIGS, RIGHT.

1843
01:30:46,874 --> 01:30:48,976
THAT WILL GIVE YOU MISTRUST AND

1844
01:30:49,043 --> 01:30:53,414
INCLUDE PEOPLE.

1845
01:30:53,481 --> 01:31:01,189
YOU WILL INCREASE THE FORCE WITH

1846
01:31:01,255 --> 01:31:02,790
LATINOS AND PEOPLE LIKE ME THAT

1847
01:31:02,857 --> 01:31:05,293
WANT TO DO BETTER IN THE

1848
01:31:05,359 --> 01:31:05,593
COMMUNITIES.

1849
01:31:05,660 --> 01:31:08,029
>> THANK YOU SO MUCH TO ALL OF

1850
01:31:08,095 --> 01:31:09,630
YOU FOR SHARING YOUR

1851
01:31:09,697 --> 01:31:09,964
PERSPECTIVES.

1852
01:31:10,031 --> 01:31:13,701
>> THANK YOU.

1853
01:31:13,768 --> 01:31:19,674
>> THAT WAS FANTASTIC.

1854
01:31:19,740 --> 01:31:20,241
THANK YOU.

1855
01:31:20,308 --> 01:31:21,943
SINCE WE'RE RUNNING 15 MINUTES

1856
01:31:22,009 --> 01:31:23,211
BEHIND SCHEDULE I WANTED TO GIVE

1857
01:31:23,277 --> 01:31:25,079
FOLKS A FEW QUICK UPDATES BEFORE

1858
01:31:25,146 --> 01:31:25,913
GOING TO LUNCH.

1859
01:31:25,980 --> 01:31:27,915
SO WE'RE GOING TO TROUBLE SHOOT

1860
01:31:27,982 --> 01:31:31,219
THE AUDIO TO HOPEFULLY HEAR FROM

1861
01:31:31,285 --> 01:31:33,020
GLENDA AFTER LUNCH BRIEFLY SINCE

1862
01:31:33,087 --> 01:31:34,755
SHE DIDN'T GET TO GIVE COMMENTS.

1863
01:31:34,822 --> 01:31:35,957
APOLOGY FOR THE TECHNICAL

1864
01:31:36,023 --> 01:31:37,458
DIFFICULTIES AND HOPEFULLY WE'LL

1865
01:31:37,525 --> 01:31:39,060
GIVE GLENDA AN OPPORTUNITY TO

1866
01:31:39,126 --> 01:31:40,728
SPEAK BRIEFLY WHEN WE COME BACK

1867
01:31:40,795 --> 01:31:41,863
FROM LUNCH.

1868
01:31:41,929 --> 01:31:43,331
SINCE WE'RE 15 MINUTES BEHIND,

1869
01:31:43,397 --> 01:31:45,433
I'M GOING TO CUT FIVE MINUTES

1870
01:31:45,499 --> 01:31:47,034
FROM LUNCH AND TRY TO GET US A

1871
01:31:47,101 --> 01:31:48,402
LITTLE BIT BACK ON SCHEDULE.

1872
01:31:48,469 --> 01:31:51,572
IF WE CAN AIM TO GET BACK HERE

1873
01:31:51,639 --> 01:31:53,241
AT 12:20.

1874
01:31:53,307 --> 01:31:54,642
THERE'S BOX LUNCHED SO THAT

1875
01:31:54,709 --> 01:31:55,710
SHOULD MAKE THE PROCESS QUICKER

1876
01:31:55,776 --> 01:32:02,250
AND APOLOGIES FOR SOME OF THE

1877
01:32:02,316 --> 01:32:03,317
TECHNICAL DIFFICULTIES.

1878
01:32:03,384 --> 01:32:04,886
FIRST I'D LIKE TO THANK THE

1879
01:32:04,952 --> 01:32:05,152
PANELISTS.

1880
01:32:05,219 --> 01:32:07,889
I THINK YOU DID A FANTASTIC JOB

1881
01:32:07,955 --> 01:32:08,556
AND AN APPRECIATE THE

1882
01:32:08,623 --> 01:32:11,692
OPPORTUNITY TO MAKE A FEW

1883
01:32:11,759 --> 01:32:11,993
COMMENTS.

1884
01:32:12,059 --> 01:32:15,696
FOR THOSE WHO KNOW ME KNOW I'M

1885
01:32:15,763 --> 01:32:17,832
VERY RESULTS ORIENTED AND THE

1886
01:32:17,899 --> 01:32:19,500
QUESTION SHOW CAN WE ACTUALIZE

1887
01:32:19,567 --> 01:32:20,668
THE FEEDBACK WE'VE RECEIVED FROM

1888
01:32:20,735 --> 01:32:22,103
OUR PANELISTS.

1889
01:32:22,169 --> 01:32:25,273
I MADE A FEW NOTES BUT BEFORE I

1890
01:32:25,339 --> 01:32:27,775
DO, I'D LIKE TO ENCOURAGE YOU TO

1891
01:32:27,842 --> 01:32:30,044
DO AN EXERCISE EITHER TONIGHT OR

1892
01:32:30,111 --> 01:32:31,312
THIS EVENING OR WHENEVER YOU

1893
01:32:31,379 --> 01:32:35,483
HAVE A CHANCE IN TERMS OF

1894
01:32:35,549 --> 01:32:37,218
INTRODUCING YOURSELVES.

1895
01:32:37,285 --> 01:32:39,420
THIS EXERCISE IS IMPORTANT

1896
01:32:39,487 --> 01:32:41,355
BECAUSE IT GIVES YOU A

1897
01:32:41,422 --> 01:32:42,890
PERSPECTIVE ON YOUR POSITION AS

1898
01:32:42,957 --> 01:32:44,992
IT RELATES TO RACISM,

1899
01:32:45,059 --> 01:32:45,426
MARGINALIZATION AND

1900
01:32:45,493 --> 01:32:45,960
DISCRIMINATION IN YOUR

1901
01:32:46,027 --> 01:32:46,227
COMMUNITY.

1902
01:32:46,294 --> 01:32:49,830
AND I'LL GIVE YOU AN EXAMPLE.

1903
01:32:49,897 --> 01:32:52,533
SO WHEN I INTRODUCE MY SELF-I

1904
01:32:52,600 --> 01:32:59,740
SAME I'M GLENDA ROBERTS, AFRICAN

1905
01:32:59,807 --> 01:33:03,644
AMERICAN I IDENTIFY AS BLACK OF

1906
01:33:03,711 --> 01:33:07,315
MIXED RACE AND KIDNEY TRANSPLANT

1907
01:33:07,381 --> 01:33:09,317
RECIPIENT AND WORK IN PATIENT

1908
01:33:09,383 --> 01:33:11,752
ENGAGEMENT FOR THE KIDNEY

1909
01:33:11,819 --> 01:33:12,620
RESEARCH INSTITUTE AT THE

1910
01:33:12,687 --> 01:33:14,288
UNIVERSITY OF WASHINGTON'S

1911
01:33:14,355 --> 01:33:16,824
CENTER FOR DIALYSIS AND

1912
01:33:16,891 --> 01:33:17,124
INNOVATION.

1913
01:33:17,191 --> 01:33:19,427
IF YOU LISTEN TO THOSE THINGS

1914
01:33:19,493 --> 01:33:21,429
YOU THINK WELL OTHER THAN BEING

1915
01:33:21,495 --> 01:33:24,131
BLACK AND HETEROSEXUAL, I

1916
01:33:24,198 --> 01:33:27,234
PROBABLY HAVEN'T HAD A LOT OF

1917
01:33:27,301 --> 01:33:29,403
EXPERIENCE WITH RACISM.

1918
01:33:29,470 --> 01:33:31,973
BUT THE REALITY IS IN MY

1919
01:33:32,039 --> 01:33:34,775
PROFESSIONAL LIFE I THINK I'VE

1920
01:33:34,842 --> 01:33:38,546
HAD MORE OF AN EXPERIENCE THAN

1921
01:33:38,612 --> 01:33:41,415
THE PERSONAL LIFE BECAUSE I MORE

1922
01:33:41,482 --> 01:33:42,883
OR LESS CONTROL THIS

1923
01:33:42,950 --> 01:33:43,184
ENVIRONMENT.

1924
01:33:43,250 --> 01:33:45,286
I ASK YOU TO DO THIS EXERCISE

1925
01:33:45,353 --> 01:33:46,454
TONIGHT TO THINK ABOUT YOUR

1926
01:33:46,520 --> 01:33:47,722
RELATIONSHIP TO R&D AND HOW TO

1927
01:33:47,788 --> 01:33:48,289
IMPACT CHANGE.

1928
01:33:48,356 --> 01:33:50,691
AND IN TERMS OF YOUR RESEARCH, I

1929
01:33:50,758 --> 01:33:52,827
HAVE SOME SPECIFIC THINGS THAT I

1930
01:33:52,893 --> 01:33:54,428
WANTED TO HIGHLIGHT.

1931
01:33:54,495 --> 01:33:56,097
I THOUGHT THAT BOBBY AND CLAUDIA

1932
01:33:56,163 --> 01:33:57,164
DID A GREAT JOB WHEN THEY

1933
01:33:57,231 --> 01:33:58,399
TALKED --

1934
01:33:58,466 --> 01:34:06,474
[NO AUDIO]

1935
01:34:06,540 --> 01:34:08,743
ONE OF THE THINGS I THINK WE CAN

1936
01:34:08,809 --> 01:34:11,312
DO AS RESEARCHERS IS TO MAKE

1937
01:34:11,379 --> 01:34:14,148
SURE THAT WE ASK PEOPLE TO

1938
01:34:14,215 --> 01:34:17,351
PARTICIPATE.

1939
01:34:17,418 --> 01:34:21,822
WE KNOW THAT THE PUGH OF

1940
01:34:21,889 --> 01:34:23,524
RESEARCH SAYS AFRICAN AMERICANS,

1941
01:34:23,591 --> 01:34:24,658
LATINX ARE ALL INTERESTED IN

1942
01:34:24,725 --> 01:34:26,660
RESEARCH AND THINK IT'S A GOOD

1943
01:34:26,727 --> 01:34:26,961
THING.

1944
01:34:27,028 --> 01:34:29,930
AS A MATTER OF FACT, MORE THAN

1945
01:34:29,997 --> 01:34:31,065
65% OF AMERICANS THINK

1946
01:34:31,132 --> 01:34:31,699
PARTICIPATION IN RESEARCH SAY

1947
01:34:31,766 --> 01:34:32,600
GOOD THING.

1948
01:34:32,666 --> 01:34:37,038
THE PROBLEM IS WHEN YOU LOOK AT

1949
01:34:37,104 --> 01:34:38,039
THE PARTICIPATION OF BLACK

1950
01:34:38,105 --> 01:34:39,640
AMERICANS, LATINX AND OTHER

1951
01:34:39,707 --> 01:34:41,742
PEOPLE OF COLOR, WE HAVE A

1952
01:34:41,809 --> 01:34:43,844
RELATIVELY LOW PARTICIPATION

1953
01:34:43,911 --> 01:34:44,045
RATE.

1954
01:34:44,111 --> 01:34:46,580
AND THAT'S BECAUSE NOBODY ASKED

1955
01:34:46,647 --> 01:34:46,747
US.

1956
01:34:46,814 --> 01:34:50,284
I ENCOURAGE YOU TO ASK PEOPLE TO

1957
01:34:50,351 --> 01:34:50,584
PARTICIPATE.

1958
01:34:50,651 --> 01:34:52,153
AND WHEN I ASK PEOPLE WELL, WHY

1959
01:34:52,219 --> 01:34:54,155
DON'T YOU ASK PEOPLE TO

1960
01:34:54,221 --> 01:34:55,990
PARTICIPATE BECAUSE WE KNOW YOU

1961
01:34:56,057 --> 01:34:58,259
CAN TALK, THEY GENERALLY SAY,

1962
01:34:58,325 --> 01:35:01,362
I'M NOT COMFORTABLE WITH THE

1963
01:35:01,429 --> 01:35:03,664
CONVERSATION THAT WILL FOLLOW.

1964
01:35:03,731 --> 01:35:05,099
BECAUSE IF I'M ASKING ANYBODY

1965
01:35:05,166 --> 01:35:09,670
OTHER THAN YOU, GLENDA, I

1966
01:35:09,737 --> 01:35:11,038
PROBABLY HAVE TO HAVE THE

1967
01:35:11,105 --> 01:35:11,939
CONVERSATION AROUND TRUST AND

1968
01:35:12,006 --> 01:35:15,142
ADVERSE IMPACTS PEOPLE HAVE HAD

1969
01:35:15,209 --> 01:35:16,177
HISTORICALLY WITH RACISM.

1970
01:35:16,243 --> 01:35:20,114
I WOULD ENCOURAGE EACH OF YOU TO

1971
01:35:20,181 --> 01:35:22,283
HAVE THAT CONVERSATION.

1972
01:35:22,349 --> 01:35:24,318
YOU KNOW, SHOW SOME EMPATHY BUT

1973
01:35:24,385 --> 01:35:26,020
BE OPEN AND HAVE THE

1974
01:35:26,087 --> 01:35:28,122
CONVERSATION AND BE PREPARED FOR

1975
01:35:28,189 --> 01:35:29,690
SOME DIFFICULT QUESTIONS AND

1976
01:35:29,757 --> 01:35:31,025
HAVE IT BE OKAY TO SAY I DON'T

1977
01:35:31,092 --> 01:35:33,661
KNOW.

1978
01:35:33,727 --> 01:35:37,331
I ENCOURAGE YOU TO TRY TO HAVE

1979
01:35:37,398 --> 01:35:38,666
MORE PEOPLE WHO ARE IN THE

1980
01:35:38,732 --> 01:35:40,901
RESEARCH ROLES WHETHER WE'RE

1981
01:35:40,968 --> 01:35:42,036
TALKING ABOUT RESEARCHERS,

1982
01:35:42,103 --> 01:35:43,938
RESEARCH COORDINATORS, BE

1983
01:35:44,004 --> 01:35:46,006
REFLECTIVE OF THE PEOPLE THAT

1984
01:35:46,073 --> 01:35:47,641
YOU ARE TRYING TO ATTRACT TO THE

1985
01:35:47,708 --> 01:35:47,875
TRIALS.

1986
01:35:47,942 --> 01:35:49,610
WHEN CLAUDIA WAS TALKING ABOUT

1987
01:35:49,677 --> 01:35:52,279
THE IMPORTANCE OF CULTURAL

1988
01:35:52,346 --> 01:35:54,415
SENSITIVITY, I CAN TELL YOU JUST

1989
01:35:54,482 --> 01:35:56,517
SEEING SOMEBODY IN THE ROOM THAT

1990
01:35:56,584 --> 01:35:59,120
LOOKS LIKE ME GIVES ME A GREATER

1991
01:35:59,186 --> 01:35:59,954
DEGREE OF COMFORT.

1992
01:36:00,020 --> 01:36:01,856
AND THE THIRD AND FINAL THING I

1993
01:36:01,922 --> 01:36:10,498
WOULD LIKE TO  EMPHASIZE IS I

1994
01:36:10,564 --> 01:36:11,632
ENCOURAGE YOU TO RECRUIT PATIENT

1995
01:36:11,699 --> 01:36:13,334
ADVISORY BOARDS AND COUNCILS.

1996
01:36:13,400 --> 01:36:16,737
SO IN THE CASE OF THE KIDNEY

1997
01:36:16,804 --> 01:36:18,606
PRECISION MEDICINE PROJECT, AND

1998
01:36:18,672 --> 01:36:19,940
THE APOLLO STUDY WHICH I'M A

1999
01:36:20,007 --> 01:36:22,877
PART OF, WE HAVE DIVERSE

2000
01:36:22,943 --> 01:36:24,411
POPULATIONS OF PATIENT PARTNER

2001
01:36:24,478 --> 01:36:25,279
RESEARCHERS.

2002
01:36:25,346 --> 01:36:29,150
WE ARE TREATED AS EQUAL PARTNERS

2003
01:36:29,216 --> 01:36:33,754
IN THE RESEARCH AND I THINK THAT

2004
01:36:33,821 --> 01:36:36,190
IS SO IMPORTANT BECAUSE WHEN

2005
01:36:36,257 --> 01:36:36,824
KWLUR TRYING TO ATTRACT PEOPLE

2006
01:36:36,891 --> 01:36:38,692
WHEN YOU TRY TO SHOW A PICTURE

2007
01:36:38,759 --> 01:36:40,361
OF PANELISTS THAT LOOK LIKE THE

2008
01:36:40,427 --> 01:36:42,496
PEOPLE YOU WANT TO ATTRACT, THAT

2009
01:36:42,563 --> 01:36:44,431
GIVES PEOPLE GREATER CONFIDENCE

2010
01:36:44,498 --> 01:36:46,367
THAT THEY'RE BEING REPRESENTED

2011
01:36:46,433 --> 01:36:47,935
IN THE RESEARCH AND THAT

2012
01:36:48,002 --> 01:36:49,236
SOMEBODY IS SPEAKING UP ON THEIR

2013
01:36:49,303 --> 01:36:51,872
BEHALF.

2014
01:36:51,939 --> 01:36:54,108
I THINK IT WAS CLAUDIA WHO SAID

2015
01:36:54,175 --> 01:36:55,776
GIVE PEOPLE AN UPDATE ABOUT

2016
01:36:55,843 --> 01:36:56,877
WHAT'S GOING ON.

2017
01:36:56,944 --> 01:37:00,014
YOU KNOW, AS PATIENTS AND

2018
01:37:00,080 --> 01:37:01,448
PATIENTS PARTICIPANTS AND STUDY

2019
01:37:01,515 --> 01:37:02,550
PARTICIPANTS, WE RECOGNIZE THAT

2020
01:37:02,616 --> 01:37:04,885
YOU CAN'T GIVE US THE END

2021
01:37:04,952 --> 01:37:06,387
RESULT, BUT YOU CAN GIVE US

2022
01:37:06,453 --> 01:37:07,922
UPDATES AS YOU'RE GOING ALONG

2023
01:37:07,988 --> 01:37:08,255
THE WAY.

2024
01:37:08,322 --> 01:37:10,124
YOU CAN TELL US HOW MANY PEOPLE

2025
01:37:10,191 --> 01:37:12,826
HAVE SIGNED UP, IF YOU HAVE

2026
01:37:12,893 --> 01:37:13,928
PUBLISHED ANY PAPERS.

2027
01:37:13,994 --> 01:37:16,130
SO THERE ARE LOTS OF WAYS THAT

2028
01:37:16,197 --> 01:37:18,866
YOU CAN BUILD TRUST, ENGAGE

2029
01:37:18,933 --> 01:37:21,135
PEOPLE, AND GET GREATER FEEDBACK

2030
01:37:21,202 --> 01:37:22,903
FOR PARTICIPATION IN YOUR

2031
01:37:22,970 --> 01:37:23,337
STUDIES.

2032
01:37:23,404 --> 01:37:24,305
AND I'D LIKE TO THANK YOU FOR

2033
01:37:24,371 --> 01:37:34,548
YOUR TIME.

2034
01:37:46,126 --> 01:37:48,395
[APPLAUSE]

2035
01:37:48,462 --> 01:37:50,231
>> SORRY, GLENDA.

2036
01:37:50,297 --> 01:37:52,600
I HAD TO RUN UP TO THE FRONT OF

2037
01:37:52,666 --> 01:37:52,967
THE ROOM.

2038
01:37:53,033 --> 01:37:53,901
>> NO PROBLEM.

2039
01:37:53,968 --> 01:37:54,702
>> THAT WAS FANTASTIC.

2040
01:37:54,768 --> 01:37:56,570
THANK YOU FOR THOSE COMMENTS.

2041
01:37:56,637 --> 01:37:59,740
SO NEXT UP, WE HAVE OUR PANEL ON

2042
01:37:59,807 --> 01:38:00,941
EPIDEMIOLOGY.

2043
01:38:01,008 --> 01:38:02,376
SO BEFORE I INVITE THAT PANEL TO

2044
01:38:02,443 --> 01:38:03,777
THE STAGE, I JUST WANT TO MAKE

2045
01:38:03,844 --> 01:38:04,812
TWO QUICK ANNOUNCEMENTS.

2046
01:38:04,878 --> 01:38:06,313
IF YOU DID NOT HAVE A CHANCE TO

2047
01:38:06,380 --> 01:38:07,748
ORDER LUNCH, PIZZA IS ON THE

2048
01:38:07,815 --> 01:38:09,516
WAY, IT SHOULD BE HERE AROUND

2049
01:38:09,583 --> 01:38:12,453
1:00, AND IF YOU ARE STILL

2050
01:38:12,519 --> 01:38:15,055
LOOKING FOR THE WIFI CODE, IT IS

2051
01:38:15,122 --> 01:38:15,222
417.

2052
01:38:15,289 --> 01:38:25,466
THANK YOU.

2053
01:38:39,380 --> 01:38:40,881
>> SINCE WE'RE RUNNING TIGHT ON

2054
01:38:40,948 --> 01:38:42,249
TIME, CAN I HAVE THE PANELISTS

2055
01:38:42,316 --> 01:38:43,617
JUST COME UP HERE AND SIT SO WE

2056
01:38:43,684 --> 01:38:46,987
DON'T HAVE TO WAIT IN BETWEEN?

2057
01:38:47,054 --> 01:38:48,756
YES, RUN!

2058
01:38:48,822 --> 01:38:58,999
[LAUGHTER]

2059
01:38:59,500 --> 01:39:04,271
SO THIS IS THE EPIDEMIOLOGY OF

2060
01:39:04,338 --> 01:39:05,039
RACISM, MARGINALIZATION AND

2061
01:39:05,105 --> 01:39:06,373
DISCRIMINATION IN NIDDK

2062
01:39:06,440 --> 01:39:06,840
DISEASES.

2063
01:39:06,907 --> 01:39:08,976
WE HAVE THREE PRESENTERS TODAY

2064
01:39:09,043 --> 01:39:09,977
AND THEN WE'LL DO QUESTIONS AT

2065
01:39:10,044 --> 01:39:10,844
THE END.

2066
01:39:10,911 --> 01:39:13,147
OUR FIRST PRESENTER IS TENE

2067
01:39:13,213 --> 01:39:15,015
LEWIS, WHO WILL BE TALKING TO US

2068
01:39:15,082 --> 01:39:16,550
ABOUT DISCRIMINATORY STRESSORS

2069
01:39:16,617 --> 01:39:18,519
IN AFRICAN AMERICAN WOMEN,

2070
01:39:18,585 --> 01:39:19,753
IMPLICATIONS FOR CARDIOMETABOLIC

2071
01:39:19,820 --> 01:39:30,297
DISEASE AND SYSTEMIC LUPUS.

2072
01:39:39,540 --> 01:39:40,674
>> HI, EVERYONE.

2073
01:39:40,741 --> 01:39:43,077
IT'S A PLEASURE TO BE HERE.

2074
01:39:43,143 --> 01:39:48,582
I AM A PROFESSOR IN THE ROLLINS

2075
01:39:48,649 --> 01:39:50,551
SCHOOL OF PUBLIC HEALTH AT EMORY

2076
01:39:50,617 --> 01:39:53,387
UNIVERSITY, FULL DISCLOSURE, I'M

2077
01:39:53,454 --> 01:39:56,857
CLATRAINED AS A CLINICAL HEALTH

2078
01:39:56,924 --> 01:39:57,524
PSYCHOLOGIST, SO YOU'LL SEE

2079
01:39:57,591 --> 01:39:58,625
EVIDENCE OF THAT THROUGHOUT MY

2080
01:39:58,692 --> 01:40:08,802
WORK.

2081
01:40:11,338 --> 01:40:21,615
NEXT SLIDE, PLEASE.

2082
01:41:24,645 --> 01:41:26,146
SO I WANT TO GIVE A BRIEF SORT

2083
01:41:26,213 --> 01:41:27,581
OF OVERVIEW OF SOME OF THE WORK

2084
01:41:27,648 --> 01:41:31,718
I'VE BEEN DOING THIS AREA, IT'S

2085
01:41:31,785 --> 01:41:36,323
WHAT I KNOW BEST AND ABLE TO

2086
01:41:36,390 --> 01:41:36,890
ANSWER QUESTIONS ABOUT.

2087
01:41:36,957 --> 01:41:38,492
SO WHEN I ENTERED THE FIELD, I

2088
01:41:38,559 --> 01:41:40,694
THINK IT'S IMPORTANT TO GIVE A

2089
01:41:40,761 --> 01:41:42,796
BIT OF A HISTORY OF THE SCIENCE

2090
01:41:42,863 --> 01:41:44,531
IN THIS AREA BECAUSE IF YOU'RE

2091
01:41:44,598 --> 01:41:47,901
SITTING IN THIS ROOM, IT'S EASY

2092
01:41:47,968 --> 01:41:48,802
TO THINK THAT PEOPLE HAVE ALWAYS

2093
01:41:48,869 --> 01:41:50,804
BEEN DOING REALLY GREAT,

2094
01:41:50,871 --> 01:41:51,839
INTERESTING CUTTING EDGE

2095
01:41:51,905 --> 01:41:53,307
RESEARCH, BUT THAT'S NOT

2096
01:41:53,373 --> 01:41:55,142
NECESSARILY THE CASE FOR A LOT

2097
01:41:55,209 --> 01:41:56,677
OF SYSTEMIC REASONS.

2098
01:41:56,743 --> 01:41:57,878
NOT BECAUSE THE INTEREST AND THE

2099
01:41:57,945 --> 01:41:58,946
PASSION WASN'T THERE, BUT

2100
01:41:59,012 --> 01:41:59,580
BECAUSE THE OPPORTUNITIES WERE

2101
01:41:59,646 --> 01:41:59,980
NOT THERE.

2102
01:42:00,047 --> 01:42:02,015
SO WHEN I ENTERED THE FIELD,

2103
01:42:02,082 --> 01:42:03,450
THERE WAS A LOT OF THEORETICAL

2104
01:42:03,517 --> 01:42:06,820
WORK THAT REALLY ARGUED THAT

2105
01:42:06,887 --> 01:42:08,789
DISCRIMINATION SHOULD MATTER FOR

2106
01:42:08,856 --> 01:42:09,556
HEALTH.

2107
01:42:09,623 --> 01:42:10,991
THERE WASN'T A LOT OF EMPIRICAL

2108
01:42:11,058 --> 01:42:12,860
WORK, AND WHAT WAS WAS REALLY

2109
01:42:12,926 --> 01:42:14,394
FOCUSED ON SMALL LABORATORY

2110
01:42:14,461 --> 01:42:17,464
STUDIES OF CARDIOVASCULAR

2111
01:42:17,531 --> 01:42:18,532
ACTIVITY AND SELF-REPORTED

2112
01:42:18,599 --> 01:42:18,866
OUTCOMES.

2113
01:42:18,932 --> 01:42:20,434
JUST TO GIVE YOU ANOTHER BIT OF

2114
01:42:20,501 --> 01:42:21,568
CONTEXT, MOST OF MY WORK IS IN

2115
01:42:21,635 --> 01:42:22,803
THE FIELD OF CARDIOMETABOLIC

2116
01:42:22,870 --> 01:42:23,036
HEALTH.

2117
01:42:23,103 --> 01:42:26,607
AND UP UNTIL 20, 30 YEARS AGO,

2118
01:42:26,673 --> 01:42:28,308
THERE WAS NOT A LOT OF WORK

2119
01:42:28,375 --> 01:42:31,345
LOOKING AT OBJECTIVE CLINICAL --

2120
01:42:31,411 --> 01:42:33,080
CLINICALLY RELEVANT MARKERS OF

2121
01:42:33,146 --> 01:42:34,281
DISEASE IN TERMS OF OUTCOMES IN

2122
01:42:34,348 --> 01:42:36,250
THIS SPACE.

2123
01:42:36,316 --> 01:42:38,051
AND THERE'S BEEN JUST A DRAMATIC

2124
01:42:38,118 --> 01:42:39,219
EXPLOSION OF RESEARCH OVER THE

2125
01:42:39,286 --> 01:42:42,289
PAST TWO DECADES.

2126
01:42:42,356 --> 01:42:44,791
MY FIRST STUDY WAS PUBLISHED

2127
01:42:44,858 --> 01:42:46,226
LOOKING AT THE ASSOCIATION

2128
01:42:46,293 --> 01:42:48,629
BETWEEN EVERYDAY DISCRIMINATION

2129
01:42:48,695 --> 01:42:51,899
AND CORONARY ARTERY

2130
01:42:51,965 --> 01:42:52,666
CLASSIFICATION, THAT PART I

2131
01:42:52,733 --> 01:42:54,301
WON'T GO INTO AS MUCH BUT I DO

2132
01:42:54,368 --> 01:42:56,837
WANT TO TALK ABOUT -- WE SAW IT

2133
01:42:56,904 --> 01:42:58,238
IN AFRICAN AMERICAN WOMEN, NOT

2134
01:42:58,305 --> 01:43:01,441
WHITE WOMEN, MORE DISCRIMINATION

2135
01:43:01,508 --> 01:43:02,175
AMONG AFRICAN AMERICAN REPORTED

2136
01:43:02,242 --> 01:43:05,178
THE MORE LIKELY THEY WERE TO

2137
01:43:05,245 --> 01:43:10,384
HAVE ANY CORONARY ARTERY CALCIUM

2138
01:43:10,450 --> 01:43:11,485
IN THEIR ARTERIES.

2139
01:43:11,552 --> 01:43:13,453
THESE FINDINGS WERE PUBLISHED

2140
01:43:13,520 --> 01:43:15,856
AND PEOPLE SAID THE WORK WAS

2141
01:43:15,923 --> 01:43:16,290
GROUNDBREAKING,

2142
01:43:16,356 --> 01:43:16,957
THOUGHT-PROVOKING AND THEN

2143
01:43:17,024 --> 01:43:18,725
ALMOST MEANINGLESS, WHICH IS NOT

2144
01:43:18,792 --> 01:43:22,296
WHAT YOU WANT TO HEAR.

2145
01:43:22,362 --> 01:43:24,598
AND SO I GOT A LOT OF FEEDBACK

2146
01:43:24,665 --> 01:43:26,900
FROM SENIOR SCHOLARS AND OTHER

2147
01:43:26,967 --> 01:43:28,969
RESEARCHERS IN THE FIELD, SENIOR

2148
01:43:29,036 --> 01:43:30,170
SCHOLARS OF COLOR WOULD COME UP

2149
01:43:30,237 --> 01:43:32,806
TO ME WHISPERING -- I BELIEVE

2150
01:43:32,873 --> 01:43:34,207
THIS, AND THIS IS REAL, THEN I

2151
01:43:34,274 --> 01:43:36,543
GOT FEEDBACK FROM OTHER PEOPLE,

2152
01:43:36,610 --> 01:43:37,744
DON'T DO THIS TYPE OF RESEARCH

2153
01:43:37,811 --> 01:43:39,146
BECAUSE IT MAKES PEOPLE

2154
01:43:39,212 --> 01:43:39,479
UNCOMFORTABLE.

2155
01:43:39,546 --> 01:43:41,348
AND THAT CAME FROM A PROGRAM

2156
01:43:41,415 --> 01:43:42,883
OFFICER, OKAY, AT NIH.

2157
01:43:42,950 --> 01:43:44,618
SO THIS WAS 20 YEARS AGO, AND

2158
01:43:44,685 --> 01:43:46,153
THAT, FOR ME, IS THE SORT OF

2159
01:43:46,219 --> 01:43:48,455
FEEDBACK THAT I GOT CONSISTENTLY

2160
01:43:48,522 --> 01:43:49,856
AT THAT TIME.

2161
01:43:49,923 --> 01:43:51,391
BUT GOING BACK TO THE PANEL THAT

2162
01:43:51,458 --> 01:43:55,429
WE JUST HEARD, WHEN YOU LISTEN

2163
01:43:55,495 --> 01:43:56,763
TO PEOPLE AND YOU LISTEN TO

2164
01:43:56,830 --> 01:43:57,764
PATIENTS, YOU KNOW THIS IS

2165
01:43:57,831 --> 01:43:58,832
SOMETHING REAL THAT IMPACTS

2166
01:43:58,899 --> 01:44:00,467
PEOPLE'S LIVES, SO I DECIDED TO

2167
01:44:00,534 --> 01:44:03,637
STICK WITH IT, AND HAVE A BODY

2168
01:44:03,704 --> 01:44:05,439
OF RESEARCH AND HEALTHY COHORTS

2169
01:44:05,505 --> 01:44:06,907
WHERE WE FOUND A LOT OF

2170
01:44:06,974 --> 01:44:07,574
DOSE-RESPONSE ASSOCIATIONS WITH

2171
01:44:07,641 --> 01:44:12,813
A RANGE OF DIFFERENT INDICATORS

2172
01:44:12,879 --> 01:44:14,915
FOR CARDIOMETABOLIC DISEASE,

2173
01:44:14,982 --> 01:44:19,186
CRP, VISCERAL FAT, INCIDENT CVD,

2174
01:44:19,252 --> 01:44:20,520
INCIDENT DIABETES, AND THIS IS

2175
01:44:20,587 --> 01:44:23,757
USING THE MOST CONSERVATIVE

2176
01:44:23,824 --> 01:44:24,691
METHODOLOGIES BECAUSE REVIEWERS

2177
01:44:24,758 --> 01:44:28,595
FORCED US TO DO IT THAT WAY, YOU

2178
01:44:28,662 --> 01:44:29,696
CAN'T CONTROL FOR THIS BUT

2179
01:44:29,763 --> 01:44:31,198
CONTROL FOR THAT, SO THIS WAS

2180
01:44:31,264 --> 01:44:32,566
SOMETHING THAT REALLY MATTERED

2181
01:44:32,633 --> 01:44:34,368
AND THERE WAS A NEED FOR AN

2182
01:44:34,434 --> 01:44:36,036
EVIDENCE BASE.

2183
01:44:36,103 --> 01:44:37,471
SO WE MOVED PAST THAT NOW AND

2184
01:44:37,537 --> 01:44:38,739
NOW I'M ACTUALLY LOOKING AT

2185
01:44:38,805 --> 01:44:45,646
OTHER SUBGROUPS OF WOMEN

2186
01:44:45,712 --> 01:44:46,747
UNIQUELY VULNERABLE TO A RANGE

2187
01:44:46,813 --> 01:44:52,085
OF DIFFERENT --

2188
01:44:52,152 --> 01:45:02,329
[NO AUDIO]

2189
01:45:08,301 --> 01:45:10,804
-- WOMEN WHO ARE BLACK.

2190
01:45:10,871 --> 01:45:12,439
AND IT'S IMPORTANT TO NOTE THAT

2191
01:45:12,506 --> 01:45:14,741
AFRICAN AMERICAN WOMEN WITH

2192
01:45:14,808 --> 01:45:18,445
LUPUS DIE FROM CARDIOVASCULAR

2193
01:45:18,512 --> 01:45:22,082
DISEASE 20 YEARS EAR EARLIER THN

2194
01:45:22,149 --> 01:45:25,352
WOMEN WITHOUT, SO I HAVE A GRANT

2195
01:45:25,419 --> 01:45:29,623
TO REALLY UNDERSTAND TO WHICH

2196
01:45:29,690 --> 01:45:30,924
SOCIAL STRESSORS PLAY A ROLE IN

2197
01:45:30,991 --> 01:45:32,793
THAT.

2198
01:45:32,859 --> 01:45:34,528
HOWEVER, CHRONIC KIDNEY DISEASE

2199
01:45:34,594 --> 01:45:36,830
IS ALSO A MAJOR COMPLICATION.

2200
01:45:36,897 --> 01:45:38,265
WHEN I WAS ASKED TO PRESENT HERE

2201
01:45:38,331 --> 01:45:39,900
BY A COLLEAGUE, THAT PERSON SAID

2202
01:45:39,966 --> 01:45:41,334
YOU HAVE THIS COHORT OF WOMEN

2203
01:45:41,401 --> 01:45:43,503
WITH LUPUS, COULD YOU LOOK AT

2204
01:45:43,570 --> 01:45:44,705
KIDNEY FUNCTION IN THAT GROUP?

2205
01:45:44,771 --> 01:45:46,239
I SAID WELL, WE HAVEN'T, BUT WE

2206
01:45:46,306 --> 01:45:47,007
COULD.

2207
01:45:47,074 --> 01:45:50,177
SO IT ANOTHER MAJOR CONTRIBUTOR

2208
01:45:50,243 --> 01:45:51,511
TO MORBIDITY AND MORTALITY IN

2209
01:45:51,578 --> 01:45:55,215
THIS GROUP.

2210
01:45:55,282 --> 01:45:57,017
SO THIS IS THE NAME OF MYCOHORT,

2211
01:45:57,084 --> 01:46:01,555
MYCOHORT, IT'S ACTUALLY FUNDED Y

2212
01:46:01,621 --> 01:46:02,355
NIAMS.

2213
01:46:02,422 --> 01:46:03,957
YOU HEARD PEOPLE TALK ABOUT

2214
01:46:04,024 --> 01:46:04,825
INTERSECTIONALITY, SO WHAT WE'RE

2215
01:46:04,891 --> 01:46:06,259
TRYING TO DO IN THIS COHORT IS

2216
01:46:06,326 --> 01:46:07,327
REALLY UNDERSTAND HOW ASPECTS OF

2217
01:46:07,394 --> 01:46:11,965
THE LIVED EXPERIENCE, RIGHT, SO

2218
01:46:12,032 --> 01:46:14,468
WHAT DOES IT MEAN TO BE A BLACK

2219
01:46:14,534 --> 01:46:16,870
A WOMAN IN THIS COUNTRY, WE

2220
01:46:16,937 --> 01:46:17,537
FOCUSED ON AFRICAN AMERICAN

2221
01:46:17,604 --> 01:46:18,505
WOMEN BECAUSE THAT'S THE

2222
01:46:18,572 --> 01:46:20,140
CONTEXT -- NOT TO GO INTO A TON

2223
01:46:20,207 --> 01:46:24,211
OF DIFFERENT DETAIL, BUT PEOPLE

2224
01:46:24,277 --> 01:46:25,378
WHO EMIGRATE TO THIS COUNTRY

2225
01:46:25,445 --> 01:46:27,681
HAVE A DIFFERENT EXPERIENCE, SO

2226
01:46:27,748 --> 01:46:28,782
THIS IS THE EXPERIENCE WE'RE

2227
01:46:28,849 --> 01:46:30,217
REALLY TALKING ABOUT AND HOW IT

2228
01:46:30,283 --> 01:46:34,254
MIGHT CONTRIBUTE TO INFLAMMA

2229
01:46:34,321 --> 01:46:36,056
INFLAMMATION, WE HAVE WOMEN WITH

2230
01:46:36,123 --> 01:46:36,990
LUPUS AND A GROUP OF WOMEN

2231
01:46:37,057 --> 01:46:40,293
WITHOUT LUPUS.

2232
01:46:40,360 --> 01:46:41,795
SO WE'RE ASSESSING GENERAL

2233
01:46:41,862 --> 01:46:43,230
SOCIAL STRESSORS AS WELL AS

2234
01:46:43,296 --> 01:46:44,331
THOSE THAT ARE INTERSECTIONAL IN

2235
01:46:44,397 --> 01:46:45,398
ORIGIN.

2236
01:46:45,465 --> 01:46:47,167
SO THIS IS A BLACK WOMAN'S

2237
01:46:47,234 --> 01:46:48,702
DISEASE, WE WANT TO UNDERSTAND

2238
01:46:48,769 --> 01:46:49,836
EXPERIENCES THAT MIGHT BE UNIQUE

2239
01:46:49,903 --> 01:46:50,570
TO BLACK WOMEN.

2240
01:46:50,637 --> 01:46:52,305
ONE OF THOSE IS THIS CONCERN FOR

2241
01:46:52,372 --> 01:46:56,910
CHILDREN, SO THIS IS THE MAYOR

2242
01:46:56,977 --> 01:47:00,213
OF ATLANTA DURING THE GEORGE

2243
01:47:00,280 --> 01:47:03,917
FLOYD MURDER AND UPRISINGS, AND

2244
01:47:03,984 --> 01:47:05,218
SHE ACTUALLY ROSE TO PROMINENCE

2245
01:47:05,285 --> 01:47:08,855
FOR THIS SPEECH THAT SHE GAVE ON

2246
01:47:08,922 --> 01:47:10,357
THE EVE OF WHAT WAS A MAJOR

2247
01:47:10,423 --> 01:47:11,858
UPRISING IN ATLANTA, SO SHE CAME

2248
01:47:11,925 --> 01:47:13,426
OUT AND BASICALLY SAID, ABOVE

2249
01:47:13,493 --> 01:47:14,861
EVERYTHING ELSE, I AM A MOTHER,

2250
01:47:14,928 --> 01:47:16,163
I'M A MOTHER TO FOUR BLACK

2251
01:47:16,229 --> 01:47:17,798
CHILDREN IN AMERICA, ONE OF WHOM

2252
01:47:17,864 --> 01:47:19,299
IS 18 YEARS OLD, AND WHEN I SAW

2253
01:47:19,366 --> 01:47:22,702
THE MURDER OF GEORGE FLOYD, I

2254
01:47:22,769 --> 01:47:23,804
HURT LIKE A MOTHER WOULD HURT.

2255
01:47:23,870 --> 01:47:25,639
AND SHE WENT ON TO SAY, SO YOU

2256
01:47:25,705 --> 01:47:27,641
ARE NOT GOING TO OUTCONCERN ME

2257
01:47:27,707 --> 01:47:29,810
OR OUTCARE, BECAUSE I WEAR THIS

2258
01:47:29,876 --> 01:47:36,483
EACH AND EVERY DAY.

2259
01:47:36,550 --> 01:47:39,119
NURU JETER HAS DONE QUALITATIVE

2260
01:47:39,186 --> 01:47:40,220
WORK WITH AFRICAN AMERICAN WOMEN

2261
01:47:40,287 --> 01:47:42,823
AND THEY TALKED ABOUT FEELING

2262
01:47:42,889 --> 01:47:44,591
RESPONSIBLE FOR PROTECTING THEIR

2263
01:47:44,658 --> 01:47:45,125
CHILDREN AGAINST RACISM.

2264
01:47:45,192 --> 01:47:50,730
SO THIS IS A MAJOR CONCERN THAT

2265
01:47:50,797 --> 01:47:51,798
AFRICAN AMERICAN WOMEN HAVE FOR

2266
01:47:51,865 --> 01:47:52,999
THEIR CHILDREN AND ALSO WOMEN OF

2267
01:47:53,066 --> 01:47:55,769
OTHER RACES, SANDRA BULLOCK HAS

2268
01:47:55,836 --> 01:47:56,837
ACTUALLY SPOKEN ABOUT THIS.

2269
01:47:56,903 --> 01:47:58,705
SO HOW THEY'RE WORRIED ABOUT

2270
01:47:58,772 --> 01:47:59,773
THINGS THAT THEIR CHILDREN MIGHT

2271
01:47:59,840 --> 01:48:03,510
FACE.

2272
01:48:03,577 --> 01:48:05,045
SO JUST TO GO INTO SOME DETAILS

2273
01:48:05,111 --> 01:48:07,180
ABOUT OUR COHORT, WE HAVE 402

2274
01:48:07,247 --> 01:48:08,315
AFRICAN AMERICAN WOMEN, 50% OF

2275
01:48:08,381 --> 01:48:11,051
THOSE HAVE LUPUS.

2276
01:48:11,117 --> 01:48:13,887
WE LIMITED CURRENT ANALYSIS TO

2277
01:48:13,954 --> 01:48:15,655
THOSE WHO ARE PARENTS AND THAT'S

2278
01:48:15,722 --> 01:48:16,756
70% OF BOTH GROUPS.

2279
01:48:16,823 --> 01:48:18,058
WOMEN HAD TO BE FREE OF HEART

2280
01:48:18,124 --> 01:48:24,064
DISEASE AND EQUIVALENTS.

2281
01:48:24,130 --> 01:48:27,467
PREMENOPAUSAL, HAD AT LEAST ONE

2282
01:48:27,534 --> 01:48:29,669
OVARY, AND FREE OF END STAGE

2283
01:48:29,736 --> 01:48:30,537
RENAL DISEASE.

2284
01:48:30,604 --> 01:48:35,675
AND THEN WOMEN WITHOUT SLE, NO

2285
01:48:35,742 --> 01:48:36,376
AUTOIMMUNE DISEASES.

2286
01:48:36,443 --> 01:48:37,510
THIS IS OUR PROTOCOL.

2287
01:48:37,577 --> 01:48:40,046
WE DO A FASTING PROTOCOL,

2288
01:48:40,113 --> 01:48:40,814
FACE-TO-FACE INTERVIEW, WE HAVE

2289
01:48:40,881 --> 01:48:45,518
OUR INTERVIEWERS MATCH RACE AND

2290
01:48:45,585 --> 01:48:49,756
GENDER FOR OUR PARPTS PANTS, ALL

2291
01:48:49,823 --> 01:48:50,857
SORTS OF THINGS.

2292
01:48:50,924 --> 01:48:52,492
SO THIS IS THE SALE.

2293
01:48:52,559 --> 01:48:55,362
WE ASKED, SELF-REPORTED, HOW

2294
01:48:55,428 --> 01:48:57,197
CONCERNED ARE YOU ABOUT YOUR

2295
01:48:57,264 --> 01:48:58,098
CHILDREN GETTING POOR

2296
01:48:58,164 --> 01:48:59,766
INSTRUCTION OR BEING IGNORED IN

2297
01:48:59,833 --> 01:49:01,268
SCHOOL BECAUSE THEY ARE BLACK,

2298
01:49:01,334 --> 01:49:02,802
BEING HARMED OR HARASSED BY THE

2299
01:49:02,869 --> 01:49:04,337
POLICE BECAUSE THEY ARE BLACK,

2300
01:49:04,404 --> 01:49:05,839
GETTING STOPPED IN A

2301
01:49:05,906 --> 01:49:06,840
PREDOMINANTLY WHITE AREA BECAUSE

2302
01:49:06,907 --> 01:49:08,575
THEY ARE BLACK, BEING DEALT WITH

2303
01:49:08,642 --> 01:49:10,710
MORE HARSHLY THAN WHITE STUDENTS

2304
01:49:10,777 --> 01:49:11,978
IN SCHOOL BECAUSE THEY ARE

2305
01:49:12,045 --> 01:49:13,280
BLACK, BEING DISCOURAGED FROM

2306
01:49:13,346 --> 01:49:14,514
TRYING THINGS OR CRITICIZED

2307
01:49:14,581 --> 01:49:16,149
BECAUSE THEY ARE BLACK, BEING

2308
01:49:16,216 --> 01:49:17,651
CONSIDERED LESS ATTRACTIVE THAN

2309
01:49:17,717 --> 01:49:19,085
THEIR WHITE COUNTERPART PAUSE

2310
01:49:19,152 --> 01:49:22,088
TBECAUSETHEY ARE BLACK?

2311
01:49:22,155 --> 01:49:24,057
A RANGE OF DIFFERENT DOMAINS,

2312
01:49:24,124 --> 01:49:26,092
THESE CONCERNS AND FEARS,

2313
01:49:26,159 --> 01:49:27,627
HONESTLY, ABOUT YOUR CHILD'S

2314
01:49:27,694 --> 01:49:31,665
EXPERIENCE IN THIS COUNTRY.

2315
01:49:31,731 --> 01:49:33,199
I'M NOT GOING TO SHARE THIS PART

2316
01:49:33,266 --> 01:49:35,368
BECAUSE THESE ARE UNPUBLISHED

2317
01:49:35,435 --> 01:49:37,037
DATA SO I ANALYZED THIS JUST FOR

2318
01:49:37,103 --> 01:49:39,439
THE PURPOSES OF THIS CONFERENCE.

2319
01:49:39,506 --> 01:49:42,609
SO WE'D LOVE TO HERE YOUR ALL'S

2320
01:49:42,676 --> 01:49:45,078
FEEDBACK BUT THIS IS RECORDED

2321
01:49:45,145 --> 01:49:46,446
BUT WHAT WE BASICALLY FOUND WAS

2322
01:49:46,513 --> 01:49:49,482
THAT THIS LEVEL OF CONCERN WAS

2323
01:49:49,549 --> 01:49:52,452
ASSOCIATED WITH LOWER EGFR

2324
01:49:52,519 --> 01:49:54,754
LEVELS IN WOMEN WITH LUPUS.

2325
01:49:54,821 --> 01:49:56,289
WE DID NOT SEE THESE

2326
01:49:56,356 --> 01:49:57,257
ASSOCIATIONS IN WOMEN WITHOUT

2327
01:49:57,324 --> 01:49:57,691
LUPUS.

2328
01:49:57,757 --> 01:50:00,093
AND WE CONTROLLED FOR A RANGE OF

2329
01:50:00,160 --> 01:50:02,162
DIFFERENT THINGS.

2330
01:50:02,228 --> 01:50:04,564
SO SOCIODEMOGRAPHICS, AGE,

2331
01:50:04,631 --> 01:50:08,835
EDUCATION LEVEL, INCOME.

2332
01:50:08,902 --> 01:50:10,503
WE DON'T HAVE DIFFERENCES IN

2333
01:50:10,570 --> 01:50:12,472
INSURANCE STATUS, WE ADJUSTED

2334
01:50:12,539 --> 01:50:13,873
FOR -- WE COLLECT BLOOD PRESSURE

2335
01:50:13,940 --> 01:50:16,176
SO WE ADJUSTED FOR HYPERTENSION,

2336
01:50:16,242 --> 01:50:19,346
WE ADJUSTED FOR DIABETES SO RISK

2337
01:50:19,412 --> 01:50:21,982
FACTORS FOR KIDNEY DISEASE, WE

2338
01:50:22,048 --> 01:50:24,117
ALSO ADJUSTED FOR BMI, SMOKING,

2339
01:50:24,184 --> 01:50:25,251
ALL OF THOSE KINDS OF THINGS,

2340
01:50:25,318 --> 01:50:26,453
AND WE STILL SAW THIS

2341
01:50:26,519 --> 01:50:26,920
ASSOCIATION.

2342
01:50:26,987 --> 01:50:29,356
BUT IT'S INTERESTING, THE TWO

2343
01:50:29,422 --> 01:50:31,057
DIFFERENT DEFINITIONS OF EGFR,

2344
01:50:31,124 --> 01:50:31,725
RIGHT?

2345
01:50:31,791 --> 01:50:34,127
SO THERE WAS ONE THAT ACTUALLY

2346
01:50:34,194 --> 01:50:36,863
INCORPORATED WHAT I WOULD CALL A

2347
01:50:36,930 --> 01:50:38,498
BIT OF MEDICAL RACISM.

2348
01:50:38,565 --> 01:50:40,500
AND WHAT WE SAW, THE EFFECTS

2349
01:50:40,567 --> 01:50:42,869
WERE SLIGHTLY STRONGER IN THE

2350
01:50:42,936 --> 01:50:44,170
CONTEXT OF MEDICAL RACISM WHICH

2351
01:50:44,237 --> 01:50:45,038
IS INTERESTING.

2352
01:50:45,105 --> 01:50:46,373
WE STILL SAW ASSOCIATION WITH

2353
01:50:46,439 --> 01:50:48,108
BOTH OUTCOMES BUT THEY WERE A

2354
01:50:48,174 --> 01:50:50,210
LITTLE BIT -- THE EFFECT SIZES

2355
01:50:50,276 --> 01:50:51,411
WERE A LITTLE BIT SMALLER WHEN

2356
01:50:51,478 --> 01:50:58,084
WE USED THE NEW 2021 NORM.

2357
01:50:58,151 --> 01:51:00,153
INDEPENDENT OF RELEVANT RISK

2358
01:51:00,220 --> 01:51:03,223
FACTORS, THEN ADDITIONAL

2359
01:51:03,289 --> 01:51:07,160
ANALYSES TO LOOK AT DAMAGE DUE

2360
01:51:07,227 --> 01:51:12,298
TO SEL AND LONG TERM DAMAGE.

2361
01:51:12,365 --> 01:51:14,601
THE THOUGHT WAS SLE MIGHT

2362
01:51:14,667 --> 01:51:15,535
CONTRIBUTE TO WEATHERING IN

2363
01:51:15,602 --> 01:51:16,903
AFRICAN AMERICAN WOMEN, THIS

2364
01:51:16,970 --> 01:51:19,639
IDEA THAT THEY'RE RACED IN

2365
01:51:19,706 --> 01:51:20,273
GENDER-RELATED -- DEVELOPED IN

2366
01:51:20,340 --> 01:51:22,042
THE CONTEXT OF STUDYING BLACK

2367
01:51:22,108 --> 01:51:23,443
WOMEN'S REPRODUCTIVE HEALTH, IT

2368
01:51:23,510 --> 01:51:25,311
BEEN APPLIED TO A RANGE OF

2369
01:51:25,378 --> 01:51:26,413
DIFFERENT OTHER HEALTH OUTCOMES,

2370
01:51:26,479 --> 01:51:29,249
BUT IN GENERAL, THIS IDEA THAT

2371
01:51:29,315 --> 01:51:31,885
THERE'S SOMETHING ABOUT

2372
01:51:31,951 --> 01:51:33,520
UNDERGOING STRESS PROCESSES THAT

2373
01:51:33,586 --> 01:51:37,457
IS PHYSIOLOGICALLY -- THAT

2374
01:51:37,524 --> 01:51:41,294
ACCELERATES PHYSIOLOGY OF AGING.

2375
01:51:41,361 --> 01:51:44,998
SO SOMEHOW SLE IS CAUSATIVE IN

2376
01:51:45,065 --> 01:51:45,398
THAT.

2377
01:51:45,465 --> 01:51:47,634
LOTS OF POTENTIAL PATHWAYS WE

2378
01:51:47,700 --> 01:51:50,804
COULD EXAMINE, THE PLAN IS TO

2379
01:51:50,870 --> 01:51:52,172
EXAMINE A RANGE OF DIFFERENT

2380
01:51:52,238 --> 01:51:53,640
INFLAMMATORY MARKERS BUT OTHER

2381
01:51:53,706 --> 01:51:54,507
PATHWAYS ARE IMPORTANT AS WELL.

2382
01:51:54,574 --> 01:51:55,708
THEN ANOTHER THOUGHT IS THAT

2383
01:51:55,775 --> 01:51:58,244
THIS CONCERN FOR CHILDREN MIGHT

2384
01:51:58,311 --> 01:51:59,679
BE PARTICULARLY PROBLEMATIC IN A

2385
01:51:59,746 --> 01:52:02,148
COHORT OF WOMEN WHO HAVE LOW

2386
01:52:02,215 --> 01:52:03,149
LIFE EXPECTANCY.

2387
01:52:03,216 --> 01:52:06,019
SO WE'RE ALREADY SEEING, WE

2388
01:52:06,086 --> 01:52:09,923
ARE -- WE STARTED IN 2017.

2389
01:52:09,989 --> 01:52:11,157
SEVEN OF OUR WOMEN IN THE COHORT

2390
01:52:11,224 --> 01:52:12,792
WITH LUPUS HAD ALREADY DIED AND

2391
01:52:12,859 --> 01:52:16,062
THEY DIED IN THEIR 30s AND

2392
01:52:16,129 --> 01:52:17,564
40s, SOME LATE 20s, SO THIS

2393
01:52:17,630 --> 01:52:22,502
IS A DISEASE THAT IS

2394
01:52:22,569 --> 01:52:23,703
PARTICULARLY -- IT INTERRUPTS

2395
01:52:23,770 --> 01:52:28,741
LIFE EXPECTANCY, AND IT

2396
01:52:28,808 --> 01:52:30,376
DISPROPORTIONATELY IMPACTS BLACK

2397
01:52:30,443 --> 01:52:32,011
WOMEN WHO ARE IN THEIR EARLY

2398
01:52:32,078 --> 01:52:34,647
SORT OF LATE REPRODUCTIVE EARLY

2399
01:52:34,714 --> 01:52:36,282
MID LIFE YEARS, SO PERHAPS THAT

2400
01:52:36,349 --> 01:52:38,151
KIND OF WORRY THAT YOU MAY NOT

2401
01:52:38,218 --> 01:52:41,221
BE AROUND TO PROTECT YOUR CHILD

2402
01:52:41,287 --> 01:52:42,555
HAD AN EVEN GREATER IMPACT ON

2403
01:52:42,622 --> 01:52:44,157
THIS GROUP.

2404
01:52:44,224 --> 01:52:45,291
SO I KNOW I ONLY HAVE 10

2405
01:52:45,358 --> 01:52:45,592
MINUTES.

2406
01:52:45,658 --> 01:52:48,528
I'LL TRY TO STICK TO THAT, SO

2407
01:52:48,595 --> 01:52:58,304
I'LL END THERE.

2408
01:52:58,371 --> 01:53:01,241
>> NEXT WE HAVE MITCHELL LUNN

2409
01:53:01,307 --> 01:53:04,744
WHO WILL BE TALKING TO US ABOUT

2410
01:53:04,811 --> 01:53:06,479
KIDNEY DISEASE IN SGM

2411
01:53:06,546 --> 01:53:16,756
POPULATIONS.

2412
01:53:17,123 --> 01:53:21,661
>> I CAN'T SING, I CAN'T DANCE.

2413
01:53:21,728 --> 01:53:29,102
-- MAYBE A LITTLE BIT.

2414
01:53:29,169 --> 01:53:29,769
ALL RIGHT.

2415
01:53:29,836 --> 01:53:30,870
HI, EVERYBODY.

2416
01:53:30,937 --> 01:53:31,638
DELIGHTED TO BE HERE.

2417
01:53:31,704 --> 01:53:33,606
THANKS TO THE ORGANIZERS FOR

2418
01:53:33,673 --> 01:53:35,041
INVITING ME.

2419
01:53:35,108 --> 01:53:37,210
I USE HE/HIM PRONOUNCE, I'M

2420
01:53:37,277 --> 01:53:38,211
ASSOCIATE PROFESSOR AT STANFORD

2421
01:53:38,278 --> 01:53:39,946
AND DELIGHTED TO BE HERE TODAY.

2422
01:53:40,013 --> 01:53:41,648
NO RELEVANT CONFLICTS TO THIS

2423
01:53:41,714 --> 01:53:44,083
PRESENTATION.

2424
01:53:44,150 --> 01:53:45,084
A LITTLE BIT ABOUT ME.

2425
01:53:45,151 --> 01:53:47,620
I'M A WHITE GAY CISGENDER MAN

2426
01:53:47,687 --> 01:53:49,155
ORIGINALLY FROM BISMARCK, NORTH

2427
01:53:49,222 --> 01:53:49,389
DAKOTA.

2428
01:53:49,455 --> 01:53:52,091
I'M A NEPHROLOGIST BY TRAINING.

2429
01:53:52,158 --> 01:53:54,294
I CALL MYSELF A NEPHROLOGIST

2430
01:53:54,360 --> 01:53:56,029
LIGHT BECAUSE I ONLY DO ABOUT

2431
01:53:56,095 --> 01:53:58,231
30% OF MY TIME IS

2432
01:53:58,298 --> 01:53:59,232
NEPHROLOGY-RELATED PATIENT CARE

2433
01:53:59,299 --> 01:54:02,602
AND 70% OF MY TIME IS

2434
01:54:02,669 --> 01:54:04,037
LGBTQ-RELATED HEALTH AND HEALTH

2435
01:54:04,103 --> 01:54:04,704
DISPARITIES-RELATED WORK.

2436
01:54:04,771 --> 01:54:05,572
I TALK FAST.

2437
01:54:05,638 --> 01:54:07,106
I HAVE A LOT OF THINGS TO GO

2438
01:54:07,173 --> 01:54:08,641
THROUGH SO HOLD ON TO YOUR

2439
01:54:08,708 --> 01:54:11,044
HORSES.

2440
01:54:11,110 --> 01:54:12,145
I'LL SEND SLIDES TO ANYBODY WHO

2441
01:54:12,212 --> 01:54:13,446
WANTS THEM AFTER AS WELL.

2442
01:54:13,513 --> 01:54:18,251
THE BOTTOM LINE UP FRONT, HERE'S

2443
01:54:18,318 --> 01:54:21,854
HERE'S -- LGBTQ+ PEOPLE ARE

2444
01:54:21,921 --> 01:54:23,056
UNDERSTUDIED, UNDERSERVED AND

2445
01:54:23,122 --> 01:54:24,791
VULNERABLE TO POOR HEALTH AND

2446
01:54:24,857 --> 01:54:26,459
HEALTHCARE INEQUITIES.

2447
01:54:26,526 --> 01:54:28,094
WE HAVE A LOT OF NEGATIVE

2448
01:54:28,161 --> 01:54:29,062
EXPERIENCES, A LOT OF

2449
01:54:29,128 --> 01:54:29,729
MARGINALIZATION IN THE

2450
01:54:29,796 --> 01:54:31,030
HEALTHCARE PROVIDERS' OFFICES

2451
01:54:31,097 --> 01:54:32,465
THAT KEEP US OUT OF MEDICAL

2452
01:54:32,532 --> 01:54:33,666
SETTINGS AND OUT OF RESEARCH

2453
01:54:33,733 --> 01:54:36,970
SETTINGS.

2454
01:54:37,036 --> 01:54:38,371
AND LIMITED FEDERAL COLLECTION

2455
01:54:38,438 --> 01:54:40,039
OF BOTH SEXUAL ORIENTATION AND

2456
01:54:40,106 --> 01:54:41,641
GENDER IDENTITY HAS SEVERELY

2457
01:54:41,708 --> 01:54:44,510
LIMITED THE BASIC EPIDEMIOLOGY

2458
01:54:44,577 --> 01:54:46,579
OF EVERYTHING, INCLUDING KIDNEY

2459
01:54:46,646 --> 01:54:49,415
DISEASE IN LGBTQ+ PEOPLE, AND

2460
01:54:49,482 --> 01:54:52,151
THUS THE LIMITATIONS OF

2461
01:54:52,218 --> 01:54:55,054
PUBLISHED DATA TYPICALLY ARE

2462
01:54:55,121 --> 01:55:00,693
RELATED TO -- OR CONVENIENT

2463
01:55:00,760 --> 01:55:01,661
SAMPLES.

2464
01:55:01,728 --> 01:55:03,963
WE TEND TO USE THE TERM SEXUAL

2465
01:55:04,030 --> 01:55:04,797
AND GENDER MINORITY WITHIN THE

2466
01:55:04,864 --> 01:55:06,032
NIH.

2467
01:55:06,099 --> 01:55:09,002
WITHIN A ACADEMIA THIS IS MORE

2468
01:55:09,068 --> 01:55:10,903
COMMONLY REFERRED TO AS LGBTQIA+

2469
01:55:10,970 --> 01:55:12,939
AND YOU CAN ADD AS MANY LETTERS

2470
01:55:13,006 --> 01:55:14,474
AS YOU'D LIKE, IT'S COMPLICATED,

2471
01:55:14,540 --> 01:55:16,276
BUT TYPICALLY WE TEND TO SAY

2472
01:55:16,342 --> 01:55:17,076
SEXUAL MINORITY PEOPLE ARE

2473
01:55:17,143 --> 01:55:19,112
PEOPLE WHO ARE NOT STRAIGHT AND

2474
01:55:19,178 --> 01:55:20,046
GENDER MINORITY PEOPLE ARE

2475
01:55:20,113 --> 01:55:22,315
PEOPLE WHO ARE NOT CISGENDER,

2476
01:55:22,382 --> 01:55:23,750
THAT THEY HAVE A GENDER IDENTITY

2477
01:55:23,816 --> 01:55:25,084
THAT IS SOMETHING DIFFERENT THAN

2478
01:55:25,151 --> 01:55:26,819
WHAT IS COMMONLY ASSOCIATED WITH

2479
01:55:26,886 --> 01:55:28,054
THE SEX THEY WERE ASSIGNED AT

2480
01:55:28,121 --> 01:55:30,757
BIRTH.

2481
01:55:30,823 --> 01:55:32,191
SO JUST A LITTLE BACKGROUND OF

2482
01:55:32,258 --> 01:55:33,926
THE POPULATION.

2483
01:55:33,993 --> 01:55:35,695
7.6% OF THE UNITED STATES

2484
01:55:35,762 --> 01:55:37,096
IDENTIFIES WITH LGBTQ+.

2485
01:55:37,163 --> 01:55:38,965
WE KNOW THIS FROM GALLOP, RANDOM

2486
01:55:39,032 --> 01:55:40,833
DIGIT DIALING TO ABOUT A

2487
01:55:40,900 --> 01:55:43,670
THOUSAND PEOPLE EVERY YEAR, AND

2488
01:55:43,736 --> 01:55:46,406
WE DON'T GET THIS FROM ANY OTHER

2489
01:55:46,472 --> 01:55:47,974
SOURCE BECAUSE IT WAS EXCLUDED

2490
01:55:48,041 --> 01:55:49,575
FROM THE 2020 CENSUS.

2491
01:55:49,642 --> 01:55:53,413
WE DO NOT KNOW WHERE LGBTQ

2492
01:55:53,479 --> 01:55:55,148
PEOPLE LIVE, WHAT THEIR AGES

2493
01:55:55,214 --> 01:55:56,582
ARE, THEIR JOBS ARE, WHO THEY

2494
01:55:56,649 --> 01:55:58,384
LIVE WITH, WHAT THEIR FAMILIES

2495
01:55:58,451 --> 01:55:59,552
ARE LIKE, ET CETERA, BECAUSE IT

2496
01:55:59,619 --> 01:56:02,055
WAS REMOVED UNDER THE TRUMP

2497
01:56:02,121 --> 01:56:03,022
ADMINISTRATION.

2498
01:56:03,089 --> 01:56:06,326
FINGERS CROSSED IN 2030 THAT WE

2499
01:56:06,392 --> 01:56:08,661
WILL HAVE SEXUAL ORIENTATION AND

2500
01:56:08,728 --> 01:56:10,463
GENDER IDENTITY INCLUDED TO

2501
01:56:10,530 --> 01:56:12,332
ACTUALLY START DOING SOME

2502
01:56:12,398 --> 01:56:13,299
APPROPRIATE EPIDEMIOLOGIC

2503
01:56:13,366 --> 01:56:14,300
SAMPLING FRAMES.

2504
01:56:14,367 --> 01:56:15,601
I'M NOT GOING TO GO THROUGH ALL

2505
01:56:15,668 --> 01:56:17,070
THESE DATA ON MARGINALIZATION,

2506
01:56:17,136 --> 01:56:21,307
BUT THIS IS I THINK REALLY

2507
01:56:21,374 --> 01:56:23,042
ECHOES THE COMMENTS WE HEARD

2508
01:56:23,109 --> 01:56:23,376
EARLIER TODAY.

2509
01:56:23,443 --> 01:56:26,879
YOU CAN SEE THESE NAVY BLUE OR

2510
01:56:26,946 --> 01:56:28,081
LIGHT GREEN BAR, ANYWHERE

2511
01:56:28,147 --> 01:56:30,183
BETWEEN 4 AND 20% OF LGBTQ+

2512
01:56:30,249 --> 01:56:31,451
PEOPLE HAD A NEGATIVE EXPERIENCE

2513
01:56:31,517 --> 01:56:32,785
IN THE HEALTHCARE PROVIDER'S

2514
01:56:32,852 --> 01:56:34,420
OFFICE, BEING PHYSICALLY ABUSED,

2515
01:56:34,487 --> 01:56:37,256
VERBALLY ABUSED, BLAMED FOR

2516
01:56:37,323 --> 01:56:38,458
THEIR HEALTH STATUS, NOT

2517
01:56:38,524 --> 01:56:40,093
LISTENED TO.

2518
01:56:40,159 --> 01:56:41,294
SIMILARLY, WE HAVE MORE RECENT

2519
01:56:41,361 --> 01:56:44,230
DATA FROM THE 2022 TRANSGENDER

2520
01:56:44,297 --> 01:56:44,597
SURVEY.

2521
01:56:44,664 --> 01:56:46,999
THIS WAS OF MORE THAN 90,000

2522
01:56:47,066 --> 01:56:49,969
TRANS PEOPLE ACROSS THE COUNTRY.

2523
01:56:50,036 --> 01:56:53,573
I THINK THE BIG ONE IS THE LAST

2524
01:56:53,639 --> 01:56:54,774
BULLET POINT, WHICH IS THAT HALF

2525
01:56:54,841 --> 01:56:56,409
OF TRANS PEOPLE HAVE HAD A

2526
01:56:56,476 --> 01:56:57,844
NEGATIVE EXPERIENCE IN THE LAST

2527
01:56:57,910 --> 01:56:59,679
12 MONTHS IN THE HEALTHCARE

2528
01:56:59,746 --> 01:57:02,215
PROVIDER'S OFFICE.

2529
01:57:02,281 --> 01:57:03,850
THIS HAS PUSHED PEOPLE AWAY FROM

2530
01:57:03,916 --> 01:57:05,651
HEALTHCARE AND IT PUSHES PEOPLE

2531
01:57:05,718 --> 01:57:09,222
AWAY FROM RESEARCH, BECAUSE IT'S

2532
01:57:09,288 --> 01:57:10,323
PRIMARILY WHERE FOLKS GET

2533
01:57:10,390 --> 01:57:11,924
RECRUITED TO VARIOUS RESEARCH

2534
01:57:11,991 --> 01:57:13,259
STUDIES, ESPECIALLY IN ACADEMIC

2535
01:57:13,326 --> 01:57:14,227
MEDICAL CENTERS.

2536
01:57:14,293 --> 01:57:16,763
WE ALSO KNOW THAT LGBTQ+ PEOPLE

2537
01:57:16,829 --> 01:57:17,797
WITH DISABILITIES, WHICH

2538
01:57:17,864 --> 01:57:21,801
INCLUDES MANY FOLKS IN THE NIDDK

2539
01:57:21,868 --> 01:57:23,102
UMBRELLA, HAVE DIFFICULTY

2540
01:57:23,169 --> 01:57:25,304
ACCESSING CARE OR DECIDED TO

2541
01:57:25,371 --> 01:57:28,941
DELAY CARE WITH ODDS RATIOS IN

2542
01:57:29,008 --> 01:57:30,777
THE 3s AND 4s DEPENDING ON

2543
01:57:30,843 --> 01:57:31,844
THE CLASSIFICATION OF DISABILITY

2544
01:57:31,911 --> 01:57:33,279
THAT FOLKS HAVE.

2545
01:57:33,346 --> 01:57:34,814
AND SO LET'S ACTUALLY TALK A

2546
01:57:34,881 --> 01:57:36,115
LITTLE ABOUT KIDNEY DISEASE,

2547
01:57:36,182 --> 01:57:38,985
WHICH IS THAT THERE ARE ABOUT

2548
01:57:39,051 --> 01:57:39,685
35, 36 MILLION PEOPLE IN THE

2549
01:57:39,752 --> 01:57:41,154
UNITED STATES WITH CHRONIC

2550
01:57:41,220 --> 01:57:41,687
KIDNEY DISEASE.

2551
01:57:41,754 --> 01:57:43,756
THERE ARE ABOUT 800,000 FOLKS

2552
01:57:43,823 --> 01:57:45,625
WITH END STAGE KIDNEY DISEASE,

2553
01:57:45,691 --> 01:57:47,360
OF WHICH TWO THIRDS OF THEM ARE

2554
01:57:47,427 --> 01:57:50,630
ON DIALYSIS APPROXIMATELY AND

2555
01:57:50,696 --> 01:57:51,664
ONE-THIRD HAVE RECEIVED A KIDNEY

2556
01:57:51,731 --> 01:57:51,964
TRANSPLANT.

2557
01:57:52,031 --> 01:57:53,232
YOU CAN SEE THE GRAPH THERE AT

2558
01:57:53,299 --> 01:57:54,734
THE BOTTOM FROM THE UNITED

2559
01:57:54,801 --> 01:57:55,802
STATES RENAL DATA SERVICE THAT

2560
01:57:55,868 --> 01:57:57,336
THE INCIDENCE OF END STAGE

2561
01:57:57,403 --> 01:57:58,538
KIDNEY DISEASE OVER THE PAST TWO

2562
01:57:58,604 --> 01:58:00,840
DECADES HAS INCREASED BY ABOUT

2563
01:58:00,907 --> 01:58:02,475
35%.

2564
01:58:02,542 --> 01:58:05,445
THIS IS PROBABLY DUE TO MANY

2565
01:58:05,511 --> 01:58:06,412
THINGS WHICH INCLUDE PEOPLE

2566
01:58:06,479 --> 01:58:07,947
LIVING LONGER SO THEIR KIDNEYS

2567
01:58:08,014 --> 01:58:09,482
DON'T LIVE AS LONG AS THEY DO,

2568
01:58:09,549 --> 01:58:12,552
AND ALSO SOME CHANGES,

2569
01:58:12,618 --> 01:58:13,753
LIFESTYLE-WISE AND IMPROVED

2570
01:58:13,820 --> 01:58:15,388
SCREENING ON KIDNEY DISEASE.

2571
01:58:15,455 --> 01:58:16,823
AMONG SEXUAL AND GENDER MINORITY

2572
01:58:16,889 --> 01:58:17,990
PEOPLE, WE HAVE VERY, VERY

2573
01:58:18,057 --> 01:58:18,624
LIMITED DATA.

2574
01:58:18,691 --> 01:58:25,198
THIS IS DATA PUBLISHED USING THE

2575
01:58:25,264 --> 01:58:27,500
RISK FACTOR SURVEILLANCE SYSTEM

2576
01:58:27,567 --> 01:58:30,703
LOOKING AT SEXUAL MINORITY OLDER

2577
01:58:30,770 --> 01:58:31,671
ADULTS, SURPRISING IT'S ONLY 50

2578
01:58:31,737 --> 01:58:33,439
OR OLDER, I'M LIKE, I'M NOW

2579
01:58:33,506 --> 01:58:38,978
ALMOST AN OLER ADULT. OLDER ADUS

2580
01:58:39,045 --> 01:58:42,615
IT REALLY SHOWED ONLY

2581
01:58:42,682 --> 01:58:45,051
SIGNIFICANT EFFECT FOR SEXUAL

2582
01:58:45,117 --> 01:58:51,257
MINORITY MEN, AT ABOUT 30% OR

2583
01:58:51,324 --> 01:58:53,025
GREATER ODDS OF HAVING INCIDENT

2584
01:58:53,092 --> 01:58:55,194
KIDNEY DISEASE IN THEIR LIFETIME

2585
01:58:55,261 --> 01:58:56,929
COMPARED TO THEIR HETEROSEXUAL

2586
01:58:56,996 --> 01:58:57,163
PEERS.

2587
01:58:57,230 --> 01:58:59,265
WE DID NOT SEE THAT IN SEXUAL

2588
01:58:59,332 --> 01:58:59,632
MINORITY WOMEN.

2589
01:58:59,699 --> 01:59:02,001
WHEN WE LOOK AT KIDNEY DISEASE

2590
01:59:02,068 --> 01:59:03,503
AND TRANSGENDER PEOPLE WERE

2591
01:59:03,569 --> 01:59:06,572
REALLY LIMITED TO SINGLE CENT

2592
01:59:06,639 --> 01:59:08,107
CENTERS, OF ABOUT

2593
01:59:08,174 --> 01:59:09,208
275 TRANSGENDER PATIENTS, AND

2594
01:59:09,275 --> 01:59:10,510
SURPRISINGLY HAD A CRAZY HIGH

2595
01:59:10,576 --> 01:59:12,578
INCIDENCE OF PREVALENT CHRONIC

2596
01:59:12,645 --> 01:59:14,881
KIDNEY DISEASE AT 36%, MUCH

2597
01:59:14,947 --> 01:59:16,649
HIGHER THAN THE 10, 12, 14% THAT

2598
01:59:16,716 --> 01:59:18,284
WE TYPICALLY SEE IN THE GENERAL

2599
01:59:18,351 --> 01:59:19,252
POPULATION.

2600
01:59:19,318 --> 01:59:21,587
SO UNCLEAR ON THE EXACT REASONS

2601
01:59:21,654 --> 01:59:24,524
FOR THIS.

2602
01:59:24,590 --> 01:59:26,092
THEN MORE RECENT DATA LOOKING AT

2603
01:59:26,158 --> 01:59:29,462
MORE THAN 350,000 PARTICIPANTS

2604
01:59:29,529 --> 01:59:30,530
IN THE ALL-OF-US RESEARCH

2605
01:59:30,596 --> 01:59:32,498
PROGRAM, OF WHICH NEARLY 31,000

2606
01:59:32,565 --> 01:59:34,567
OF THEM WERE SEXUAL OR GENDER

2607
01:59:34,634 --> 01:59:35,001
MINORITY PEOPLE.

2608
01:59:35,067 --> 01:59:38,271
IN THIS CASE, THE SGM GROUPS HAD

2609
01:59:38,337 --> 01:59:41,240
LOWER ODDS OF DIABETES, HEART

2610
01:59:41,307 --> 01:59:42,775
DISEASE, HYPERTENSION, AND

2611
01:59:42,842 --> 01:59:43,309
CHRONIC KIDNEY DISEASE.

2612
01:59:43,376 --> 01:59:45,278
WE THINK THIS IS LIKELY DUE TO

2613
01:59:45,344 --> 01:59:47,179
THE POPULATION PARTICIPATING IN

2614
01:59:47,246 --> 01:59:50,449
ALL-OF-US AND NOT THE ACTUAL

2615
01:59:50,516 --> 01:59:53,719
POPULATION IN THE REAL WORLD,

2616
01:59:53,786 --> 01:59:55,922
BUT THIS WAS I THINK ANOTHER

2617
01:59:55,988 --> 01:59:56,455
SURPRISING FINDING.

2618
01:59:56,522 --> 01:59:59,959
THESE ARE JUST THE PLOT -- I'LL

2619
02:00:00,026 --> 02:00:01,260
BE SURE TO SHARE THESE WITH

2620
02:00:01,327 --> 02:00:02,795
FOLKS, YOU CAN SEE FOR THE ONE

2621
02:00:02,862 --> 02:00:05,531
OUTLINED IN RED FOR

2622
02:00:05,598 --> 02:00:07,833
CARDIOVASCULAR DISEASE, MOST OF

2623
02:00:07,900 --> 02:00:10,636
THOSE DOTS ARE LESS THAN 1 OR

2624
02:00:10,703 --> 02:00:12,104
THEY HAVE ERROR BARS THAT CROSS

2625
02:00:12,171 --> 02:00:13,606
OVER 1, SAME THING FOR CHRONIC

2626
02:00:13,673 --> 02:00:14,840
KIDNEY DISEASE IN THE PURPLE

2627
02:00:14,907 --> 02:00:16,909
BOX, AND THEN HERE THE PURPLE

2628
02:00:16,976 --> 02:00:18,210
BOX IS HYPERTENSION AND THE RED

2629
02:00:18,277 --> 02:00:18,778
BOX IS DIABETES.

2630
02:00:18,844 --> 02:00:21,347
SO WE'RE SEEING LOWER ODDS AMONG

2631
02:00:21,414 --> 02:00:22,481
SEXUAL AND GENDER MINORITY

2632
02:00:22,548 --> 02:00:26,552
GROUPS COMPARED TO THEIR

2633
02:00:26,619 --> 02:00:27,486
CISGENDER HETEROSEXUAL

2634
02:00:27,553 --> 02:00:27,954
COUNTERPARTS.

2635
02:00:28,020 --> 02:00:29,155
THEN JUST TO WRAP UP, I'M GOING

2636
02:00:29,221 --> 02:00:31,457
TO THROW OUT THE CONCEPT OF CYST

2637
02:00:31,524 --> 02:00:34,860
STATIN C, SO FOLKS MAY BE

2638
02:00:34,927 --> 02:00:40,766
FAMILIAR WITH THIS MUSCLE-BASED

2639
02:00:40,833 --> 02:00:41,634
MEASUREMENT, AND RECENT EFFORTS

2640
02:00:41,701 --> 02:00:43,869
AS WE JUST HEARD FROM DR. LEWIS

2641
02:00:43,936 --> 02:00:45,771
HAVE ALREADY REMOVED THE RACE

2642
02:00:45,838 --> 02:00:46,606
COEFFICIENT FROM THE EQUATION

2643
02:00:46,672 --> 02:00:50,109
THAT WE WOULD USE TO ESTIMATE

2644
02:00:50,176 --> 02:00:51,377
GLO MAYOR YAL FILTRATION OR

2645
02:00:51,444 --> 02:00:52,545
ESTIMATE KIDNEY FUNCTION, BUT WE

2646
02:00:52,612 --> 02:00:54,413
HAVE SEX-BASED COEFFICIENTS THAT

2647
02:00:54,480 --> 02:00:55,114
REMAIN.

2648
02:00:55,181 --> 02:00:57,383
SO YOUR EGFR IS ACTUALLY 12%

2649
02:00:57,450 --> 02:00:59,485
HIGHER IF YOU ARE FEMALE VERSUS

2650
02:00:59,552 --> 02:01:01,320
IF YOU ARE MALE.

2651
02:01:01,387 --> 02:01:03,155
SO THE QUESTION BECOMES HERE,

2652
02:01:03,222 --> 02:01:04,924
WHAT EQUATION DO WE USE FOR

2653
02:01:04,991 --> 02:01:06,359
GENDER MINORITY PEOPLE?

2654
02:01:06,425 --> 02:01:07,994
WHAT EQUATION DO WE USE FOR

2655
02:01:08,060 --> 02:01:10,262
PEOPLE WHO ARE NON-BINARY?

2656
02:01:10,329 --> 02:01:13,332
SHOULD WE STILL BE USING THE SEX

2657
02:01:13,399 --> 02:01:14,900
THEY WERE ASSIGNED AT BIRTH OR

2658
02:01:14,967 --> 02:01:16,102
THEIR CURRENT GENDER IDENTITY?

2659
02:01:16,168 --> 02:01:17,703
WHAT IF THEY'VE BEEN ON

2660
02:01:17,770 --> 02:01:18,638
GENDER-AFFIRMING HORMONES FOR

2661
02:01:18,704 --> 02:01:20,006
FIVE YEARS AND THEY'RE A TRANS

2662
02:01:20,072 --> 02:01:24,944
MAN TAKING SESS  TESTOSTERONE FR

2663
02:01:25,011 --> 02:01:29,849
YEARS AND YEARS, BUT I DO WONDER

2664
02:01:29,915 --> 02:01:36,088
IF CYST STATIN C QUESTIONS -- IF

2665
02:01:36,155 --> 02:01:37,723
ONES THAT DON'T USE CREATININE

2666
02:01:37,790 --> 02:01:39,158
AT ALL ARE ACTUALLY GOING TO BE

2667
02:01:39,225 --> 02:01:41,327
AN ANSWER FOR ACCURATELY

2668
02:01:41,394 --> 02:01:44,864
ESTIMATING GFR GOING FORWARD.

2669
02:01:44,930 --> 02:01:52,838
SO -- AVAILABLE AT EVERY

2670
02:01:52,905 --> 02:01:54,473
LAB.

2671
02:01:54,540 --> 02:01:57,109
SO WHEN WE LOOK AT THE RACE

2672
02:01:57,176 --> 02:01:58,944
VALUES, WE LOOK ACROSS THE TOP,

2673
02:01:59,011 --> 02:01:59,745
FOR FOLKS WHO ARE AFRICAN

2674
02:01:59,812 --> 02:02:00,780
AMERICAN, WHEN WE WERE USING THE

2675
02:02:00,846 --> 02:02:02,548
OLD EQUATIONS, THEY ACTUALLY

2676
02:02:02,615 --> 02:02:05,084
NEEDED HIGHER DOSES OF DRUGS,

2677
02:02:05,151 --> 02:02:06,719
THEY GOT WAIT LISTED FOR

2678
02:02:06,786 --> 02:02:07,720
TRANSPLANT LATER, THEY GOT

2679
02:02:07,787 --> 02:02:10,756
REFERRED TO A NEPHROLOGIST LATER

2680
02:02:10,823 --> 02:02:12,191
AND THEY STARTED DIALYSIS LATER.

2681
02:02:12,258 --> 02:02:13,526
SO THIS WAS ONE OF THE KEY

2682
02:02:13,592 --> 02:02:16,028
REASONS TO GET RID OF THE RACE

2683
02:02:16,095 --> 02:02:18,431
MODIFIER IN THE EGFR EQUATION SO

2684
02:02:18,497 --> 02:02:20,032
NOW WE NEED TO START LOOKING AT

2685
02:02:20,099 --> 02:02:22,034
WHAT WOULD HAPPEN FOR GENDER

2686
02:02:22,101 --> 02:02:24,336
MINORITY FOLKS, ESPECIALLY THOSE

2687
02:02:24,403 --> 02:02:26,305
ON GENDER-AFFIRMING HORMONES.

2688
02:02:26,372 --> 02:02:28,174
SO MY LAST SLIDE TO WRAP UP IS

2689
02:02:28,240 --> 02:02:30,142
MOST OF THE THINGS THAT I HOPE I

2690
02:02:30,209 --> 02:02:31,444
SHARED WITH YOU IS THAT WE

2691
02:02:31,510 --> 02:02:33,646
REALLY REMAIN UNDERSERVED UNTIL

2692
02:02:33,713 --> 02:02:35,948
THERE IS IMPROVED SEXUAL

2693
02:02:36,015 --> 02:02:37,383
ORIENTATION AND GENDER IDENTITY

2694
02:02:37,450 --> 02:02:38,250
COLLECTION THAT'S HAPPENING AT

2695
02:02:38,317 --> 02:02:40,219
BOTH THE LOCAL AND THE FEDERAL

2696
02:02:40,286 --> 02:02:41,420
LEVEL.

2697
02:02:41,487 --> 02:02:42,822
WE NEED MUCH MORE RESEARCH IN

2698
02:02:42,888 --> 02:02:44,156
THIS AREA BECAUSE THERE'S VERY,

2699
02:02:44,223 --> 02:02:46,859
VERY LITTLE, AND NOW LOOKING

2700
02:02:46,926 --> 02:02:49,495
FORWARD, IF NON-CREATININE-BASED

2701
02:02:49,562 --> 02:02:51,363
EGFR MEASUREMENTS ARE GOING TO

2702
02:02:51,430 --> 02:02:53,566
BE THE SOLUTION TO HELP

2703
02:02:53,632 --> 02:02:55,201
DESCRIBING THE KIDNEY DISEASE

2704
02:02:55,267 --> 02:02:56,736
BURDEN, ESPECIALLY AMONG GENDER

2705
02:02:56,802 --> 02:02:57,703
MINORITY POPULATIONS GOING

2706
02:02:57,770 --> 02:02:58,471
FORWARD.

2707
02:02:58,537 --> 02:03:00,206
THAO SO MUCH.

2708
02:03:00,272 --> 02:03:02,541
HAPPY TO SEND SLIDES TO ANYBODY.

2709
02:03:02,608 --> 02:03:08,547
[APPLAUSE]

2710
02:03:08,614 --> 02:03:13,219
>> FINALLY WE HAVE DR. LEONARD

2711
02:03:13,285 --> 02:03:14,754
EGEDE WHO WILL BE SPEAKING ABOUT

2712
02:03:14,820 --> 02:03:16,522
STRUCTURAL RACISM AND DIABETES

2713
02:03:16,589 --> 02:03:21,026
OUTCOMES.

2714
02:03:21,093 --> 02:03:23,829
>> I KNOW I'M THE LAST ONE SO I

2715
02:03:23,896 --> 02:03:28,434
WANT TO START BY THANKING THE

2716
02:03:28,501 --> 02:03:30,402
GROUP, COMMUNITY MEMBERS BECAUSE

2717
02:03:30,469 --> 02:03:32,805
I THINK WE SOMETIMES DO NOT

2718
02:03:32,872 --> 02:03:34,106
APPRECIATE THE LIVED EXPERIENCE,

2719
02:03:34,173 --> 02:03:35,875
HOW WE INCORPORATE THAT INTO

2720
02:03:35,941 --> 02:03:37,743
RESEARCH, SO I REALLY LIKED THAT

2721
02:03:37,810 --> 02:03:38,277
PERSPECTIVE.

2722
02:03:38,344 --> 02:03:43,849
WE USE THAT -- SO MY WORK IS

2723
02:03:43,916 --> 02:03:47,353
REALLY -- TO THE POINT WHERE THE

2724
02:03:47,419 --> 02:03:53,058
MORE YOU LOOK -- YOU REALIZE

2725
02:03:53,125 --> 02:03:55,027
EVERYTHING IS UPSTREAM.

2726
02:03:55,094 --> 02:03:57,096
YOU STILL FOCUS ON DOWNSTREAM,

2727
02:03:57,163 --> 02:03:59,732
WE DON'T PAY ATTENTION TO

2728
02:03:59,799 --> 02:04:00,933
STRUCTURES, I'M TRYING TO FIND

2729
02:04:01,000 --> 02:04:04,737
OUT HOW DO WE DO THIS AT A

2730
02:04:04,804 --> 02:04:06,739
LARGER SCALE AS OPPOSED TO THE

2731
02:04:06,806 --> 02:04:17,149
INDIVIDUAL PATIENT.

2732
02:04:18,017 --> 02:04:19,852
DISCLOSURES, A LOT OF SOCIAL

2733
02:04:19,919 --> 02:04:23,889
ISSUES TIED TO IT, A LOT OF --

2734
02:04:23,956 --> 02:04:26,725
AND IT -- A VERY NICE MODEL TO

2735
02:04:26,792 --> 02:04:27,927
REALLY UNDERSTAND HOW SOME OF

2736
02:04:27,993 --> 02:04:31,330
THIS STUFF IS BUILT.

2737
02:04:31,397 --> 02:04:32,665
WHAT YOU SEE HERE IS RACIAL

2738
02:04:32,731 --> 02:04:33,899
DISPARITIES IN DIABETES, IF YOU

2739
02:04:33,966 --> 02:04:38,671
LOOK AT THE AVERAGE, ABOUT 15%

2740
02:04:38,737 --> 02:04:40,840
IN THE U.S., BY RACE.

2741
02:04:40,906 --> 02:04:42,474
BY GENDER YOU ACTUALLY SEE SOME

2742
02:04:42,541 --> 02:04:43,576
DIFFERENCES ESPECIALLY FOR

2743
02:04:43,642 --> 02:04:44,577
MINORITY GROUPS.

2744
02:04:44,643 --> 02:04:46,912
SO THERE IS A MINORITY-DRIVEN

2745
02:04:46,979 --> 02:04:48,280
DIFFERENCE IN SOME OF THESE

2746
02:04:48,347 --> 02:04:51,450
FACTORS.

2747
02:04:51,517 --> 02:04:52,885
SO I'LL GO RIGHT INTO

2748
02:04:52,952 --> 02:04:53,886
DEFINITIONS MOST PEOPLE USE.

2749
02:04:53,953 --> 02:04:57,156
WE USE ONE OF THEM EQUALLY,

2750
02:04:57,223 --> 02:04:59,558
SO -- BUT KEY THING TO

2751
02:04:59,625 --> 02:05:00,659
UNDERSTAND IS THIS IS ABOUT

2752
02:05:00,726 --> 02:05:00,993
POWER.

2753
02:05:01,060 --> 02:05:02,928
IT DOESN'T MATTER HOW YOU DEFINE

2754
02:05:02,995 --> 02:05:12,938
IT, IT'S REALLY -- I THINK IT'S

2755
02:05:13,005 --> 02:05:15,574
JUST -- TWO CONCEPTS I REALLY

2756
02:05:15,641 --> 02:05:16,775
WANT YOU TO APPRECIATE, SO ONE

2757
02:05:16,842 --> 02:05:20,579
IS THE CONCEPT AND THIS IS WORK

2758
02:05:20,646 --> 02:05:22,348
OF -- WHICH I THINK IS REALLY

2759
02:05:22,414 --> 02:05:24,950
SESEMINAL IN HELPING US UNDERSTD

2760
02:05:25,017 --> 02:05:26,051
THE SPECIES.

2761
02:05:26,118 --> 02:05:28,454
ONE IS DE FACTO, TRUE IN FACT

2762
02:05:28,520 --> 02:05:29,889
BUT NOT OFFICIALLY SANCTIONED,

2763
02:05:29,955 --> 02:05:31,290
RESULT OF PRIVATE PRACTICE AND

2764
02:05:31,357 --> 02:05:31,957
PERSONAL PREFERENCE OR

2765
02:05:32,024 --> 02:05:33,926
INDIVIDUAL CHOICE, NOT THE

2766
02:05:33,993 --> 02:05:35,594
RESULT OF GOVERNMENT POLICY.

2767
02:05:35,661 --> 02:05:39,164
THE OTHER IS DE JURE, SANCTIONED

2768
02:05:39,231 --> 02:05:40,165
BY LAW AND PUBLIC POLICY.

2769
02:05:40,232 --> 02:05:42,334
I THINK WHAT IS IMPORTANT IS

2770
02:05:42,401 --> 02:05:45,738
THAT WITHOUT GOVERNMENT AND LAW,

2771
02:05:45,804 --> 02:05:47,806
PREJUDICE HAS LESS OPPORTUNITY

2772
02:05:47,873 --> 02:05:50,109
FOR EXPRESSION.

2773
02:05:50,175 --> 02:05:53,612
SO AS WE -- WE HAVE TO

2774
02:05:53,679 --> 02:05:55,381
UNDERSTAND INDIVIDUAL

2775
02:05:55,447 --> 02:05:56,682
PREFERENCES AND -- WHEN IT'S

2776
02:05:56,749 --> 02:05:57,883
ACTUALLY SANCTIONED BY LAW, IT

2777
02:05:57,950 --> 02:06:00,386
BECOMES A BIGGER ISSUE.

2778
02:06:00,452 --> 02:06:01,720
THESE ARE EXAMPLES MANY OF YOU

2779
02:06:01,787 --> 02:06:04,223
ARE FAMILIAR WITH THIS.

2780
02:06:04,290 --> 02:06:05,391
HOUSING AND RESIDENTIAL

2781
02:06:05,457 --> 02:06:08,160
SEGREGATION DUE TO HISTORIC RED

2782
02:06:08,227 --> 02:06:13,632
LINING, THE IDEA THAT EDUCATION

2783
02:06:13,699 --> 02:06:14,733
BASED ON HOUSING IN THE TAX

2784
02:06:14,800 --> 02:06:17,136
BASE, WHEN YOU DO THAT YOU

2785
02:06:17,202 --> 02:06:24,576
REALLY PERPETRATE DISCRIMINATION

2786
02:06:24,643 --> 02:06:29,281
AND -- BECAUSE OF THAT.

2787
02:06:29,348 --> 02:06:32,117
AND THEN STATE SANCTIONED

2788
02:06:32,184 --> 02:06:36,922
VIOLENCE, IT'S A JUDICIAL SYSTEM

2789
02:06:36,989 --> 02:06:39,992
THAT'S JUST NOT FAIR.

2790
02:06:40,059 --> 02:06:41,860
ACTUALLY FACTORS THAT LED TO

2791
02:06:41,927 --> 02:06:43,595
SOME OF THESE DIFFERENCES.

2792
02:06:43,662 --> 02:06:45,230
SO I WANT TO SPEND SOME TIME

2793
02:06:45,297 --> 02:06:48,300
TALKING ABOUT RED LINING.

2794
02:06:48,367 --> 02:06:52,471
SOME PEOPLE -- WE RECOGNIZE THAT

2795
02:06:52,538 --> 02:06:54,773
REDLINING IS AN EXPRESSION OF

2796
02:06:54,840 --> 02:06:58,043
STRUCTURAL RACISM.

2797
02:06:58,110 --> 02:07:00,779
IT'S NOT -- ALLOWS US TO

2798
02:07:00,846 --> 02:07:01,947
ACTUALLY IDENTIFY THE EXPRESSION

2799
02:07:02,014 --> 02:07:04,483
OF STRUCTURAL RACISM AND HOW IT

2800
02:07:04,550 --> 02:07:05,684
ACTUALLY IMPACTS HEALTH AND

2801
02:07:05,751 --> 02:07:06,685
HEALTH OUTCOMES.

2802
02:07:06,752 --> 02:07:09,288
SO THIS IS SOMETHING THAT WAS

2803
02:07:09,355 --> 02:07:11,824
FORMALIZED IN 1934 BY THE

2804
02:07:11,890 --> 02:07:12,725
FEDERAL HOUSING ADMINISTRATION,

2805
02:07:12,791 --> 02:07:14,827
IT WAS LATER PROHIBITED IN THE

2806
02:07:14,893 --> 02:07:16,528
FAIR HOUSING ACT OF 1968.

2807
02:07:16,595 --> 02:07:20,899
AT THAT TIME, A WAS COLORED

2808
02:07:20,966 --> 02:07:22,534
GREEN, B WAS STILL DESIRABLE,

2809
02:07:22,601 --> 02:07:23,635
COLOR BLUE.

2810
02:07:23,702 --> 02:07:25,504
C WAS DECLINING, COLORED YELLOW,

2811
02:07:25,571 --> 02:07:28,340
AND D WAS HAZARDOUS, COLORED

2812
02:07:28,407 --> 02:07:29,775
RED, THE TERM REDLINING.

2813
02:07:29,842 --> 02:07:31,510
SO WHAT WE HAVE TRIED TO DO IS

2814
02:07:31,577 --> 02:07:34,279
TO UNDERSTAND HOW DOES THIS

2815
02:07:34,346 --> 02:07:37,883
HISTORIC EVENT REALLY PLAY OUT

2816
02:07:37,950 --> 02:07:38,751
TODAY.

2817
02:07:38,817 --> 02:07:40,953
IT'S NOT JUST ABOUT HOUSING.

2818
02:07:41,020 --> 02:07:43,355
IT'S ABOUT CREDIT, IT'S ABOUT

2819
02:07:43,422 --> 02:07:45,324
HOSPITALS.

2820
02:07:45,391 --> 02:07:49,361
IT'S ABOUT -- IT'S ABOUT

2821
02:07:49,428 --> 02:07:49,795
EDUCATION.

2822
02:07:49,862 --> 02:07:51,663
SO IT'S VERY MUCH INTEGRAL TO SO

2823
02:07:51,730 --> 02:07:52,965
MANY FACTORS WE TALK ABOUT IN

2824
02:07:53,032 --> 02:07:56,268
TERMS OF PUBLIC POLICY, IT'S

2825
02:07:56,335 --> 02:08:01,607
ALSO ABOUT POWER -- INFORMATION.

2826
02:08:01,673 --> 02:08:03,142
SO TO LOOK AT THE RELATIONSHIP

2827
02:08:03,208 --> 02:08:08,514
BETWEEN REDLINING AND PRESENT

2828
02:08:08,580 --> 02:08:14,420
DAY DIABETES.

2829
02:08:14,486 --> 02:08:23,362
-- TH CREATED -- WE LOOKED AT -

2830
02:08:23,429 --> 02:08:25,564
FIVE YEARS OF DATA.

2831
02:08:25,631 --> 02:08:26,565
THIS IS SOMETHING THAT'S

2832
02:08:26,632 --> 02:08:30,069
IMPORTANT, THIS IS -- WHAT YOU

2833
02:08:30,135 --> 02:08:33,238
FIND IS THAT IF YOU LOOK AT 1990

2834
02:08:33,305 --> 02:08:40,145
TO 2014 IN TERMS OF -- AS YOU GO

2835
02:08:40,212 --> 02:08:41,814
FROM GREEN TO RED, YOUR

2836
02:08:41,880 --> 02:08:44,850
MORTALITY INCREASES AND YEARS OF

2837
02:08:44,917 --> 02:08:47,586
LIFE LOSS INCREASES.

2838
02:08:47,653 --> 02:08:50,222
WHAT WAS ACTUALLY MORE

2839
02:08:50,289 --> 02:08:54,159
CONCERNING WAS -- 2014, YOU SEE

2840
02:08:54,226 --> 02:09:01,400
IT AFFECTS - -- ACTUALLY SUSTAID

2841
02:09:01,467 --> 02:09:05,471
OVER TIME, SO PERSISTENT OVER

2842
02:09:05,537 --> 02:09:08,273
TIME -- YOU SEE THE EFFECTS OF

2843
02:09:08,340 --> 02:09:09,908
REDLINING.

2844
02:09:09,975 --> 02:09:13,412
AND THEN WE NEXT -- LOOKING AT

2845
02:09:13,479 --> 02:09:15,814
WHAT'S OUT THERE IN THE

2846
02:09:15,881 --> 02:09:16,915
LITERATURE IN TERMS OF

2847
02:09:16,982 --> 02:09:18,217
STRUCTURAL RACISM AND DIABETES

2848
02:09:18,283 --> 02:09:21,487
OUTCOMES.

2849
02:09:21,553 --> 02:09:26,425
SO CYST TI MATIC REVIEW, USING

2850
02:09:26,492 --> 02:09:28,827
THE -- MODEL TO ACTUALLY ASK THE

2851
02:09:28,894 --> 02:09:32,331
QUESTION CAN WE CLASSIFY SOME OF

2852
02:09:32,397 --> 02:09:35,501
THESE -- WHAT WE FOUND WAS THAT

2853
02:09:35,567 --> 02:09:39,671
STRUCTURAL RACISM AS YOU DEFINE

2854
02:09:39,738 --> 02:09:44,042
IT -- WAS -- LOWER STANDARDS OF

2855
02:09:44,109 --> 02:09:45,477
CARE AND HIGHER MORTALITY AND

2856
02:09:45,544 --> 02:09:47,012
YEARS OF LIFE LOST.

2857
02:09:47,079 --> 02:09:48,547
WHAT WAS MISSING AND WHAT'S

2858
02:09:48,614 --> 02:09:50,182
STILL MISSING IS THE PATHWAYS.

2859
02:09:50,249 --> 02:09:53,986
BECAUSE WITHOUT PATHWAYS, WE

2860
02:09:54,052 --> 02:09:55,854
CANNOT TALK ABOUT INTERVENTION.

2861
02:09:55,921 --> 02:09:57,389
SO WHAT WE TRIED TO DO WAS TO

2862
02:09:57,456 --> 02:10:03,195
FIND OUT COULD WE ACCESS AT THE

2863
02:10:03,262 --> 02:10:05,497
NATIONAL LEVEL -- SO WE USED A

2864
02:10:05,564 --> 02:10:09,001
LOT OF CENSUS DATA, ALMOST 3,000

2865
02:10:09,067 --> 02:10:12,171
CENSUS TRACTS ACROSS THE UNITED

2866
02:10:12,237 --> 02:10:13,472
STATES -- REDLINING AND WE

2867
02:10:13,539 --> 02:10:16,441
ACTUALLY USED STRUCTURED MODEL

2868
02:10:16,508 --> 02:10:18,944
TO IDENTIFY DIRECT AND INDIRECT

2869
02:10:19,011 --> 02:10:19,945
PATHWAYS.

2870
02:10:20,012 --> 02:10:20,712
PUBLISHED IN DIABETES CARE.

2871
02:10:20,779 --> 02:10:22,447
THIS IS WHAT WE FOUND.

2872
02:10:22,514 --> 02:10:25,617
SO WHAT'S INTERESTING IS THAT,

2873
02:10:25,684 --> 02:10:31,323
YOU KNOW, THIS IS A PATH

2874
02:10:31,390 --> 02:10:34,927
ANALYSIS, ALL OF THE PATHWAYS,

2875
02:10:34,993 --> 02:10:36,995
INCARCERATION, POVERTY,

2876
02:10:37,062 --> 02:10:38,230
DISCRIMINATION, SUBSTANCE ABUSE

2877
02:10:38,297 --> 02:10:40,065
OR SUBSTANCE USE DISORDER,

2878
02:10:40,132 --> 02:10:41,833
HOUSING INSTABILITY, EDUCATION,

2879
02:10:41,900 --> 02:10:43,802
UNEMPLOYMENT, REDLINING HAD A

2880
02:10:43,869 --> 02:10:44,803
NEGATIVE EFFECT ON THOSE

2881
02:10:44,870 --> 02:10:45,637
FACTORS.

2882
02:10:45,704 --> 02:10:49,174
AND THOSE FACTORS HAD AN EFFECT

2883
02:10:49,241 --> 02:10:50,676
ON PREVALENCE OF DIABETES.

2884
02:10:50,742 --> 02:10:53,078
SO IT WASN'T JUST REDLINING THAT

2885
02:10:53,145 --> 02:10:53,745
WAS THE ISSUE.

2886
02:10:53,812 --> 02:10:55,614
IT WAS WHAT REDLINING ACTUALLY

2887
02:10:55,681 --> 02:10:57,683
LED TO THAT DROVE SOME OF THOSE

2888
02:10:57,749 --> 02:10:58,350
OUTCOMES.

2889
02:10:58,417 --> 02:11:01,286
SO THIS IS GETTING US ANOTHER

2890
02:11:01,353 --> 02:11:03,055
CHANCE TO ASK REAL SCIENTIFIC

2891
02:11:03,121 --> 02:11:03,956
QUESTIONS BECAUSE ONE OF THE

2892
02:11:04,022 --> 02:11:11,463
THINGS I HEAR IS THIS IS SO --

2893
02:11:11,530 --> 02:11:14,099
BECAUSE THIS IS REAL -- TO BRING

2894
02:11:14,166 --> 02:11:14,733
ABOUT CHANGE.

2895
02:11:14,800 --> 02:11:19,638
SO THIS JUST CAME OUT, AND SO

2896
02:11:19,705 --> 02:11:21,974
NOW WE HAVE TWO NIH GRANTS, AND

2897
02:11:22,040 --> 02:11:23,942
WE ACTUALLY LOOK AT THIS FROM

2898
02:11:24,009 --> 02:11:26,144
THE STANDPOINT OF WHAT CAN WE

2899
02:11:26,211 --> 02:11:26,712
DO.

2900
02:11:26,778 --> 02:11:30,749
IT'S NOT JUST ENOUGH TO -- SO

2901
02:11:30,816 --> 02:11:35,020
THE FIRST GRANT IS LOOKING AT --

2902
02:11:35,087 --> 02:11:40,525
CONVERSATION ABOUT -- ONE WAS

2903
02:11:40,592 --> 02:11:42,894
LOOKING AT PATHWAYS, SOCIAL

2904
02:11:42,961 --> 02:11:44,863
RISK, HUMAN CAPITAL, HEALTHCARE

2905
02:11:44,930 --> 02:11:46,265
RESOURCES, AND THE GOAL OF THIS

2906
02:11:46,331 --> 02:11:47,699
STUDY IS TO ACTUALLY IDENTIFY

2907
02:11:47,766 --> 02:11:53,739
THE RELATIONSHIP OF REGIONAL

2908
02:11:53,805 --> 02:11:56,241
EXPOSURE TO STRUCTURAL RACISM.

2909
02:11:56,308 --> 02:12:00,245
AND TO IDENTIFY -- USING -- OF

2910
02:12:00,312 --> 02:12:03,915
THE LITERATURE, ONE OF THE KEY

2911
02:12:03,982 --> 02:12:06,218
THINGS -- TO IDENTIFY AND

2912
02:12:06,285 --> 02:12:08,086
PRIORITIZE STRATEGIES.

2913
02:12:08,153 --> 02:12:09,721
WHAT SHOULD WE PRIORITIZE, WHAT

2914
02:12:09,788 --> 02:12:11,156
SHOULD WE BE DOING, WHAT TYPES

2915
02:12:11,223 --> 02:12:13,659
OF INTERVENTIONS AT THE POLICY

2916
02:12:13,725 --> 02:12:14,893
LEVEL WILL HAVE THE MOST IMPACT.

2917
02:12:14,960 --> 02:12:17,963
SO AS WE DO THIS WORK -- THAT

2918
02:12:18,030 --> 02:12:20,999
PEOPLE CAN ACTUALLY WORK ON AT A

2919
02:12:21,066 --> 02:12:22,334
NATIONAL LEVEL.

2920
02:12:22,401 --> 02:12:31,610
THE SECOND ONE IS TIED TO --

2921
02:12:31,677 --> 02:12:36,548
MORE POSSIBILITIES -- SOME OF

2922
02:12:36,615 --> 02:12:40,252
THE EFFECTS OF CREDIT AND

2923
02:12:40,319 --> 02:12:42,754
REDLINING AND -- IN COMMUNITIES

2924
02:12:42,821 --> 02:12:43,989
WHERE THERE'S NO BENEFIT FOR

2925
02:12:44,056 --> 02:12:47,693
THOSE WHO ARE INVESTING.

2926
02:12:47,759 --> 02:12:50,862
SO -- HOSPITALS -- IT'S NOT

2927
02:12:50,929 --> 02:12:51,863
FINANCIALLY VIABLE FOR THEM TO

2928
02:12:51,930 --> 02:12:55,133
STAY INTEREST.

2929
02:12:55,200 --> 02:12:56,568
STAY THERE SO WE ARE TRYING TO

2930
02:12:56,635 --> 02:12:58,970
UNDERSTAND WHAT'S HAPPENING TO

2931
02:12:59,037 --> 02:13:00,605
THESE, HOW DO -- FACTORS PLAY A

2932
02:13:00,672 --> 02:13:01,940
ROLE, WHAT ARE SOME

2933
02:13:02,007 --> 02:13:03,108
INTERVENTIONS THAT CAN BE PUT IN

2934
02:13:03,175 --> 02:13:04,876
PLACE, WHAT ARE COMMUNITIES

2935
02:13:04,943 --> 02:13:06,311
DOING, HOW DO YOU ADVOCATE, AND

2936
02:13:06,378 --> 02:13:08,046
WHAT EVIDENCE DO YOU NEED TO

2937
02:13:08,113 --> 02:13:14,386
HAVE TO ADVOCATE -- ISSUE.

2938
02:13:14,453 --> 02:13:16,288
SO I'M GOING TO SUMMARIZE AND

2939
02:13:16,355 --> 02:13:17,789
JUST SAY WHEN WE TALK ABOUT

2940
02:13:17,856 --> 02:13:20,992
HISTORIC REDLINING -- STILL

2941
02:13:21,059 --> 02:13:21,526
PRESENT TODAY.

2942
02:13:21,593 --> 02:13:25,497
WE DON'T HAVE A PERFECT -- FOR

2943
02:13:25,564 --> 02:13:26,465
STRUCTURAL -- BUT WE'VE HAD

2944
02:13:26,531 --> 02:13:27,232
ENOUGH.

2945
02:13:27,299 --> 02:13:32,404
WE KNOW ENOUGH TO ACTUALLY START

2946
02:13:32,471 --> 02:13:32,637
ACTING.

2947
02:13:32,704 --> 02:13:35,340
WE CAN'T KEEP WAITING FOR MORE

2948
02:13:35,407 --> 02:13:38,076
MEASURES TO DO SOMETHING, SO --

2949
02:13:38,143 --> 02:13:39,344
GIVE US INFORMATION, WE NEED TO

2950
02:13:39,411 --> 02:13:41,046
ACT ON WHAT WE KNOW AND WHAT WE

2951
02:13:41,113 --> 02:13:41,613
CAN DO TODAY.

2952
02:13:41,680 --> 02:13:45,250
THANK YOU.

2953
02:13:45,317 --> 02:13:50,255
[APPLAUSE]

2954
02:13:50,322 --> 02:13:51,790
>> THANK YOU TO OUR PANELISTS.

2955
02:13:51,857 --> 02:13:53,525
NOW WE HAVE TIME FOR QUESTIONS,

2956
02:13:53,592 --> 02:13:55,093
COMMENTS, CONCERNS, QUERIES,

2957
02:13:55,160 --> 02:14:04,236
COMPLIMENTS.

2958
02:14:04,302 --> 02:14:06,405
>> HI.

2959
02:14:06,471 --> 02:14:07,506
I'M DEBBIE, COMPLIMENTS TO ALL

2960
02:14:07,572 --> 02:14:09,708
OF YOU.

2961
02:14:09,775 --> 02:14:11,042
QUESTION FOR DR. LEWIS.

2962
02:14:11,109 --> 02:14:12,911
I'M CURIOUS ABOUT WHETHER OR NOT

2963
02:14:12,978 --> 02:14:14,279
THERE'S ASSOCIATIONS WITH OTHER

2964
02:14:14,346 --> 02:14:17,816
TYPES OF AUTOIMMUNE DISEASE

2965
02:14:17,883 --> 02:14:21,853
OTHER THAN SLE AND WHAT THAT

2966
02:14:21,920 --> 02:14:25,791
MIGHT -- [INAUDIBLE]

2967
02:14:25,857 --> 02:14:27,426
>> ARE THERE ASSOCIATIONS

2968
02:14:27,492 --> 02:14:30,162
BETWEEN OTHER AUTOIMMUNE DISEASE

2969
02:14:30,228 --> 02:14:31,463
AND CARDIOVASCULAR DISEASE OR --

2970
02:14:31,530 --> 02:14:34,533
OKAY.

2971
02:14:34,599 --> 02:14:37,169
SO I THINK THERE ARE

2972
02:14:37,235 --> 02:14:38,470
ASSOCIATIONS BETWEEN, FOR

2973
02:14:38,537 --> 02:14:39,704
EXAMPLE, RHEUMATOID ARTHRITIS

2974
02:14:39,771 --> 02:14:41,740
AND A FEW OTHERS, AND A LOT OF

2975
02:14:41,807 --> 02:14:44,042
IT IS AUTOIMMUNITY IS USUALLY AN

2976
02:14:44,109 --> 02:14:46,545
INFLAMMATORY PROCESS, AND

2977
02:14:46,611 --> 02:14:48,847
INFLAMMATORY MARKERS ARE KNOWN

2978
02:14:48,914 --> 02:14:51,149
CONTRIBUTORS TO PLAQUE AND ALL

2979
02:14:51,216 --> 02:14:53,351
SORTS OF OTHER SORT OF PATHWAYS

2980
02:14:53,418 --> 02:14:58,890
THAT LEAD TO ATHEROGENESIS AND

2981
02:14:58,957 --> 02:15:00,225
ALL SORTS OF POOR OUTCOMES, SO

2982
02:15:00,292 --> 02:15:01,927
NOT JUST CARDIOVASCULAR OUTCOMES

2983
02:15:01,993 --> 02:15:04,729
BUT PROBABLY ALSO KIDNEY

2984
02:15:04,796 --> 02:15:05,430
OUTCOMES AS WELL.

2985
02:15:05,497 --> 02:15:10,535
I THINK WHAT IS UNIQUE ABOUT SLE

2986
02:15:10,602 --> 02:15:12,604
IS THE MULTI-SYSTEMIC NATURE OF

2987
02:15:12,671 --> 02:15:17,309
IT, AND IT MANIFESTS DIFFERENTLY

2988
02:15:17,375 --> 02:15:18,610
FOR DIFFERENT PEOPLE, AND IT

2989
02:15:18,677 --> 02:15:21,046
INTERESTING AS YOU WERE

2990
02:15:21,112 --> 02:15:24,983
TALKING -- MY MY CO-PANELIST WAS

2991
02:15:25,050 --> 02:15:26,318
TALKING ABOUT NEEDING TO REMOVE

2992
02:15:26,384 --> 02:15:28,386
THE SEX-SPECIFIC WEIGHT TO EGFR,

2993
02:15:28,453 --> 02:15:30,455
I WAS THINKING PERHAPS FOR SLE,

2994
02:15:30,522 --> 02:15:31,656
WE WOULD NOT DO THAT, BECAUSE IT

2995
02:15:31,723 --> 02:15:35,861
IS A DISEASE THAT IS

2996
02:15:35,927 --> 02:15:37,496
PREDOMINANTLY -- ONSET IS OFTEN

2997
02:15:37,562 --> 02:15:38,797
AROUND PUBERTY, WE KNOW THERE'S

2998
02:15:38,864 --> 02:15:39,898
A HORMONAL COMPONENT.

2999
02:15:39,965 --> 02:15:43,835
THERE IS SOMETHING -- AUTOIMMUNE

3000
02:15:43,902 --> 02:15:45,170
DISEASES IN GENERAL ARE MORE

3001
02:15:45,237 --> 02:15:49,107
AREPREVALENT AMONG WOMEN.

3002
02:15:49,174 --> 02:15:51,610
THAT IS PARTICULARLY TREUL FOR

3003
02:15:51,676 --> 02:15:55,447
SLE AND IT IS PARTICULARLY A

3004
02:15:55,514 --> 02:15:56,214
BLACK WOMAN'S DISEASE.

3005
02:15:56,281 --> 02:15:57,749
FOR REASONS THAT I THINK WE'RE

3006
02:15:57,816 --> 02:15:59,718
STILL GRA PEPPING WELL, I DON'T

3007
02:15:59,784 --> 02:16:00,852
THINK THERE'S AS MUCH ATTENTION

3008
02:16:00,919 --> 02:16:01,720
GIVEN TO THAT DISEASE BECAUSE OF

3009
02:16:01,786 --> 02:16:03,188
THE POPULATION THAT IT IMPACTS,

3010
02:16:03,255 --> 02:16:05,557
QUITE FRANKLY.

3011
02:16:05,624 --> 02:16:07,726
BUT I HAVE A NEPHROLOGY

3012
02:16:07,792 --> 02:16:09,361
COLLEAGUE IN THE FRONT LOW WHO

3013
02:16:09,427 --> 02:16:14,933
IS LOOKING PENSIVE WHO MAY HAVE

3014
02:16:15,000 --> 02:16:18,770
MORE ABOUT THAT, I DON'T KNOW.

3015
02:16:18,837 --> 02:16:20,639
>>  -- THAT WE NEED TO SORT OF

3016
02:16:20,705 --> 02:16:23,275
FOLLOW UP WITH IN ADDITION TO

3017
02:16:23,341 --> 02:16:25,677
HORMONES AND PUBERTAL ONSET

3018
02:16:25,744 --> 02:16:26,978
IS -- I WANT TO GIVE A SHOUT OUT

3019
02:16:27,045 --> 02:16:29,948
TO THE CHROMOSOMES X AND Y, AND

3020
02:16:30,015 --> 02:16:32,584
THERE'S SO MUCH IMMUNE-RELATED

3021
02:16:32,651 --> 02:16:33,885
GENES, WE DON'T REALLY

3022
02:16:33,952 --> 02:16:36,721
UNDERSTAND A LOT OF THE

3023
02:16:36,788 --> 02:16:38,490
EPIGENETIC INTERACTION OF LIFE

3024
02:16:38,557 --> 02:16:41,760
EXPERIENCES, CHRONIC ADVERSITY,

3025
02:16:41,826 --> 02:16:44,262
TRAUMA, THAT MAY ALSO PLAY A LOT

3026
02:16:44,329 --> 02:16:45,931
INTO THE RISK, IN ADDITION TO

3027
02:16:45,997 --> 02:16:52,637
THE HORMONES.

3028
02:16:52,704 --> 02:16:56,441
>> I'LL JUST MAKE A COMMENT

3029
02:16:56,508 --> 02:16:59,411
ABOUT THE SEX OR GENDER MODIFIER

3030
02:16:59,477 --> 02:17:02,380
IN EGFR.

3031
02:17:02,447 --> 02:17:04,115
SO IT'S SOMETHING WE'RE GOING TO

3032
02:17:04,182 --> 02:17:10,021
NEED TO LOOK AT VERY CLOSELY.

3033
02:17:10,088 --> 02:17:12,891
THE FORMULAS WE HAVE SAY THAT AT

3034
02:17:12,958 --> 02:17:14,960
A GROUP LEVEL, THERE ARE SOME

3035
02:17:15,026 --> 02:17:18,263
DIFFERENCES AMONGST THE GROUPS.

3036
02:17:18,330 --> 02:17:19,464
THE VARIATION COULD BE VERY

3037
02:17:19,531 --> 02:17:22,867
SUBSTANTIAL.

3038
02:17:22,934 --> 02:17:26,037
AND PROBABLY OVER TIME, A LOT OF

3039
02:17:26,104 --> 02:17:28,139
IT EARLY ON MAY HAVE BEEN DUE TO

3040
02:17:28,206 --> 02:17:30,208
MAJOR DIFFERENCES IN BODY MASS

3041
02:17:30,275 --> 02:17:31,509
BETWEEN WOMEN AND MEN.

3042
02:17:31,576 --> 02:17:33,712
SO THAT'S CHANGING, AND WE HAVE

3043
02:17:33,778 --> 02:17:37,549
SEXUAL GENDER MINORITIES.

3044
02:17:37,616 --> 02:17:41,286
SO THE QUESTION IS, IS THAT AN

3045
02:17:41,353 --> 02:17:42,721
APPROPRIATE METHODOLOGIC

3046
02:17:42,787 --> 02:17:45,123
APPROACH TO ASSIGN THE GROUP

3047
02:17:45,190 --> 02:17:46,758
LEVEL DIFFERENCES EQUALLY TO

3048
02:17:46,825 --> 02:17:49,327
EACH INDIVIDUAL OF THE GROUP?

3049
02:17:49,394 --> 02:17:51,062
YOU CAN ONLY DO THAT

3050
02:17:51,129 --> 02:17:53,131
METHODOLOGICALLY IF THE VARIABLE

3051
02:17:53,198 --> 02:17:58,870
MEETS THREE QUALITY FIXES:  IT'.

3052
02:17:58,937 --> 02:18:00,538
IT IS CONSISTENTLY MEASURED,

3053
02:18:00,605 --> 02:18:01,940
WHICH IS GOING TO BE A

3054
02:18:02,007 --> 02:18:03,241
CHALLENGE, IT IS ORDERED, THERE

3055
02:18:03,308 --> 02:18:05,977
IS AN ORDER DIFFERENCE BETWEEN

3056
02:18:06,044 --> 02:18:08,813
IT, AND IT IS CAUSALLY RELATED

3057
02:18:08,880 --> 02:18:09,914
TO THE OUTCOME OF INTEREST.

3058
02:18:09,981 --> 02:18:11,883
SO A LOT OF TIMES, THERE MAY BE

3059
02:18:11,950 --> 02:18:13,084
SOME DIFFERENCES, THERE COULD BE

3060
02:18:13,151 --> 02:18:15,487
AN ORDER, THERE COULD BE SOME

3061
02:18:15,553 --> 02:18:16,588
DIFFERENCES BETWEEN MEN AND

3062
02:18:16,655 --> 02:18:20,091
WOMEN IN DIFFERENT DISEASE

3063
02:18:20,158 --> 02:18:22,961
CONDITIONS BECAUSE OF SEX

3064
02:18:23,028 --> 02:18:25,030
HORMONES, BECAUSE OF DIFFERENT

3065
02:18:25,096 --> 02:18:28,299
LEVELS OF ESTROGEN,

3066
02:18:28,366 --> 02:18:29,200
TESTOSTERONE, ET CETERA, YET

3067
02:18:29,267 --> 02:18:30,402
THERE ARE MANY OTHER INSTANCES

3068
02:18:30,468 --> 02:18:32,170
WHERE IT WILL BE DUE TO SOCIETAL

3069
02:18:32,237 --> 02:18:34,005
DIFFERENCES THAT LEAD TO THE

3070
02:18:34,072 --> 02:18:35,240
CHANGES IN THE OUTCOME, AND

3071
02:18:35,306 --> 02:18:36,875
THOSE CANNOT BE ASSIGNED TO

3072
02:18:36,941 --> 02:18:39,511
INDIVIDUALS.

3073
02:18:39,577 --> 02:18:40,545
METHODOLOGICALLY.

3074
02:18:40,612 --> 02:18:42,013
SO I THINK IT'S SOMETHING THAT

3075
02:18:42,080 --> 02:18:43,882
WE HAVE TO WATCH CAREFULLY, AND

3076
02:18:43,948 --> 02:18:46,718
WE NEED TO REALLY THINK ABOUT

3077
02:18:46,785 --> 02:18:49,354
WHETHER OR NOT THAT MODIFIER IS

3078
02:18:49,421 --> 02:18:50,355
APPROPRIATE, AND SO I THINK

3079
02:18:50,422 --> 02:18:52,223
WE'RE GOING TO BE MOVING CLOSER

3080
02:18:52,290 --> 02:18:58,329
AND CLOSER TO THE USE OF

3081
02:18:58,396 --> 02:18:59,464
CYSTATIN PARTICULARLY FOR SEXUAL

3082
02:18:59,531 --> 02:19:01,199
AND GENDER MINORITIES, WHERE

3083
02:19:01,266 --> 02:19:05,437
OVER TIME I THINK WE HAVE TO

3084
02:19:05,503 --> 02:19:06,705
RELOOK AT THESE FORMULAS IN

3085
02:19:06,771 --> 02:19:08,106
GENERAL WHERE WE'RE GIVING

3086
02:19:08,173 --> 02:19:09,207
INDIVIDUAL LEVEL MODIFIERS FOR

3087
02:19:09,274 --> 02:19:11,509
WOMEN BECAUSE, AGAIN, FROM

3088
02:19:11,576 --> 02:19:13,812
SEXISM, THERE'S BEEN THIS

3089
02:19:13,878 --> 02:19:14,679
INHERENT SENSE THAT MEN AND

3090
02:19:14,746 --> 02:19:16,014
WOMEN ARE JUST DIFFERENT FOR

3091
02:19:16,081 --> 02:19:17,348
EVERYTHING, AND THAT -- WHILE

3092
02:19:17,415 --> 02:19:18,583
THERE ARE MAJOR DIFFERENCES, IT

3093
02:19:18,650 --> 02:19:21,453
MAY OR MAY NOT BE CAUSALLY

3094
02:19:21,519 --> 02:19:23,655
LINKED TO CERTAIN DISEASE

3095
02:19:23,722 --> 02:19:27,158
PROCESSES.

3096
02:19:27,225 --> 02:19:29,060
>> SO A QUICK ANNOUNCEMENT --

3097
02:19:29,127 --> 02:19:30,962
>> COMPLIMENTS TO THE GROUP.

3098
02:19:31,029 --> 02:19:33,064
GREAT TALKS.

3099
02:19:33,131 --> 02:19:35,066
>> FIRST I SHOULD SAY EXCELLENT

3100
02:19:35,133 --> 02:19:36,000
SERIES OF TALKS, THANK YOU VERY

3101
02:19:36,067 --> 02:19:36,201
MUCH.

3102
02:19:36,267 --> 02:19:37,368
I WANTED TO BRING FORWARD A

3103
02:19:37,435 --> 02:19:38,036
QUESTION FROM THE ZOOM, BUT

3104
02:19:38,103 --> 02:19:39,704
BEFORE I DO, I ALSO WANT TO LET

3105
02:19:39,771 --> 02:19:40,672
FOLKS KNOW IF YOU HAVEN'T

3106
02:19:40,739 --> 02:19:42,340
SMELLED IT ALREADY, THERE IS

3107
02:19:42,407 --> 02:19:43,341
PIZZA NOW IN THE HALLWAY FOR

3108
02:19:43,408 --> 02:19:45,076
THOSE WHO DIDN'T HAVE TIME TO

3109
02:19:45,143 --> 02:19:46,611
GRAB LUNCH SO FEEL FREE TO SLIP

3110
02:19:46,678 --> 02:19:49,347
OUT A FEW AT A TIME AND GRAB A

3111
02:19:49,414 --> 02:19:49,581
SLICE.

3112
02:19:49,647 --> 02:19:52,217
THEN AS FOR THE QUESTION, THE

3113
02:19:52,283 --> 02:19:53,084
QUESTION -- I'M GOING TO

3114
02:19:53,151 --> 02:19:54,219
PARAPHRASE A LITTLE BIT, YOU

3115
02:19:54,285 --> 02:19:55,420
GUYS EACH PRESENTED ON SORT OF

3116
02:19:55,487 --> 02:19:58,723
DIFFERENT POPULATIONS AND

3117
02:19:58,790 --> 02:19:59,924
DIFFERENT OUTCOMES, DIFFERENT

3118
02:19:59,991 --> 02:20:01,025
DISEASE AREAS.

3119
02:20:01,092 --> 02:20:02,427
TO WHAT DEGREE DO YOU THINK SOME

3120
02:20:02,494 --> 02:20:05,430
OF THESE MECHANISMS ARE

3121
02:20:05,497 --> 02:20:06,698
ACTING -- ARE COMMON ACROSS

3122
02:20:06,765 --> 02:20:14,973
THESE DIFFERENT DISEASE AREAS?

3123
02:20:15,039 --> 02:20:16,741
>> SO I THINK FROM THE WORK

3124
02:20:16,808 --> 02:20:18,777
WE'RE DOING, LIKE I SAID, WE'RE

3125
02:20:18,843 --> 02:20:20,879
USING DIABETES AS A SIGNATURE

3126
02:20:20,945 --> 02:20:22,947
DISEASE, IT COULD EQUALLY APPLY

3127
02:20:23,014 --> 02:20:25,617
TO HYPERTENSION, TO KIDNEY

3128
02:20:25,683 --> 02:20:27,018
DISEASE, SO WE DON'T THINK THESE

3129
02:20:27,085 --> 02:20:29,587
FACTORS ARE GENERALLY DIFFERENT

3130
02:20:29,654 --> 02:20:30,755
AT A DISEASE LEVEL, WE THINK

3131
02:20:30,822 --> 02:20:32,490
IT'S MORE A SOCIETAL ISSUE THAT

3132
02:20:32,557 --> 02:20:33,691
HAS IMPACT, SO WE'RE NOT

3133
02:20:33,758 --> 02:20:35,226
EXPECTING TO SEE DIFFERENCES

3134
02:20:35,293 --> 02:20:35,994
ACROSS DISEASE GROUPS.

3135
02:20:36,060 --> 02:20:39,631
IT JUST HAPPENS TO BE WE CAN

3136
02:20:39,697 --> 02:20:40,732
ACTUALLY MEASURE THIS IN

3137
02:20:40,799 --> 02:20:41,833
DIABETES BECAUSE IT'S EASIER TO

3138
02:20:41,900 --> 02:20:44,402
HAVE AN A1C MEASURE, AN OUTCOME

3139
02:20:44,469 --> 02:20:45,470
MEASURE AND ESTABLISHED COHORTS

3140
02:20:45,537 --> 02:20:46,137
TO WORK WITH.

3141
02:20:46,204 --> 02:20:48,773
>> YEAH, I THINK I WOULD ADD, I

3142
02:20:48,840 --> 02:20:51,376
WOULD AGREE THAT THERE'S

3143
02:20:51,442 --> 02:20:52,911
PROBABLY MULTIPLE

3144
02:20:52,977 --> 02:20:54,012
STRESS/INFLAMMATION PATHWAYS

3145
02:20:54,078 --> 02:20:56,014
THAT SOME OF WHICH WE KNOW,

3146
02:20:56,080 --> 02:20:56,981
PROBABLY MANY OF WHICH WE ALSO

3147
02:20:57,048 --> 02:20:58,616
DON'T KNOW, AND THEN ALSO, YOU

3148
02:20:58,683 --> 02:21:00,285
KNOW, WE DON'T TYPICALLY MEASURE

3149
02:21:00,351 --> 02:21:02,587
A LOT OF THESE DIRECT MARKERS OF

3150
02:21:02,654 --> 02:21:03,788
INFLAMMATION, THINGS LIKE CRP

3151
02:21:03,855 --> 02:21:05,757
FOR THE CLINICIANS IN THE ROOM.

3152
02:21:05,824 --> 02:21:07,625
I THINK I'VE ORDERED, YOU KNOW,

3153
02:21:07,692 --> 02:21:09,394
FIVE CRPs TOTAL IN MY LIFE

3154
02:21:09,460 --> 02:21:10,795
BECAUSE IT'S NONSPECIFIC AND

3155
02:21:10,862 --> 02:21:15,400
RELATIVELY NOT USEFUL, YOU KNOW,

3156
02:21:15,466 --> 02:21:18,803
AND SO AT THE SAME TIME, I THINK

3157
02:21:18,870 --> 02:21:20,205
THERE'S LOTS OF OTHER PATHWAYS

3158
02:21:20,271 --> 02:21:21,606
WHICH ARE BEING RESEARCHED,

3159
02:21:21,673 --> 02:21:23,508
THINGS LIKE, YOU KNOW, DNA

3160
02:21:23,575 --> 02:21:26,678
METHYLATION AND OTHER EPIGENOMIC

3161
02:21:26,744 --> 02:21:28,780
CHANGES THAT ARE OBVIOUSLY ONLY

3162
02:21:28,847 --> 02:21:30,114
IN A RESEARCH SETTING, BUT I

3163
02:21:30,181 --> 02:21:32,951
WONDER IF, YOU KNOW, TWO, THREE,

3164
02:21:33,017 --> 02:21:36,387
FIVE, 10 YEARS FROM NOW, WHOLE

3165
02:21:36,454 --> 02:21:39,324
GENOME SEQUENCING PLUS, YOU

3166
02:21:39,390 --> 02:21:41,960
KNOW, THE METHYLOME AND OTHER

3167
02:21:42,026 --> 02:21:43,294
THINGS WILL BE PART OF OUR

3168
02:21:43,361 --> 02:21:44,729
STANDARD PRIMARY OF CARE FOR

3169
02:21:44,796 --> 02:21:46,598
EVERYBODY AND BETTER WAYS OF

3170
02:21:46,664 --> 02:21:47,899
ASSESSING THE STRESS THEY'VE

3171
02:21:47,966 --> 02:21:48,800
RECEIVED, WHETHER THAT'S FROM

3172
02:21:48,867 --> 02:21:51,002
RACISM, FROM SEXISM, FROM

3173
02:21:51,069 --> 02:21:52,871
HOMOPHOBIA, FROM TRANSPHOBIA,

3174
02:21:52,937 --> 02:21:54,405
FROM ANY OF THE OTHER WAYS THAT

3175
02:21:54,472 --> 02:21:55,974
PEOPLE GET MARGINALIZED OR

3176
02:21:56,040 --> 02:21:59,143
DISCRIMINATED AGAINST.

3177
02:21:59,210 --> 02:22:01,179
>> I REALLY APPRECIATE THAT

3178
02:22:01,246 --> 02:22:02,113
QUESTION BECAUSE I DO THINK

3179
02:22:02,180 --> 02:22:03,982
THERE'S A LOT OF EMPHASIS ON THE

3180
02:22:04,048 --> 02:22:05,083
MECHANISMS AND YOU HAVE PEOPLE

3181
02:22:05,149 --> 02:22:08,519
SAY, WELL, MAYBE THIS KIND OF

3182
02:22:08,586 --> 02:22:09,921
STRESS LEADS TO ALLOSTATIC LOAD

3183
02:22:09,988 --> 02:22:12,090
AND THIS ONE DOESN'T OR FOR THIS

3184
02:22:12,156 --> 02:22:13,758
GROUP OR THAT GROUP AND THERE

3185
02:22:13,825 --> 02:22:15,393
ARE BIOMARKERS THAT ARE A LITTLE

3186
02:22:15,460 --> 02:22:16,928
MORE RELEVANT DEPENDING ON WHICH

3187
02:22:16,995 --> 02:22:18,162
OUT COME YOU'RE USING SO IT

3188
02:22:18,229 --> 02:22:20,431
DEPENDS ON, I THINK, WHAT LEVEL

3189
02:22:20,498 --> 02:22:21,366
OF ANALYSIS THAT YOU'RE AT.

3190
02:22:21,432 --> 02:22:25,603
BUT I ALSO THINK THAT WHAT THE

3191
02:22:25,670 --> 02:22:26,604
LITERATURE HAS SHOWN IS THAT

3192
02:22:26,671 --> 02:22:28,172
THERE ARE CERTAIN KINDS OF

3193
02:22:28,239 --> 02:22:30,408
STRESSORS THAT ARE WORSE FOR

3194
02:22:30,475 --> 02:22:31,442
HEALTH AND THOSE ARE THE KINDS

3195
02:22:31,509 --> 02:22:33,511
OF STRESSORS THAT MARGINALIZED

3196
02:22:33,578 --> 02:22:35,847
GROUPS TEND TO EXPERIENCE.

3197
02:22:35,914 --> 02:22:37,615
SO THE THOUGHT IS THAT THESE

3198
02:22:37,682 --> 02:22:39,250
STRESSORS THAT INVOLVE SOCIAL

3199
02:22:39,317 --> 02:22:40,885
REJECTION, LIKE WE ARE DESIGNED

3200
02:22:40,952 --> 02:22:42,153
TO BE COMMUNAL PEOPLE, YOU SAW

3201
02:22:42,220 --> 02:22:43,855
WHAT HAPPENED DURING THE

3202
02:22:43,922 --> 02:22:46,157
PANDEMIC WHEN OUR SOCIAL FABRIC

3203
02:22:46,224 --> 02:22:47,592
FELL APART AND YOU SEE THESE

3204
02:22:47,659 --> 02:22:48,459
INCREDIBLY HIGH RATES OF

3205
02:22:48,526 --> 02:22:49,994
DEPRESSION AND SUICIDE AND

3206
02:22:50,061 --> 02:22:51,663
LONELINESS AND SO ON.

3207
02:22:51,729 --> 02:22:53,831
WE'RE DESIGNED TO BE TOGETHER

3208
02:22:53,898 --> 02:22:55,700
WITH ONE ANOTHER.

3209
02:22:55,767 --> 02:22:57,435
SO THE THOUGHT IS, AND THERE'S

3210
02:22:57,502 --> 02:22:58,436
LITERATURE THAT SUPPORTS THIS,

3211
02:22:58,503 --> 02:23:00,405
YOU KNOW, FROM ANIMAL MODELS,

3212
02:23:00,471 --> 02:23:02,073
WHEN PEOPLE FEEL REJECTED AND

3213
02:23:02,140 --> 02:23:05,343
THEY ARE EXCLUDED, THAT THAT IN

3214
02:23:05,410 --> 02:23:07,679
PARTICULAR IS A LOT WORSE FOR

3215
02:23:07,745 --> 02:23:08,880
PHYSIOLOGY THAN OTHER KINDS OF

3216
02:23:08,947 --> 02:23:10,081
STRESSORS.

3217
02:23:10,148 --> 02:23:11,482
AND WE KNOW MINORITIZED

3218
02:23:11,549 --> 02:23:13,351
POPULATIONS DEAL WITH A RANGE OF

3219
02:23:13,418 --> 02:23:15,019
DIFFERENT THINGS, SO THERE'S

3220
02:23:15,086 --> 02:23:16,220
THIS THEORY AND THERE'S SOME,

3221
02:23:16,287 --> 02:23:18,189
YOU KNOW, AGAIN, EVIDENCE FOR

3222
02:23:18,256 --> 02:23:18,990
THAT, BUT THAT WOULD BE WHAT I

3223
02:23:19,057 --> 02:23:20,291
WOULD SAY.

3224
02:23:20,358 --> 02:23:22,260
AND YOU'RE GOING TO SEE THAT

3225
02:23:22,327 --> 02:23:24,996
WHETHER IT'S IN REDLINED

3226
02:23:25,063 --> 02:23:26,531
NEIGHBORHOODS OR SEXUAL GENDER

3227
02:23:26,597 --> 02:23:27,532
MINORITIES OR BLACK WOMEN

3228
02:23:27,598 --> 02:23:30,368
DEALING WITH LUPUS, AND IT WILL

3229
02:23:30,435 --> 02:23:31,135
MANIFEST DIFFERENTLY BECAUSE

3230
02:23:31,202 --> 02:23:33,571
SOMETIMES PEOPLE LIVING IN

3231
02:23:33,638 --> 02:23:34,205
PREDOMINANTLY -- I'M JUST

3232
02:23:34,272 --> 02:23:36,107
THINKING FOR THE ANTI-BLACK

3233
02:23:36,174 --> 02:23:38,309
LITERATURE, WE SEE A LOT OF THE

3234
02:23:38,376 --> 02:23:39,110
EFFECTS OF INDIVIDUAL EXPOSURE

3235
02:23:39,177 --> 02:23:40,812
TO RACISM OR WE SEE THE GROUPS

3236
02:23:40,878 --> 02:23:42,880
THAT REPORT THAT MOST BEING THE

3237
02:23:42,947 --> 02:23:45,116
HIGHER SES GROUPS, BECAUSE LOWER

3238
02:23:45,183 --> 02:23:46,651
SES INDIVIDUALS TEND TO BE MORE

3239
02:23:46,718 --> 02:23:48,619
SEGREGATED AND SO THEY'RE

3240
02:23:48,686 --> 02:23:50,588
WORKING AND LIVING AND PLAYING

3241
02:23:50,655 --> 02:23:51,723
AROUND PEOPLE WHO SORT OF LOOK

3242
02:23:51,789 --> 02:23:53,224
LIKE THEM.

3243
02:23:53,291 --> 02:23:55,560
BUT THEN PEOPLE LIKE ME ARE

3244
02:23:55,626 --> 02:23:56,861
MOVING THROUGH SPACES WHERE I

3245
02:23:56,928 --> 02:24:00,498
MAY BE ONE OF THE ONLY ONES.

3246
02:24:00,565 --> 02:24:01,899
SO JUST SORT OF ADDING A BIT OF

3247
02:24:01,966 --> 02:24:03,901
THAT NUANCE AND CONTEXT TO THE

3248
02:24:03,968 --> 02:24:04,202
LITERATURE.

3249
02:24:04,268 --> 02:24:05,670
>> I JUST WANTED TO ADD, I THINK

3250
02:24:05,737 --> 02:24:07,405
IT'S IMPORTANT FOR US TO PAY

3251
02:24:07,472 --> 02:24:10,174
ATTENTION TO THIS PROCESS OF

3252
02:24:10,241 --> 02:24:12,043
MULTIPLE PATHWAYS, BECAUSE I

3253
02:24:12,110 --> 02:24:14,012
THINK WE LIKE TO HAVE A VERY

3254
02:24:14,078 --> 02:24:15,446
SIMPLE ANSWER, AND THIS IS VERY

3255
02:24:15,513 --> 02:24:16,347
COMPLEX.

3256
02:24:16,414 --> 02:24:18,316
AND SO WE NEED TO DO MORE WORK

3257
02:24:18,383 --> 02:24:20,184
ON INCORPORATING ALL OF THESE

3258
02:24:20,251 --> 02:24:22,053
MEASURES, BIOLOGY, SOCIAL

3259
02:24:22,120 --> 02:24:23,388
ENVIRONMENT, AND ALL OF THESE

3260
02:24:23,454 --> 02:24:24,555
FACTORS COMING TOGETHER TO

3261
02:24:24,622 --> 02:24:25,590
UNDERSTAND HOW THEY ACTUALLY

3262
02:24:25,656 --> 02:24:25,923
INTERACT.

3263
02:24:25,990 --> 02:24:27,125
SO I THINK THE MORE WE DO THAT,

3264
02:24:27,191 --> 02:24:28,426
THE MORE WE'RE GOING TO GET

3265
02:24:28,493 --> 02:24:29,827
BETTER ANSWERS THAN JUST BEING

3266
02:24:29,894 --> 02:24:31,062
VERY SIMPLISTIC AND

3267
02:24:31,129 --> 02:24:35,033
STRAIGHTFORWARD ABOUT IT.

3268
02:24:35,099 --> 02:24:37,101
>> ANOTHER QUESTION FROM THE

3269
02:24:37,168 --> 02:24:40,371
ZOOM, PARAPHRASING FROM VALERIE,

3270
02:24:40,438 --> 02:24:42,140
SHE IS ASKING ABOUT A POTENTIAL

3271
02:24:42,206 --> 02:24:44,342
CONNECTION WITH INTERPERSONAL

3272
02:24:44,409 --> 02:24:47,178
VIOLENCE AND COMMUNITY VIOLENCE,

3273
02:24:47,245 --> 02:24:48,379
AND WHETHER YOU'VE LOOKED AT

3274
02:24:48,446 --> 02:24:50,615
THAT AT ALL IN YOUR RESEARCH ON

3275
02:24:50,681 --> 02:24:55,653
SLE AND OUTCOMES IN WOMEN.

3276
02:24:55,720 --> 02:25:01,559
>> SO WE HAVE MEASURES OF

3277
02:25:01,626 --> 02:25:02,126
INTERPERSONAL VIOLENCE.

3278
02:25:02,193 --> 02:25:04,529
WE ARE JUST NOW STARTING TO

3279
02:25:04,595 --> 02:25:06,064
CLEAN THOSE DATA AND LOOK AT

3280
02:25:06,130 --> 02:25:10,635
THOSE DATA.

3281
02:25:10,701 --> 02:25:15,173
BUT I THINK JUST ANECDOTALLY AT

3282
02:25:15,239 --> 02:25:16,474
BASELINE, BECAUSE OF HOW IT WAS

3283
02:25:16,541 --> 02:25:17,809
FUNDED AND I ASKED A LOT OF

3284
02:25:17,875 --> 02:25:19,911
QUESTIONS ABOUT RACE, AND THEN

3285
02:25:19,977 --> 02:25:21,446
AT 12 MONTHS, I WAS LIKE I

3286
02:25:21,512 --> 02:25:22,847
DIDN'T ASK AS MANY QUESTIONS

3287
02:25:22,914 --> 02:25:26,050
AROUND GENDER, SO THAT'S WHEN WE

3288
02:25:26,117 --> 02:25:27,251
BEGAN TO GET INTO -- WE HAVE A

3289
02:25:27,318 --> 02:25:29,654
LOT OF THINGS ABOUT PEOPLE BEING

3290
02:25:29,720 --> 02:25:30,855
STALKED AND FINANCIAL CONTROL,

3291
02:25:30,922 --> 02:25:33,724
SO NOT JUST PHYSICAL OR SEXUAL

3292
02:25:33,791 --> 02:25:37,929
VIOLENCE, BUT OTHER FORMS OF

3293
02:25:37,995 --> 02:25:39,997
EMOTIONAL CONTROL THAT YOU SEE

3294
02:25:40,064 --> 02:25:40,898
AND PSYCHOLOGICAL CONTROL THAT

3295
02:25:40,965 --> 02:25:43,367
YOU SEE IN INTERPERSONAL

3296
02:25:43,434 --> 02:25:44,535
RELATIONSHIPS, THINGS AROUND

3297
02:25:44,602 --> 02:25:45,136
SELF-SILENCING.

3298
02:25:45,203 --> 02:25:46,204
SO WE HAVE ALL OF THAT AND IT'S

3299
02:25:46,270 --> 02:25:49,774
JUST A MATTER OF LACKING LOOKIN.

3300
02:25:49,841 --> 02:25:51,109
>> I'LL KEEP THE FINAL QUESTION

3301
02:25:51,175 --> 02:25:53,144
FOR THE PANEL.

3302
02:25:53,211 --> 02:25:54,245
>> JUST FOR THE PANEL IN

3303
02:25:54,312 --> 02:25:55,980
GENERAL.

3304
02:25:56,047 --> 02:25:58,316
SO ONE THING THAT'S VERY

3305
02:25:58,382 --> 02:25:59,150
INTERESTING, AND I LIKE THE WORK

3306
02:25:59,217 --> 02:26:00,818
ON THE REDLINING WHERE YOU HAVE

3307
02:26:00,885 --> 02:26:03,888
HIGHER RATES OF DIABETES, OTHER

3308
02:26:03,955 --> 02:26:05,923
CHRONIC DISEASES IN REDLINED

3309
02:26:05,990 --> 02:26:06,324
COMMUNITIES.

3310
02:26:06,390 --> 02:26:08,192
HAVE YOU HAD AN OPPORTUNITY TO

3311
02:26:08,259 --> 02:26:10,795
LOOK MORE DEEPLY WITHIN THOSE

3312
02:26:10,862 --> 02:26:13,698
COMMUNITIES, SO ONE THING

3313
02:26:13,764 --> 02:26:15,433
THAT -- TENE IS ASKING THESE

3314
02:26:15,500 --> 02:26:16,534
QUESTIONS ABOUT HOW COMFORTABLE

3315
02:26:16,601 --> 02:26:17,935
DO YOU FEEL AND ARE YOU

3316
02:26:18,002 --> 02:26:19,403
CONCERNED ABOUT BEING

3317
02:26:19,470 --> 02:26:20,071
DISCRIMINATED AGAINST AND

3318
02:26:20,138 --> 02:26:21,072
PROBLEMS AT SCHOOL, ET CETERA,

3319
02:26:21,139 --> 02:26:24,876
ET CETERA, ET CETERA.

3320
02:26:24,942 --> 02:26:28,646
SOME RED LINED COMMUNITIES ARE

3321
02:26:28,713 --> 02:26:29,180
LIKE 99% BLACK.

3322
02:26:29,247 --> 02:26:34,218
SO IN THAT SPACE, THERE COULD BE

3323
02:26:34,285 --> 02:26:35,086
MORE DISCRIMINATION AS IT

3324
02:26:35,153 --> 02:26:36,888
RELATES TO SOCIAL STRUCTURES

3325
02:26:36,954 --> 02:26:39,624
THAT ARE THERE TO BE SUPPORTED,

3326
02:26:39,690 --> 02:26:41,159
BUT THEN ON THE OTHER SIDE,

3327
02:26:41,225 --> 02:26:42,460
THERE COULD BE MORE

3328
02:26:42,527 --> 02:26:44,128
CONNECTEDNESS AND SENSE OF

3329
02:26:44,195 --> 02:26:45,229
SELF-WORTH, AND SO DO YOU KNOW

3330
02:26:45,296 --> 02:26:47,398
IF THERE'S ANY DATA OR YOUR TEAM

3331
02:26:47,465 --> 02:26:49,433
HAD A CHANCE TO LOOK YET IF

3332
02:26:49,500 --> 02:26:52,703
WITHIN THAT -- WITHIN THE

3333
02:26:52,770 --> 02:26:55,006
REDLINED COMMUNITIES, IF THE

3334
02:26:55,072 --> 02:26:58,643
PERCENT OF RACIAL GROUP WITHIN

3335
02:26:58,709 --> 02:27:00,645
THERE THEN EXPRESSES HIGHER OR

3336
02:27:00,711 --> 02:27:03,581
LOWER AMOUNTS OF --

3337
02:27:03,648 --> 02:27:05,349
>> THAT'S A VERY IMPORTANT

3338
02:27:05,416 --> 02:27:06,317
COMPONENT OF THE NEXT PHASE OF

3339
02:27:06,384 --> 02:27:06,651
RESEARCH.

3340
02:27:06,717 --> 02:27:07,952
SO WHAT WE HAVE RIGHT NOW, WE

3341
02:27:08,019 --> 02:27:11,923
KNOW THERE IS -- WITHIN STATE,

3342
02:27:11,989 --> 02:27:12,723
THERE'S GREAT VARIABILITY WITHIN

3343
02:27:12,790 --> 02:27:13,124
STATES.

3344
02:27:13,191 --> 02:27:14,559
AND BETWEEN STATES, THERE ARE

3345
02:27:14,625 --> 02:27:16,928
DIFFERENCES.

3346
02:27:16,994 --> 02:27:19,330
SO YOU SEE EXPRESSION OF EFFECT,

3347
02:27:19,397 --> 02:27:21,299
EFFECTS VARY ACROSS STATES, AND

3348
02:27:21,365 --> 02:27:22,867
ACTUALLY DIVE DEEP INTO

3349
02:27:22,934 --> 02:27:24,602
DIFFERENT -- DEPENDING ON --

3350
02:27:24,669 --> 02:27:26,337
PROPORTION BLACK IN THAT

3351
02:27:26,404 --> 02:27:28,105
ENVIRONMENT, OR PROPORTION

3352
02:27:28,172 --> 02:27:29,106
HISPANIC, YOU CAN ACTUALLY SEE

3353
02:27:29,173 --> 02:27:30,441
THAT THAT EXPRESSION AS YOU LOOK

3354
02:27:30,508 --> 02:27:32,944
AT SOCIAL CONNECTIVITY, THOSE

3355
02:27:33,010 --> 02:27:34,812
RELATIONSHIPS ARE DIFFERENT.

3356
02:27:34,879 --> 02:27:36,547
AND SO THAT'S ONE OF THE -- THE

3357
02:27:36,614 --> 02:27:37,348
FIRST PROJECT WE'RE TALKING

3358
02:27:37,415 --> 02:27:38,449
ABOUT, WE'RE GOING TO ACTUALLY

3359
02:27:38,516 --> 02:27:42,954
BE ABLE TO DO THAT AT A CENSUS

3360
02:27:43,020 --> 02:27:45,489
TRACT LEVEL ACROSS ALL STATES,

3361
02:27:45,556 --> 02:27:47,024
AND TEASE APART WHAT'S REALLY

3362
02:27:47,091 --> 02:27:48,092
DRIVING SOME OF THESE

3363
02:27:48,159 --> 02:27:50,528
DIFFERENCES AND WHICH OF THESE

3364
02:27:50,595 --> 02:27:52,296
APPROACHES ARE ACTUALLY

3365
02:27:52,363 --> 02:27:52,597
PROTECTIVE.

3366
02:27:52,663 --> 02:27:53,898
IF YOU LIVE IN AN ENVIRONMENT

3367
02:27:53,965 --> 02:27:55,099
WHERE EVERYONE LOOKS LIKE YOU,

3368
02:27:55,166 --> 02:27:56,534
YOU HAVE THAT SOCIAL

3369
02:27:56,601 --> 02:27:57,635
CONNECTEDNESS, YOU MAY HAVE A

3370
02:27:57,702 --> 02:27:58,402
VERY DIFFERENT EXPERIENCE

3371
02:27:58,469 --> 02:28:00,037
COMPARED TO SOMEONE WHO ACTUALLY

3372
02:28:00,104 --> 02:28:01,606
LIVES -- SO WE'RE TRYING TO

3373
02:28:01,672 --> 02:28:02,940
ACTUALLY ISOLATE SOME OF THOSE

3374
02:28:03,007 --> 02:28:06,444
RELATIONSHIPS OVER TIME.

3375
02:28:06,510 --> 02:28:09,080
>> YOU'LL ACTUALLY JUST ADD, THE

3376
02:28:09,146 --> 02:28:10,615
MEASURES WE HAVE AROUND -- I

3377
02:28:10,681 --> 02:28:11,849
WANT TO DISTINGUISH BETWEEN THE

3378
02:28:11,916 --> 02:28:13,351
EXPERIENCES THAT PEOPLE REPORT

3379
02:28:13,417 --> 02:28:15,253
AND THE CONCERNS OR THE WORRY

3380
02:28:15,319 --> 02:28:16,988
THAT THEY HAVE OR THE FORM OF

3381
02:28:17,054 --> 02:28:18,089
VIGILANCE, RIGHT, SO THIS IS

3382
02:28:18,155 --> 02:28:21,058
REALLY LIKE A FORM OF VIGILANCE

3383
02:28:21,125 --> 02:28:22,159
THAT BLACK WOMEN HAVE AROUND

3384
02:28:22,226 --> 02:28:23,461
THINGS HAPPENING TO THEIR

3385
02:28:23,527 --> 02:28:24,128
CHILDREN.

3386
02:28:24,195 --> 02:28:26,530
AND WE SEE SO LITTLE VAIRNL ON

3387
02:28:26,597 --> 02:28:27,732
THAT SCALE.

3388
02:28:27,798 --> 02:28:32,370
I MEAN, LIKE SO MANY -- AND WE

3389
02:28:32,436 --> 02:28:34,138
HAVE ONE THE MY OTHER COHORTS WE

3390
02:28:34,205 --> 02:28:36,741
HAVE WOMEN ACROSS 200 DIFFERENT

3391
02:28:36,807 --> 02:28:39,310
CENSUS TRACTS OR 190-SOMETHING,

3392
02:28:39,377 --> 02:28:41,712
RIGHT, AND THEY'RE ALL VERY

3393
02:28:41,779 --> 02:28:42,046
CONCERNED.

3394
02:28:42,113 --> 02:28:43,247
SO SOME OF THAT, WHAT WE SEE IN

3395
02:28:43,314 --> 02:28:44,615
THE LITERATURE ON EXPOSURE IS A

3396
02:28:44,682 --> 02:28:46,684
LOT OF IT IS MEDIATED THROUGH

3397
02:28:46,751 --> 02:28:46,984
SEGREGATION.

3398
02:28:47,051 --> 02:28:50,221
SO WOMEN WHO LIVE IN SEGREGATED

3399
02:28:50,288 --> 02:28:51,622
AREAS JUST REPORT LESS EXPOSURE.

3400
02:28:51,689 --> 02:28:53,057
BUT THE CONCERN, AND, YOU KNOW,

3401
02:28:53,124 --> 02:28:55,126
BECAUSE YOU HAVE THIS CHILD WHO

3402
02:28:55,192 --> 02:28:56,594
MIGHT LEAVE THAT NEIGHBORHOOD

3403
02:28:56,661 --> 02:28:57,595
AND NEED TO GO A LOT OF

3404
02:28:57,662 --> 02:28:59,230
DIFFERENT PLACES AND THEY ARE

3405
02:28:59,297 --> 02:29:00,531
REPORTING OFF THE CHART -- I

3406
02:29:00,598 --> 02:29:02,233
MEAN, LIKE VERY, VERY HIGH

3407
02:29:02,300 --> 02:29:04,068
LEVELS OF CONCERN ABOUT THINGS

3408
02:29:04,135 --> 02:29:05,169
HAPPENING TO THEIR CHILDREN

3409
02:29:05,236 --> 02:29:10,007
BECAUSE THEY'RE BLACK.

3410
02:29:10,074 --> 02:29:13,711
>> COULD WE GET ANOTHER ROUND OF

3411
02:29:13,778 --> 02:29:15,813
APPLAUSE FOR THE PANEL?

3412
02:29:15,880 --> 02:29:16,080
[APPLAUSE]

3413
02:29:16,147 --> 02:29:20,718
AND AT THIS TIME, I WILL INVITE

3414
02:29:20,785 --> 02:29:31,095
UP THE NEXT PANEL.

3415
02:30:59,617 --> 02:31:01,552
>> SO WE ARE READY TO START THE

3416
02:31:01,619 --> 02:31:11,996
NEXT SERIES OF PANELS.

3417
02:31:15,900 --> 02:31:17,301
WE WILL HAVE A SERIES OF PANELS

3418
02:31:17,368 --> 02:31:19,303
THAT WILL FOCUS ON SPECIFIC

3419
02:31:19,370 --> 02:31:23,073
BIOLOGICAL MECHANISMS THAT

3420
02:31:23,140 --> 02:31:25,342
[INAUDIBLE] THE FIRST PANEL WILL

3421
02:31:25,409 --> 02:31:30,581
BE ON EPIGENETICS AND TELOMERES.

3422
02:31:30,648 --> 02:31:33,017
I'D LIKE TO INVITE OUR FIRST

3423
02:31:33,083 --> 02:31:35,753
SPEAKER, DR. SHAKIRA SUGLIA, TO

3424
02:31:35,820 --> 02:31:39,156
SPEAK ABOUT SOCIAL STRESSORS AND

3425
02:31:39,223 --> 02:31:40,191
EPIGENETIC AGING AMONG HISPANIC

3426
02:31:40,257 --> 02:31:44,361
AND LATINO ADULTS.

3427
02:31:44,428 --> 02:31:44,662
DR. SUGLIA.

3428
02:31:44,728 --> 02:31:47,097
>> THANK YOU.

3429
02:31:47,164 --> 02:31:54,405
GOOD AFTERNOON, EVERYONE.

3430
02:31:54,472 --> 02:31:56,440
I WILL SHARE SOME OF MY WORK

3431
02:31:56,507 --> 02:31:59,610
FOCUSING ON SOCIAL STRESSORS AND

3432
02:31:59,677 --> 02:32:01,011
EPIGENETIC AGING IN LATINO

3433
02:32:01,078 --> 02:32:05,216
ADULTS IN THE U.S.

3434
02:32:05,282 --> 02:32:06,517
AS A MOTIVATION FOR THIS WORK

3435
02:32:06,584 --> 02:32:11,121
AND WHY WE'RE FOCUSING ON THE

3436
02:32:11,188 --> 02:32:12,256
LATINO POPULATION IN THE UNITED

3437
02:32:12,323 --> 02:32:12,490
STATES.

3438
02:32:12,556 --> 02:32:15,359
WHEN IT COMES TO CARDIOVASCULAR,

3439
02:32:15,426 --> 02:32:16,861
CARDIOMETABOLIC DISEASES,

3440
02:32:16,927 --> 02:32:18,229
LATINOS HAVE A HIGH PREVALENCE

3441
02:32:18,295 --> 02:32:23,033
OF THESE DISEASES IN THE U.S

3442
02:32:23,100 --> 02:32:24,768
U.S., -- I'LL GIVE YOU A FEW

3443
02:32:24,835 --> 02:32:26,036
MORE DETAILS OF THAT STUDY IN A

3444
02:32:26,103 --> 02:32:28,205
SECOND.

3445
02:32:28,272 --> 02:32:31,609
HAS SHOWN THAT THE MULTIPLE

3446
02:32:31,675 --> 02:32:33,377
GROUPS OF LATINOS ACROSS THE

3447
02:32:33,444 --> 02:32:35,713
U.S. HAVE REALLY HIGH PREVALENCE

3448
02:32:35,779 --> 02:32:37,348
OF THESE CONDITIONS.

3449
02:32:37,414 --> 02:32:40,184
AS AN EXAMPLE -- MEN AND WOMEN

3450
02:32:40,251 --> 02:32:42,653
IN THIS COHORT ACTUALLY HAVE THE

3451
02:32:42,720 --> 02:32:44,088
HIGHEST PREVALENCE OF DEVELOPING

3452
02:32:44,154 --> 02:32:48,559
THESE FACTORS, INCLUDING

3453
02:32:48,626 --> 02:32:51,862
DIABETES, OVER 40% PREVALENCE OF

3454
02:32:51,929 --> 02:32:53,264
DIABETES, AROUND 60 AND ALMOST

3455
02:32:53,330 --> 02:32:56,200
20% IN THIS GROUP.

3456
02:32:56,267 --> 02:33:03,073
THE OTHER SORT OF KNOW VAITING G

3457
02:33:03,140 --> 02:33:05,042
FACTOR TO FOCUS ON THE LATINO

3458
02:33:05,109 --> 02:33:06,777
POPULATION IS MULTILEVEL

3459
02:33:06,844 --> 02:33:09,580
EXPERIENCES OF FACTORS THAT CAN

3460
02:33:09,647 --> 02:33:11,015
IMPACT STRUCTURAL RACISM,

3461
02:33:11,081 --> 02:33:15,553
INDIVIDUAL LEVEL EXPERIENCES OF

3462
02:33:15,619 --> 02:33:16,887
DISCRIMINATION ACROSS THESE

3463
02:33:16,954 --> 02:33:18,222
MULTIPLE INDIVIDUAL FAMILY

3464
02:33:18,289 --> 02:33:20,791
COMMUNITY NEIGHBORHOOD LEVELS,

3465
02:33:20,858 --> 02:33:22,660
POLICY LEVELS, AND THE LATINO

3466
02:33:22,726 --> 02:33:24,094
POPULATION IN PARTICULAR WE'RE

3467
02:33:24,161 --> 02:33:27,965
ALSO THINKING ABOUT THE ROLE OF

3468
02:33:28,032 --> 02:33:30,467
DIFFERENT LIVED EXPERIENCES,

3469
02:33:30,534 --> 02:33:34,939
COUNTRIES OF ORIGIN, IMMIGRA

3470
02:33:35,005 --> 02:33:35,739
IMMIGRATION, DIFFERING LANGUAGE

3471
02:33:35,806 --> 02:33:36,874
BARRIERS THAT CAN PRESENT

3472
02:33:36,941 --> 02:33:38,943
THEMSELVES AS ADDITIONAL

3473
02:33:39,009 --> 02:33:41,445
STRESSORS AND ADDITIONAL

3474
02:33:41,512 --> 02:33:43,314
MEASURES OF DISCRIMINATION AND

3475
02:33:43,380 --> 02:33:44,148
RACISM.

3476
02:33:44,214 --> 02:33:48,852
THESE FACTORS ALL DIFFER AS THIS

3477
02:33:48,919 --> 02:33:50,955
POPULATION IS IN THE UNITED

3478
02:33:51,021 --> 02:33:54,425
STATES, SO -- WITH TIME IN THE

3479
02:33:54,491 --> 02:33:55,492
U.S. -- HOW MUCH OF THESE

3480
02:33:55,559 --> 02:33:58,095
EXPERIENCES WE MAY ENCOUNTER,

3481
02:33:58,162 --> 02:34:01,699
THEN ALSO WE RECOGNIZE THERE IS

3482
02:34:01,765 --> 02:34:04,101
INTERSECTIONALITY SO LATINOS ARE

3483
02:34:04,168 --> 02:34:05,836
ALL DIFFERENT RACES, IT'S AN

3484
02:34:05,903 --> 02:34:07,705
ETHNIC GROUP, COUNTRY OF ORIGIN,

3485
02:34:07,771 --> 02:34:10,007
NOT NECESSARILY -- SO YOU HAVE

3486
02:34:10,074 --> 02:34:11,075
THAT SORT OF ADDITIONAL

3487
02:34:11,141 --> 02:34:12,810
DIMENSION OF NOT JUST LATINO

3488
02:34:12,876 --> 02:34:15,012
IDENTITY BUT RACIAL IDENTITY

3489
02:34:15,079 --> 02:34:20,618
ALSO.

3490
02:34:20,684 --> 02:34:23,053
SO CONCEPTUALLY IT LOOKS AT THE

3491
02:34:23,120 --> 02:34:24,121
IMPACT OF DIFFERENT SOCIAL AND

3492
02:34:24,188 --> 02:34:28,225
ECONOMIC STRESSORS IN THE LATINO

3493
02:34:28,292 --> 02:34:32,963
POPULATION, HOW IT MAY BE -- HOW

3494
02:34:33,030 --> 02:34:38,102
IMPACT -- AGE AND HOW THAT IN

3495
02:34:38,168 --> 02:34:40,170
TURN AFFECTS CARDIOMETABOLIC

3496
02:34:40,237 --> 02:34:41,505
HEALTH.

3497
02:34:41,572 --> 02:34:45,609
THERE ARE SOCIOCULTURAL FACTORS,

3498
02:34:45,676 --> 02:34:49,213
ACCULTURATION AND -- NEGATIVE

3499
02:34:49,279 --> 02:34:51,448
FACTOR, THE IMPACT OF THE

3500
02:34:51,515 --> 02:34:53,984
STRESSORS ON EPIGENETIC MARKERS

3501
02:34:54,051 --> 02:34:54,952
AND CARDIOMETABOLIC HEALTH.

3502
02:34:55,019 --> 02:34:59,323
FOR THOSE THAT ARE NOT FAMILIAR,

3503
02:34:59,390 --> 02:35:00,591
I'VE THROWN AROUND THE TERM A

3504
02:35:00,658 --> 02:35:04,628
COUPLE TIMES BUT THE GENES ARE

3505
02:35:04,695 --> 02:35:08,999
YOUR GENES, EPIGENETICS IS HOW

3506
02:35:09,066 --> 02:35:12,169
THE GENES ARE EXPRESSION, THE

3507
02:35:12,236 --> 02:35:14,104
EXPRESSION CAN CHANGE WHEN

3508
02:35:14,171 --> 02:35:15,305
EXPOSED TO SOCIAL AND

3509
02:35:15,372 --> 02:35:21,879
ENVIRONMENTAL STRESSORS.

3510
02:35:21,945 --> 02:35:24,181
DNA METHYLATION IS THE MOST WELL

3511
02:35:24,248 --> 02:35:25,549
STUDIED EPIGENETIC MARKER AND

3512
02:35:25,616 --> 02:35:26,784
THAT'S WHAT THIS WORK FOCUSES

3513
02:35:26,850 --> 02:35:30,387
ON.

3514
02:35:30,454 --> 02:35:34,792
DNA METHYLATION MARKERS, WE CAN

3515
02:35:34,858 --> 02:35:37,995
OBTAIN -- AGING OR A MEASURE OF

3516
02:35:38,062 --> 02:35:41,732
BIOLOGICAL AGE -- IN THE ABSENCE

3517
02:35:41,799 --> 02:35:43,467
OF DISEASE.

3518
02:35:43,534 --> 02:35:45,369
AND IT'S A WAY TO CAPTURE THE

3519
02:35:45,436 --> 02:35:52,910
IMPACT OF STRESS -- HOW MUCH

3520
02:35:52,976 --> 02:35:53,777
WE'RE AGING.

3521
02:35:53,844 --> 02:35:55,846
SO WE COMPARE THE CHRONOLOGICAL

3522
02:35:55,913 --> 02:36:06,423
AGE TO YOUR BIOLOGICAL AGE, --

3523
02:36:09,259 --> 02:36:10,227
ACCELERATES THE AGING PROCESS

3524
02:36:10,294 --> 02:36:12,863
AND HAVE AN IMPACT ON BU BIOLOGL

3525
02:36:12,930 --> 02:36:14,398
AGE.

3526
02:36:14,465 --> 02:36:16,400
THESE CLOCKS -- WE HAVE A NUMBER

3527
02:36:16,467 --> 02:36:17,401
OF DIFFERENT CLOCKS AND I'LL

3528
02:36:17,468 --> 02:36:18,502
SHOW YOU RESULTS FROM A COUPLE

3529
02:36:18,569 --> 02:36:21,105
OF THEM.

3530
02:36:21,171 --> 02:36:24,141
FIRST OF ALL HORVATH, THE SECOND

3531
02:36:24,208 --> 02:36:25,109
GENERATION CLOCKS HAVE BEEN

3532
02:36:25,175 --> 02:36:27,644
SHOWN TO PREDICT CHRONIC

3533
02:36:27,711 --> 02:36:28,846
DISEASES IN THE ABSENCE OF SORT

3534
02:36:28,912 --> 02:36:37,855
OF OUR TRADITIONAL RISK FACTORS.

3535
02:36:37,921 --> 02:36:40,491
-- LATINO ADULTS IN THE UNITED

3536
02:36:40,557 --> 02:36:41,125
STATES.

3537
02:36:41,191 --> 02:36:43,260
SAMPLE LATINOS -- DIFFERENT U.S.

3538
02:36:43,327 --> 02:36:45,863
SITES WHICH LARGE -- LATINO

3539
02:36:45,929 --> 02:36:51,001
POPULATIONS.

3540
02:36:51,068 --> 02:36:53,504
RECOGNIZING HETEROJA NATE OF THE

3541
02:36:53,570 --> 02:36:54,471
POPULATION, WE ACTUALLY HAVE

3542
02:36:54,538 --> 02:36:55,973
LARGE NUMBERS OF PARTICULAR

3543
02:36:56,039 --> 02:36:57,708
GROUPS OF LATINOS THAT WE CAN

3544
02:36:57,775 --> 02:37:01,311
LOOK AT THAT ACROSS LATINO

3545
02:37:01,378 --> 02:37:02,613
POPULATION BECAUSE OF COUNTRY OF

3546
02:37:02,679 --> 02:37:03,947
ORIGIN.

3547
02:37:04,014 --> 02:37:06,283
AND IT'S BEEN ONGOING FOR A

3548
02:37:06,350 --> 02:37:08,485
NUMBER OF YEARS NOW, I'M GOING

3549
02:37:08,552 --> 02:37:10,020
TO SHOW YOU DATA THAT'S BEEN

3550
02:37:10,087 --> 02:37:14,558
DLBEENCOLLECTED AT BASELINE ANDD

3551
02:37:14,625 --> 02:37:15,893
TIME ASSESSMENT.

3552
02:37:15,959 --> 02:37:16,960
THERE'S A NUMBER OF DIFFERENT

3553
02:37:17,027 --> 02:37:18,862
ANCILLARY STUDIES TO THIS WHOLE

3554
02:37:18,929 --> 02:37:21,398
COHORT.

3555
02:37:21,465 --> 02:37:26,937
THE HCHS/SOL INCLUDED A HOST OF

3556
02:37:27,004 --> 02:37:28,438
MEASURES -- SOCIAL MEASURES.

3557
02:37:28,505 --> 02:37:31,408
AS WELL AS MENTAL HEALTH

3558
02:37:31,475 --> 02:37:32,142
MEASURES, AND SORT OF THE

3559
02:37:32,209 --> 02:37:36,613
PROJECT THAT I DEVELOPED FOCUSED

3560
02:37:36,680 --> 02:37:38,015
ON -- OF THAT POPULATION WHO HAD

3561
02:37:38,081 --> 02:37:42,052
ALSO COMPLETED SECOND VISIT AND

3562
02:37:42,119 --> 02:37:43,487
PROVIDED BLOOD SAMPLE AND AGREED

3563
02:37:43,554 --> 02:37:46,824
THAT WE COULD LOOK AT THEIR

3564
02:37:46,890 --> 02:37:51,762
SAMPLES FOR DNA ANALYSIS.

3565
02:37:51,829 --> 02:37:53,297
SO THE IDEA WE HAVE TWO TIME

3566
02:37:53,363 --> 02:37:57,301
POINTS OF EPIGENETIC AGE, -- WE

3567
02:37:57,367 --> 02:38:00,337
CAN LOOK AT THESE STRESSORS THAT

3568
02:38:00,404 --> 02:38:05,275
OCCUR -- THAT WE CAN LOOK AT

3569
02:38:05,342 --> 02:38:10,681
STRESSORS AND HOW ARE WE GOING

3570
02:38:10,747 --> 02:38:12,783
TO -- EPIGENETIC AGE IS

3571
02:38:12,850 --> 02:38:14,284
POTENTIALLY CONNECTED TO

3572
02:38:14,351 --> 02:38:14,985
CARDIOMETABOLIC HEALTH.

3573
02:38:15,052 --> 02:38:16,086
JUST TO GIVE YOU AN IDEA OF THE

3574
02:38:16,153 --> 02:38:18,922
SAMPLE FOR THE STUDY, WE HAVE

3575
02:38:18,989 --> 02:38:20,991
JUST UNDER A THOUSAND

3576
02:38:21,058 --> 02:38:21,558
PARTICIPANTS.

3577
02:38:21,625 --> 02:38:24,027
IF IT'S REPRESENTATIVE OF THE

3578
02:38:24,094 --> 02:38:26,163
ORIGINAL -- COHORT WHERE 20% OF

3579
02:38:26,230 --> 02:38:27,831
THE POPULATION IS U.S.-BORN, SO

3580
02:38:27,898 --> 02:38:30,534
THIS IS LARGELY FOREIGN-BORN

3581
02:38:30,601 --> 02:38:34,471
POPULATION, AND WE HAVE AVERAGE

3582
02:38:34,538 --> 02:38:37,441
AGE OF 45, AT BASELINE WITH AS I

3583
02:38:37,507 --> 02:38:39,776
MENTIONED LARGE GROUPS OF --

3584
02:38:39,843 --> 02:38:43,280
DISTINCT GROUPS OF HISPANIC AND

3585
02:38:43,347 --> 02:38:45,249
LATINOS -- MEXICAN, CUBAN AND

3586
02:38:45,315 --> 02:38:46,416
PUERTO RICAN GROUPS IN THIS

3587
02:38:46,483 --> 02:38:47,084
POPULATION.

3588
02:38:47,150 --> 02:38:49,253
SO ONE OF THE FIRST ANALYSIS

3589
02:38:49,319 --> 02:38:50,821
THAT WE FOCUSED ON IS LOOKING AT

3590
02:38:50,888 --> 02:38:56,093
WHAT IS THE -- POTENTIALLY

3591
02:38:56,159 --> 02:38:59,496
RELATE TO EPIGENETIC AGING,

3592
02:38:59,563 --> 02:39:04,001
KNOWING THE ACCULTURATION

3593
02:39:04,067 --> 02:39:05,235
PROCESS IS A STRESSFUL

3594
02:39:05,302 --> 02:39:07,638
EXPERIENCE THAT THEY

3595
02:39:07,704 --> 02:39:09,072
ENCOMPASS -- LOOK AT A NUMBER OF

3596
02:39:09,139 --> 02:39:11,041
DIFFERENT FACTORS, IN RELATION

3597
02:39:11,108 --> 02:39:12,009
TO EPIGENETIC AGING, WHETHER

3598
02:39:12,075 --> 02:39:12,743
THERE WAS A DIFFERENCE THERE.

3599
02:39:12,809 --> 02:39:14,912
SO WE LOOKED AT A COUPLE

3600
02:39:14,978 --> 02:39:19,316
DIFFERENT CLOCKS, SHOWING -- WE

3601
02:39:19,383 --> 02:39:21,885
HAVEN'T PUBLISHED THESE FINDINGS

3602
02:39:21,952 --> 02:39:23,086
YET.

3603
02:39:23,153 --> 02:39:30,294
LOOKING AT JETT AGE IS ONE TYPEE

3604
02:39:30,360 --> 02:39:34,097
TYPE OF INDEX -- THE RATE OF

3605
02:39:34,164 --> 02:39:34,431
AGING.

3606
02:39:34,498 --> 02:39:36,500
SO WHEN WE COMPARE FOREIGN BORN

3607
02:39:36,566 --> 02:39:37,801
AND WE CHARACTERIZE PEOPLE AT

3608
02:39:37,868 --> 02:39:39,836
U.S. BORN OR ARRIVING IN THE

3609
02:39:39,903 --> 02:39:42,673
UNITED STATES AS A CHILD OR

3610
02:39:42,739 --> 02:39:44,207
ARRIVING IN THE UNITED STATES AS

3611
02:39:44,274 --> 02:39:45,342
AN ADULT, BECAUSE WE KNOW

3612
02:39:45,409 --> 02:39:46,743
THERE'S A DIFFERENCE OF LIVED

3613
02:39:46,810 --> 02:39:47,878
EXPERIENCE WHEN YOU COME IN TO

3614
02:39:47,945 --> 02:39:49,212
THE U.S. AS A CHILD VERSUS AN

3615
02:39:49,279 --> 02:39:54,551
ADULT, WE SEE THAT THE

3616
02:39:54,618 --> 02:39:55,519
COMBINATION THAT ARE NOT U.S.

3617
02:39:55,585 --> 02:39:59,222
BORN, YOU HAVE A LOWER AGE OR A

3618
02:39:59,289 --> 02:40:00,524
DECELERATION OF AGE, IF YOU

3619
02:40:00,590 --> 02:40:02,392
WILL, A PROTECTIVE EFFECT OF NOT

3620
02:40:02,459 --> 02:40:03,994
BEING BORN IN THE UNITED STATES,

3621
02:40:04,061 --> 02:40:05,729
COMING TO THIS COUNTRY AS AN

3622
02:40:05,796 --> 02:40:08,131
ADULT.

3623
02:40:08,198 --> 02:40:11,134
IT'S NOT STATISTICALLY

3624
02:40:11,201 --> 02:40:11,835
SIGNIFICANT -- LIVED IN A

3625
02:40:11,902 --> 02:40:13,770
POPULATION ARRIVING AS A CHILD,

3626
02:40:13,837 --> 02:40:16,506
SO THIS SORT OF LIKE KIND OF

3627
02:40:16,573 --> 02:40:17,307
REPRESENTS A LOT OF WHAT WE SEE

3628
02:40:17,374 --> 02:40:20,410
IN THE LITERATURE, AND THE

3629
02:40:20,477 --> 02:40:23,046
IMPACT OF ACCULTURATION,

3630
02:40:23,113 --> 02:40:24,648
HISPANIC PARADOX, WE KNOW THAT

3631
02:40:24,715 --> 02:40:27,718
IMMIGRANT POPULATIONS ARE COMING

3632
02:40:27,784 --> 02:40:29,386
IN POTENTIALLY HEALTHIER AND

3633
02:40:29,453 --> 02:40:32,189
THAT HEALTH STARTS TO WANE AS

3634
02:40:32,255 --> 02:40:33,590
THE POPULATION SPENDS MORE TIME

3635
02:40:33,657 --> 02:40:34,591
IN THE UNITED STATES.

3636
02:40:34,658 --> 02:40:37,761
WE HAVE PROTECTIVE FACTORS --

3637
02:40:37,828 --> 02:40:44,167
PRO TENSIONALLY WPOTENTIALLY WEE

3638
02:40:44,234 --> 02:40:45,602
CONTEXT OF POTENTIALLY

3639
02:40:45,669 --> 02:40:49,740
DISCRIMINATION AND OTHER FACTORS

3640
02:40:49,806 --> 02:40:51,908
HAVE A WEARING EFFECT ON THE

3641
02:40:51,975 --> 02:40:53,010
AGING OF THIS POPULATION.

3642
02:40:53,076 --> 02:40:56,480
WE HAVE CHARACTERIZED AN

3643
02:40:56,546 --> 02:40:57,347
ACTIVITY TWO DIFFERENT WAYS IN

3644
02:40:57,414 --> 02:41:00,617
THE COHORT BECAUSE IF YOU ARE

3645
02:41:00,684 --> 02:41:03,787
BORN -- FOR EXAMPLE, IF YOU'RE

3646
02:41:03,854 --> 02:41:07,157
BORN IN U.S. MAINLAND OR

3647
02:41:07,224 --> 02:41:11,061
TERRITORY, -- INCLUDING THE U.S.

3648
02:41:11,128 --> 02:41:11,595
TERRITORIES.

3649
02:41:11,661 --> 02:41:14,898
SO WHEN WE CONSIDER U.S. NATIVES

3650
02:41:14,965 --> 02:41:16,767
BORN IN THE MAINLAND UNITED

3651
02:41:16,833 --> 02:41:18,001
STATES OR IN THE TERRITORIES WE

3652
02:41:18,068 --> 02:41:19,569
SEE A SLIGHTLY STRONGER EFFECT,

3653
02:41:19,636 --> 02:41:21,438
BUT WE SORT OF ISOLATE THIS

3654
02:41:21,505 --> 02:41:24,007
FOREIGN BORN POPULATION TO BEING

3655
02:41:24,074 --> 02:41:25,542
BORN COMPLETELY OUTSIDE OF THE

3656
02:41:25,609 --> 02:41:31,681
U.S. AND U.S. TERRITORIES.

3657
02:41:31,748 --> 02:41:33,150
ANOTHER WAY WE LOOKED AT SOME OF

3658
02:41:33,216 --> 02:41:34,351
THE IMPACT OF STRESSORS ON THIS

3659
02:41:34,418 --> 02:41:35,419
POPULATION IS REALLY THINKING

3660
02:41:35,485 --> 02:41:37,421
ABOUT -- SO IT'S NOT JUST -- BUT

3661
02:41:37,487 --> 02:41:39,556
WE ACTUALLY HAVE MEASURES OF

3662
02:41:39,623 --> 02:41:42,192
WHAT POTENTIALLY THOSE

3663
02:41:42,259 --> 02:41:46,129
FACTORS -- THESE GROUPS.

3664
02:41:46,196 --> 02:41:50,567
SO NUMBER OF MEASURES ON SES,

3665
02:41:50,634 --> 02:41:55,806
ALL THESE OTHER FACTORS, SO WE

3666
02:41:55,872 --> 02:41:58,108
CONDUCTED ANALYSIS LOOKING AT

3667
02:41:58,175 --> 02:41:59,409
HOW THE ACCUMULATION OF

3668
02:41:59,476 --> 02:42:03,013
DIFFERENT FACTORS BOTH SOCIAL

3669
02:42:03,080 --> 02:42:05,749
STRESSORS AS WELL AS SOCIAL

3670
02:42:05,816 --> 02:42:07,150
SUPPORT -- POTENTIALLY -- SO IT

3671
02:42:07,217 --> 02:42:09,419
MAY IN PART DIFFERENTIAL EFFECT

3672
02:42:09,486 --> 02:42:11,621
ON EPIGENETIC AGING.

3673
02:42:11,688 --> 02:42:21,998
SO THIS IS -- TRADITIONALLY A

3674
02:42:22,065 --> 02:42:26,470
METHOD THAT'S USED IN

3675
02:42:26,536 --> 02:42:28,205
EPIDEMIOLOGY FOR DIFFERENT

3676
02:42:28,271 --> 02:42:29,539
MIXTURES -- TO SEE HOW IT

3677
02:42:29,606 --> 02:42:29,873
CLUSTERED.

3678
02:42:29,940 --> 02:42:31,875
SO WE'VE LOOKED AT OUR DATA, AND

3679
02:42:31,942 --> 02:42:35,278
WE CAN CHARACTERIZE OUR

3680
02:42:35,345 --> 02:42:36,413
POPULATION AS ABOUT BELONGING OR

3681
02:42:36,480 --> 02:42:40,150
SORT OF BEING -- SORT OF

3682
02:42:40,217 --> 02:42:41,051
CLUSTERS.

3683
02:42:41,118 --> 02:42:42,552
CLUSTER ONE IS A CLUSTER THAT

3684
02:42:42,619 --> 02:42:43,954
HAS HIGH EXPOSURE TO EVERYTHING

3685
02:42:44,020 --> 02:42:46,022
WE LOOKED AT, SO IMMIGRATION

3686
02:42:46,089 --> 02:42:47,657
STRESS, DEPRESSIVE SYMPTOMS,

3687
02:42:47,724 --> 02:42:51,194
ANXIETY, PERCEIVED STRESS --

3688
02:42:51,261 --> 02:42:54,197
SUPPORT AND A NUMBER OF

3689
02:42:54,264 --> 02:42:56,500
DIFFERENT FACTORS.

3690
02:42:56,566 --> 02:42:57,634
CLUSTER FOUR IS THE OTHER

3691
02:42:57,701 --> 02:43:00,670
EXTREME WHERE THEY JUST DID NOT

3692
02:43:00,737 --> 02:43:04,040
EXPERIENCE ANY OF THESE MARKERS,

3693
02:43:04,107 --> 02:43:05,575
AND CLUSTER 2 AND 3 ARE

3694
02:43:05,642 --> 02:43:06,877
SOMEWHERE IN BETWEEN.

3695
02:43:06,943 --> 02:43:08,745
CLUSTER 2 IS MORE CHARACTERIZED

3696
02:43:08,812 --> 02:43:12,182
BY HIGH TRAUMA, HIGH ACES, HYPER

3697
02:43:12,249 --> 02:43:13,416
RECEIVED STRESS, AND CLUSTER

3698
02:43:13,483 --> 02:43:15,118
THREE IS MORE CHARACTERIZED BY

3699
02:43:15,185 --> 02:43:17,854
HIGH LEVELS OF DEPRESSION,

3700
02:43:17,921 --> 02:43:19,289
ANXIETY AND PERCEIVED STRESS.

3701
02:43:19,356 --> 02:43:22,959
AND WHAT WE SEE IS THAT CLUSTER

3702
02:43:23,026 --> 02:43:25,595
1, 2 AND 3 ARE ALSO SEEING

3703
02:43:25,662 --> 02:43:28,765
INCREASED AGE ACCELERATION.

3704
02:43:28,832 --> 02:43:32,302
SO -- ASSOCIATED WITH INCREASING

3705
02:43:32,369 --> 02:43:34,938
ACCELERATION IN -- AGE AND PACE

3706
02:43:35,005 --> 02:43:36,907
OF AGING COMPARED TO CLUSTER 4,

3707
02:43:36,973 --> 02:43:39,176
WITH DIFFERENT LEVELS OF --

3708
02:43:39,242 --> 02:43:41,178
ASSOCIATION DEPENDING ON HOW

3709
02:43:41,244 --> 02:43:43,647
MUCH PEOPLE WHO WANT TO.

3710
02:43:43,713 --> 02:43:45,315
SO CLUSTER ONE IS SORT OF

3711
02:43:45,382 --> 02:43:47,651
EXPOSED TO OTHER FACTORS AND YOU

3712
02:43:47,717 --> 02:43:49,519
WOULD EXPECT -- SITUATION.

3713
02:43:49,586 --> 02:43:50,720
BUT THE INTERESTING THING HERE

3714
02:43:50,787 --> 02:43:53,290
IS THAT WHETHER PEOPLE ARE

3715
02:43:53,356 --> 02:43:55,825
REPORTING HIGH LEVELS OF TRAUMA

3716
02:43:55,892 --> 02:43:56,593
POTENTIALLY WITHOUT MENTAL

3717
02:43:56,660 --> 02:43:57,994
HEALTH SYMPTOMATOLOGY OR THEY'RE

3718
02:43:58,061 --> 02:43:59,963
EXPERIENCING HIGH LEVELS OF

3719
02:44:00,030 --> 02:44:01,898
THESE MENTAL HEALTH

3720
02:44:01,965 --> 02:44:02,899
SYMPTOMATOLOGY WITHOUT -- OF

3721
02:44:02,966 --> 02:44:09,239
TRAUMA, WE STILL SEE THIS IMPACT

3722
02:44:09,306 --> 02:44:11,107
ON THE --.

3723
02:44:11,174 --> 02:44:13,043
I'LL JUST END BY GIVING A LITTLE

3724
02:44:13,109 --> 02:44:15,879
BIT OF WHERE WE FOCUSED ON JUST

3725
02:44:15,946 --> 02:44:17,547
ONE OF THESE STRESSORS, SO WE DO

3726
02:44:17,614 --> 02:44:21,418
A LOT OF WORK ON ACES AND THEIR

3727
02:44:21,484 --> 02:44:24,254
IMPACT ON -- ACROSS THE LIFE

3728
02:44:24,321 --> 02:44:26,089
COURSE, SO WE ALSO DO WORK JUST

3729
02:44:26,156 --> 02:44:27,857
FOCUSING ON ONE TYPE OF

3730
02:44:27,924 --> 02:44:30,360
STRESSOR, SO AGES IN RELATION TO

3731
02:44:30,427 --> 02:44:31,027
EPIGENETIC AGING.

3732
02:44:31,094 --> 02:44:34,864
THIS IS WORK BY -- THE DOCTORAL

3733
02:44:34,931 --> 02:44:36,166
STUDENT ALSO -- WORKING WITH ME,

3734
02:44:36,233 --> 02:44:39,536
AND WE DO SEE HIGHER LEVELS OF

3735
02:44:39,603 --> 02:44:42,272
ACE EXPOSURE -- THAT ARE

3736
02:44:42,339 --> 02:44:45,208
ASSOCIATED WITH AGE ACCELERATION

3737
02:44:45,275 --> 02:44:49,112
AND WE'RE ALSO LOOKING AT TIME

3738
02:44:49,179 --> 02:44:52,082
WHEN -- AS WE HAVE MULTIPLE

3739
02:44:52,148 --> 02:44:56,553
MEASURES OF -- AND NOT THE RATE

3740
02:44:56,620 --> 02:44:57,454
OF AGING.

3741
02:44:57,520 --> 02:44:59,789
IT WAS REALLY INTERESTING, WE

3742
02:44:59,856 --> 02:45:04,728
LOOK AT SORT OF THE -- POTENTIAL

3743
02:45:04,794 --> 02:45:06,596
MODIFIER OF THE AGES ON

3744
02:45:06,663 --> 02:45:07,731
EPIGENETIC AGING AND IN FACT WE

3745
02:45:07,797 --> 02:45:10,166
DO SEE THE U.S. -- POPULATION

3746
02:45:10,233 --> 02:45:12,902
WHERE WE SEE -- EPIGENETIC AGING

3747
02:45:12,969 --> 02:45:15,872
SO SORT OF THAT POTENTIAL SORT

3748
02:45:15,939 --> 02:45:19,542
OF EXACERBATING FACT -- EARLY

3749
02:45:19,609 --> 02:45:22,078
CHILD EXPERIENCES AND THEN THE

3750
02:45:22,145 --> 02:45:26,149
IMPACT OF WHAT BEING A LATINO IN

3751
02:45:26,216 --> 02:45:28,285
THE UNITED STATES REPRESENTS.

3752
02:45:28,351 --> 02:45:30,253
THAT EXACERBATES EPIGENETIC

3753
02:45:30,320 --> 02:45:34,257
AGING IN OUR SAMPLE.

3754
02:45:34,324 --> 02:45:34,924
SO I'LL END THERE.

3755
02:45:34,991 --> 02:45:36,993
THESE FINDINGS ARE SORT OF

3756
02:45:37,060 --> 02:45:37,994
ADJUSTED FOR A NUMBER OF

3757
02:45:38,061 --> 02:45:41,231
DIFFERENT FACTORS AND THEY'RE

3758
02:45:41,298 --> 02:45:45,502
ROBUST --.

3759
02:45:45,568 --> 02:45:47,370
WE -- THE NEXT STEPS FOR THIS

3760
02:45:47,437 --> 02:45:50,740
WORK IS TO -- AGING AND

3761
02:45:50,807 --> 02:45:52,242
CARDIOVASCULAR HEALTH

3762
02:45:52,309 --> 02:45:53,543
MEASURES -- OVERALL CONCEPTUAL

3763
02:45:53,610 --> 02:45:54,311
FRAMEWORK.

3764
02:45:54,377 --> 02:46:04,287
I WILL STOP THERE.

3765
02:46:04,354 --> 02:46:04,921
>> THANK YOU.

3766
02:46:04,988 --> 02:46:15,065
NEXT WE HAVE DR. SYLVIE MRUG WHO

3767
02:46:15,131 --> 02:46:16,700
WILL TALK ABOUT THE ROLE OF DNA

3768
02:46:16,766 --> 02:46:17,667
METHYLATION IN THE CONNECTIONS

3769
02:46:17,734 --> 02:46:19,302
BETWEEN EARLY LIFE STRESS,

3770
02:46:19,369 --> 02:46:20,704
PROTECTIVE FACTORS AND HEALTH

3771
02:46:20,770 --> 02:46:22,138
DISPARITIES IN EARLY MARKERS OF

3772
02:46:22,205 --> 02:46:32,482
CHRONIC DISEASE.

3773
02:46:57,173 --> 02:47:02,345
>> SO GOOD AFTERNOON, EVERYBODY.

3774
02:47:02,412 --> 02:47:03,880
JUST TO INTRODUCE MYSELF A

3775
02:47:03,947 --> 02:47:05,749
LITTLE BIT, AS YOU CAN HEAR, I'M

3776
02:47:05,815 --> 02:47:12,155
NOT A NATIVE -- I CAME TO THIS

3777
02:47:12,222 --> 02:47:14,557
COUNTRY -- YEARS AGO FROM

3778
02:47:14,624 --> 02:47:18,094
EASTERN EUROPE WITH $200 AND

3779
02:47:18,161 --> 02:47:21,331
THIS MUCH ENGLISH, SO I LIKE I

3780
02:47:21,398 --> 02:47:22,532
CAN SPEAK BETTER.

3781
02:47:22,599 --> 02:47:24,334
MOST OF THE TIME I'VE BEEN IN

3782
02:47:24,401 --> 02:47:27,404
THE U.S., I HAVE LIVED IN

3783
02:47:27,470 --> 02:47:32,108
ALABAMA, WHERE WE HAVE -- AND --

3784
02:47:32,175 --> 02:47:34,644
[INAUDIBLE].

3785
02:47:34,711 --> 02:47:36,413
TODAY I WILL TELL YOU A LITTLE

3786
02:47:36,479 --> 02:47:37,781
BIT ABOUT OUR WORK ON THE ROLE

3787
02:47:37,847 --> 02:47:41,184
OF DNA METHYLATION AND THE

3788
02:47:41,251 --> 02:47:41,851
CONNECTIONS -- PROTECTIVE

3789
02:47:41,918 --> 02:47:43,119
FACTORS AND HEALTH DISPARITIES

3790
02:47:43,186 --> 02:47:45,755
IN EARLY MARKERS OF CHRONIC

3791
02:47:45,822 --> 02:47:48,825
DISEASE.

3792
02:47:48,892 --> 02:47:59,102
[INAUDIBLE].

3793
02:48:57,160 --> 02:49:00,430
>> WONDERFUL.

3794
02:49:00,497 --> 02:49:01,831
SO -- SUBSTANTIAL -- EVIDENCE

3795
02:49:01,898 --> 02:49:04,567
SHOWING THAT THERE ARE --

3796
02:49:04,634 --> 02:49:05,568
DISPARITIES BETWEEN BLACK AND

3797
02:49:05,635 --> 02:49:10,373
WHITE AMERICANS, I LIVE AND WORK

3798
02:49:10,440 --> 02:49:14,511
IN ALABAMA -- DISEASE

3799
02:49:14,577 --> 02:49:17,113
DISPARITIES AND OVERALL -- OF

3800
02:49:17,180 --> 02:49:18,548
CHRONIC -- CONDITIONS INCLUDING

3801
02:49:18,615 --> 02:49:22,352
OBESITY, DIABETES, HYPERTENSION,

3802
02:49:22,418 --> 02:49:24,087
CARDIOVASCULAR DISEASE, KIDNEY

3803
02:49:24,153 --> 02:49:25,321
DISEASE, AS WELL AS LIFE

3804
02:49:25,388 --> 02:49:26,389
EXPECTANCY.

3805
02:49:26,456 --> 02:49:28,791
AND INTERESTING -- DISPARITY

3806
02:49:28,858 --> 02:49:29,726
BETWEEN BLACK AND WHITE

3807
02:49:29,792 --> 02:49:33,329
AMERICANS ARE MUCH MORE

3808
02:49:33,396 --> 02:49:34,330
EXTENSIVE AND -- COMPARED TO

3809
02:49:34,397 --> 02:49:35,865
OTHER REGIONS IN THE COUNTRY.

3810
02:49:35,932 --> 02:49:38,368
WE ALSO KNOW THAT THESE

3811
02:49:38,434 --> 02:49:39,769
DISPARITIES EMERGE QUITE EARLY,

3812
02:49:39,836 --> 02:49:42,739
SO SOME OF THAT CAN BE SEEN IN

3813
02:49:42,805 --> 02:49:44,274
CHILDHOOD, YOUNG ADULTHOOD SUCH

3814
02:49:44,340 --> 02:49:47,844
AS OBESITY, HYPERTENSION,

3815
02:49:47,911 --> 02:49:48,611
GLYCATED HEMOGLOBIN OR

3816
02:49:48,678 --> 02:49:49,812
INFLAMMATION.

3817
02:49:49,879 --> 02:49:52,081
WE ALSO KNOW THAT THESE EARLY

3818
02:49:52,148 --> 02:49:54,150
METABOLIC INDICATORS CONTRIBUTE

3819
02:49:54,217 --> 02:49:55,585
TO LATER CHRONIC DISEASE AND

3820
02:49:55,652 --> 02:49:57,754
HEALTH DISPARITIES IN LATER

3821
02:49:57,820 --> 02:49:58,621
CHRONIC DISEASE.

3822
02:49:58,688 --> 02:49:59,822
NEXT, WE KNOW THAT EARLY LIFE

3823
02:49:59,889 --> 02:50:03,526
STRESS HAS PROFOUND EFFECTS ON

3824
02:50:03,593 --> 02:50:09,766
HEALTH, SO -- LIVING IN POVERTY,

3825
02:50:09,832 --> 02:50:11,935
DISADVANTAGED NEIGHBORHOODS,

3826
02:50:12,001 --> 02:50:16,406
EXPERIENCING DISCRIMINATION, ALL

3827
02:50:16,472 --> 02:50:17,840
OF THESE FACTORS LEAD TO CHRONIC

3828
02:50:17,907 --> 02:50:18,942
HEALTH DISORDERS.

3829
02:50:19,008 --> 02:50:21,444
AND BLACK AMERICANS CARRY A

3830
02:50:21,511 --> 02:50:22,412
DISPROPORTIONATE BURDEN OF THESE

3831
02:50:22,478 --> 02:50:26,583
EARLY LIFE STRESSORS.

3832
02:50:26,649 --> 02:50:28,851
THESE CHRONIC PSYCHOSOCIAL

3833
02:50:28,918 --> 02:50:32,755
STRESS AFFECTS -- BIOLOGICAL AND

3834
02:50:32,822 --> 02:50:33,890
PSYCHOLOGICAL AND BEHAVIORAL

3835
02:50:33,957 --> 02:50:35,758
PROCESSES INCLUDING DNA

3836
02:50:35,825 --> 02:50:37,794
METHYLATION, WHICH IN TURN

3837
02:50:37,860 --> 02:50:39,529
ALTERED STRESS REACTIVITY,

3838
02:50:39,596 --> 02:50:42,165
METABOLISM AND INFLAMMATION.

3839
02:50:42,231 --> 02:50:44,567
SO THERE ARE A NUMBER OF

3840
02:50:44,634 --> 02:50:48,237
RESEARCH GAPS -- WORK.

3841
02:50:48,304 --> 02:50:50,974
THE QUESTION IS DEVELOPMENTAL

3842
02:50:51,040 --> 02:50:52,275
TIMING OF LINKS BETWEEN EARLY

3843
02:50:52,342 --> 02:50:55,044
LIFE STRESS AND DNA METHYLATION.

3844
02:50:55,111 --> 02:50:58,481
THIS -- TIMING OF THE STRESS

3845
02:50:58,548 --> 02:50:59,382
EXPOSURE -- FOR EXPOSURE TO

3846
02:50:59,449 --> 02:51:03,186
EARLY LIFE STRESS THIS IS

3847
02:51:03,252 --> 02:51:04,153
ESPECIALLY IMPACTFUL.

3848
02:51:04,220 --> 02:51:05,488
SECOND, WHAT IS THE TIMING OF

3849
02:51:05,555 --> 02:51:12,128
DNA METHYLATION -- AND -- FOCUS

3850
02:51:12,195 --> 02:51:13,763
ON IN TERMS OF DEVELOPMENT

3851
02:51:13,830 --> 02:51:15,398
INCLUDING CHILDHOOD, ADOLESCENCE

3852
02:51:15,465 --> 02:51:19,636
AND YOUNG ADULTHOOD.

3853
02:51:19,702 --> 02:51:22,372
AND -- PROCESSES SO THEY CAN

3854
02:51:22,438 --> 02:51:25,742
BE -- INTERVENTIONS BEFORE

3855
02:51:25,808 --> 02:51:28,911
PEOPLE DEVELOP CHRONIC DISEASE.

3856
02:51:28,978 --> 02:51:30,880
WE ALSO HAVE RACIAL DIFFERENCES

3857
02:51:30,947 --> 02:51:32,649
IN THESE LINKS BETWEEN EARLY

3858
02:51:32,715 --> 02:51:35,118
LIFE STRESS, DNA METHYLATION AND

3859
02:51:35,184 --> 02:51:36,119
EARLY CARDIOMETABOLIC

3860
02:51:36,185 --> 02:51:37,420
INDICATORS, AND PROTECTIVE

3861
02:51:37,487 --> 02:51:40,156
FACTORS THAT MAY REDUCE THE

3862
02:51:40,223 --> 02:51:42,091
EFFECTS OF EARLY LIFE STRESS ON

3863
02:51:42,158 --> 02:51:43,192
ADA METHYLATION AND HEALTH

3864
02:51:43,259 --> 02:51:44,227
OUTCOMES.

3865
02:51:44,293 --> 02:51:46,996
THESE PROTECTIVE FACTORS --

3866
02:51:47,063 --> 02:51:48,364
INCLUDING INDIVIDUAL, FAMILY AND

3867
02:51:48,431 --> 02:51:50,600
COMMUNITY.

3868
02:51:50,667 --> 02:51:52,702
SO I'LL FOCUS ON DNA METHYLATION

3869
02:51:52,769 --> 02:51:57,940
HAS BEEN PRIMARILY ON EPIGENETIC

3870
02:51:58,007 --> 02:52:00,743
AGING, SO AS WE GET OLDER, OUR

3871
02:52:00,810 --> 02:52:02,712
DNA METHYLATION GENERALLY

3872
02:52:02,779 --> 02:52:03,312
DECREASES.

3873
02:52:03,379 --> 02:52:05,248
BUT THERE ARE SUBSTANTIAL

3874
02:52:05,314 --> 02:52:08,384
INDIVIDUAL DIFFERENCES IN DNA

3875
02:52:08,451 --> 02:52:10,353
METHYLATION WHICH HAVE BEEN --

3876
02:52:10,420 --> 02:52:12,755
IN THESE EPIGENETIC CLOCKS WHICH

3877
02:52:12,822 --> 02:52:15,158
PROVIDE INFORMATION ON DNA

3878
02:52:15,224 --> 02:52:19,395
METHYLATION [INAUDIBLE] ON THE

3879
02:52:19,462 --> 02:52:22,365
GENOME AND INDICATE HOW FASTER

3880
02:52:22,432 --> 02:52:25,535
OR SLOWER YOUR BIOLOGICAL AGING

3881
02:52:25,601 --> 02:52:27,737
IS COMPARED TO YOUR

3882
02:52:27,804 --> 02:52:29,372
CHRONOLOGICAL AGE.

3883
02:52:29,439 --> 02:52:30,773
SO FIRST I WOULD LIKE TO PRESENT

3884
02:52:30,840 --> 02:52:33,076
SOME FINDINGS FROM THE HEALTHY

3885
02:52:33,142 --> 02:52:36,112
PASSAGES STUDY WHERE WE HAVE

3886
02:52:36,179 --> 02:52:37,080
OVER 1200 INDIVIDUALS FROM

3887
02:52:37,146 --> 02:52:42,251
CHILDHOOD TO YOUNG ADULTHOOD,

3888
02:52:42,318 --> 02:52:48,891
60% BLACK, 35% WHITE, AND AROUND

3889
02:52:48,958 --> 02:52:50,326
[INAUDIBLE].

3890
02:52:50,393 --> 02:52:54,263
SO AT AGES 11, 13, 16 AND 19, WE

3891
02:52:54,330 --> 02:52:55,031
ASSESSED SEVERAL DIFFERENT EARLY

3892
02:52:55,098 --> 02:52:57,734
LIFE STRESSORS INCLUDING FAMILY

3893
02:52:57,800 --> 02:53:01,137
INCOME AND WITNESSING VIOLENCE

3894
02:53:01,204 --> 02:53:03,206
AND VICTIMIZATION.

3895
02:53:03,272 --> 02:53:06,876
AT AGE 11 -- PEOPLE'S ADDRESSES

3896
02:53:06,943 --> 02:53:08,077
AND LINKED THEM WITH INFORMATION

3897
02:53:08,144 --> 02:53:12,148
FROM THE U.S. CENSUS ON POVERTY,

3898
02:53:12,215 --> 02:53:13,750
LEVEL OF EDUCATION,

3899
02:53:13,816 --> 02:53:15,284
UNEMPLOYMENT.

3900
02:53:15,351 --> 02:53:19,122
AT AGE 19, WE ALSO ASKED ARE

3901
02:53:19,188 --> 02:53:21,758
PARTICIPANTS LIFETIME EXPOSURE

3902
02:53:21,824 --> 02:53:26,996
TO DISCRIMINATION.

3903
02:53:27,063 --> 02:53:34,637
AND -- SALIVA -- SECOND AND

3904
02:53:34,704 --> 02:53:35,505
THIRD GENERATION EPIGENETIC

3905
02:53:35,571 --> 02:53:41,944
CLOCKS AND PHENOAGE, GRIMAGE AND

3906
02:53:42,011 --> 02:53:44,247
DUNEDINPO AM -- ARE BETTER AT

3907
02:53:44,313 --> 02:53:48,050
PREDICTING HEALTHSPAN AND --

3908
02:53:48,117 --> 02:53:54,290
DISEASE -- CHRONOLOGICAL AGING.

3909
02:53:54,357 --> 02:53:57,460
-- INCLUDING AGE, SEX, RACE,

3910
02:53:57,527 --> 02:54:02,031
BMI, SMOKING AND CELL --.

3911
02:54:02,098 --> 02:54:04,667
SO -- THE QUESTION OF RACIAL

3912
02:54:04,734 --> 02:54:08,371
DISPARITIES IN EPIGENETIC AGING.

3913
02:54:08,437 --> 02:54:13,509
SO AGAIN ADJUSTING FOR -- BEING

3914
02:54:13,576 --> 02:54:16,779
BLACK PREDICTED ACCELERATED

3915
02:54:16,846 --> 02:54:20,049
HIGHER GRIMAGE, THIS IS AGE 19

3916
02:54:20,116 --> 02:54:23,653
METHYLATION DATA, AS WELL AS

3917
02:54:23,719 --> 02:54:28,224
HIGHER -- OF EPIGENETIC AGING.

3918
02:54:28,291 --> 02:54:30,326
THIS IS ONLY -- PERCEPT OF THE

3919
02:54:30,393 --> 02:54:33,596
SAMPLE BUT IT STILL PREDICTED

3920
02:54:33,663 --> 02:54:35,565
HIGHER -- AGING.

3921
02:54:35,631 --> 02:54:39,769
INTERESTING -- DIFFERENCES ON

3922
02:54:39,836 --> 02:54:42,772
THE -- AGE.

3923
02:54:42,839 --> 02:54:45,208
[INAUDIBLE] DIFFERENT MEDIATORS

3924
02:54:45,274 --> 02:54:46,475
SO I'M JUST GOING TO SHOW IT

3925
02:54:46,542 --> 02:54:47,877
PIECE BY PIECE BUT IT WAS ALL

3926
02:54:47,944 --> 02:54:48,544
ANALYZED TOGETHER.

3927
02:54:48,611 --> 02:54:52,248
WHEN YOU COME HERE --

3928
02:54:52,315 --> 02:54:57,386
DIFFERENCES IN ACCELERATED -- BY

3929
02:54:57,453 --> 02:54:59,255
GREATER NEIGHBORHOOD

3930
02:54:59,322 --> 02:55:01,224
DISADVANTAGE AND -- AS WELL AS

3931
02:55:01,290 --> 02:55:05,561
VIOLENCE -- [INAUDIBLE].

3932
02:55:05,628 --> 02:55:09,699
DIFFERENCES IN THE -- OF AGI

3933
02:55:09,765 --> 02:55:11,033
AGING -- FAMILY INCOME

3934
02:55:11,100 --> 02:55:12,001
EXPERIENCED BY THE BLACK YOUTH

3935
02:55:12,068 --> 02:55:15,271
IN OUR STUDY, AND SAME FOR THE

3936
02:55:15,338 --> 02:55:16,806
OTHER RACIAL GROUPS ALSO

3937
02:55:16,873 --> 02:55:18,774
EXPLAINED BY FAMILY INCOME AND

3938
02:55:18,841 --> 02:55:20,009
INTERESTINGLY ALTHOUGH THERE

3939
02:55:20,076 --> 02:55:23,145
WERE NO RACIAL DIFFERENCES ON --

3940
02:55:23,212 --> 02:55:24,447
AGE -- MODEL, THERE WAS A

3941
02:55:24,513 --> 02:55:26,315
SIGNIFICANT MEDIATED EFFECT

3942
02:55:26,382 --> 02:55:28,618
BETWEEN BLACK AND WHITE

3943
02:55:28,684 --> 02:55:32,288
INDIVIDUALS, AGAIN FASTER

3944
02:55:32,355 --> 02:55:36,025
EPIGENETIC AGING -- FEMALE AGE

3945
02:55:36,092 --> 02:55:37,560
AND EXPLAINED BY HIGHER EXPOSURE

3946
02:55:37,627 --> 02:55:38,394
TO VIOLENCE.

3947
02:55:38,461 --> 02:55:41,898
SO NEXT WE TACKLED THE QUESTION

3948
02:55:41,964 --> 02:55:43,132
OF DEVELOPMENTAL TIMING FOCUSING

3949
02:55:43,199 --> 02:55:45,067
ON VIOLENCE EXPOSURE.

3950
02:55:45,134 --> 02:55:49,238
YOU CAN SEE THEY HAVE COLLECTED

3951
02:55:49,305 --> 02:55:52,041
AGE 11, 13, 16 AND 19 AND WE

3952
02:55:52,108 --> 02:55:53,910
WERE ALSO INTERESTED IN THE

3953
02:55:53,976 --> 02:55:55,311
DIFFERENCES BETWEEN WITNESSING

3954
02:55:55,378 --> 02:56:01,250
AND VICTIMIZATION.

3955
02:56:01,317 --> 02:56:03,185
-- FOR THE LAST 12 MONTHS, YOU

3956
02:56:03,252 --> 02:56:08,858
CAN SEE -- VIOLENCE -- HIGH FOR

3957
02:56:08,925 --> 02:56:10,293
WHAT WE WOULD LIKE TO SEE.

3958
02:56:10,359 --> 02:56:14,230
SO OVER 70% OF YOUTH REPORTED --

3959
02:56:14,297 --> 02:56:17,333
VIOLENCE AND BETWEEN 20 AND

3960
02:56:17,400 --> 02:56:21,103
50% -- VI VICTIMIZATION.

3961
02:56:21,170 --> 02:56:29,078
ALSO NOTICE -- SO PREDICTED

3962
02:56:29,145 --> 02:56:31,580
EPIGENETIC AGING -- VIOLENCE AT

3963
02:56:31,647 --> 02:56:33,449
THE DIFFERENT AGES WHAT WE FOUND

3964
02:56:33,516 --> 02:56:38,254
WAS THAT AGE 11 -- PREDICTED

3965
02:56:38,321 --> 02:56:40,022
HIGHER AGE.

3966
02:56:40,089 --> 02:56:42,091
AGE 13 AND AGE 16 WITNESSING

3967
02:56:42,158 --> 02:56:44,961
VIOLENCE PREDICTED HIGHER -- AGE

3968
02:56:45,027 --> 02:56:49,198
AND HIGHER DUNEDIN DB OF AGING,

3969
02:56:49,265 --> 02:56:52,368
AND AGE 19 DID NOT PREDICT ANY

3970
02:56:52,435 --> 02:56:55,438
EPIGENETIC AGING VARIABLES.

3971
02:56:55,504 --> 02:56:56,505
THE -- WERE PRETTY SMALL BUT

3972
02:56:56,572 --> 02:56:59,442
THEY WERE ROBUST ACROSS

3973
02:56:59,508 --> 02:57:00,109
DIFFERENT OUTCOMES AND THERE

3974
02:57:00,176 --> 02:57:02,945
WERE NO SEX DIFFERENCES IN -- SO

3975
02:57:03,012 --> 02:57:06,816
THESE RESULTS SUGGEST THAT --

3976
02:57:06,882 --> 02:57:09,719
MAY BE A CRITICAL PERIOD FOR

3977
02:57:09,785 --> 02:57:11,253
EXPOSURE -- VIOLENCE.

3978
02:57:11,320 --> 02:57:13,222
NOW FOR VICTIMIZATION,

3979
02:57:13,289 --> 02:57:13,856
INTERESTINGLY THERE WERE NO

3980
02:57:13,923 --> 02:57:17,159
EFFECTS WHATSOEVER VICTIMIZATION

3981
02:57:17,226 --> 02:57:20,763
AT ANY AGE DID NOT PREDICT

3982
02:57:20,830 --> 02:57:23,799
ACCELERATED AGING --

3983
02:57:23,866 --> 02:57:24,100
DIFFERENCES.

3984
02:57:24,166 --> 02:57:26,969
IN THE NEXT PROJECT THAT I'LL

3985
02:57:27,036 --> 02:57:28,170
PRESENT, THE QUESTION OF

3986
02:57:28,237 --> 02:57:32,308
PROTECTIVE FACTORS, SPECIFICALLY

3987
02:57:32,375 --> 02:57:35,611
FOCUSED ON -- COMING FROM

3988
02:57:35,678 --> 02:57:37,680
NEIGHBORHOODS, NEIGHBORHOOD

3989
02:57:37,747 --> 02:57:41,183
DISADVANTAGE AND [INAUDIBLE]

3990
02:57:41,250 --> 02:57:41,517
EFFECTS.

3991
02:57:41,584 --> 02:57:44,453
FOR THIS STUDY, DATA FROM --

3992
02:57:44,520 --> 02:57:48,824
PROJECT THE BIRMINGHAM -- OVER

3993
02:57:48,891 --> 02:57:50,693
304 CHILDREN WHO WERE POLLED

3994
02:57:50,760 --> 02:57:53,963
FROM AGE 11 TO AGE 27.

3995
02:57:54,030 --> 02:57:56,465
61% FEMALE, 82% BLACK, 18%

3996
02:57:56,532 --> 02:57:57,033
WHITE.

3997
02:57:57,099 --> 02:57:59,769
AND AGE 11, WE GATHERED

3998
02:57:59,835 --> 02:58:00,836
INFORMATION ON NEIGHBORHOOD

3999
02:58:00,903 --> 02:58:03,439
POVERTY FROM U.S. CENSUS DATA

4000
02:58:03,506 --> 02:58:05,207
AND -- DISORDER AND DISORDER

4001
02:58:05,274 --> 02:58:10,112
INCLUDED THINGS LIKE -- FEELING

4002
02:58:10,179 --> 02:58:11,113
UNSAFE IN THE NEIGHBORHOOD.

4003
02:58:11,180 --> 02:58:14,383
AND WE ALSO ASKED CHILDREN AND

4004
02:58:14,450 --> 02:58:20,589
PARENTS ABOUT -- EXPERIENCES

4005
02:58:20,656 --> 02:58:21,757
INCLUDING SUPPORTIVE PARENTING

4006
02:58:21,824 --> 02:58:23,225
AS WELL AS HARSH AND

4007
02:58:23,292 --> 02:58:24,994
INCONSISTENT PARENTING, YELLING,

4008
02:58:25,061 --> 02:58:27,663
SPANKING THE CHILD --

4009
02:58:27,730 --> 02:58:28,464
CONSEQUENCES BUT NOT FOLLOWING

4010
02:58:28,531 --> 02:58:30,666
THROUGH OR JUST USING DIFFERENT

4011
02:58:30,733 --> 02:58:34,837
PUNISHMENT AND -- [INAUDIBLE].

4012
02:58:34,904 --> 02:58:40,376
-- YEARS LATER AT AGE 27 27 --

4013
02:58:40,443 --> 02:58:45,748
INCLUDING BMI, CORTISOL, CRP --

4014
02:58:45,815 --> 02:58:47,483
FROM THE BLOOD AS WELL AS DNA

4015
02:58:47,550 --> 02:58:50,419
METHYLATION THAT HAS BEEN

4016
02:58:50,486 --> 02:58:52,321
RELATED TO INFORMATION -- PRIOR

4017
02:58:52,388 --> 02:58:53,622
RESEARCH.

4018
02:58:53,689 --> 02:58:55,724
AND THE -- PAPER WE FOCUSED ON

4019
02:58:55,791 --> 02:58:57,426
THE EPIGENETIC CLOCKS AND

4020
02:58:57,493 --> 02:59:00,096
EPIGENETIC MORTALITY INDEX.

4021
02:59:00,162 --> 02:59:01,964
SO WHAT WE FOUND WAS THAT

4022
02:59:02,031 --> 02:59:03,132
NEIGHBORHOOD POVERTY, THIS WAS

4023
02:59:03,199 --> 02:59:06,001
FROM CENSUS DATA, EXPERIENCED

4024
02:59:06,068 --> 02:59:07,303
AGING LEVEL PREDICTED LOWER

4025
02:59:07,369 --> 02:59:09,038
LEVELS OF CORTISOL 16 YEARS

4026
02:59:09,105 --> 02:59:12,741
LATER.

4027
02:59:12,808 --> 02:59:14,710
AND -- AS REPORTED BY PARENTS AT

4028
02:59:14,777 --> 02:59:16,479
AGE 11 PREDICTED HIGHER

4029
02:59:16,545 --> 02:59:18,781
METHYLATION RELATED

4030
02:59:18,848 --> 02:59:19,648
INFLAMMATION, 16 YEARS LATER.

4031
02:59:19,715 --> 02:59:22,918
WE ALSO OBTAINED A NUMBER OF

4032
02:59:22,985 --> 02:59:24,720
INTERACTIVE -- BETWEEN PARENTING

4033
02:59:24,787 --> 02:59:25,754
AND [INAUDIBLE].

4034
02:59:25,821 --> 02:59:28,491
ALL OF THEM ARE IN THE DIRECTION

4035
02:59:28,557 --> 02:59:29,892
OF NEIGHBORHOOD DIVERSITY ONLY

4036
02:59:29,959 --> 02:59:36,065
BE ASSOCIATED FO WITH POOR OU

4037
02:59:36,132 --> 02:59:38,200
OUTCOMES -- AND HIGH

4038
02:59:38,267 --> 02:59:38,767
INCONSISTENT DISCIPLINE.

4039
02:59:38,834 --> 02:59:40,402
SO HERE YOU CAN SEE -- ON THE

4040
02:59:40,469 --> 02:59:41,570
BOTTOM YOU CAN SEE THAT

4041
02:59:41,637 --> 02:59:43,339
NEIGHBORHOOD POVERTY IS ALL

4042
02:59:43,405 --> 02:59:48,711
ASSOCIATED WITH INFLAMMATION.

4043
02:59:48,777 --> 02:59:52,615
-- FOR INCONSISTENT DISCIPLINE,

4044
02:59:52,681 --> 02:59:55,784
AND LAST ONE IS FOR THE --

4045
02:59:55,851 --> 02:59:56,986
METHYLATION.

4046
02:59:57,052 --> 03:00:01,790
ALSO YOU -- ASSOCIATION THAN --

4047
03:00:01,857 --> 03:00:04,527
INCONSISTENT DISCIPLINE.

4048
03:00:04,593 --> 03:00:06,695
PAPER FOCUSING ON EPIGENETIC

4049
03:00:06,762 --> 03:00:08,564
OUTCOMES WE DID NOT OBSERVE

4050
03:00:08,631 --> 03:00:10,866
ANY -- OF NEIGHBORHOOD POVERTY

4051
03:00:10,933 --> 03:00:13,369
OR NEIGHBORHOOD DISORDER -- BUT

4052
03:00:13,435 --> 03:00:15,137
AGAIN, WE HAD A NUMBER OF

4053
03:00:15,204 --> 03:00:19,508
SIGNIFICANT INTERACTIONS BETWEEN

4054
03:00:19,575 --> 03:00:25,014
NEIGHBORHOOD -- SO THESE ARE T

4055
03:00:25,080 --> 03:00:32,288
THE -- THE SHADED AREA IS NOT

4056
03:00:32,354 --> 03:00:34,590
SIGNIFICANT, THE WHITE AREA IS

4057
03:00:34,657 --> 03:00:35,691
SIGNIFICANT.

4058
03:00:35,758 --> 03:00:37,326
WHAT THESE TWO GRAPHS ARE SHOW

4059
03:00:37,393 --> 03:00:38,627
SOMETHING WHEN THE CHILD WAS

4060
03:00:38,694 --> 03:00:43,365
REPORTING LOW LEVELS OF PAREN

4061
03:00:43,432 --> 03:00:45,100
PARENTAL -- PARENTAL SUPPORT WE

4062
03:00:45,167 --> 03:00:46,869
SAW POSITIVE ASSOCIATION

4063
03:00:46,936 --> 03:00:48,170
BETWEEN -- AND EPIGENETIC

4064
03:00:48,237 --> 03:00:50,239
MORTALITIES AND -- EPIGENETIC

4065
03:00:50,306 --> 03:00:50,573
AGING.

4066
03:00:50,639 --> 03:00:54,510
ON THE BOTTOM IS OUR PARENT

4067
03:00:54,577 --> 03:00:55,945
REPORTED -- CONSISTENT

4068
03:00:56,011 --> 03:00:57,112
DISCIPLINE, SO WHEN THE PARENTS

4069
03:00:57,179 --> 03:01:00,082
REPORTED BEING MORE HARSH, BEING

4070
03:01:00,149 --> 03:01:01,183
MORE INCONSISTENT, AGAIN WE SEE

4071
03:01:01,250 --> 03:01:02,618
A POSITIVE ASSOCIATION BETWEEN

4072
03:01:02,685 --> 03:01:05,554
NEIGHBORHOOD POVERTY AND

4073
03:01:05,621 --> 03:01:11,026
DISORDER AND ACCELERATED

4074
03:01:11,093 --> 03:01:11,660
EPIGENETIC --.

4075
03:01:11,727 --> 03:01:13,329
OUR CURRENT PROJECT, WE ARE

4076
03:01:13,395 --> 03:01:16,599
EXAMINING THESE SAME QUESTIONS

4077
03:01:16,665 --> 03:01:17,900
IN -- COHORT.

4078
03:01:17,967 --> 03:01:19,768
SO USING THE OFFSPRING, THE

4079
03:01:19,835 --> 03:01:22,071
CHILDREN OF OUR ADULT

4080
03:01:22,137 --> 03:01:30,512
PARTICIPANTS, SO WE HAVE -- SO

4081
03:01:30,579 --> 03:01:31,714
THE CHILDREN RANGE FROM LITTLE

4082
03:01:31,780 --> 03:01:35,184
BABIES TO 14 YEARS OLD WITH A

4083
03:01:35,251 --> 03:01:36,485
MEAN OF 4, 4 YEARS.

4084
03:01:36,552 --> 03:01:37,519
WHAT WE FOUND WAS THAT

4085
03:01:37,586 --> 03:01:40,456
NEIGHBORHOOD POVERTY, AND THIS

4086
03:01:40,522 --> 03:01:44,593
IS NEIGHBORHOOD POVERTY OF --

4087
03:01:44,660 --> 03:01:46,428
WAS ASSOCIATED WITH HIGHER

4088
03:01:46,495 --> 03:01:50,933
EPIGENETIC AGING USING PEDBE

4089
03:01:51,000 --> 03:01:52,901
CLOCK IN CHILDREN AGES 7 OR

4090
03:01:52,968 --> 03:01:54,870
ABOVE, WHICH IS CONSISTENT WITH

4091
03:01:54,937 --> 03:01:59,141
THE PAST EPIGENETIC AGING BEING

4092
03:01:59,208 --> 03:01:59,441
NEGATIVE --.

4093
03:01:59,508 --> 03:02:04,146
ON THE OTHER HAND, WE SAW

4094
03:02:04,213 --> 03:02:05,681
NEIGHBORHOOD -- ASSOCIATED WITH

4095
03:02:05,748 --> 03:02:08,317
LOWER EPIGENETIC AGING --

4096
03:02:08,384 --> 03:02:10,052
2 YEARS OF AGE WHICH ACTUALLY IS

4097
03:02:10,119 --> 03:02:16,725
CONSISTENT WITH -- SO -- LOARP R

4098
03:02:16,792 --> 03:02:20,262
EPIGENETIC AGING IS A -- BETWEEN

4099
03:02:20,329 --> 03:02:20,796
NEIGHBORHOOD DISORDER AND

4100
03:02:20,863 --> 03:02:23,499
PARENTING.

4101
03:02:23,565 --> 03:02:24,600
SO NEIGHBORHOOD DISORDER WAS

4102
03:02:24,667 --> 03:02:26,468
RELATED TO LOWER EPIGENETIC

4103
03:02:26,535 --> 03:02:28,537
AGING AT LOW INCONSISTENT

4104
03:02:28,604 --> 03:02:31,907
DISCIPLINE SUCH AS NO PROTECTIVE

4105
03:02:31,974 --> 03:02:33,242
EFFECT OF CONSISTENT DISCIPLINE,

4106
03:02:33,309 --> 03:02:36,078
AND WE SAW LOWER NEIGHBORHOOD

4107
03:02:36,145 --> 03:02:38,480
DISORDER BEING ASSOCIATED WITH

4108
03:02:38,547 --> 03:02:42,451
LOWER METHYLATION RELATED TO

4109
03:02:42,518 --> 03:02:43,886
OBESITY AGAIN SUGGESTING

4110
03:02:43,952 --> 03:02:47,589
PROTECTIVE IMPACT OF

4111
03:02:47,656 --> 03:02:48,257
[INAUDIBLE].

4112
03:02:48,324 --> 03:02:49,858
THE FINAL PROJECT I WANT TO SHOW

4113
03:02:49,925 --> 03:02:53,595
YOU IS WHERE WE ASKED ABOUT

4114
03:02:53,662 --> 03:02:57,333
ALTERNATIVE FACTORS TO -- FROM

4115
03:02:57,399 --> 03:03:00,602
COMMUNITY VIOLENCE IMPACTS ON

4116
03:03:00,669 --> 03:03:03,772
EPIGENETIC OUTCOMES.

4117
03:03:03,839 --> 03:03:06,508
WE MEASURED EXPOSURE -- VIOLENCE

4118
03:03:06,575 --> 03:03:08,811
AT AGE 11 AND AT THE SAME TIME,

4119
03:03:08,877 --> 03:03:10,112
ASSESSED THE NUMBER OF

4120
03:03:10,179 --> 03:03:11,113
PROTECTIVE FACTORS.

4121
03:03:11,180 --> 03:03:12,614
THESE FACTORS ALL COME FROM

4122
03:03:12,681 --> 03:03:14,917
RESEARCH AND THEY HAVE WELL

4123
03:03:14,983 --> 03:03:16,585
ESTABLISHED AS PROTECTIVE FOR --

4124
03:03:16,652 --> 03:03:19,188
MORE OU OUTCOMES.

4125
03:03:19,254 --> 03:03:22,491
THEY INCLUDE INDULGENCE -- TO

4126
03:03:22,558 --> 03:03:25,661
SCHOOL, HAVING GOOD EMOTIONAL

4127
03:03:25,728 --> 03:03:29,264
BEHAVIORAL ADJUSTMENT, POSITIVE

4128
03:03:29,331 --> 03:03:30,232
PARENTING, AS WELL AS

4129
03:03:30,299 --> 03:03:33,302
COMMUNITY -- AND OUR OUTCOME WAS

4130
03:03:33,369 --> 03:03:36,472
EPIGENETIC MORTALITY INDEX --

4131
03:03:36,538 --> 03:03:37,005
AGE 7.

4132
03:03:37,072 --> 03:03:40,209
WE SAW THAT -- HIGHER EXPOSURE

4133
03:03:40,275 --> 03:03:42,945
TO COMMUNITY VIOLENCE AND HIGHER

4134
03:03:43,011 --> 03:03:44,246
EPIGENETIC MORTALITY RISK 16

4135
03:03:44,313 --> 03:03:46,248
YEARS LATER.

4136
03:03:46,315 --> 03:03:50,285
HOWEVER, -- PROTECTIVE

4137
03:03:50,352 --> 03:03:51,720
FACTORS -- ASSOCIATION AT A

4138
03:03:51,787 --> 03:03:55,557
CONVENTIONAL P VALUE AT .05.

4139
03:03:55,624 --> 03:03:57,626
THERE WAS MARGINAL INTERACTION

4140
03:03:57,693 --> 03:04:00,028
WITH COMMUNITY SOCIAL

4141
03:04:00,095 --> 03:04:01,163
CONNECTEDNESS, JUST -- WE MAY

4142
03:04:01,230 --> 03:04:02,798
NEED TO LOOK MORE INTO THIS

4143
03:04:02,865 --> 03:04:05,968
VARIABLE, BUT I THINK THIS IS

4144
03:04:06,034 --> 03:04:09,571
SHOWING, BECAUSE I REALIZE --

4145
03:04:09,638 --> 03:04:13,409
PROTECTIVE FACTORS -- THERE MAY

4146
03:04:13,475 --> 03:04:20,983
BE -- WHICH -- CONNECTED FACT

4147
03:04:21,049 --> 03:04:22,050
FACTORS -- SO TO SUMMARIZE THE

4148
03:04:22,117 --> 03:04:23,819
KEY FINDINGS.

4149
03:04:23,886 --> 03:04:25,654
WE SEE RACIAL DISPARITIES IN

4150
03:04:25,721 --> 03:04:26,989
EPIGENETIC AGING EMERGING QUITE

4151
03:04:27,055 --> 03:04:28,190
EARLY, DEFINITELY IN PLACE BY

4152
03:04:28,257 --> 03:04:29,091
AGE 19.

4153
03:04:29,158 --> 03:04:31,593
THEY ARE PARTLY EXPLAINED BY

4154
03:04:31,660 --> 03:04:33,762
EARLY LIFE STRESS FACTORS, SUCH

4155
03:04:33,829 --> 03:04:38,367
AS FAMILY POVERTY, NEGATIVE

4156
03:04:38,434 --> 03:04:46,575
DISADVANTAGE AND VIOLENCE --

4157
03:04:46,642 --> 03:04:49,311
PERIOD FOR STRESS EFFECTS ON

4158
03:04:49,378 --> 03:04:51,280
EPIGENETIC OUTCOMES, SUPPORTIVE

4159
03:04:51,346 --> 03:04:52,381
AND CONSISTENT PARENTING

4160
03:04:52,448 --> 03:04:54,216
MITIGATES THE LONG TERM EFFECTS

4161
03:04:54,283 --> 03:05:00,689
OF NEIGHBORHOOD DIVERSITY.

4162
03:05:00,756 --> 03:05:03,959
OF NEIGHBORHOOD ADVERSITY.

4163
03:05:04,026 --> 03:05:06,462
AS WELL AS EPIGENETIC AGING AND

4164
03:05:06,528 --> 03:05:09,097
OBESITY RELATED METHYLATION IN

4165
03:05:09,164 --> 03:05:09,865
CHILDHOOD.

4166
03:05:09,932 --> 03:05:11,533
WE OBSERVED NO PROTECTIVE

4167
03:05:11,600 --> 03:05:12,835
FACTORS FOR EXPOSURE TO

4168
03:05:12,901 --> 03:05:17,105
COMMUNITY VIOLENCE AND -- SO IN

4169
03:05:17,172 --> 03:05:23,212
TERMS OF FUTURE DIRECTIONS, WE

4170
03:05:23,278 --> 03:05:24,446
DON'T -- THESE DIFFERENTIAL

4171
03:05:24,513 --> 03:05:26,415
EFFECTS OF EARLY LIFE STRESS AND

4172
03:05:26,482 --> 03:05:30,986
PROTECTIVE FACTORS AS WELL AS --

4173
03:05:31,053 --> 03:05:32,654
EXPOSURE AND EPIGENETIC

4174
03:05:32,721 --> 03:05:32,988
OUTCOMES.

4175
03:05:33,055 --> 03:05:35,491
NOW WE ARE COLLECTING DATA ON

4176
03:05:35,557 --> 03:05:38,160
THE SAME -- THE FIRST COHORT --

4177
03:05:38,227 --> 03:05:39,895
SO WE WILL BE ABLE TO PREDICT

4178
03:05:39,962 --> 03:05:43,165
THE CHANGES IN EPIGENETIC

4179
03:05:43,232 --> 03:05:45,801
AGING -- TO YOUNG ADULTHOOD FROM

4180
03:05:45,868 --> 03:05:47,903
EARLY AND LATER LIFE STRESS AND

4181
03:05:47,970 --> 03:05:50,839
PROTECTIVE FACTORS.

4182
03:05:50,906 --> 03:05:54,443
SINCE WE ARE COLLECTING DATA --

4183
03:05:54,510 --> 03:05:58,046
AND -- TO INVESTIGATE THOSE

4184
03:05:58,113 --> 03:06:01,216
GENERATIONAL EFFECTS OF EARLY

4185
03:06:01,283 --> 03:06:04,620
AND LATER LIFE STRESS AS WELL AS

4186
03:06:04,686 --> 03:06:08,223
IDENTIFY PROTECTIVE FACTORS

4187
03:06:08,290 --> 03:06:10,092
THAT -- OF HEALTH DISPARITIES.

4188
03:06:10,158 --> 03:06:14,997
AND FINALLY, INTERSECTIONALITY,

4189
03:06:15,063 --> 03:06:17,299
WE NEED TO FOCUS MORE ON THE

4190
03:06:17,366 --> 03:06:18,967
INTERSECTION OF SEX AND RACIAL

4191
03:06:19,034 --> 03:06:24,640
AND SES DIFFERENCES IN THE --

4192
03:06:24,706 --> 03:06:25,841
EPIGENETIC MARKERS.

4193
03:06:25,908 --> 03:06:29,678
AND SHOUT OUT TO OUR TEAM AND --

4194
03:06:29,745 --> 03:06:37,920
THIS WORK.

4195
03:06:37,986 --> 03:06:38,987
>> THANK YOU.

4196
03:06:39,054 --> 03:06:44,126
NEXT WE HAVE DR. LUDMILA

4197
03:06:44,192 --> 03:06:54,736
PAWLIKOWSKA WHO WILL TALK ABOUT

4198
03:06:55,537 --> 03:06:55,704
[INAUDIBLE].

4199
03:06:55,771 --> 03:07:06,014
>> THANK YOU.

4200
03:07:09,518 --> 03:07:10,786
THANK YOU FOR HAVING ME HERE.

4201
03:07:10,852 --> 03:07:16,058
IT'S REALLY WONDERFUL TALKS SO

4202
03:07:16,124 --> 03:07:17,492
FAR TODAY AND I'M HERE TO HELP

4203
03:07:17,559 --> 03:07:18,927
US UNDERSTAND POTENTIALLY HOW WE

4204
03:07:18,994 --> 03:07:22,864
CAN USE ANIMAL MODELS -- TO

4205
03:07:22,931 --> 03:07:23,932
UNDERSTAND SOME OF THE

4206
03:07:23,999 --> 03:07:28,637
MECHANISMS LINKING THE ADVERSE

4207
03:07:28,704 --> 03:07:31,673
EFFECTS OF RACISM AND

4208
03:07:31,740 --> 03:07:33,442
MARGINALIZATION -- AND HOW

4209
03:07:33,508 --> 03:07:35,978
THOSE -- MIGHT IMPACT HEALTH,

4210
03:07:36,044 --> 03:07:46,421
DISEASE AND SURVIVAL.

4211
03:08:02,337 --> 03:08:10,012
[INAUDIBLE] THERE ARE HUGE

4212
03:08:10,078 --> 03:08:14,816
DISPARITIES IN HEALTH THAT SPAN

4213
03:08:14,883 --> 03:08:23,859
SOCIAL -- -- MORTALITY ACROSS

4214
03:08:23,925 --> 03:08:27,963
THE GLOBE, IN PARTICULAR IN THE

4215
03:08:28,030 --> 03:08:34,736
U.S. -- SO THIS IS SOMETHING

4216
03:08:34,803 --> 03:08:37,739
THAT'S VERY, VERY WELL

4217
03:08:37,806 --> 03:08:41,243
ESTABLISHED -- ABOUT HOW THAT

4218
03:08:41,309 --> 03:08:44,413
MIGHT IMPACT OR ACCELERATE

4219
03:08:44,479 --> 03:08:45,614
THE -- PROCESS FROM --

4220
03:08:45,681 --> 03:08:46,381
PERSPECTIVE MEANS IT WOULD

4221
03:08:46,448 --> 03:08:49,551
INCREASE THE RISK OF -- RISK AND

4222
03:08:49,618 --> 03:08:54,156
ONSET OF MANY DISEASES OF

4223
03:08:54,222 --> 03:09:04,733
WHICH -- OTHER -- [INAUDIBLE].

4224
03:09:08,637 --> 03:09:18,146
SO WE CAN -- SOCIAL DETERMINANTS

4225
03:09:18,213 --> 03:09:21,383
OF HEALTH FOR SURE --

4226
03:09:21,450 --> 03:09:23,719
MARGINALIZATION AND

4227
03:09:23,785 --> 03:09:25,887
DISCRIMINATION -- PATTERNS

4228
03:09:25,954 --> 03:09:31,359
HEALTH AND WELL-BEING --

4229
03:09:31,426 --> 03:09:32,360
INCREASES IN STROKE AND

4230
03:09:32,427 --> 03:09:35,897
MORTALITY DAW TO CARDIOVASCULAR

4231
03:09:35,964 --> 03:09:39,634
DISEASE IS MUCH HIGHER THAN ANY

4232
03:09:39,701 --> 03:09:40,802
OTHER RACIAL AND ETHNIC

4233
03:09:40,869 --> 03:09:45,040
BACKGROUND.

4234
03:09:45,107 --> 03:09:48,643
BUT WHAT WE MAY NOT ALL KNOW IN

4235
03:09:48,710 --> 03:09:50,412
THIS ROOM -- IN SOCIAL

4236
03:09:50,479 --> 03:09:52,581
ENVIRONMENTS AND FACE SOME OF

4237
03:09:52,647 --> 03:09:54,883
THESE -- SOME SIMILAR SOCIAL

4238
03:09:54,950 --> 03:09:55,217
ADVERSITIES.

4239
03:09:55,283 --> 03:09:57,619
NOW I'M NOT SAYING THAT -- THESE

4240
03:09:57,686 --> 03:10:01,456
SAME SORTS OF THINGS -- RACISM,

4241
03:10:01,523 --> 03:10:02,224
MARGINALIZATION AND

4242
03:10:02,290 --> 03:10:03,658
DISCRIMINATION OR OTHER SOCIAL

4243
03:10:03,725 --> 03:10:05,827
DETERMINANTS OF HEALTH THAT ARE

4244
03:10:05,894 --> 03:10:07,596
BASED ON OUR BUILT ENVIRONMENTS,

4245
03:10:07,662 --> 03:10:12,100
BUT THEY DO INCUR SOME OF THESE

4246
03:10:12,167 --> 03:10:14,936
SAME RESPONSES OR PHYSIOLOGICAL

4247
03:10:15,003 --> 03:10:24,246
RESPONSES TO CHRONIC ADVERS Y

4248
03:10:24,312 --> 03:10:26,114
ADVERSITY -- PAPER YEARS AGO

4249
03:10:26,181 --> 03:10:27,616
WHERE WE BROUGHT TOGETHER --

4250
03:10:27,682 --> 03:10:31,920
MORE CROSSTALK WITH

4251
03:10:31,987 --> 03:10:36,091
SOCIOLOGISTS, EPIDEMIOLOGISTS --

4252
03:10:36,158 --> 03:10:38,260
AS WELL AS THOSE WHO ARE DOING

4253
03:10:38,326 --> 03:10:39,861
MORE BIOMEDICALLY RELEVANT

4254
03:10:39,928 --> 03:10:43,431
RESEARCH TO TRY AND UNDERSTAND

4255
03:10:43,498 --> 03:10:47,469
HOW -- ARE THESE RESPONSES TO --

4256
03:10:47,536 --> 03:10:49,237
ACROSS THE ANIMAL KINGDOM AND

4257
03:10:49,304 --> 03:10:52,641
HOW CAN WE SORT OF LEVERAGE THAT

4258
03:10:52,707 --> 03:10:53,742
NATURAL VARIATION TO DESIGN SOME

4259
03:10:53,809 --> 03:10:54,843
EXPERIMENTS TO UNDERSTAND WHAT

4260
03:10:54,910 --> 03:10:56,711
ARE SOME OF THE MECHANISMS THAT

4261
03:10:56,778 --> 03:10:57,579
MIGHT BE DRIVING THIS

4262
03:10:57,646 --> 03:11:00,215
ASSOCIATION.

4263
03:11:00,282 --> 03:11:01,283
ALSO TO UNDERSTAND WHAT ARE SOME

4264
03:11:01,349 --> 03:11:04,820
OF THE ASPECTS OF THE -- THAT --

4265
03:11:04,886 --> 03:11:10,759
MOST FAMILY -- SURVIVAL.

4266
03:11:10,826 --> 03:11:13,929
SO I MIGHT GIVE YOU ONE EXAMPLE

4267
03:11:13,995 --> 03:11:15,330
TO GET US A LITTLE BIT BACK ON

4268
03:11:15,397 --> 03:11:20,402
TIME TODAY, BUT ONE STUDY WHE

4269
03:11:20,468 --> 03:11:21,570
WHERE -- TO TRY TO UNDERSTAND

4270
03:11:21,636 --> 03:11:22,571
SORT OF WHAT'S GOING ON UNDER

4271
03:11:22,637 --> 03:11:25,974
THE HOOD, HOW DOES SOCIAL

4272
03:11:26,041 --> 03:11:28,610
ADVERSITY ALTER MOLECULAR

4273
03:11:28,677 --> 03:11:31,780
FUNCTION OR OUR IMMUNE CELLS --

4274
03:11:31,847 --> 03:11:35,183
AND WHAT DOES THAT MEAN FOR DUNN

4275
03:11:35,250 --> 03:11:40,121
STREAM HEALTH AND U. SURVIVAL.

4276
03:11:40,188 --> 03:11:41,323
THIS LINK IS REALLY DIFFICULT TO

4277
03:11:41,389 --> 03:11:42,290
STUDY IN HUMANS.

4278
03:11:42,357 --> 03:11:44,259
WE ARE VERY, VERY CHALLENGING

4279
03:11:44,326 --> 03:11:46,928
AND COMPLEX MODEL ORGANISMS, WE

4280
03:11:46,995 --> 03:11:49,197
LIVE REALLY LONG LIVES, WE LIVE

4281
03:11:49,264 --> 03:11:51,066
IN VERY COMPLEX SOCIAL

4282
03:11:51,132 --> 03:11:51,433
ENVIRONMENTS.

4283
03:11:51,499 --> 03:11:53,935
WE ALL HAVE VARIABLE ACCESS TO

4284
03:11:54,002 --> 03:11:58,206
HEALTHCARE, WE ALL HAVE VARIABLE

4285
03:11:58,273 --> 03:12:03,044
ACCESS TO -- NUTRITION AND --

4286
03:12:03,111 --> 03:12:04,813
BUT -- ACTUALLY CONTROL MANY OF

4287
03:12:04,880 --> 03:12:06,548
THOSE THINGS AND TRY AND

4288
03:12:06,615 --> 03:12:07,983
MANIPULATE ASPECTS OF THE SOCIAL

4289
03:12:08,049 --> 03:12:12,254
ENVIRONMENT TO GET AT CAUSALITY

4290
03:12:12,320 --> 03:12:13,889
BETWEEN YOUR EXPOSURES TO

4291
03:12:13,955 --> 03:12:15,757
ADVERSITY, SOCIAL EXPERIENCES

4292
03:12:15,824 --> 03:12:17,292
AND HOW THAT MIGHT AFFECT YOUR

4293
03:12:17,359 --> 03:12:18,927
CELLS AND YOUR WELL-BEING -- VUR

4294
03:12:18,994 --> 03:12:22,464
VIEFL.

4295
03:12:22,530 --> 03:12:24,165
SO WE CAN CONTROL THINGS LIKE

4296
03:12:24,232 --> 03:12:25,834
VARIABLE ACCESS TO HEALTHCARE,

4297
03:12:25,901 --> 03:12:27,502
GETTING ALL THE MONKEYS THE SAME

4298
03:12:27,569 --> 03:12:28,803
ACCESS TO HEALTHCARE, THE SAME

4299
03:12:28,870 --> 03:12:30,338
NUTRITION, MAKING SURE THEY'RE

4300
03:12:30,405 --> 03:12:32,540
NOT SMOKING, THEY'RE NOT

4301
03:12:32,607 --> 03:12:33,441
DRINKING, [INAUDIBLE].

4302
03:12:33,508 --> 03:12:35,944
WE CAN ALSO DO SOMETHING

4303
03:12:36,011 --> 03:12:36,711
EXPERIMENTAL MANIPULATIONS THAT

4304
03:12:36,778 --> 03:12:43,518
ALLOW US TO AVOID THIS REVERSE

4305
03:12:43,585 --> 03:12:44,419
CAUSALITY WHICH IS OFTEN THE

4306
03:12:44,486 --> 03:12:48,556
CASE AND IS HARD TO SORT OF --

4307
03:12:48,623 --> 03:12:49,324
PARTICULARLY CROSS-SECTION

4308
03:12:49,391 --> 03:12:51,192
STUDIES OF HUMAN COHORTS WHICH

4309
03:12:51,259 --> 03:12:54,296
IS THOSE INDIVIDUALS WHO ARE --

4310
03:12:54,362 --> 03:12:56,364
WHO ARE IN POORER HEALTH MAY

4311
03:12:56,431 --> 03:12:59,534
ACTUALLY FIND THEMSELVES --

4312
03:12:59,601 --> 03:13:00,402
SITUATION SO [INAUDIBLE].

4313
03:13:00,468 --> 03:13:02,971
SO ANIMALS ARE REALLY RELEVANT

4314
03:13:03,038 --> 03:13:05,006
HERE IN THAT WE CAN CONTROL SOME

4315
03:13:05,073 --> 03:13:11,813
OF THESE THINGS, CARRY OUT

4316
03:13:11,880 --> 03:13:13,348
MANIPULATIONS THAT MIGHT

4317
03:13:13,415 --> 03:13:14,649
ACTUALLY ALLOW US TO GET AT

4318
03:13:14,716 --> 03:13:16,518
CAUSALITY HERE.

4319
03:13:16,584 --> 03:13:17,953
SO I'M GOING TO TELL BUT ONE

4320
03:13:18,019 --> 03:13:19,921
STUDY THAT WE DID ALMOST A

4321
03:13:19,988 --> 03:13:23,458
DECADE AGO, WHICH IS A VERY LONG

4322
03:13:23,525 --> 03:13:27,595
TIME, ON THIS SPECIES, RHESUS

4323
03:13:27,662 --> 03:13:28,697
MACAQUES, SPECIFICALLY FEMALE

4324
03:13:28,763 --> 03:13:29,898
RHESUS MACAQUES.

4325
03:13:29,965 --> 03:13:32,334
SO THEY ARE EVOLUTIONARY

4326
03:13:32,400 --> 03:13:35,270
COUSINS, I GUESS, WE SHARE ABOUT

4327
03:13:35,337 --> 03:13:36,938
94% OF OUR DNA WITH THEM, THEY

4328
03:13:37,005 --> 03:13:39,841
HAVE VERY SIMILAR CELLS, ORGAN

4329
03:13:39,908 --> 03:13:42,377
SYSTEMS, BRAINS, AND THEY ARE

4330
03:13:42,444 --> 03:13:43,778
SOCIALLY COMPLEX AND FORM VERY

4331
03:13:43,845 --> 03:13:45,914
INTERESTING KIND OF -- VERY

4332
03:13:45,981 --> 03:13:48,984
STRONG SOCIAL RELATIONSHIPS, AND

4333
03:13:49,050 --> 03:13:52,354
VERY STRICT SOCIAL -- BASICALLY

4334
03:13:52,420 --> 03:13:54,990
THE FEMALES HERE WERE EASIER TO

4335
03:13:55,056 --> 03:13:57,726
STUDY SO WE CAN SORT OF HIJACK

4336
03:13:57,792 --> 03:14:00,028
THEIR NATURAL HISTORY TO CHANGE

4337
03:14:00,095 --> 03:14:01,796
THEIR SOCIAL STATUS,

4338
03:14:01,863 --> 03:14:03,131
SPECIFICALLY LOOKING AT WHETHER

4339
03:14:03,198 --> 03:14:06,101
OR NOT THE HIGH VERSUS LOW

4340
03:14:06,167 --> 03:14:07,535
SOCIAL STATUS ALTERED SORT OF

4341
03:14:07,602 --> 03:14:09,037
THE MOLECULAR MACHINERY OF THE

4342
03:14:09,104 --> 03:14:13,942
IMMUNE CELLS IN THESE ANIMALS.

4343
03:14:14,009 --> 03:14:16,344
SO THIS WORK WAS DONE, POSTDOC

4344
03:14:16,411 --> 03:14:22,917
MENTOR JENNY TUNG -- WITH RHESUS

4345
03:14:22,984 --> 03:14:23,251
MACAQUES.

4346
03:14:23,318 --> 03:14:26,654
SO WHAT WE DID IS WE MANIPULATED

4347
03:14:26,721 --> 03:14:28,056
THEIR SOCIAL LINE, THEIR SOCIAL

4348
03:14:28,123 --> 03:14:29,524
STATUS, BASICALLY BY INTRODUCING

4349
03:14:29,591 --> 03:14:32,894
THEM TO SOCIAL GROUPS.

4350
03:14:32,961 --> 03:14:35,096
STRONGLY PREDICTED THEIR

4351
03:14:35,163 --> 03:14:38,033
SUBSEQUENT SOCIAL STATUS OR

4352
03:14:38,099 --> 03:14:43,004
DOMINANCE -- FIRST FEMALE THAT

4353
03:14:43,071 --> 03:14:45,073
WENT INTO THE CAGE, BEING THE

4354
03:14:45,140 --> 03:14:47,175
DOMINANT FEMALE, SECOND -- SO

4355
03:14:47,242 --> 03:14:48,243
ON, SO FORTH.

4356
03:14:48,309 --> 03:14:49,811
WE CREATED NINE DIFFERENT GROWPS

4357
03:14:49,878 --> 03:14:53,648
OF THESE FEMALES.

4358
03:14:53,715 --> 03:14:59,988
AND MOST OF THE TIME, -- ALMOST

4359
03:15:00,055 --> 03:15:01,623
PERFECTLY PREDICTED -- THAT

4360
03:15:01,689 --> 03:15:04,159
SOCIAL GROUP.

4361
03:15:04,225 --> 03:15:05,493
SO I'LL SHOW YOU ONE EXAMPLE

4362
03:15:05,560 --> 03:15:06,861
HERE WHICH IS EVERY TIME YOU SEE

4363
03:15:06,928 --> 03:15:09,230
ONE OF THESE LINES MOVE, SO EACH

4364
03:15:09,297 --> 03:15:11,466
OF THESE LINES HAS A FEMALE --

4365
03:15:11,533 --> 03:15:14,269
THE ORDER IN WHICH THEY

4366
03:15:14,335 --> 03:15:17,105
RETRIEVE -- SO THE FIRST FEMALE

4367
03:15:17,172 --> 03:15:21,409
IS ONE, THE SECOND IS -- TWO

4368
03:15:21,476 --> 03:15:23,144
FEMALES ARE INTERACTING,

4369
03:15:23,211 --> 03:15:27,215
ENGAGING IN SOME SORT OF --

4370
03:15:27,282 --> 03:15:28,950
INTERACTION AND -- INDIVIDUAL

4371
03:15:29,017 --> 03:15:31,252
ONE INCREASED IN THEIR RANK AND

4372
03:15:31,319 --> 03:15:34,122
THEY LOST THE INCREASE

4373
03:15:34,189 --> 03:15:36,858
[INAUDIBLE] ALL SORTS OF OTHER

4374
03:15:36,925 --> 03:15:37,725
THINGS.

4375
03:15:37,792 --> 03:15:41,563
GAMING AND -- ANYWAY.

4376
03:15:41,629 --> 03:15:43,431
SO YOU CAN SEE THIS GROUP VERY

4377
03:15:43,498 --> 03:15:43,865
QUICKLY.

4378
03:15:43,932 --> 03:15:48,903
THEY ESTABLISHED STRICT LINE

4379
03:15:48,970 --> 03:15:55,810
LINEAR -- COURSE OF THE STUD

4380
03:15:55,877 --> 03:15:58,780
STUDY, -- BUT THIS ALLOWS US TO

4381
03:15:58,847 --> 03:16:01,316
ACTUALLY TAKE OUT INDIVIDUAL

4382
03:16:01,382 --> 03:16:02,717
DIFFERENCES THAT MIGHT BE

4383
03:16:02,784 --> 03:16:05,253
DRIVING -- THAT MIGHT EXPLAIN

4384
03:16:05,320 --> 03:16:07,355
VARIATION IN SOCIAL STATUS HERE.

4385
03:16:07,422 --> 03:16:09,657
ACTUALLY MANY BELIEVE -- YOU'RE

4386
03:16:09,724 --> 03:16:11,559
GOING TO BE -- THEN SEE WHAT

4387
03:16:11,626 --> 03:16:16,231
HAPPENS TO THEIR CELLS.

4388
03:16:16,297 --> 03:16:22,470
SO -- VERY SIMPLE FIGURE HERE --

4389
03:16:22,537 --> 03:16:25,874
WHICH IS WE EXTRACTED --

4390
03:16:25,940 --> 03:16:28,510
MULTIPLE TIMES THROUGHOUT THE

4391
03:16:28,576 --> 03:16:30,044
EXPERIMENT.

4392
03:16:30,111 --> 03:16:34,849
THESE ARE -- LYMPHOCYTES,

4393
03:16:34,916 --> 03:16:36,651
MONOCYTES, WHAT WE DID IS WE

4394
03:16:36,718 --> 03:16:39,587
CARRIED OUT RNA SEQUENCING ON

4395
03:16:39,654 --> 03:16:41,556
INDIVIDUALS THAT SORTED AND

4396
03:16:41,623 --> 03:16:45,994
ISOLATED CELL -- SINGLE CELL

4397
03:16:46,060 --> 03:16:47,495
SEQUENCING, AND JUST SORT OF

4398
03:16:47,562 --> 03:16:50,565
INITY INFANCY, TO MEASURE GENE

4399
03:16:50,632 --> 03:16:53,768
EXPRESSION IN INDIVIDUAL CELL

4400
03:16:53,835 --> 03:16:55,203
TYPES, SPECIFICALLY -- CELL

4401
03:16:55,270 --> 03:16:55,837
TYPES.

4402
03:16:55,904 --> 03:16:57,272
LARGELY WHAT WE FOUND IS THAT

4403
03:16:57,338 --> 03:16:58,907
OUR EXPERIMENTAL MANIPULATION,

4404
03:16:58,973 --> 03:17:02,110
THOSE FEMALES WHO WERE OF LOWER

4405
03:17:02,177 --> 03:17:05,213
STATUS WHO WEREN'T -- EXHIBITED

4406
03:17:05,280 --> 03:17:09,984
HIGHER LEVELS OF -- RELATED GENE

4407
03:17:10,051 --> 03:17:11,319
EXPRESSION -- RELATIVE TO THOSE

4408
03:17:11,386 --> 03:17:12,754
FEMALES WHO WERE OF HIGHER

4409
03:17:12,820 --> 03:17:14,155
SOCIAL STATUS.

4410
03:17:14,222 --> 03:17:15,790
FURTHER, WE COULD DO SOME EX

4411
03:17:15,857 --> 03:17:17,692
VIVO STIMULATIONS WITH

4412
03:17:17,759 --> 03:17:19,661
POLYSACCHARIDE, WHICH IS

4413
03:17:19,727 --> 03:17:21,629
BASICALLY LIKE SIMULATING A

4414
03:17:21,696 --> 03:17:22,564
BACTERIAL INFECTION IN THE CELL,

4415
03:17:22,630 --> 03:17:26,935
WE EXTRACTED IT -- OUTSIDE AND

4416
03:17:27,001 --> 03:17:28,269
WE -- HIGHER BASELINE -- THAT

4417
03:17:28,336 --> 03:17:32,006
ACTUALLY HAD AN EXACERBATED

4418
03:17:32,073 --> 03:17:33,875
RESULTS, OVERREACTED -- RESPONSE

4419
03:17:33,942 --> 03:17:40,081
TO EXPOSURE TO THIS STIMULUS.

4420
03:17:40,148 --> 03:17:41,649
AND WE -- SINCE THIS SESSION IS

4421
03:17:41,716 --> 03:17:42,884
ALSO ABOUT THE EPIGENOME, I'M

4422
03:17:42,951 --> 03:17:44,485
GOING TO TELL YOU ABOUT ONE

4423
03:17:44,552 --> 03:17:45,787
OTHER COMPONENT OF THE EPIGENOME

4424
03:17:45,853 --> 03:17:53,127
WE LOOKED AT, -- HOW OPEN OR

4425
03:17:53,194 --> 03:17:54,429
CLOSED ARE PARTS OF THE GENOME

4426
03:17:54,495 --> 03:17:58,266
SO THAT SORT OF TRAN JIPTION

4427
03:17:58,333 --> 03:18:00,468
FACTOR IS -- TURN ON -- I'M

4428
03:18:00,535 --> 03:18:01,669
TELLING YOU ALL THIS BECAUSE

4429
03:18:01,736 --> 03:18:03,638
WE'RE ABLE TO SORT OF FOCUS ON

4430
03:18:03,705 --> 03:18:06,741
AND BEEN DOING THIS TO LOOK AT

4431
03:18:06,808 --> 03:18:08,243
HOW DIFFERENT CORTICOIDS,

4432
03:18:08,309 --> 03:18:15,516
PARTICULARLY THE GEU COCORTICOID

4433
03:18:15,583 --> 03:18:18,353
RECEPTOR, BUT IT BINDS TO THE

4434
03:18:18,419 --> 03:18:20,922
GLU COCORTICOID RECEPTOR, IT

4435
03:18:20,989 --> 03:18:24,392
ENTERS INTO THE NUCLEUS, IT

4436
03:18:24,459 --> 03:18:25,927
FINDS -- GENE, TURNS IT ON OR

4437
03:18:25,994 --> 03:18:26,728
TURNS IT OFF.

4438
03:18:26,794 --> 03:18:29,097
WE KNOW WHEN WE ARE STRESSED,

4439
03:18:29,163 --> 03:18:30,598
LIKE MAYBE I WAS GETTING UP HERE

4440
03:18:30,665 --> 03:18:33,001
NOT KNOWING HOW THIS TALK WOULD

4441
03:18:33,067 --> 03:18:39,007
GO, OUR CORTISOL INCREASES, THAT

4442
03:18:39,073 --> 03:18:45,813
IS USEFUL -- CONDITIONS.

4443
03:18:45,880 --> 03:18:46,814
HOWEVER, WHAT WE KNOW IS THAT

4444
03:18:46,881 --> 03:18:49,450
WHEN PEOPLE ARE TREATED

4445
03:18:49,517 --> 03:18:51,119
CHRONICALLY WITH STEROIDS AND/OR

4446
03:18:51,185 --> 03:18:53,187
WHEN PEOPLE ARE CHRONICALLY

4447
03:18:53,254 --> 03:18:55,056
STRESSED, THIS PATHWAY BECOMES

4448
03:18:55,123 --> 03:18:56,090
DESENSITIZED.

4449
03:18:56,157 --> 03:19:00,662
WHICH LEADS TO DYSREGULATION OF

4450
03:19:00,728 --> 03:19:02,196
THE INFLAMMATORY RESPONSE AND

4451
03:19:02,263 --> 03:19:03,998
CHRONIC LEVELS OF INCREASED

4452
03:19:04,065 --> 03:19:04,332
INFLAMMATION.

4453
03:19:04,399 --> 03:19:07,402
SO WE CALL THIS GLUCOCORTICOID

4454
03:19:07,468 --> 03:19:07,835
RESISTANCE.

4455
03:19:07,902 --> 03:19:12,140
SO USING THIS EX VIVO MODEL AS

4456
03:19:12,206 --> 03:19:14,309
WELL -- ACCESSIBILITY, AND GENE

4457
03:19:14,375 --> 03:19:16,711
EXPRESSION, QUICKLY SHOWING THE

4458
03:19:16,778 --> 03:19:18,246
TREATMENTS THAT WE DID WORKED.

4459
03:19:18,313 --> 03:19:21,783
WE WERE ABLE TO END GUY THAT

4460
03:19:21,849 --> 03:19:24,319
THEREOF WERE LIT TOURS IN THE

4461
03:19:24,385 --> 03:19:25,853
LOW STATUS SIGNALS SUCH AS THEY

4462
03:19:25,920 --> 03:19:28,923
WERE NOT AS RESPONSIVE TO THE

4463
03:19:28,990 --> 03:19:31,459
DEXAMETHASONE TREATMENT AS

4464
03:19:31,526 --> 03:19:34,829
OPPOSED TO LESS ADVERSITY.

4465
03:19:34,896 --> 03:19:37,498
-- THAT MIGHT BE LEADING TO

4466
03:19:37,565 --> 03:19:39,467
THIS CHRONIC SOCIAL ADVERSITY

4467
03:19:39,534 --> 03:19:42,203
AND DOWNSTREAM HEALTH OUTCOMES

4468
03:19:42,270 --> 03:19:44,405
HERE SORT OF ACUTELY LOOKING AT

4469
03:19:44,472 --> 03:19:46,140
THEIR IMMUNE CELL GENE

4470
03:19:46,207 --> 03:19:51,946
REGULATION.

4471
03:19:52,013 --> 03:19:53,247
SO AFTER ONE YEAR IN THESE

4472
03:19:53,314 --> 03:19:55,683
SOCIAL GROUPS, GIVEN THIS

4473
03:19:55,750 --> 03:19:56,784
EXPERIMENTAL MODEL, WE COULD

4474
03:19:56,851 --> 03:19:57,785
MANIPULATE THEIR SOCIAL STATUS.

4475
03:19:57,852 --> 03:19:58,853
WE COULD ACTUALLY SAY WHAT

4476
03:19:58,920 --> 03:20:02,090
HAPPENS IF WE TAKE THIS

4477
03:20:02,156 --> 03:20:04,392
HIGH-RANKING -- MAKE THEM HIGH

4478
03:20:04,459 --> 03:20:05,259
STATUS, RIGHT?

4479
03:20:05,326 --> 03:20:07,328
HOW STICKY WAS YOUR PRIOR SOCIAL

4480
03:20:07,395 --> 03:20:09,530
ENVIRONMENT?

4481
03:20:09,597 --> 03:20:11,966
IS THIS REVERSIBLE -- SUGGEST

4482
03:20:12,033 --> 03:20:14,369
THAT WE CAN IMPROVE SOCIAL

4483
03:20:14,435 --> 03:20:16,437
CONDITIONS, SOCIAL

4484
03:20:16,504 --> 03:20:18,539
ENVIRONMENTS -- SHORT TERM.

4485
03:20:18,606 --> 03:20:21,409
WE CAN HOPEFULLY -- GOOD HEALTH

4486
03:20:21,476 --> 03:20:22,043
LONG TERM.

4487
03:20:22,110 --> 03:20:26,214
SO WHAT WE DID IS WE TOOK ALL

4488
03:20:26,280 --> 03:20:32,320
HUMANS -- HAVE TO CHANGE -- SO

4489
03:20:32,387 --> 03:20:38,593
IT'S ALL -- VICE VERSA.

4490
03:20:38,659 --> 03:20:39,894
SAME SORT OF THING, THIS IS

4491
03:20:39,961 --> 03:20:43,731
SHOWING HOW MANIPULATION WORKS,

4492
03:20:43,798 --> 03:20:50,338
[INAUDIBLE] LARGELY WE FOCUSED

4493
03:20:50,405 --> 03:20:56,277
HERE AGAIN OVER -- WE'RE LOOKING

4494
03:20:56,344 --> 03:20:58,780
SPECIFICALLY GENE EXPRESSION

4495
03:20:58,846 --> 03:21:04,118
PROGRAM -- RELATED -- PROGRAM,

4496
03:21:04,185 --> 03:21:06,788
MORE HIGHLY EXPRESSED WHEN

4497
03:21:06,854 --> 03:21:11,592
EXPOSED TO ADVERSITY AND LOW --

4498
03:21:11,659 --> 03:21:13,594
STATUS -- YOU'RE EXPOSED TO MORE

4499
03:21:13,661 --> 03:21:14,595
ADVERSITY, WE SHOULD SEE AN

4500
03:21:14,662 --> 03:21:16,030
INCREASE IN THE EXPRESSION OF

4501
03:21:16,097 --> 03:21:20,701
GENES RELATED TO --.

4502
03:21:20,768 --> 03:21:28,509
THE UNIVERSE FOR -- THAT'S

4503
03:21:28,576 --> 03:21:30,144
EXACTLY WHAT WE SAW WHEN WE LOOK

4504
03:21:30,211 --> 03:21:32,780
AT SORT OF AVERAGES OF THESE

4505
03:21:32,847 --> 03:21:34,348
GENE REGULATORY PROGRAMS, WE SAW

4506
03:21:34,415 --> 03:21:35,550
INCREASE IN SOCIAL -- DECREASE

4507
03:21:35,616 --> 03:21:37,084
IN SOCIAL STATUS, YOU SAW AN

4508
03:21:37,151 --> 03:21:41,556
INCREASE IN YOUR INFLAMMATORY

4509
03:21:41,622 --> 03:21:45,426
GENE -- PATTERN -- CELLS AND ON

4510
03:21:45,493 --> 03:21:48,463
THE FLIP SIDE OF THAT, IF WE

4511
03:21:48,529 --> 03:21:50,131
IMPROVED YOUR SOCIAL -- INCREASE

4512
03:21:50,198 --> 03:21:51,599
YOUR SOCIAL STATUS, PREVIOUSLY

4513
03:21:51,666 --> 03:21:53,568
LOWER SOCIAL STATUS, WE SAW A

4514
03:21:53,634 --> 03:21:56,971
DECREASE IN THE EXPRESSION OF

4515
03:21:57,038 --> 03:22:03,244
THOSE -- RELATED GENES.

4516
03:22:03,311 --> 03:22:07,849
SO -- YOUR GENES REALLY DON'T

4517
03:22:07,915 --> 03:22:08,950
MATTER THAT MUCH, YOUR

4518
03:22:09,016 --> 03:22:10,251
ENVIRONMENTAL EXPERIENCES DO.

4519
03:22:10,318 --> 03:22:10,818
RIGHT?

4520
03:22:10,885 --> 03:22:14,522
AND WHAT I WANT TAKE HOMES TO

4521
03:22:14,589 --> 03:22:15,990
BE -- THERE IS NOTHING ABOUT

4522
03:22:16,057 --> 03:22:16,991
THESE INDIVIDUAL ANIMALS THAT

4523
03:22:17,058 --> 03:22:22,697
DDICTATED WHETHER OR NOT THEY

4524
03:22:22,763 --> 03:22:24,198
WERE GOING TO BE EXPOSED TO --

4525
03:22:24,265 --> 03:22:27,902
IT WAS PURELY US PLAYING GOD AND

4526
03:22:27,969 --> 03:22:28,870
MANIPULATING THEIR EXPERIENCE,

4527
03:22:28,936 --> 03:22:29,470
RIGHT?

4528
03:22:29,537 --> 03:22:32,039
WHICH SUGGESTS THAT OUR

4529
03:22:32,106 --> 03:22:34,442
ENVIRONMENT IS LARGELY -- MUCH

4530
03:22:34,509 --> 03:22:38,212
OF WHAT HAPPENS IN -- NOW THIS

4531
03:22:38,279 --> 03:22:44,352
IS OVER SIMPLIFIED BECAUSE WE

4532
03:22:44,418 --> 03:22:45,319
ARE CONTROLLED FOR MANY THINGS

4533
03:22:45,386 --> 03:22:46,888
THAT WE ALSO KNOW ARE STRONGLY

4534
03:22:46,954 --> 03:22:48,523
CORRELATED WITH EXPOSURES TO

4535
03:22:48,589 --> 03:22:51,325
ADVERSITY SUCH AS ACCESS TO ANY

4536
03:22:51,392 --> 03:22:53,160
RESOURCES AND PREDICTABLE

4537
03:22:53,227 --> 03:22:53,528
FUTURE.

4538
03:22:53,594 --> 03:22:56,564
BUT THIS ALLOWS US TO AT

4539
03:22:56,631 --> 03:22:59,567
LEAST -- SOME OF THESE APART AND

4540
03:22:59,634 --> 03:23:02,737
UNDERSTAND -- IDENTIFY MESM

4541
03:23:02,803 --> 03:23:05,473
NISMS -- HOW WILL I BE ABLE TO

4542
03:23:05,540 --> 03:23:07,775
INTERVENE [INAUDIBLE].

4543
03:23:07,842 --> 03:23:09,110
SO WITH -- I THINK WE'LL HAVE

4544
03:23:09,176 --> 03:23:12,613
SOME DISCUSSION ON ANIMAL MODELS

4545
03:23:12,680 --> 03:23:13,915
TOMORROW DURING -- TALK ABOUT

4546
03:23:13,981 --> 03:23:16,584
WHAT WE CAN AND -- SO I WON'T

4547
03:23:16,651 --> 03:23:17,451
GET INTO THAT NOW.

4548
03:23:17,518 --> 03:23:21,522
BUT I DO WANT TO THANK ALL THE

4549
03:23:21,589 --> 03:23:22,890
COLLABORATORS FOR PART OF THIS

4550
03:23:22,957 --> 03:23:24,725
WORKING GROUP THAT WE BUILT --

4551
03:23:24,792 --> 03:23:25,560
POSTDOC THAT WAS BRINGING

4552
03:23:25,626 --> 03:23:28,696
TOGETHER LOTS OF SOCIOLOGISTS

4553
03:23:28,763 --> 03:23:31,165
AND -- AND ANIMAL -- NON-HUMAN

4554
03:23:31,232 --> 03:23:34,201
ANIMAL RESEARCHERS.

4555
03:23:34,268 --> 03:23:36,037
AND THEN THANK YOU FROM THE LAB,

4556
03:23:36,103 --> 03:23:40,074
THANK YOU TO ALL OF YOU, HAPPY

4557
03:23:40,141 --> 03:23:41,175
TO ANSWER ANY QUESTIONS LATER

4558
03:23:41,242 --> 03:23:45,112
ON.

4559
03:23:45,179 --> 03:23:46,414
>> THANK YOU.

4560
03:23:46,480 --> 03:23:48,149
AND NOW FOR THE FINAL TALK IN

4561
03:23:48,215 --> 03:23:53,120
THIS SESSION, IT'S DR. IDAN

4562
03:23:53,187 --> 03:23:53,754
SHALEV TALKING ABOUT THE

4563
03:23:53,821 --> 03:23:56,290
POTENTIAL ROLE OF RACISM,

4564
03:23:56,357 --> 03:23:57,625
MARGINALIZATION AND

4565
03:23:57,692 --> 03:23:59,727
DISCRIMINATION IN SYSTEMIC

4566
03:23:59,794 --> 03:24:01,429
DYSFUNCTION AND BIOLOGICAL

4567
03:24:01,495 --> 03:24:11,606
AGING.

4568
03:24:29,690 --> 03:24:31,192
I KNOW WE'RE A LITTLE LOW ON

4569
03:24:31,258 --> 03:24:34,929
TIME SO I'LL TRY TO TALK FOR

4570
03:24:34,996 --> 03:24:45,506
LESS AND ALLOW A LOT OF TIME.

4571
03:25:07,461 --> 03:25:08,195
I FIRST WANT TO START BY

4572
03:25:08,262 --> 03:25:10,364
THANKING THE ORGANIZERS FOR BE

4573
03:25:10,431 --> 03:25:11,832
INVITING ME TO THIS REALLY

4574
03:25:11,899 --> 03:25:12,600
IMPORTANT AND INTERESTING

4575
03:25:12,667 --> 03:25:13,367
WORKSHOP.

4576
03:25:13,434 --> 03:25:14,368
I'M EXCITED TO BE HERE AND SHARE

4577
03:25:14,435 --> 03:25:16,904
WITH YOU SOME OF THE INSIGHTS IN

4578
03:25:16,971 --> 03:25:20,408
RELATION TO R & D, THEIR

4579
03:25:20,474 --> 03:25:23,477
POTENTIAL ROLE OF R & D IN

4580
03:25:23,544 --> 03:25:24,512
SYSTEMIC DYSFUNCTION AND

4581
03:25:24,578 --> 03:25:26,914
BIOLOGICAL AGING.

4582
03:25:26,981 --> 03:25:31,519
AS THE TITLE IND INDICATES, WE

4583
03:25:31,585 --> 03:25:38,225
FOCUS IN THE LAB ON -- MORE

4584
03:25:38,292 --> 03:25:41,829
BROADLY BUT I WILL TRY TO --

4585
03:25:41,896 --> 03:25:44,131
CONTEXT FOR FUTURE RESEARCH.

4586
03:25:44,198 --> 03:25:48,002
SO I WANT TO START WITH THE BIG

4587
03:25:48,069 --> 03:25:51,605
QUESTION, TO GENERATE

4588
03:25:51,672 --> 03:25:54,341
VARIABILITY IN HEALTH AND AGING.

4589
03:25:54,408 --> 03:25:55,309
THERE ARE TWO IMPORTANT

4590
03:25:55,376 --> 03:25:57,111
QUESTIONS HERE.

4591
03:25:57,178 --> 03:25:59,947
FIRST HOW EARLY LIFE PROCESSES

4592
03:26:00,014 --> 03:26:02,483
WOULD HELP -- THAT IS OBSERVED

4593
03:26:02,550 --> 03:26:03,951
DECADES LATER, AND SECOND, WHY

4594
03:26:04,018 --> 03:26:06,454
SHOULD WE EVEN CARE ABOUT AGING

4595
03:26:06,520 --> 03:26:09,990
IN OUR LIFE, CAN WE EVEN MEASURE

4596
03:26:10,057 --> 03:26:11,525
AGING -- WE ALREADY KNOW THE

4597
03:26:11,592 --> 03:26:12,193
ANSWER IS YES.

4598
03:26:12,259 --> 03:26:13,527
SHOULD WE CALL IT AGING, SHOULD

4599
03:26:13,594 --> 03:26:15,196
WE CALL IT DEVELOPMENT, SHOULD

4600
03:26:15,262 --> 03:26:17,064
WE CALL IT SOMETHING DIFFERENT,

4601
03:26:17,131 --> 03:26:18,365
SO WE'LL TRY TO ANSWER THAT

4602
03:26:18,432 --> 03:26:19,667
QUESTION IN THE NEXT FEW SLIDES.

4603
03:26:19,734 --> 03:26:22,670
IF YOU WILL JUST EXCUSE ME FOR A

4604
03:26:22,737 --> 03:26:25,539
MINUTE BECAUSE I DIDN'T TAKE MY

4605
03:26:25,606 --> 03:26:26,741
GLASSES AND I WON'T BE ABLE TO

4606
03:26:26,807 --> 03:26:27,174
SEE.

4607
03:26:27,241 --> 03:26:35,249
ALL RIGHT.

4608
03:26:35,316 --> 03:26:36,717
SO THIS IS THE CONCEPTUAL

4609
03:26:36,784 --> 03:26:39,153
FRAMEWORK THAT WE USE IN OUR

4610
03:26:39,220 --> 03:26:40,554
RESEARCH.

4611
03:26:40,621 --> 03:26:43,958
SO -- THOUGHT TO BE MEDIATED BY

4612
03:26:44,024 --> 03:26:46,827
ACCUMULATION OF -- WE CONSIDER

4613
03:26:46,894 --> 03:26:49,363
THESE MOMENT BY MOMENT

4614
03:26:49,430 --> 03:26:55,035
VARIATIONS INCLUDING -- AS WELL

4615
03:26:55,102 --> 03:26:58,873
AS MORE DYNAMIC CHANGES AT A

4616
03:26:58,939 --> 03:27:01,008
CELLULAR LEVEL TO CAPTURE

4617
03:27:01,075 --> 03:27:02,977
BIOLOGICAL AGING OVER TIME.

4618
03:27:03,043 --> 03:27:05,045
AND THESE CHANGES MOMENT BY

4619
03:27:05,112 --> 03:27:06,947
MOMENT CHANGES BY HOURS, BY

4620
03:27:07,014 --> 03:27:10,351
DAYS, BY WEEKS, CAN COMPOUND

4621
03:27:10,417 --> 03:27:13,621
OVER TIME TO GENERATE THIS

4622
03:27:13,687 --> 03:27:15,256
VARIABILITY IN SYSTEMIC

4623
03:27:15,322 --> 03:27:16,090
DYSFUNCTION, AGING AND DISEASE

4624
03:27:16,157 --> 03:27:19,460
THAT IS OBSERVED DECADES LATER.

4625
03:27:19,527 --> 03:27:22,863
SO IN TAKING THESE LAST --

4626
03:27:22,930 --> 03:27:26,834
INCLUDING BIOPSYCHOSOCIAL

4627
03:27:26,901 --> 03:27:30,905
ASPECTS INCLUDING -- OUR NEXT

4628
03:27:30,971 --> 03:27:32,840
SESSION IS GOING TO FOCUS ON

4629
03:27:32,907 --> 03:27:34,408
PRENATAL FACTORS AND I'M LOOKING

4630
03:27:34,475 --> 03:27:38,245
FORWARD TO THAT SESSION AS WELL,

4631
03:27:38,312 --> 03:27:42,550
BUT HERE -- AND DEVELOPMENT.

4632
03:27:42,616 --> 03:27:48,222
SO EVEN THOUGH GERENTOLOGICAL

4633
03:27:48,289 --> 03:27:50,224
RESEARCH IS STARTING TO -- AGING

4634
03:27:50,291 --> 03:27:51,959
EARLY IN LIFE PRIOR TO THE ONSET

4635
03:27:52,026 --> 03:27:53,727
OF AGE-RELATED DISEASES, MUCH OF

4636
03:27:53,794 --> 03:27:57,932
THIS WORK IS STILL RELATED TO

4637
03:27:57,998 --> 03:27:59,900
ADULTS BUT THIS -- NEEDS TO

4638
03:27:59,967 --> 03:28:02,102
START EARLY IN LIFE AND WE'VE

4639
03:28:02,169 --> 03:28:05,206
ALREADY HEARD SOME EXAMPLES OF

4640
03:28:05,272 --> 03:28:06,407
MEASURING -- IN CHILDREN AND

4641
03:28:06,473 --> 03:28:13,414
THIS IS WHAT WE ARE TRYING TO --

4642
03:28:13,480 --> 03:28:14,448
THIS -- ARTICLE THAT WAS

4643
03:28:14,515 --> 03:28:16,417
PUBLISHED RECENTLY, AND

4644
03:28:16,483 --> 03:28:18,385
SPECIFICALLY WE WERE OUT OF --

4645
03:28:18,452 --> 03:28:21,722
THAT AGING AND DEVELOPMENT ARE

4646
03:28:21,789 --> 03:28:25,759
TWO SIDES OF THE SA SAME COIN AD

4647
03:28:25,826 --> 03:28:27,294
THAT DEVELOPING A COMPREHENSIVE

4648
03:28:27,361 --> 03:28:28,495
UNDERSTANDING OF HEALTH AND

4649
03:28:28,562 --> 03:28:30,297
DISEASE RISK REQUIRES EXAMINING

4650
03:28:30,364 --> 03:28:32,032
AGE-RE LATED PROCESSES OCCURRING

4651
03:28:32,099 --> 03:28:32,933
THROUGHOUT THE EARLIEST YEARS OF

4652
03:28:33,000 --> 03:28:34,101
LIFE.

4653
03:28:34,168 --> 03:28:36,804
SO THIS IS THE OPPOSITE OF WHAT

4654
03:28:36,871 --> 03:28:42,376
WE SEE -- WEAR AND TEAR,

4655
03:28:42,443 --> 03:28:43,344
BIOLOGICALLY CHILDREN ARE AGING

4656
03:28:43,410 --> 03:28:48,582
AND ARE ACTUALLY -- THAN WHAT WE

4657
03:28:48,649 --> 03:28:50,384
SEE LATER IN LIFE.

4658
03:28:50,451 --> 03:28:52,720
-- WHAT YOU SEE HERE AT THE

4659
03:28:52,786 --> 03:28:58,025
TOP, THIS IS THE -- AND BOTTOM

4660
03:28:58,092 --> 03:29:05,799
PANEL IS JUST BIOLOGICAL AGE --

4661
03:29:05,866 --> 03:29:07,334
EXPOSURE ACCELERATED TRAJECTORY

4662
03:29:07,401 --> 03:29:09,036
OF BIOLOGICAL AGING WHICH

4663
03:29:09,103 --> 03:29:09,703
THERE'S ALREADY A LOT OF

4664
03:29:09,770 --> 03:29:11,138
EVIDENCE OUT THERE SHOWING THAT

4665
03:29:11,205 --> 03:29:15,042
IT CAN ACCELERATE AGING DURING

4666
03:29:15,109 --> 03:29:18,412
CHILDHOOD AND ADOLESCENCE, YOU

4667
03:29:18,479 --> 03:29:19,914
WANT TO ALSO HIGHLIGHT THE

4668
03:29:19,980 --> 03:29:22,983
POTENTIAL ROLE FOR POST EXPOSURE

4669
03:29:23,050 --> 03:29:26,787
DIMENSION, ESPECIALLY IF

4670
03:29:26,854 --> 03:29:27,988
IMPLEMENTED EARLY IN LIFE,

4671
03:29:28,055 --> 03:29:30,157
GETTING THIS TRAJECTORY OF --

4672
03:29:30,224 --> 03:29:33,394
AGING AND DELAYING ONSET OF

4673
03:29:33,460 --> 03:29:34,061
AGE-RELATED DISEASES.

4674
03:29:34,128 --> 03:29:37,698
SO IN SHORT -- TRYING TO SUPPORT

4675
03:29:37,765 --> 03:29:40,634
MORE OF THIS WORK OF BIOLOGICAL

4676
03:29:40,701 --> 03:29:44,171
AGING THAT WILL START ALREADY IN

4677
03:29:44,238 --> 03:29:45,706
UTERO ACROSS CHILDHOOD AND INTO

4678
03:29:45,773 --> 03:29:50,311
ADOLESCENCE.

4679
03:29:50,377 --> 03:29:54,615
AND TO PROVIDE -- TO ILLUSTRATE

4680
03:29:54,682 --> 03:29:57,918
THIS WITH MORE EMPIRICAL EXAM

4681
03:29:57,985 --> 03:30:00,321
EXAMPLE, THIS -- CHRONOLOGICAL

4682
03:30:00,387 --> 03:30:02,723
AGE ACROSS THE LIFESPAN.

4683
03:30:02,790 --> 03:30:06,060
SO WITH TELOMERES, WE KNOW -- AS

4684
03:30:06,126 --> 03:30:09,463
WE GROW OLDER, OUR -- WILL GET

4685
03:30:09,530 --> 03:30:19,373
SHORTER ON AVERAGE -- BUT IT'S

4686
03:30:19,440 --> 03:30:19,673
NOT LINEAR.

4687
03:30:19,740 --> 03:30:22,076
SO THIS IS ONE OF THE MAIN

4688
03:30:22,142 --> 03:30:24,044
FIGURES FROM THIS META-ANALYSIS.

4689
03:30:24,111 --> 03:30:28,482
WHAT YOU SEE HERE, THE Y AXIS IS

4690
03:30:28,549 --> 03:30:31,885
THE CORRECTED CORRELATION

4691
03:30:31,952 --> 03:30:33,287
BETWEEN TELOMERES AND

4692
03:30:33,354 --> 03:30:35,055
CHRONOLOGICAL AGE AND THEY

4693
03:30:35,122 --> 03:30:37,291
PLOTTED ACROSS MULTIPLE AGE AND

4694
03:30:37,358 --> 03:30:38,258
AGE ACROSS THE LIFESPAN.

4695
03:30:38,325 --> 03:30:44,732
THIS IS USING -- T LENGTH.

4696
03:30:44,798 --> 03:30:47,968
-- OF THIS FIGURE IS THE

4697
03:30:48,035 --> 03:30:49,470
STRENGTH OF THE CORRELATION IS

4698
03:30:49,536 --> 03:30:51,005
STRONGER IN THE OPENING YEARS OF

4699
03:30:51,071 --> 03:30:53,307
LIFE.

4700
03:30:53,374 --> 03:30:57,411
SO IF YOU ARE MEASURING -- YOU

4701
03:30:57,478 --> 03:31:02,216
HAVE THE WIDER AGE RANGE -- THIS

4702
03:31:02,282 --> 03:31:03,550
IS INDEPENDENT OF STRESS AND

4703
03:31:03,617 --> 03:31:05,452
INDEPENDENT OF ANY OTHER --

4704
03:31:05,519 --> 03:31:06,653
EXPOSURES.

4705
03:31:06,720 --> 03:31:09,256
THIS HAS ALWAYS BEEN A VERY

4706
03:31:09,323 --> 03:31:10,024
SENSITIVE DEVELOPMENT -- THAT IF

4707
03:31:10,090 --> 03:31:13,594
WE EXPERIENCE ADVERSITIES, WE

4708
03:31:13,660 --> 03:31:15,763
WILL EXPECT TO SEE HIGHER

4709
03:31:15,829 --> 03:31:17,097
ACCELERATED AGING.

4710
03:31:17,164 --> 03:31:19,933
THAT WILL IMPACT HEALTH DISEASE

4711
03:31:20,000 --> 03:31:22,870
LATER IN LIFE.

4712
03:31:22,936 --> 03:31:25,606
SO THESE ARE SOME OF THE REAS

4713
03:31:25,672 --> 03:31:28,776
REASONS -- SOME ARE ASKING,

4714
03:31:28,842 --> 03:31:32,880
SO -- MECHANISMS -- HOW DOES

4715
03:31:32,946 --> 03:31:34,515
STRESS GET UNDER THE SKIN.

4716
03:31:34,581 --> 03:31:35,916
BUT I CAN REPLACE THIS QUESTION

4717
03:31:35,983 --> 03:31:38,419
WITH WHAT ARE THE BIOLOGICAL

4718
03:31:38,485 --> 03:31:43,257
MECHANISMS UNDERLYING THE

4719
03:31:43,323 --> 03:31:44,892
RMD-DISEASE RELATION OR HOW DOES

4720
03:31:44,958 --> 03:31:47,127
RMD GET UNDER THE SKIN, THINKING

4721
03:31:47,194 --> 03:31:50,864
ABOUT RMD AS A STRESSOR.

4722
03:31:50,931 --> 03:31:54,802
HOW DO I MENTION TSH WE'RE ME

4723
03:31:54,868 --> 03:31:58,572
SEEING -- TO CAPTURE BIOLOGICAL

4724
03:31:58,639 --> 03:32:00,307
AGING, AND WHAT FACTORS CAN

4725
03:32:00,374 --> 03:32:02,609
PROMOTE SUCCESSFUL ADAPTATION

4726
03:32:02,676 --> 03:32:06,180
AND/OR RESI RESILIENCY TO ADVER?

4727
03:32:06,246 --> 03:32:07,147
SO THERE'S ALSO A LOT OF

4728
03:32:07,214 --> 03:32:08,916
INTEREST TO TRY TO UNDERSTAND

4729
03:32:08,982 --> 03:32:13,287
RESILIENCY AND HOW WE CAN

4730
03:32:13,353 --> 03:32:14,721
MITIGATE THE FIRST CONSEQUENCES

4731
03:32:14,788 --> 03:32:17,791
LATER IN LIFE.

4732
03:32:17,858 --> 03:32:19,493
-- SO AS I MENTIONED WE FOCUS A

4733
03:32:19,560 --> 03:32:25,265
LOT ON TELOMERES, USING QVCR,

4734
03:32:25,332 --> 03:32:27,501
NOT THE MOST PRECISE METHOD BUT

4735
03:32:27,568 --> 03:32:29,670
IT'S -- FOR A LARGE PROPORTION

4736
03:32:29,736 --> 03:32:31,438
OF THESE STUDIES.

4737
03:32:31,505 --> 03:32:35,175
WE ALSO USE DNA METHYLATION AS

4738
03:32:35,242 --> 03:32:36,643
YOU'VE HEARD BEFORE IN PREVIOUS

4739
03:32:36,710 --> 03:32:37,311
TALKS.

4740
03:32:37,377 --> 03:32:38,612
THERE'S OBVIOUSLY A LOT OF

4741
03:32:38,679 --> 03:32:46,253
INTEREST WITH THESE -- WE'RE

4742
03:32:46,320 --> 03:32:53,060
CURRENTLY DEVELOPED -- THERE

4743
03:32:53,127 --> 03:32:54,361
WILL BE MORE OF THESE DEVELOPED

4744
03:32:54,428 --> 03:33:00,634
IN THE FUTURE -- TO BE DEVELOPED

4745
03:33:00,701 --> 03:33:03,971
SPECIFICALLY -- EVEN THOUGH --

4746
03:33:04,037 --> 03:33:08,175
IN CHILDREN.

4747
03:33:08,242 --> 03:33:10,110
TO CAPTURE THE MORE DYNAMIC

4748
03:33:10,177 --> 03:33:12,412
MOMENT BY MOMENT VARIATION, WE

4749
03:33:12,479 --> 03:33:14,148
ALSO MEASURE GENE EXPRESSION

4750
03:33:14,214 --> 03:33:18,352
THRETHROUGH RNA SEQUENCING,

4751
03:33:18,418 --> 03:33:19,887
SPECIFICALLY TAPPING THE IMMUNE,

4752
03:33:19,953 --> 03:33:22,689
ENDOCRINE AND METABOLIC SYSTEMS,

4753
03:33:22,756 --> 03:33:25,959
AS WELL AS METABOLOMICS IN NMR,

4754
03:33:26,026 --> 03:33:28,162
IN BLOOD OR URINE, TO TRY TO GET

4755
03:33:28,228 --> 03:33:29,530
THIS COMPREHENSIVE UNDERSTANDING

4756
03:33:29,596 --> 03:33:36,837
OF MULTIPLE BA BIOLOGICAL FACTOS

4757
03:33:36,904 --> 03:33:40,741
AND -- TO UNDERSTAND DISEASE

4758
03:33:40,807 --> 03:33:43,243
RELATIONSHIPS.

4759
03:33:43,310 --> 03:33:46,547
-- METHODS -- BIOLOGICAL AGE IS

4760
03:33:46,613 --> 03:33:48,382
A METHOD DEFINED TO PREDICT AGE

4761
03:33:48,448 --> 03:33:51,084
IN YEARS OF A SUBJECT OR --

4762
03:33:51,151 --> 03:33:52,286
SYMBOL, SO TELOMERE HAS PROBABLY

4763
03:33:52,352 --> 03:33:55,222
BEEN STUDIED IN MOST -- CONTEXT

4764
03:33:55,289 --> 03:33:57,858
BUT EPIGENETIC AGING PLOTS ARE

4765
03:33:57,925 --> 03:33:59,159
REALLY -- A LOT OF PEOPLE AREN'T

4766
03:33:59,226 --> 03:34:02,362
USING THOSE MEASURES, THEY'RE

4767
03:34:02,429 --> 03:34:06,767
MORE ACCURATE THAN TELOMERES BUT

4768
03:34:06,833 --> 03:34:11,405
LIST -- THE M M MECHANISMS --

4769
03:34:11,471 --> 03:34:14,708
CAPTURING GENE EXPRESSION --

4770
03:34:14,775 --> 03:34:19,279
MEASURING MULTIPLE AGE --

4771
03:34:19,346 --> 03:34:20,280
TELOMERES -- DNA METHYLATION

4772
03:34:20,347 --> 03:34:24,084
WHICH IS MORE AGE SIMILAR LEVEL.

4773
03:34:24,151 --> 03:34:28,222
SPEAKING OF TELOMERE LENGTH --

4774
03:34:28,288 --> 03:34:30,657
SHOUT OUT TO NIH FOR SUPPORTING

4775
03:34:30,724 --> 03:34:37,397
THE TELOMERE RESEARCH NETWORK.

4776
03:34:37,464 --> 03:34:39,466
SO I WAS SUPPOSED TO READ TO

4777
03:34:39,533 --> 03:34:41,235
YOU -- BUT I CAN'T EVEN READ --

4778
03:34:41,301 --> 03:34:44,771
THIS IS FROM THE WEBSITE, YOU

4779
03:34:44,838 --> 03:34:46,740
CAN GO TO JUST TELOMERE RESEARCH

4780
03:34:46,807 --> 03:34:47,841
NETWORK, YOU WILL GO THERE AND

4781
03:34:47,908 --> 03:34:49,343
SEE WHAT THIS RESEARCH IS REALLY

4782
03:34:49,409 --> 03:34:49,876
ABOUT.

4783
03:34:49,943 --> 03:34:51,979
THE BOTTOM LINE, THIS IS A

4784
03:34:52,045 --> 03:34:55,515
NETWORK THAT STARTED IN 2019.

4785
03:34:55,582 --> 03:34:56,416
AND WE'RE REALLY TRYING TO

4786
03:34:56,483 --> 03:34:58,352
INCREASE THE RIGOR AND

4787
03:34:58,418 --> 03:34:59,786
REPRODUCIBILITY OF TELOMERE

4788
03:34:59,853 --> 03:35:01,955
LENGTH AND MEASUREMENT --

4789
03:35:02,022 --> 03:35:04,458
STUDIES AND COHORTS, AND THIS

4790
03:35:04,524 --> 03:35:06,426
NETWORK IS STILL ACTIVE AND

4791
03:35:06,493 --> 03:35:07,527
GENERATES A LOT OF REALLY

4792
03:35:07,594 --> 03:35:08,562
INTERESTING AND IMPORTANT

4793
03:35:08,629 --> 03:35:10,230
RESEARCH AND PAPERS.

4794
03:35:10,297 --> 03:35:11,765
SO YOU CAN CHECK IT OUT ALSO ON

4795
03:35:11,832 --> 03:35:12,866
THEIR WEBSITE.

4796
03:35:12,933 --> 03:35:15,002
BUT ONE OF THE REASONS -- IS

4797
03:35:15,068 --> 03:35:16,870
BECAUSE THE -- WAS REALLY

4798
03:35:16,937 --> 03:35:19,940
INITIATED IN 2017 BY A WORKSHOP

4799
03:35:20,007 --> 03:35:23,610
ORGANIZED BY NIH -- TO THIS

4800
03:35:23,677 --> 03:35:26,113
WORKSHOP THAT INVITED A LOT OF

4801
03:35:26,179 --> 03:35:28,415
EXPERTS AND IN THE FIELD TO

4802
03:35:28,482 --> 03:35:30,150
DISCUSS ALL THESE QUESTIONS

4803
03:35:30,217 --> 03:35:33,520
ABOUT TELOMERE SCIENCE.

4804
03:35:33,587 --> 03:35:35,989
THIS WAS THE TITLE FOR THAT

4805
03:35:36,056 --> 03:35:37,190
WORKSHOP, TELOMERES AND

4806
03:35:37,257 --> 03:35:39,459
SENTINELS FOR ENVIRONMENTAL

4807
03:35:39,526 --> 03:35:40,427
EXPOSURES, PSYCHOSOCIAL STRESS

4808
03:35:40,494 --> 03:35:41,962
AND DISEASE SUSCEPTIBILITY.

4809
03:35:42,029 --> 03:35:44,298
THESE ARE SOME OF THE POINTS

4810
03:35:44,364 --> 03:35:45,866
FROM THE EXECUTIVE SUMMARY AT

4811
03:35:45,932 --> 03:35:46,733
THE END OF THIS WORKSHOP.

4812
03:35:46,800 --> 03:35:52,406
SO DEVELOP CONSENSUS GUIDELINES,

4813
03:35:52,472 --> 03:35:55,309
WHICH WE ALREADY DID, CONDUCT

4814
03:35:55,375 --> 03:35:56,743
ROBUST METHODS COMPARISON STUDY,

4815
03:35:56,810 --> 03:36:01,348
STILL A WORK IN PROCESS.

4816
03:36:01,415 --> 03:36:02,549
FOCUS -- DEVELOPING BETTER

4817
03:36:02,616 --> 03:36:05,485
MEASURES OF STRESS EXPOSURE,

4818
03:36:05,552 --> 03:36:06,253
FOSTER INTERDISCIPLINARY

4819
03:36:06,320 --> 03:36:06,687
COLLABORATION.

4820
03:36:06,753 --> 03:36:08,088
SO A LOT OF REALLY IMPORTANT

4821
03:36:08,155 --> 03:36:10,424
POINTS THAT CAN BE IMPLEMENTED

4822
03:36:10,490 --> 03:36:14,628
IN RMD HA-RELATED RESEARCH.

4823
03:36:14,695 --> 03:36:16,096
SO -- FOR FUTURE DISCUSSIONS,

4824
03:36:16,163 --> 03:36:19,833
BUT THIS WORKSHOP WAS REALLY --

4825
03:36:19,900 --> 03:36:23,403
WAS INITIATED BY THE TELOMERE

4826
03:36:23,470 --> 03:36:24,905
RESEARCH NETWORK.

4827
03:36:24,971 --> 03:36:27,074
SO -- THE LIFESPAN INFLUENCES ON

4828
03:36:27,140 --> 03:36:31,912
TELOMERE, THIS IS FOR A REVIEW

4829
03:36:31,978 --> 03:36:33,046
PAPER -- 10 YEARS AGO BUT THIS

4830
03:36:33,113 --> 03:36:35,015
IS STILL RELEVANT CONCEPTUALLY

4831
03:36:35,082 --> 03:36:35,449
TODAY.

4832
03:36:35,515 --> 03:36:38,752
WHAT YOU SEE HERE IS

4833
03:36:38,819 --> 03:36:41,655
BIOLOGICAL -- AGE IN PARALLEL

4834
03:36:41,722 --> 03:36:42,756
WITH MULTIPLE AGE.

4835
03:36:42,823 --> 03:36:44,725
ON THE LEFT YOU CAN SEE THE

4836
03:36:44,791 --> 03:36:47,260
IMENT FER IMPACT -- CHILDHOOD

4837
03:36:47,327 --> 03:36:50,864
TRAUMA THAT CAN ACCELERATE OR

4838
03:36:50,931 --> 03:36:52,299
EPIGENETIC AGING CLOCKS.

4839
03:36:52,366 --> 03:36:55,702
THIS GENERATIONAL -- SUPPOSED TO

4840
03:36:55,769 --> 03:37:02,109
CAPTURE THE CAUSAL DIRECTION,

4841
03:37:02,175 --> 03:37:08,548
SO -- BUT ADULT MENTAL

4842
03:37:08,615 --> 03:37:10,450
DISORDERS, DEPRESSION, ANXIETY

4843
03:37:10,517 --> 03:37:12,652
HAVE BEEN STUDIED A LOT,

4844
03:37:12,719 --> 03:37:18,892
AGE-RELATED DISEASES INCLU INCLG

4845
03:37:18,959 --> 03:37:28,502
CARDIOVASCULAR DECEMB DISEASE --

4846
03:37:28,568 --> 03:37:30,904
PLAYING A ROLE IN CAUSAL PATHWAY

4847
03:37:30,971 --> 03:37:32,205
LEADING TO -- DISEASE.

4848
03:37:32,272 --> 03:37:38,078
THEN ON THE TOP WE HAVE ALL TH

4849
03:37:38,145 --> 03:37:41,581
THE -- EFFECT ON -- AGING

4850
03:37:41,648 --> 03:37:43,984
INCLUDING DIET, SLEEP, STRESS

4851
03:37:44,050 --> 03:37:47,220
REDUCTION, ALL OF THESE FACTORS

4852
03:37:47,287 --> 03:37:51,158
ARE DB TO CONSIDER AND THEN,

4853
03:37:51,224 --> 03:37:57,497
GETTING -- ACROSS THE LIFESPAN,

4854
03:37:57,564 --> 03:38:01,401
INCLUDING INTEGER TRANSMISSION

4855
03:38:01,468 --> 03:38:01,835
GAUZE RIGHT.

4856
03:38:01,902 --> 03:38:03,703
SO IN TERMS OF THE MECHANISMS,

4857
03:38:03,770 --> 03:38:08,942
THIS IS STILL ONE OF THOSE --

4858
03:38:09,009 --> 03:38:10,210
ADVERSITY AND STRESS MAY LEAD TO

4859
03:38:10,277 --> 03:38:12,312
OUR INCREASED RISK FOR

4860
03:38:12,379 --> 03:38:13,180
AGE-RELATED DISEASES.

4861
03:38:13,246 --> 03:38:16,082
SO IF WE THINK ABOUT TELOMERES

4862
03:38:16,149 --> 03:38:22,088
OR EPIGENETIC AGING CLOCKS, --

4863
03:38:22,155 --> 03:38:29,162
ESPECIALLY, AGAIN, SPEAR THAT ME

4864
03:38:29,229 --> 03:38:36,269
THE MASTER INTEGRATOR OR -- AND

4865
03:38:36,336 --> 03:38:39,339
ACCELERATES -- AGING --

4866
03:38:39,406 --> 03:38:41,141
INDICATES INCREASED RISK OF

4867
03:38:41,208 --> 03:38:42,676
AGE-RELATED DISEASES, BUT AGAIN

4868
03:38:42,742 --> 03:38:47,581
THE QUESTION IS, HOW DOES STRESS

4869
03:38:47,647 --> 03:38:48,915
AFFECT -- TELOMERES TO GET

4870
03:38:48,982 --> 03:38:50,817
SHORTER ACTUALLY -- INCREASED

4871
03:38:50,884 --> 03:38:52,586
RISK OF -- THAT, WE STILL DON'T

4872
03:38:52,652 --> 03:38:58,325
KNOW, BUT IT'S A COMPLICATED

4873
03:38:58,391 --> 03:39:01,828
PROCESSPROCESS, EPIGENETIC REGU,

4874
03:39:01,895 --> 03:39:08,168
TAP IN -- INFLAMMATION -- ARE

4875
03:39:08,235 --> 03:39:10,971
ALSO VERY IMPORTANT.

4876
03:39:11,037 --> 03:39:11,638
MITOCHONDRIAL REGULATION WILL BE

4877
03:39:11,705 --> 03:39:14,474
IMPORTANT AS WELL.

4878
03:39:14,541 --> 03:39:23,016
IT'S VERY -- TO CONSIDER TO

4879
03:39:23,083 --> 03:39:24,818
INTERACT, SO WE REALLY NEED TO

4880
03:39:24,885 --> 03:39:25,585
UNDERSTAND THIS MECHANISM TO BE

4881
03:39:25,652 --> 03:39:27,153
ABLE TO INTERVENE BETTER IN THE

4882
03:39:27,220 --> 03:39:29,422
FUTURE.

4883
03:39:29,489 --> 03:39:33,426
AND I WAS -- THERE'S NOT A LOT

4884
03:39:33,493 --> 03:39:35,495
OF PAPERS, THERE ARE SOME BUT

4885
03:39:35,562 --> 03:39:37,597
NOT A LOT IN CHILDHOOD.

4886
03:39:37,664 --> 03:39:40,800
THIS IS A RECENT -- I WAS NOT

4887
03:39:40,867 --> 03:39:41,935
INVOLVED WITH THIS STUDY BUT I

4888
03:39:42,002 --> 03:39:43,670
THOUGHT IT WAS A NICE PAPER TO

4889
03:39:43,737 --> 03:39:46,640
SHOWCASE.

4890
03:39:46,706 --> 03:39:48,375
FOR SPECIFICALLY FOR THIS

4891
03:39:48,441 --> 03:39:50,644
MEETING, AND THEY FOCUSED ON

4892
03:39:50,710 --> 03:39:52,746
EPIGENETIC AGING CLOCKS, SO THE

4893
03:39:52,812 --> 03:39:54,481
SAME AGING CLOCKS AS YOU'VE

4894
03:39:54,548 --> 03:39:55,448
HEARD BEFORE.

4895
03:39:55,515 --> 03:40:01,354
I DID AN -- SPECIFICALLY IN A

4896
03:40:01,421 --> 03:40:01,888
SCHOOL CONTEXT.

4897
03:40:01,955 --> 03:40:06,426
SO THEY HAVE LEFT THREE AGING --

4898
03:40:06,493 --> 03:40:09,696
BLACK YOUTH AND ON THE RIGHT --

4899
03:40:09,763 --> 03:40:11,798
IN WHITE YOUTH.

4900
03:40:11,865 --> 03:40:12,899
AND SPECIFICALLY THE FINDING

4901
03:40:12,966 --> 03:40:14,334
HERE WAS THAT BLACK YOUTH IN

4902
03:40:14,401 --> 03:40:16,136
SEGREGATED AND HIGHLY

4903
03:40:16,202 --> 03:40:17,771
DISADVANTAGED SCHOOLS

4904
03:40:17,837 --> 03:40:19,973
EXPERIENCED INCREASING SPEED OF

4905
03:40:20,040 --> 03:40:21,408
EPIGENETIC AGING OVER TIME, SO

4906
03:40:21,474 --> 03:40:23,043
THEY'RE MEASURED OVER SIX YEARS.

4907
03:40:23,109 --> 03:40:28,114
THAT WAS NOT THE CASE FOR BLACK

4908
03:40:28,181 --> 03:40:35,255
OR -- SO THERE'S MORE NUANCED --

4909
03:40:35,322 --> 03:40:39,059
EXAMPLE TO SHOW RELATIONSHIP

4910
03:40:39,125 --> 03:40:40,694
OF -- AGING IN RELATION TO RMD

4911
03:40:40,760 --> 03:40:41,328
IN EARLY LIFE.

4912
03:40:41,394 --> 03:40:43,096
SO I'LL FINISH WITH THIS, I JUST

4913
03:40:43,163 --> 03:40:45,365
WANTED TO ACKNOWLEDGE ALL THE

4914
03:40:45,432 --> 03:40:47,267
COLLEAGUES AND COOPERATOR OVER

4915
03:40:47,334 --> 03:40:49,502
THE YEARS THAT HUNDREDED THE

4916
03:40:49,569 --> 03:40:52,005
WORK WE'RE DOING -- SUPPORT, AND

4917
03:40:52,072 --> 03:40:52,772
I'LL BE HAPPY TO TAKE ANY

4918
03:40:52,839 --> 03:41:02,749
QUESTIONS.

4919
03:41:02,816 --> 03:41:03,717
>> THANK YOU VERY MUCH.

4920
03:41:03,783 --> 03:41:04,818
THIS PANEL IS NOW OPEN FOR

4921
03:41:04,884 --> 03:41:05,752
QUESTIONS, BOTH FROM THE

4922
03:41:05,819 --> 03:41:07,287
AUDIENCE AND FROM REMOTE

4923
03:41:07,354 --> 03:41:14,394
PARTICIPANTS.

4924
03:41:14,461 --> 03:41:15,695
I CAN START US UP.

4925
03:41:15,762 --> 03:41:16,763
OH, GO AHEAD.

4926
03:41:16,830 --> 03:41:20,233
>> THANK YOU VERY MUCH.

4927
03:41:20,300 --> 03:41:24,738
GREAT PRESENTATIONS.

4928
03:41:24,804 --> 03:41:28,675
SO SOME INSIGHTS -- I THINK

4929
03:41:28,742 --> 03:41:31,344
ABOUT EPIGENETIC AGING AND

4930
03:41:31,411 --> 03:41:32,646
POVERTY AND VIOLENCE, ET CETERA,

4931
03:41:32,712 --> 03:41:41,855
ET CETERA.  ARE THERE -- DO

4932
03:41:41,921 --> 03:41:42,956
DIFFERENT GROUPS INTERPRET

4933
03:41:43,023 --> 03:41:44,090
VIOLENCE DIFFERENTLY AND

4934
03:41:44,157 --> 03:41:48,695
INTERPRET POVERTY DIFFERENTLY

4935
03:41:48,762 --> 03:41:51,965
BASED ON WHO THEY ARE AND WHERE

4936
03:41:52,032 --> 03:41:56,736
THEY ARE?

4937
03:41:56,803 --> 03:42:01,007
I GAVE MY FIRST EULOGY AND 16 --

4938
03:42:01,074 --> 03:42:03,309
ACROSS THE STREET FROM ME DIED

4939
03:42:03,376 --> 03:42:04,310
IN POLICE CUSTODY.

4940
03:42:04,377 --> 03:42:05,545
I HEARD OTHER NEIGHBORHOODS THAT

4941
03:42:05,612 --> 03:42:06,646
WERE MORE VIOLENT.

4942
03:42:06,713 --> 03:42:09,149
AND SO I DON'T KNOW HOW THAT

4943
03:42:09,215 --> 03:42:10,950
PLAYS INTO THE SAME THING FOR

4944
03:42:11,017 --> 03:42:12,952
POVERTY, PEOPLE MAY -- IF THEY

4945
03:42:13,019 --> 03:42:14,688
DON'T SEE WHAT THEY HAVE IN

4946
03:42:14,754 --> 03:42:17,323
RELATION TO OTHER THINGS, THEY

4947
03:42:17,390 --> 03:42:19,025
MAY FEEL COMFORTABLE AND GOOD

4948
03:42:19,092 --> 03:42:20,994
WHERE THEY ARE.

4949
03:42:21,061 --> 03:42:25,165
BUT THEN FROM MANHATTAN, HE WAS

4950
03:42:25,231 --> 03:42:26,900
WALKING DOWN THE STREET WITH HIS

4951
03:42:26,966 --> 03:42:28,168
FRIEND, WHERE IS THIS PLACE THEY

4952
03:42:28,234 --> 03:42:30,470
CALL THE GHETTO?

4953
03:42:30,537 --> 03:42:33,540
HE'S LIVING IN HARLEM.

4954
03:42:33,606 --> 03:42:36,009
SO -- A LOT DEPENDS ON YOUR

4955
03:42:36,076 --> 03:42:36,342
PERSPECTIVE.

4956
03:42:36,409 --> 03:42:37,877
DO YOU SEE THAT IN THE DATA,

4957
03:42:37,944 --> 03:42:40,180
DOES IT SHOW OR HOW DOES THAT --

4958
03:42:40,246 --> 03:42:41,414
OR HOW DO YOU TRY TO THINK ABOUT

4959
03:42:41,481 --> 03:42:45,285
THAT?

4960
03:42:45,351 --> 03:42:46,786
>> I CAN SAY A LITTLE BIT ABOUT

4961
03:42:46,853 --> 03:42:48,888
IT.

4962
03:42:48,955 --> 03:42:52,358
SO ONE, IN OUR RESEARCH, WE SEE

4963
03:42:52,425 --> 03:42:54,527
EFFECTS OF OBJECTIVELY MEASURED

4964
03:42:54,594 --> 03:42:55,962
NEIGHBORHOOD DISADVANTAGE, WHICH

4965
03:42:56,029 --> 03:43:00,633
IS REALLY NOT TAINTED BY

4966
03:43:00,700 --> 03:43:02,268
PEOPLE'S PERCEPTIONS BECAUSE

4967
03:43:02,335 --> 03:43:05,872
IT'S JUST -- POVERTY,

4968
03:43:05,939 --> 03:43:08,041
UNEMPLOYMENT, LOW INDICATION

4969
03:43:08,108 --> 03:43:09,175
INDEX BASE.

4970
03:43:09,242 --> 03:43:13,079
I THINK SOMEONE WITH -- SO IN

4971
03:43:13,146 --> 03:43:15,682
OUR RESEARCH WE ASK OUR

4972
03:43:15,749 --> 03:43:17,450
PARTICIPANTS, HAVE YOU SEEN

4973
03:43:17,517 --> 03:43:18,752
PEOPLE THREATEN EACH OTHER, HAVE

4974
03:43:18,818 --> 03:43:23,056
YOU SEEN PEOPLE BEAT EACH OTHER,

4975
03:43:23,123 --> 03:43:26,893
HAVE YOU SEEN PEOPLE COMMITTING

4976
03:43:26,960 --> 03:43:27,660
VIOLENCE WITH WEAPONS.

4977
03:43:27,727 --> 03:43:30,063
SO THERE COULD BE SOME

4978
03:43:30,130 --> 03:43:31,331
PERCEPTION, SOME BIAS IN THAT,

4979
03:43:31,397 --> 03:43:33,099
IF YOU THINK IT'S NORMAL, MAYBE

4980
03:43:33,166 --> 03:43:35,602
YOU UNDERREPORT, MAYBE YOUR

4981
03:43:35,668 --> 03:43:37,303
THRESHOLD FOR WHAT'S THE THREAT,

4982
03:43:37,370 --> 03:43:40,373
WHAT'S THE LEVEL OF VIE L VIOLES

4983
03:43:40,440 --> 03:43:41,508
IN A DIFFERENT PLACE.

4984
03:43:41,574 --> 03:43:42,642
I'M NOT SURE HOW EXACTLY WE

4985
03:43:42,709 --> 03:43:43,476
WOULD INVESTIGATE IT.

4986
03:43:43,543 --> 03:43:46,212
HAVE YOU -- HAS YOUR RESEARCH --

4987
03:43:46,279 --> 03:43:48,782
>> IN RELATION TO EPIGENETIC

4988
03:43:48,848 --> 03:43:50,250
AGING, WE HAVE NOT LOOKED

4989
03:43:50,316 --> 03:43:51,751
SEPARATELY AT THE PERCEPTIONS OF

4990
03:43:51,818 --> 03:43:53,419
EXPERIENCES VERSUS JUST

4991
03:43:53,486 --> 03:43:54,487
OBJECTIVELY MEASURED EXPERIENCES

4992
03:43:54,554 --> 03:43:57,957
SO I CAN'T REALLY -- WE DO HAVE

4993
03:43:58,024 --> 03:44:00,026
WHAT WE CATEGORIZE AS STRESSORS

4994
03:44:00,093 --> 03:44:01,728
AND THEN WE HAVE THE PERCEPTION

4995
03:44:01,795 --> 03:44:04,898
OF STRESS, SO WE DO HAVE THOSE

4996
03:44:04,964 --> 03:44:07,634
MEASURES WHICH THEY BOTH KNOWED

4997
03:44:07,700 --> 03:44:09,903
IN TERMS OF CLUSTERS OF HIGH

4998
03:44:09,969 --> 03:44:11,971
LEVELS OF THESE EXPERIENCES THAT

4999
03:44:12,038 --> 03:44:13,506
ARE ASSOCIATED WITH EPIGENETIC

5000
03:44:13,573 --> 03:44:15,642
AGING REGARDLESS OF WHETHER

5001
03:44:15,708 --> 03:44:17,210
YOU'RE HIGH ON PERCEPTION MENTAL

5002
03:44:17,277 --> 03:44:18,611
HEALTH OR HIGH ON THE OBJECTIVE

5003
03:44:18,678 --> 03:44:20,713
MEASURES LIKE YOU STILL SEE A

5004
03:44:20,780 --> 03:44:23,082
LEVEL OF IMPACT ON EPIGENETIC

5005
03:44:23,149 --> 03:44:27,020
AGING, BUT WE HAVEN'T

5006
03:44:27,086 --> 03:44:28,988
SPECIFICALLY ANALYZED

5007
03:44:29,055 --> 03:44:30,857
PERCEPTIONS OF A PARTICULAR TYPE

5008
03:44:30,924 --> 03:44:32,559
OF STRESS COMPARED TO ANOTHER

5009
03:44:32,625 --> 03:44:36,429
PARTICULAR TYPE OF STRESS.

5010
03:44:36,496 --> 03:44:39,365
>> THERE WAS AN INTERESTING

5011
03:44:39,432 --> 03:44:42,202
CONCEPT THAT JOON BRODY, GREG

5012
03:44:42,268 --> 03:44:44,237
MILLER, EDITH CHAN, THE SKIN

5013
03:44:44,304 --> 03:44:45,471
DEEP RESILIENCE, IF YOU HEARD

5014
03:44:45,538 --> 03:44:45,738
ABOUT IT.

5015
03:44:45,805 --> 03:44:47,640
SO I THINK THIS IS A MODEL THAT

5016
03:44:47,707 --> 03:44:49,375
CAN ASCRIBE HOW PEOPLE CAN BE

5017
03:44:49,442 --> 03:44:51,778
RESILIENT IN THE FACE OF A

5018
03:44:51,845 --> 03:44:53,413
DISCRIMINATION AND ADVERSITY,

5019
03:44:53,479 --> 03:44:55,215
BUT STILL UNDER THE SKIN IF

5020
03:44:55,281 --> 03:44:58,184
YOU'RE LOOKING AT SOME

5021
03:44:58,251 --> 03:44:59,619
BIOMARKERS YOU CAN SEE THAT THEY

5022
03:44:59,686 --> 03:45:00,587
ACTUALLY AREN'T DOING AS WELL,

5023
03:45:00,653 --> 03:45:03,089
SO I THINK THIS MAY BE A MODEL

5024
03:45:03,156 --> 03:45:04,657
THAT'S RELATED TO YOUR QUESTION.

5025
03:45:04,724 --> 03:45:07,427
>> AND ACTUALLY THAT MODEL IS

5026
03:45:07,493 --> 03:45:09,729
SUPPORTED BY SOME OF OUR DATA.

5027
03:45:09,796 --> 03:45:12,999
>> THANK YOU.

5028
03:45:13,066 --> 03:45:15,168
>> THANK YOU ALL FOR YOUR TALKS.

5029
03:45:15,235 --> 03:45:23,343
EXCELLENT TALKS.

5030
03:45:23,409 --> 03:45:24,544
DR. NOAH, AT THE END, I THOUGHT

5031
03:45:24,611 --> 03:45:29,048
IT WAS LIKE REALLY, LIKE --

5032
03:45:29,115 --> 03:45:33,052
BECAUSE YOU WERE ABLE TO REVERSE

5033
03:45:33,119 --> 03:45:34,787
THESE ISSUES THAT THEY HAD WHEN

5034
03:45:34,854 --> 03:45:38,825
YOU REORDERED YOUR -- THE

5035
03:45:38,892 --> 03:45:42,295
SPECIES, RIGHT, AND SO I WAS

5036
03:45:42,362 --> 03:45:44,797
WONDERING ABOUT POST-TRAUMATIC

5037
03:45:44,864 --> 03:45:50,069
SLEEP SYNDROME, AND HOW THAT

5038
03:45:50,136 --> 03:45:52,205
IMPACTED OUR -- GENERATION BY

5039
03:45:52,272 --> 03:45:54,707
GENERATION OVER TIME, DO OUR

5040
03:45:54,774 --> 03:45:57,577
JEANS STILL MATTER IN THAT

5041
03:45:57,644 --> 03:45:58,111
SPENCE.

5042
03:45:58,177 --> 03:45:59,145
THINKING ABOUT OTHER

5043
03:45:59,212 --> 03:45:59,946
ENVIRONMENTAL STRESSORS OR EVEN

5044
03:46:00,013 --> 03:46:03,449
IF I'M A HEALTHY INDIVIDUAL --

5045
03:46:03,516 --> 03:46:06,953
PEEKING OF EARLIER, AND I'M

5046
03:46:07,020 --> 03:46:08,221
FACED WITH ADVERSITY AND WORK

5047
03:46:08,288 --> 03:46:13,393
SUCH AS MICRO AGGRESSIONS, AND

5048
03:46:13,459 --> 03:46:17,597
IF YOU LOOK AT -- ALMOST EVERY

5049
03:46:17,664 --> 03:46:19,132
CHRONIC ILLNESS IS -- AFRICAN

5050
03:46:19,198 --> 03:46:22,068
AMERICANS ARE AT THE HIGHEST

5051
03:46:22,135 --> 03:46:23,369
RATE, SO I'M WONDERING HOW ALL

5052
03:46:23,436 --> 03:46:27,440
OF THAT KIND OF FITS TOGETHER

5053
03:46:27,507 --> 03:46:30,076
AND EPIGENETICS AND HOW THEY

5054
03:46:30,143 --> 03:46:31,377
EXPRESS THAT IN OUR GENES.

5055
03:46:31,444 --> 03:46:32,345
>> THAT'S A REALLY GREAT

5056
03:46:32,412 --> 03:46:32,946
QUESTION.

5057
03:46:33,012 --> 03:46:34,547
I WAS BEING A LITTLE GLIB IN

5058
03:46:34,614 --> 03:46:36,716
TERMS OF SAYING THAT GENES DON'T

5059
03:46:36,783 --> 03:46:38,117
MATTER, RIGHT?

5060
03:46:38,184 --> 03:46:39,652
I THINK THE RELATIVE IMPORTANCE

5061
03:46:39,719 --> 03:46:41,721
OF THEM IS MUCH SMALLER THAN

5062
03:46:41,788 --> 03:46:43,656
IT'S BEEN MADE OUT TO BE, WHEN

5063
03:46:43,723 --> 03:46:44,991
THE HUMAN GENOME CAME OUT,

5064
03:46:45,058 --> 03:46:47,226
CLINTON GOT UP THERE AND SAID

5065
03:46:47,293 --> 03:46:50,897
ANSWCANCER IS GOING TO BE GONE ,

5066
03:46:50,964 --> 03:46:52,465
10 YEARS, WHICH WAS NOT CORRECT,

5067
03:46:52,532 --> 03:46:54,233
RIGHT, BECAUSE THIS PERSONALIZED

5068
03:46:54,300 --> 03:46:55,535
MEDICINE, EVEN POLYGENIC RISK

5069
03:46:55,601 --> 03:46:56,736
SCORES AND THINGS LIKE THAT ARE

5070
03:46:56,803 --> 03:46:58,137
NOT THAT PREDICTIVE AT THE

5071
03:46:58,204 --> 03:46:59,539
INDIVIDUAL LEVEL AS WELL, RIGHT?

5072
03:46:59,605 --> 03:47:01,441
AND WE KNOW THAT OUR EXPOSURES

5073
03:47:01,507 --> 03:47:04,844
AND EXPERIENCES HAVE SHORT OF AN

5074
03:47:04,911 --> 03:47:11,417
UTESIZEED EFFECT AND WELL-BEING.

5075
03:47:11,484 --> 03:47:14,988
YOU MENTIONED SORT OF TRANS

5076
03:47:15,054 --> 03:47:15,755
GENERATIONAL EFFECTS OF THESE

5077
03:47:15,822 --> 03:47:17,724
AND WHETHER THAT'S PASSED DOWN

5078
03:47:17,790 --> 03:47:20,126
THROUGH YOUR EPIGENOME, WHICH IS

5079
03:47:20,193 --> 03:47:22,862
NOT SPECIFICALLY YOUR DNA

5080
03:47:22,929 --> 03:47:24,897
SEQUENCE BUT, YOU KNOW,

5081
03:47:24,964 --> 03:47:27,433
MOLECULAR MODIFIER MARKS -- I

5082
03:47:27,500 --> 03:47:30,603
WOULDN'T CALL THAT OUR GENES, SO

5083
03:47:30,670 --> 03:47:32,005
WOT COULD BE TRUE AND SORT OF

5084
03:47:32,071 --> 03:47:33,306
THE TRANS GENERATIONAL

5085
03:47:33,373 --> 03:47:35,608
TRANSMISSION OF THESE TRAUMAS,

5086
03:47:35,675 --> 03:47:37,243
RIGHT, THAT YOU MENTIONED.

5087
03:47:37,310 --> 03:47:39,045
I MEAN, COULD ALSO BE DUE TO

5088
03:47:39,112 --> 03:47:41,914
SORT OF THE TRANSMISSION OF

5089
03:47:41,981 --> 03:47:44,283
THOSE TRAUMAS DURING DEVELOPMENT

5090
03:47:44,350 --> 03:47:46,285
AND GROWING UP.

5091
03:47:46,352 --> 03:47:47,920
THESE EXPERIENCES AND EXPOSURE,

5092
03:47:47,987 --> 03:47:49,555
THEY MAY NOT NECESSARILY BE

5093
03:47:49,622 --> 03:47:50,857
MOLECULAR MARKS THAT ARE PASSED

5094
03:47:50,923 --> 03:47:54,227
DOWN THROUGH GENERATION IN

5095
03:47:54,293 --> 03:47:55,962
UTERO, BUT THEY CAN BE PASSED

5096
03:47:56,029 --> 03:47:59,032
DOWN THROUGH LIVED EXPERIENCES

5097
03:47:59,098 --> 03:48:04,570
AND CONTINUED MARGINALIZATION,

5098
03:48:04,637 --> 03:48:06,873
DISCRIMINATION ANDAS WELL.

5099
03:48:06,939 --> 03:48:08,074
ONE COMMENT I WANT TO MAKE ABOUT

5100
03:48:08,141 --> 03:48:10,743
THE STUDY WE DID, IT'S REALLY,

5101
03:48:10,810 --> 03:48:13,579
REALLY CAL T COOL THAT IT'S REVE

5102
03:48:13,646 --> 03:48:14,981
BUT STILL, WE DON'T NECESSARILY

5103
03:48:15,048 --> 03:48:17,283
KNOW HOW LONG TERM THE EXPOSURE

5104
03:48:17,350 --> 03:48:18,651
WOULD NEED TO BE IN TERMS OF

5105
03:48:18,718 --> 03:48:20,620
WHETHER OR NOT IT COULD BE

5106
03:48:20,686 --> 03:48:22,055
REVERSED VERSUS NOT OR HOW WE

5107
03:48:22,121 --> 03:48:23,790
COULD REVERSE THIS EFFECT.

5108
03:48:23,856 --> 03:48:26,325
AND I THINK THAT'S PROBABLY ONE

5109
03:48:26,392 --> 03:48:28,728
OF THE -- THE STRENGTHS OF

5110
03:48:28,795 --> 03:48:30,029
ANIMAL MODELS IS THAT THEY LIVE

5111
03:48:30,096 --> 03:48:31,664
SHORTER LIVES THAN US SO WE CAN

5112
03:48:31,731 --> 03:48:33,599
CONDUCT THESE LONGITUDAL

5113
03:48:33,666 --> 03:48:35,568
STUDIES, RIGHT, THAT CAPTURE ALL

5114
03:48:35,635 --> 03:48:36,869
ASPECTS OF DEVELOPMENT, ALL

5115
03:48:36,936 --> 03:48:38,838
ASPECTS OF AGING BECAUSE AGING

5116
03:48:38,905 --> 03:48:40,239
IS A DEVELOPMENTAL PROCESS TO

5117
03:48:40,306 --> 03:48:41,574
TRY AND SEE WHEN THIS MATTERS

5118
03:48:41,641 --> 03:48:42,942
AND HOW LONG IT MATTERS AND

5119
03:48:43,009 --> 03:48:45,078
WHETHER OR NOT IT IS TOO STICKY

5120
03:48:45,144 --> 03:48:51,851
AFTER A CERTAIN POINT.

5121
03:48:51,918 --> 03:48:55,655
>> THANK YOU.

5122
03:48:55,721 --> 03:48:57,423
I HAD A QUICK QUESTION FOR

5123
03:48:57,490 --> 03:48:58,624
EVERYBODY ON THE PANEL AND THAT

5124
03:48:58,691 --> 03:49:00,827
IS AS WE KNOW, TYPE~2 DIABETES

5125
03:49:00,893 --> 03:49:01,761
IN YOUTH IS ASSOCIATED WITH MUCH

5126
03:49:01,828 --> 03:49:04,597
MORE SEVERE AND MUCH MORE RAPID

5127
03:49:04,664 --> 03:49:05,798
ONSET OF COMPLICATIONS THAN WE

5128
03:49:05,865 --> 03:49:06,432
SEE IN ADULTS.

5129
03:49:06,499 --> 03:49:07,867
I WAS WONDERING IF ANY OF YOU

5130
03:49:07,934 --> 03:49:09,902
HAVE LOOKED AT THAT KIND OF

5131
03:49:09,969 --> 03:49:10,970
INTERSECTION OF AGING AND, OF

5132
03:49:11,037 --> 03:49:13,940
COURSE, INDIVIDUAL TYPE

5133
03:49:14,006 --> 03:49:15,374
2 DIABETES AND SOME OF THESE

5134
03:49:15,441 --> 03:49:17,176
OTHER EX-PRESSORS WE'VE TALKED

5135
03:49:17,243 --> 03:49:18,744
ABOUT IN THE RMD SPACE, SO

5136
03:49:18,811 --> 03:49:26,252
LOOKING AT THESE -- TYPE

5137
03:49:26,319 --> 03:49:27,587
2 DIABETES IN YOUTH.

5138
03:49:27,653 --> 03:49:30,089
>> WE HAVE NOT, UNFORTUNATELY.

5139
03:49:30,156 --> 03:49:32,258
>> WE HAVEN'T, BUT THERE'S A

5140
03:49:32,325 --> 03:49:33,359
MULTISITE STUDY, I DON'T

5141
03:49:33,426 --> 03:49:35,495
REMEMBER WHAT IT'S CALLED,

5142
03:49:35,561 --> 03:49:37,029
BUT -- I'M A CO-INVESTIGATOR ON

5143
03:49:37,096 --> 03:49:39,532
IT, BUT IT'S A MULTISITE STUDY,

5144
03:49:39,599 --> 03:49:42,034
IT'S A LARGE STUDY OF -- I THINK

5145
03:49:42,101 --> 03:49:43,336
IT'S TYPE 2 DIABETES IN EUROPE,

5146
03:49:43,402 --> 03:49:44,670
AND THEY ARE LOOKING AT THE

5147
03:49:44,737 --> 03:49:46,606
EARLY LIFE STRESS AS ONE OF THE

5148
03:49:46,672 --> 03:49:47,573
FACTORS AS WELL AS A LOT OF

5149
03:49:47,640 --> 03:49:49,442
OTHER FACTORS, SO I IMAGINE WE

5150
03:49:49,509 --> 03:49:53,679
WILL BE ADDRESSING SOME OF THOSE

5151
03:49:53,746 --> 03:49:56,549
QUESTIONS, IN THAT STUDY.

5152
03:49:56,616 --> 03:50:00,052
>> SORRY, I JUST HAD TO COMMENT

5153
03:50:00,119 --> 03:50:03,789
A LITTLE BIT ON -- ABOUT GENES

5154
03:50:03,856 --> 03:50:05,558
NOT MATTERING AS MUCH.

5155
03:50:05,625 --> 03:50:06,659
I THINK WE'VE GOT A HUGE

5156
03:50:06,726 --> 03:50:07,660
DISCUSSION ON THAT BUT I WILL

5157
03:50:07,727 --> 03:50:09,495
SAY A COUPLE THINGS.

5158
03:50:09,562 --> 03:50:10,897
ONE, BECAUSE YOU CAN ALTER SOME

5159
03:50:10,963 --> 03:50:14,500
OF THE BIOLOGICAL RESPONSES AND

5160
03:50:14,567 --> 03:50:16,569
BEHAVIOR OF PRETTY MUCH

5161
03:50:16,636 --> 03:50:17,203
GENETICALLY VERY SIMILAR

5162
03:50:17,270 --> 03:50:18,571
ANIMALS.

5163
03:50:18,638 --> 03:50:20,006
DOES NOT MAKE GENES NOT

5164
03:50:20,072 --> 03:50:20,873
IMPORTANT.

5165
03:50:20,940 --> 03:50:21,507
OBVIOUSLY.

5166
03:50:21,574 --> 03:50:23,342
BUT WE KNOW HUMANS ARE

5167
03:50:23,409 --> 03:50:25,545
INCREDIBLY DIVERSE, AND IN FACT,

5168
03:50:25,611 --> 03:50:27,513
OUR GENES DETERMINE VERY MUCH

5169
03:50:27,580 --> 03:50:30,449
THESE RISKS.

5170
03:50:30,516 --> 03:50:33,586
SO -- YOU WEREN'T MEASURING --

5171
03:50:33,653 --> 03:50:36,422
ANIMALS RISK OR MAJOR DEPRESSIVE

5172
03:50:36,489 --> 03:50:37,657
DISORDER OR AUTISM OR

5173
03:50:37,723 --> 03:50:38,090
HYPERTENSION.

5174
03:50:38,157 --> 03:50:39,926
SO I THINK WE HAVE TO BE VERY

5175
03:50:39,992 --> 03:50:41,661
CAREFUL WHEN YOUR GENES DON'T

5176
03:50:41,727 --> 03:50:43,095
MATTER BECAUSE ULTIMATELY

5177
03:50:43,162 --> 03:50:44,597
INDIVIDUALS IN VERY SIMILAR

5178
03:50:44,664 --> 03:50:47,433
ENVIRONMENTS, AND EVEN IN SAME

5179
03:50:47,500 --> 03:50:51,304
HOUSEHOLDS, CAN PRESENT -- THE

5180
03:50:51,370 --> 03:50:52,572
FACT THAT OUR GENES VERY MUCH

5181
03:50:52,638 --> 03:50:53,873
MATTER AND THAT THEY INTERACT

5182
03:50:53,940 --> 03:50:55,374
WITH OUR ENVIRONMENT.

5183
03:50:55,441 --> 03:50:56,576
SO I THINK WE SHOULD BE VERY

5184
03:50:56,642 --> 03:50:58,878
CAREFUL TO NOT MAKE STATEMENTS

5185
03:50:58,945 --> 03:51:03,616
LIKE GENES DON'T MATTER.

5186
03:51:03,683 --> 03:51:04,984
>> I WOULD PUSH BACK A LITTLE

5187
03:51:05,051 --> 03:51:08,054
BIT, I THINK, ACTUALLY.

5188
03:51:08,120 --> 03:51:10,356
[LAUGHTER]

5189
03:51:10,423 --> 03:51:12,191
GLOVES ARE COMING OFF.

5190
03:51:12,258 --> 03:51:14,093
SO I WOULD PUSH BACK SLIGHTLY

5191
03:51:14,160 --> 03:51:15,561
BECAUSE I DO THINK THAT THERE IS

5192
03:51:15,628 --> 03:51:20,433
EVIDENCE FOR, YOU KNOW, GENETIC

5193
03:51:20,499 --> 03:51:21,434
DIFFERENCES FOR SOME DISEASES,

5194
03:51:21,500 --> 03:51:22,168
BUT MANY COMPLEX --

5195
03:51:22,235 --> 03:51:23,869
>> NO, NO, NO, SAY THAT AGAIN?

5196
03:51:23,936 --> 03:51:26,572
>> THERE'S EVIDENCE FOR GENES,

5197
03:51:26,639 --> 03:51:28,207
YOU KNOW, INCREASING RISK FOR

5198
03:51:28,274 --> 03:51:29,208
SOME DISEASES, RIGHT?

5199
03:51:29,275 --> 03:51:31,877
MANY DISEASES.

5200
03:51:31,944 --> 03:51:34,180
>> THERE'S A LOT OF EVIDENCE --

5201
03:51:34,247 --> 03:51:35,948
>> THERE TOTALLY IS, BUT GENES

5202
03:51:36,015 --> 03:51:38,217
HAVE LARGE EFFECT ON MANY

5203
03:51:38,284 --> 03:51:39,785
DISEASES LIKE COMPLEX DISEASES

5204
03:51:39,852 --> 03:51:42,021
LIKE MDD YOU MENTIONED, RIGHT?

5205
03:51:42,088 --> 03:51:43,789
DO NOT HAVE THE -- HAVE A

5206
03:51:43,856 --> 03:51:45,958
STRONGER EFFECT ON MDD THAN

5207
03:51:46,025 --> 03:51:47,893
CHILDHOOD EXPOSURES TO

5208
03:51:47,960 --> 03:51:49,161
ADVERSITY, CORRECT?

5209
03:51:49,228 --> 03:51:50,529
>> IT'S AN INTERACTION.

5210
03:51:50,596 --> 03:51:53,366
IT'S AN INTERACTION OF GENES BY

5211
03:51:53,432 --> 03:51:54,667
ENVIRONMENT, 100% IT'S AN

5212
03:51:54,734 --> 03:51:55,201
INTERACTION.

5213
03:51:55,268 --> 03:52:02,875
WE HAVE NO GENES THAT -- TO

5214
03:52:02,942 --> 03:52:03,142
DEVELOP --

5215
03:52:03,209 --> 03:52:03,542
>> CORRECT.

5216
03:52:03,609 --> 03:52:05,511
SO I GUESS I WAS -- MY PUSHBACK

5217
03:52:05,578 --> 03:52:06,879
THERE WAS NOT NECESSARILY THAT

5218
03:52:06,946 --> 03:52:08,080
GENES DON'T MATTER COMPLETELY,

5219
03:52:08,147 --> 03:52:09,615
BUT THAT I THINK THEY HAVE A

5220
03:52:09,682 --> 03:52:12,451
SMALLER EFFECT THAN OUR

5221
03:52:12,518 --> 03:52:13,653
ENVIRONMENT, AND WHEN WE'VE DONE

5222
03:52:13,719 --> 03:52:15,187
LARGE SCALE STUDIES OF THESE, I

5223
03:52:15,254 --> 03:52:18,991
THINK WE'VE SEEN THAT YOUR DNA

5224
03:52:19,058 --> 03:52:20,960
SEQUENCE AND POLYGENIC RISK

5225
03:52:21,027 --> 03:52:23,162
SCORES -- LARGE STUDIES IN THE

5226
03:52:23,229 --> 03:52:24,764
UK BIOBANK SHOW THEY HAVE A

5227
03:52:24,830 --> 03:52:28,701
SMALLER EFFECT THAN OTHER

5228
03:52:28,768 --> 03:52:30,002
FACTORS LIKE YOUR EXPOSURES AND

5229
03:52:30,069 --> 03:52:40,179
LIFE EXPERIENCES.

5230
03:52:40,246 --> 03:52:43,549
>> THAT GROUP DIFFERENCES IN

5231
03:52:43,616 --> 03:52:45,484
HEALTH ARE DRIVEN MORE BY

5232
03:52:45,551 --> 03:52:49,121
ENVIRONMENT THAN GENES.

5233
03:52:49,188 --> 03:52:54,560
GEANS WILL HELP -- DIFFERENCES

5234
03:52:54,627 --> 03:52:59,131
FOR THE ENVIRONMENT.

5235
03:52:59,198 --> 03:53:01,801
BUT THE GENETIC RISK IS FAIRLY

5236
03:53:01,867 --> 03:53:03,002
UBIQUITOUS AND EQUAL BETWEEN

5237
03:53:03,069 --> 03:53:03,336
GROUPS.

5238
03:53:03,402 --> 03:53:06,038
THERE ARE SOME SMALL DIFFERENCES

5239
03:53:06,105 --> 03:53:07,673
IN GENE PROMINENCE ACROSS

5240
03:53:07,740 --> 03:53:09,075
DIFFERENT GROUPS, BUT THE KISS

5241
03:53:09,141 --> 03:53:14,413
PATHEDISPARITIES WE SEE -- BY

5242
03:53:14,480 --> 03:53:15,081
DEFINITION DISPARITIES ARE.

5243
03:53:15,147 --> 03:53:16,816
SO DIFFERENCES WE SEE IN

5244
03:53:16,882 --> 03:53:18,784
POPULATIONS ARE MOSTLY DRIVEN BY

5245
03:53:18,851 --> 03:53:25,224
THE SOCIAL FACTORS THAT --

5246
03:53:25,291 --> 03:53:27,259
ENVIRONMENT GENE INTERACTION.

5247
03:53:27,326 --> 03:53:28,694
MOST PEOPLE IN GENERAL HAVE A

5248
03:53:28,761 --> 03:53:30,963
SIMILAR GENETIC PROFILE.

5249
03:53:31,030 --> 03:53:33,099
DOES THAT SOUND --

5250
03:53:33,165 --> 03:53:35,668
>> I FEEL, YOU KNOW, IN A

5251
03:53:35,735 --> 03:53:37,870
CONFERENCE ON MARGINALIZATION,

5252
03:53:37,937 --> 03:53:42,308
RIGHT, I THIDGES T I THINK THATT

5253
03:53:42,375 --> 03:53:43,876
OF US PUSH BACK AGAINST, THIS

5254
03:53:43,943 --> 03:53:49,181
IDEA THAT YOU SEE -- DISEASE IN

5255
03:53:49,248 --> 03:53:49,982
LATINO AND BLACK PEOPLE BECAUSE

5256
03:53:50,049 --> 03:53:53,119
THEY ARE INHERENTLY BIOLOGICALLY

5257
03:53:53,185 --> 03:53:54,286
INFERIOR AND I THINK THAT'S IS

5258
03:53:54,353 --> 03:53:55,488
WHAT THESE ARGUMENTS PUSH BACK

5259
03:53:55,554 --> 03:53:56,922
AGAINST, AND I THINK WE'RE

5260
03:53:56,989 --> 03:54:01,394
LIVING IN A TIME IN A SOCIETY

5261
03:54:01,460 --> 03:54:03,562
WHERE PEOPLE WHO EXIST THIS IDEA

5262
03:54:03,629 --> 03:54:04,997
THAT THERE ARE SOCIAL

5263
03:54:05,064 --> 03:54:05,965
HIERARCHIES IN SOCIETY AND

5264
03:54:06,031 --> 03:54:07,900
PEOPLE WHO RE TOP OF THOSE

5265
03:54:07,967 --> 03:54:08,701
SOCIAL HIERARCHIES, AND FOR

5266
03:54:08,768 --> 03:54:13,072
REASONS I THINK SOME PEOPLE ARE

5267
03:54:13,139 --> 03:54:15,141
AT THE TOP OF THE SOCIAL

5268
03:54:15,207 --> 03:54:16,876
HIERARCHY FEEL INVALIDATED IN

5269
03:54:16,942 --> 03:54:17,676
THEIR OWN PERSONAL EXPERIENCE

5270
03:54:17,743 --> 03:54:18,844
AND I DON'T THINK THAT'S WHAT WE

5271
03:54:18,911 --> 03:54:20,980
WANT TO SAY OR DO, BUT I THINK

5272
03:54:21,046 --> 03:54:25,851
WE DO WANT TO ACKNOWLEDGE THAT

5273
03:54:25,918 --> 03:54:28,154
TO PUSH AGAINST BU BIOLOGIC

5274
03:54:28,220 --> 03:54:29,121
ESSENTIALISM THAT ESSENTIALLY

5275
03:54:29,188 --> 03:54:32,191
ARGUES THAT THESE GROUPS HAVE

5276
03:54:32,258 --> 03:54:33,192
WORSE DISEASE BECAUSE IT'S THEIR

5277
03:54:33,259 --> 03:54:34,393
FAULT OR BECAUSE IT HAS NOTHING

5278
03:54:34,460 --> 03:54:35,594
TO DO WITH POLICIES AND

5279
03:54:35,661 --> 03:54:36,462
PRACTICES THAT HAVE BEEN IN

5280
03:54:36,529 --> 03:54:38,631
PLACE FOR HUNDREDS AND HUNDREDS

5281
03:54:38,697 --> 03:54:40,933
OF YEARS THAT DISENFRANCHISE

5282
03:54:41,000 --> 03:54:42,168
GROUPS VIS-A-VIS ONE ANOTHER.

5283
03:54:42,234 --> 03:54:43,335
AND I WOULD ARGUE THAT PEOPLE

5284
03:54:43,402 --> 03:54:44,537
WHO WANT TO SAY THAT THOSE

5285
03:54:44,603 --> 03:54:47,373
THINGS DON'T MATTER, THEY SHOULD

5286
03:54:47,440 --> 03:54:49,809
VOLUNTEER TO BE IMPOVERISHED,

5287
03:54:49,875 --> 03:54:51,210
THEY SHOULD VOLUNTEER TO BE

5288
03:54:51,277 --> 03:54:51,977
DISCRIMINATED AGAINST, THEY

5289
03:54:52,044 --> 03:54:54,180
SHOULD VOLUNTEER TO HAVE THE

5290
03:54:54,246 --> 03:54:55,915
WORST JOBS AND WORK THE WORST

5291
03:54:55,981 --> 03:54:57,116
SHIFTS IN SOCIETY AND THEN WE

5292
03:54:57,183 --> 03:55:00,019
CAN HAVE THAT CONVERSATION AGA

5293
03:55:00,085 --> 03:55:05,658
AGAIN.

5294
03:55:05,724 --> 03:55:07,593
>> I'LL ASK A QUESTION FROM THE

5295
03:55:07,660 --> 03:55:08,828
VIRTUAL PARTICIPANTS.

5296
03:55:08,894 --> 03:55:11,430
SO GETTING BACK TO THE QUESTION

5297
03:55:11,497 --> 03:55:13,265
OF ACCELERATION OF EPIGENETIC

5298
03:55:13,332 --> 03:55:15,468
AGING.

5299
03:55:15,534 --> 03:55:16,802
CAN THE PANELISTS CLARIFY WHAT

5300
03:55:16,869 --> 03:55:20,072
ARE THE CONCRETE OR SPECIFIC

5301
03:55:20,139 --> 03:55:21,774
OUTCOMES OF THE DIFFERENCES IN

5302
03:55:21,841 --> 03:55:23,542
OR ACCELERATION OF EPIGENETIC

5303
03:55:23,609 --> 03:55:27,713
AGING THAT ARE OBSERVED?

5304
03:55:27,780 --> 03:55:32,117
OR MAYBE WHAT DOES IT MEAN?

5305
03:55:32,184 --> 03:55:33,919
>> SO I GUESS THE QUESTION IS

5306
03:55:33,986 --> 03:55:36,455
GETTING AT IS THE ACCELERATED

5307
03:55:36,522 --> 03:55:40,025
AGING RELATED TO DISEASE

5308
03:55:40,092 --> 03:55:40,626
OUTCOMES?

5309
03:55:40,693 --> 03:55:44,230
SO YES, IN OUR WORK, WE'RE

5310
03:55:44,296 --> 03:55:46,532
FOCUSING ON CARDIOMETABOLIC

5311
03:55:46,599 --> 03:55:48,200
HEALTH, SO WE'VE SORT OF TAKEN

5312
03:55:48,267 --> 03:55:50,102
THIS KIND OF AS A TWO-STEP

5313
03:55:50,169 --> 03:55:54,173
LOOKING FIRST AT THE STRESSORS

5314
03:55:54,240 --> 03:55:56,242
AND THESE MEASURES IN RELATION

5315
03:55:56,308 --> 03:55:58,310
TO EPIGENETIC AGING AND

5316
03:55:58,377 --> 03:56:01,146
SEPARATELY LOOKING AT THE IMPACT

5317
03:56:01,213 --> 03:56:01,680
ON CARDIOMETABOLIC HEALTH

5318
03:56:01,747 --> 03:56:02,147
OUTCOMES.

5319
03:56:02,214 --> 03:56:03,148
SO I JUST PRESENTED THE FIRST

5320
03:56:03,215 --> 03:56:04,750
PART OF THAT, BUT WE DO ALSO SEE

5321
03:56:04,817 --> 03:56:08,454
THAT THE AGING IS ASSOCIATED

5322
03:56:08,521 --> 03:56:09,989
WITH INCREASE INCIDENCE, FOR

5323
03:56:10,055 --> 03:56:11,290
EXAMPLE, OF METABOLIC SYNDROME

5324
03:56:11,357 --> 03:56:12,124
IS ONE OF THE FIRST MEASURES

5325
03:56:12,191 --> 03:56:16,762
THAT WE'RE LOOKING AT.

5326
03:56:16,829 --> 03:56:19,298
>> SO ACTUALLY THE SECOND AND

5327
03:56:19,365 --> 03:56:20,432
THIRD GENERATION EPIGENETIC

5328
03:56:20,499 --> 03:56:23,969
CLOCKS WERE DEVELOPED TO PREDICT

5329
03:56:24,036 --> 03:56:26,705
FASTER CHRONIC DISEASE,

5330
03:56:26,772 --> 03:56:28,541
MORTALITY, SO THEY'RE PRETTY

5331
03:56:28,607 --> 03:56:29,975
ROBUST PREDICTORS OF ALL SORTS

5332
03:56:30,042 --> 03:56:31,410
OF FUNCTIONAL DECLINE INCLUDING

5333
03:56:31,477 --> 03:56:32,811
COGNITIVE DECLINE AS WELL AS

5334
03:56:32,878 --> 03:56:34,346
DIFFERENT TYPES OF CHRONIC

5335
03:56:34,413 --> 03:56:35,881
HEALTH CONDITIONS AS WELL AS

5336
03:56:35,948 --> 03:56:36,649
MORTALITY.

5337
03:56:36,715 --> 03:56:40,152
SO YES, THEY HAVE BEEN QUITE

5338
03:56:40,219 --> 03:56:41,687
ROBUST IN PREDICTING THOSE

5339
03:56:41,754 --> 03:56:45,324
HEALTH OUTCOMES.

5340
03:56:45,391 --> 03:56:47,359
>> CAPTURING THE PACE OF AGING

5341
03:56:47,426 --> 03:56:48,894
SO THIS IS A UNIQUE CLOCK

5342
03:56:48,961 --> 03:56:52,898
COMPARED TO THE OTHER CLOCKS.

5343
03:56:52,965 --> 03:56:53,999
IT ALSO SHOWING TO WORK IN

5344
03:56:54,066 --> 03:56:55,100
INTERVENTION STUDIES, SO THERE

5345
03:56:55,167 --> 03:56:57,503
WAS A RECENT PAPER THAT WAS

5346
03:56:57,570 --> 03:56:59,805
TESTING THE IMPACT OF CALORIC

5347
03:56:59,872 --> 03:57:00,906
RESTRICTION WHICH IS A

5348
03:57:00,973 --> 03:57:03,075
SUCCESSFUL INTERVENTION TO SLOW

5349
03:57:03,142 --> 03:57:04,410
DOWN AGING AND A VARIETY OF

5350
03:57:04,476 --> 03:57:07,246
ANIMAL MODELS, SO THERE WAS ONE

5351
03:57:07,313 --> 03:57:09,949
DONE IN HUMANS AND -- THE ONLY

5352
03:57:10,015 --> 03:57:11,483
CLOCK THAT WORKED OVER TWO YEARS

5353
03:57:11,550 --> 03:57:13,552
TO SHOW THAT CALORIC RESTRICTION

5354
03:57:13,619 --> 03:57:15,087
ACTUALLY ABLE TO SLOW DOWN

5355
03:57:15,154 --> 03:57:15,788
AGING.

5356
03:57:15,854 --> 03:57:17,056
SO THERE'S A LOT OF PROMISE IN

5357
03:57:17,122 --> 03:57:21,093
THIS TYPE OF MEASURES TO BE USED

5358
03:57:21,160 --> 03:57:22,294
IN INTERVENTION STUDIES, EVEN

5359
03:57:22,361 --> 03:57:23,596
THOUGH THE MECHANISMS AS I

5360
03:57:23,662 --> 03:57:25,030
MENTIONED IN MY TALK ARE NOT

5361
03:57:25,097 --> 03:57:26,899
CLEAR, WHAT DOES IT MEAN TO HAVE

5362
03:57:26,966 --> 03:57:28,400
THESE ACCELERATED AGING -- WITH

5363
03:57:28,467 --> 03:57:30,603
ALL OF THE DIFFERENT MECHANISMS

5364
03:57:30,669 --> 03:57:31,904
THAT ARE REGULATED.

5365
03:57:31,971 --> 03:57:37,042
SO WE KNOW TELOMERES ARE GETTING

5366
03:57:37,109 --> 03:57:40,312
SHORTER -- SENESCENT -- TO DIE.

5367
03:57:40,379 --> 03:57:41,847
-- ACROSS THE GENOME THAT MAY

5368
03:57:41,914 --> 03:57:43,048
OR MAY NOT BE RELATED TO

5369
03:57:43,115 --> 03:57:49,088
DISEASE.

5370
03:57:49,154 --> 03:57:50,122
>> THANK YOU.

5371
03:57:50,189 --> 03:57:51,290
ONE LAST QUESTION.

5372
03:57:51,357 --> 03:57:51,890
>> GREAT SESSION.

5373
03:57:51,957 --> 03:57:53,659
I HAVE A QUESTION ABOUT MAYBE

5374
03:57:53,726 --> 03:57:54,526
MOVING TOWARDS SOLUTIONS.

5375
03:57:54,593 --> 03:57:57,463
WE HEARD THAT WE DO WAY MORE --

5376
03:57:57,529 --> 03:57:59,531
WAY LESS THAN WHAT WE KNOW, AND

5377
03:57:59,598 --> 03:58:00,833
WE CAN DO MORE.

5378
03:58:00,899 --> 03:58:02,835
I THINK DR. LEWIS OR TENE

5379
03:58:02,901 --> 03:58:04,903
BROUGHT OUT THE IMPORTANCE OF

5380
03:58:04,970 --> 03:58:07,740
POWERFUL EFFECT ON SOCIAL

5381
03:58:07,806 --> 03:58:08,807
REJECTION ON THE EXPERIENCE OF

5382
03:58:08,874 --> 03:58:09,808
STRESS OR DIFFERENTIAL

5383
03:58:09,875 --> 03:58:12,011
EXPERIENCE OF THAT.

5384
03:58:12,077 --> 03:58:15,814
AND I -- YOU TALK ABOUT THE

5385
03:58:15,881 --> 03:58:17,650
DOMINANT AND -- BEHAVIORS THAT

5386
03:58:17,716 --> 03:58:19,518
WERE EXPRESSED.

5387
03:58:19,585 --> 03:58:23,222
DID YOU NOTE ANY -- THE ONES

5388
03:58:23,288 --> 03:58:27,259
THAT MADE A DIFFERENCE AND ALSO

5389
03:58:27,326 --> 03:58:31,196
THE IP COLLUS --

5390
03:58:31,263 --> 03:58:32,531
>> ALL I TALKED ABOUT HERE WAS

5391
03:58:32,598 --> 03:58:33,966
PART OF THE PAPER WHERE WE WERE

5392
03:58:34,033 --> 03:58:35,601
LOOKING AT SORT OF THE DOMINANT

5393
03:58:35,668 --> 03:58:41,473
AND SUBORDINATE SMI S SUBMISSIVE

5394
03:58:41,540 --> 03:58:43,542
BEHAVIORS, WE WERE NOT VIOLENT

5395
03:58:43,609 --> 03:58:44,743
BEHAVIORS IN THESE ANIMALS,

5396
03:58:44,810 --> 03:58:47,146
THESE WERE NON-CONTACT,

5397
03:58:47,212 --> 03:58:47,813
DISPLACEMENTS, ONE FEMALE WAS

5398
03:58:47,880 --> 03:58:49,314
SITTING IN A CORNER, ANOTHER

5399
03:58:49,381 --> 03:58:50,416
CAME BY AND LOOKED AT HER AND

5400
03:58:50,482 --> 03:58:52,484
THEN SHE WALKED AWAY BECAUSE SHE

5401
03:58:52,551 --> 03:58:54,553
WAS SUBORDINATE, SO THIS

5402
03:58:54,620 --> 03:58:55,320
CONSTANT SORT OF HARASSMENT EVEN

5403
03:58:55,387 --> 03:58:57,523
IN SOME SENSE.

5404
03:58:57,589 --> 03:59:00,359
IT WASN'T FUN, I THINK.

5405
03:59:00,426 --> 03:59:04,396
AND SO -- THEY ARE ALSO SOCIAL

5406
03:59:04,463 --> 03:59:05,264
ORGANISMS IN THE SENSE THAT

5407
03:59:05,330 --> 03:59:06,565
THEIR SOCIAL RELATIONSHIPS

5408
03:59:06,632 --> 03:59:08,534
MATTER, SO IN CAPTIVITY AND IN

5409
03:59:08,600 --> 03:59:10,502
WILD POPULATIONS FOR MANY SOCIAL

5410
03:59:10,569 --> 03:59:11,937
ANIMALS, YOUR LEVEL OF SOCIAL

5411
03:59:12,004 --> 03:59:15,741
INTEGRATION VERSUS ISOLATION HAS

5412
03:59:15,808 --> 03:59:17,509
A STRONG IMPACT ON YOUR HEALTH,

5413
03:59:17,576 --> 03:59:18,711
REPRODUCTION AND SURVIVAL, MUCH

5414
03:59:18,777 --> 03:59:21,013
AS IT DOES IN US, MENTIONED

5415
03:59:21,080 --> 03:59:23,515
EARLIER, TALKING ABOUT THE COVID

5416
03:59:23,582 --> 03:59:25,384
PANDEMIC LEAVING US ISOLATED AND

5417
03:59:25,451 --> 03:59:27,119
LEADING TO INCREASES IN MANY

5418
03:59:27,186 --> 03:59:27,753
DISEASES, MENTAL HEALTH

5419
03:59:27,820 --> 03:59:28,887
DISORDERS AND OTHER DISEASES AND

5420
03:59:28,954 --> 03:59:30,189
EVEN MORTALITY, RIGHT?

5421
03:59:30,255 --> 03:59:31,490
SO WE THINK THAT THOSE THINGS

5422
03:59:31,557 --> 03:59:32,725
CAN INTERSECT, RIGHT, AND THEY

5423
03:59:32,791 --> 03:59:33,358
CAN INTERACT.

5424
03:59:33,425 --> 03:59:34,860
AND WE ACTUALLY DID SEE THAT A

5425
03:59:34,927 --> 03:59:37,496
LOT OF THE DIFFERENCES THAT WERE

5426
03:59:37,563 --> 03:59:38,363
DRIVING -- WHICH I DIDN'T GET

5427
03:59:38,430 --> 03:59:39,898
INTO THAT WERE DRIVING SOME OF

5428
03:59:39,965 --> 03:59:41,266
THESE INFLAMMATORY RESPONSES WAS

5429
03:59:41,333 --> 03:59:44,136
THE FACT THAT THESE SOCIALLY

5430
03:59:44,203 --> 03:59:45,704
SUBORDINATE FEMALES WERE ALSO

5431
03:59:45,771 --> 03:59:47,172
ACTUALLY MORE SOCIALLY ISOLATED

5432
03:59:47,239 --> 03:59:47,873
IN THE GROUPS.

5433
03:59:47,940 --> 03:59:49,441
THEY DIDN'T HAVE AS MUCH SOCIAL

5434
03:59:49,508 --> 03:59:50,609
CONTACT AND CONNECTION, SO WE

5435
03:59:50,676 --> 03:59:52,911
THINK THAT THIS SOCIAL

5436
03:59:52,978 --> 03:59:54,780
BUFFERING, RIGHT, SO HAVING A

5437
03:59:54,847 --> 03:59:56,281
STRONG SOCIAL SUPPORT NETWORK IS

5438
03:59:56,348 --> 03:59:59,585
A WAY TO PROTECT FROM SOME OF

5439
03:59:59,651 --> 04:00:02,521
THE NEGATIVE EFFECTS OF ADVERSE

5440
04:00:02,588 --> 04:00:04,690
SITUATIONS, BE IT SOCIAL,

5441
04:00:04,757 --> 04:00:06,225
ENVIRONMENTAL, BE IT PHYSICAL,

5442
04:00:06,291 --> 04:00:06,892
ENVIRONMENTAL, THINGS LIKE THAT.

5443
04:00:06,959 --> 04:00:08,293
SO I THINK THAT'S A GREAT POINT

5444
04:00:08,360 --> 04:00:09,661
AND I THINK MOVING TOWARDS

5445
04:00:09,728 --> 04:00:10,629
SOLUTIONS AND FINDING WHAT WE

5446
04:00:10,696 --> 04:00:12,064
CAN DO ABOUT IT IS REALLY,

5447
04:00:12,131 --> 04:00:14,166
REALLY IMPORTANT.

5448
04:00:14,233 --> 04:00:15,434
>> THANK YOU.

5449
04:00:15,501 --> 04:00:17,069
AND WITH THAT, LET'S THANK THE

5450
04:00:17,136 --> 04:00:17,903
PANELISTS ONCE AGAIN.

5451
04:00:17,970 --> 04:00:24,676
[APPLAUSE]

5452
04:00:24,743 --> 04:00:25,911
>> WE'LL GO AHEAD AND GET

5453
04:00:25,978 --> 04:00:26,945
STARTED WITH THE TALK HERE.

5454
04:00:27,012 --> 04:00:28,814
THE GREAT THING ABOUT GOING IN

5455
04:00:28,881 --> 04:00:31,817
THE AFTERNOON FOLLOWING SO

5456
04:00:31,884 --> 04:00:32,050
MANY --

5457
04:00:32,117 --> 04:00:35,521
>> DO WE NEED TO INTRODUCE YOU?

5458
04:00:35,587 --> 04:00:36,855
SHE'LL BE INTRODUCING HERSELF.

5459
04:00:36,922 --> 04:00:42,861
>> NO I, WILL NOT.

5460
04:00:42,928 --> 04:00:46,331
>> I'M NOT READING YOUR BIOBUT I

5461
04:00:46,398 --> 04:00:51,904
CAN SAY NEXT UP, OUR SESSION ON

5462
04:00:51,970 --> 04:00:55,207
ENERGETIC MECHANISMS -- IS

5463
04:00:55,274 --> 04:00:57,009
CHANTEL MARTIN, TALKING ABOUT

5464
04:00:57,075 --> 04:00:58,811
EPIGENETIC MECHANISMS OF

5465
04:00:58,877 --> 04:01:03,182
PRENATAL SOCIAL ENVIRONMENT

5466
04:01:03,248 --> 04:01:04,817
STRESSORS AND OFFSPRING,

5467
04:01:04,883 --> 04:01:05,818
OFFSPRING HEALTH DISPARITIES.

5468
04:01:05,884 --> 04:01:07,886
>> THE GREAT THING ABOUT GOING

5469
04:01:07,953 --> 04:01:09,855
IN THE AFTERNOON AFTER SO MANY

5470
04:01:09,922 --> 04:01:11,056
AMAZING SESSIONS IS THAT I CAN

5471
04:01:11,123 --> 04:01:12,257
KIND OF BREEZE THROUGH AND NOT

5472
04:01:12,324 --> 04:01:13,659
GO INTO TOO MUCH DETAIL ABOUT

5473
04:01:13,725 --> 04:01:15,861
SOME OF THESE EARLY BACKGROUND

5474
04:01:15,928 --> 04:01:18,063
SLIDES AND KIND OF GET TO THE

5475
04:01:18,130 --> 04:01:21,033
STUDIES THAT IE I'VE BEEN

5476
04:01:21,099 --> 04:01:22,434
CONDUCTING WITH MY RESEARCH LAB

5477
04:01:22,501 --> 04:01:23,468
LOOKING AT THE NEIGHBORHOOD,

5478
04:01:23,535 --> 04:01:25,504
SOCIAL ENVIRONMENT, PRENATAL

5479
04:01:25,571 --> 04:01:27,606
PERIOD AND OFFSPRING HEALTH AND

5480
04:01:27,673 --> 04:01:29,007
HEALTH DISPARITIES.

5481
04:01:29,074 --> 04:01:31,543
STARTING OUT WHY WE'RE ALL HERE,

5482
04:01:31,610 --> 04:01:32,978
THAT AS MANY HAVE POINTED OUT

5483
04:01:33,045 --> 04:01:34,613
BEFORE, DESPITE IMPROVEMENTS IN

5484
04:01:34,680 --> 04:01:36,148
MEDICINE AND TECHNOLOGY, BLACK

5485
04:01:36,215 --> 04:01:37,482
AMERICANS HAVE WORSE HEALTH

5486
04:01:37,549 --> 04:01:39,551
OUTCOMES AT EVERY STAGE OF THE

5487
04:01:39,618 --> 04:01:40,185
LIFE COURSE.

5488
04:01:40,252 --> 04:01:42,387
HERE I'M JUST NOTING SOME OF THE

5489
04:01:42,454 --> 04:01:44,389
MANY OUTCOMES.

5490
04:01:44,456 --> 04:01:49,628
THE WORK THAT I'VE BEEN DOING

5491
04:01:49,695 --> 04:01:52,264
AND THINKING ABOUT EARLY IN LIFE

5492
04:01:52,331 --> 04:01:55,434
WITH PRETERM BIRTH, LOW BIRTH

5493
04:01:55,500 --> 04:01:58,036
WEIGHT AND CHILD OBESITY, A LOT

5494
04:01:58,103 --> 04:02:00,806
OF THE HEALTH OUT COMES WE'RE

5495
04:02:00,873 --> 04:02:01,573
TALKING ABOUT BEGIN EARLY IN THE

5496
04:02:01,640 --> 04:02:02,908
LIFE COURSE, AND THAT IS WHEN A

5497
04:02:02,975 --> 04:02:04,209
LOT OF THE DIFFERENT HEALTH

5498
04:02:04,276 --> 04:02:05,410
TRAJECTORIES ARE FORMED AND

5499
04:02:05,477 --> 04:02:11,116
THESE OUTCOMES TRACK INTO LATER

5500
04:02:11,183 --> 04:02:12,050
LIFE, WHERE BLACK ADULTS HAVE

5501
04:02:12,117 --> 04:02:14,853
THE PHYSIOLOGICAL PROFILE ABOUT

5502
04:02:14,920 --> 04:02:15,487
SIX TO 10 YEARS OLDER.

5503
04:02:15,554 --> 04:02:21,426
SO IN MY WORK THINKING ABOUT

5504
04:02:21,493 --> 04:02:22,194
INTERVIEWABLE PERIODS AND

5505
04:02:22,261 --> 04:02:23,829
FACTORS THAT CAN BE MOST

5506
04:02:23,896 --> 04:02:25,697
EFFECTIVE DURING EARLIER TIME

5507
04:02:25,764 --> 04:02:27,566
PERIODS, BEFORE DISEASE

5508
04:02:27,633 --> 04:02:27,933
MANIFESTATION.

5509
04:02:28,000 --> 04:02:31,236
THANKS TO AN EARLIER TALK ON

5510
04:02:31,303 --> 04:02:33,205
STRUCTURAL RACISM AND ITS

5511
04:02:33,272 --> 04:02:34,172
MANIFESTATIONS, I JUST WANT TO

5512
04:02:34,239 --> 04:02:36,475
REAL QUICKLY TALK ABOUT

5513
04:02:36,541 --> 04:02:39,411
STRUCTURAL RACISM AS IT'S

5514
04:02:39,478 --> 04:02:40,512
MULTIDIMENSIONAL AND COMPLEX

5515
04:02:40,579 --> 04:02:43,582
SYSTEM OF MANY INSTITUTIONS SUCH

5516
04:02:43,649 --> 04:02:45,784
AS THE HOUSING MARKET, CREDIT,

5517
04:02:45,851 --> 04:02:47,219
EDUCATIONAL, LABOR, ALL OF THESE

5518
04:02:47,286 --> 04:02:49,521
WORKING TOGETHER TO INFLUENCE

5519
04:02:49,588 --> 04:02:50,722
HEALTH.

5520
04:02:50,789 --> 04:02:51,723
THIS STRUCTURAL RACISM REFLECTS

5521
04:02:51,790 --> 04:02:53,692
THE HISTORICAL AND PERVASIVE

5522
04:02:53,759 --> 04:02:55,761
FORMS OF RACISM THAT ARE

5523
04:02:55,827 --> 04:02:57,863
ENTRENCHED IN YOUR SYSTEM'S

5524
04:02:57,930 --> 04:03:01,466
LAWS, POLICIES AND PRACTICES AND

5525
04:03:01,533 --> 04:03:04,536
CAN BE TRACKED TO DELIBERATE

5526
04:03:04,603 --> 04:03:08,473
ACTS OF DISCRIMINATION AND

5527
04:03:08,540 --> 04:03:09,341
REVERSE EVEN AFTER THE MEASURE

5528
04:03:09,408 --> 04:03:14,279
IS NO LONGER IN PLACE.

5529
04:03:14,346 --> 04:03:16,248
RACIAL RESIDENTIAL SEGREGATION

5530
04:03:16,315 --> 04:03:18,450
AS MANIFESTATION OF STRUCTURAL

5531
04:03:18,517 --> 04:03:19,751
RACISM HAS ACTUALLY BEEN

5532
04:03:19,818 --> 04:03:22,054
ESTABLISHED AS A FUNDAMENTAL

5533
04:03:22,120 --> 04:03:23,622
CAUSE, SAYING IF WE WANT TO

5534
04:03:23,689 --> 04:03:24,489
ELIMINATE HEALTH DISPARITIES, WE

5535
04:03:24,556 --> 04:03:27,225
HAVE TO CONFRONT THE PERVASIVE

5536
04:03:27,292 --> 04:03:29,594
EFFECTS OF RACIAL RESIDENTIAL

5537
04:03:29,661 --> 04:03:30,929
SEGREGATION.

5538
04:03:30,996 --> 04:03:32,898
I WON'T TALK ABOUT REDLINING

5539
04:03:32,965 --> 04:03:33,999
BECAUSE THE PREVIOUS -- ONE OF

5540
04:03:34,066 --> 04:03:35,200
THE SESSIONS EARLIER TALKED

5541
04:03:35,267 --> 04:03:37,536
ABOUT IT, BUT WHAT'S IMPORTANT

5542
04:03:37,602 --> 04:03:41,473
ABOUT RED LINING AS THIS

5543
04:03:41,540 --> 04:03:43,642
IMPACTFUL FORM OF RACIAL

5544
04:03:43,709 --> 04:03:46,178
RESIDENTIAL SEGREGATION, WAS

5545
04:03:46,244 --> 04:03:47,479
HISTORICALLY CONSTRUCTED AND

5546
04:03:47,546 --> 04:03:48,680
THESE POLICIES AND PRACTICES

5547
04:03:48,747 --> 04:03:51,116
WERE PUT IN PLACE TO ACTUALLY

5548
04:03:51,183 --> 04:03:52,751
EXCLUDE BLACK AND OTHER

5549
04:03:52,818 --> 04:03:54,286
IMMIGRANT GROUPS FROM BEING ABLE

5550
04:03:54,353 --> 04:03:56,822
TO PARTICIPATE IN THE HOUSING

5551
04:03:56,888 --> 04:03:59,024
MARKET, DENYING THEM ACCESS TO

5552
04:03:59,091 --> 04:04:00,192
THIS WEALTH ACCUMULATION.

5553
04:04:00,258 --> 04:04:01,626
BUT AS THESE ARTICLES SHOW ON

5554
04:04:01,693 --> 04:04:06,465
THE RIGHT-HAND SIDE, THE

5555
04:04:06,531 --> 04:04:07,299
HISTORICAL POLICY AND THE

5556
04:04:07,366 --> 04:04:08,767
PRACTICE OF RED LINING HAS

5557
04:04:08,834 --> 04:04:10,402
ACTUALLY SHAPED NEIGHBORHOODS AS

5558
04:04:10,469 --> 04:04:13,905
WE SEE THEM TODAY.

5559
04:04:13,972 --> 04:04:15,340
SO WHY IS THIS IMPORTANT?

5560
04:04:15,407 --> 04:04:19,277
BECAUSE RACIAL AND ETHNICALLY MY

5561
04:04:19,344 --> 04:04:22,614
MINORITIZED GROUPS ARE -- TODAY

5562
04:04:22,681 --> 04:04:24,282
ARE CHARACTERIZED BY POORER

5563
04:04:24,349 --> 04:04:26,251
EDUCATIONAL AND EMPLOYMENT

5564
04:04:26,318 --> 04:04:28,520
OPPORTUNITIES, LIMITED ACCESS TO

5565
04:04:28,587 --> 04:04:30,555
QUALITY NUTRITION, RECREATIONAL

5566
04:04:30,622 --> 04:04:32,391
SPACE AND HEALTHCARE, AS WELL AS

5567
04:04:32,457 --> 04:04:38,864
HIGHER DISADVAN DISADVANTAGE, CD

5568
04:04:38,930 --> 04:04:39,297
POLICING.

5569
04:04:39,364 --> 04:04:40,499
WHAT WE'VE ACTUALLY LEARNED FROM

5570
04:04:40,565 --> 04:04:42,000
STUDIES THAT HAVE TAKEN PLACE,

5571
04:04:42,067 --> 04:04:42,634
THAT NEIGHBORHOOD ENVIRONMENTS

5572
04:04:42,701 --> 04:04:43,902
AND EXPOSURES CAN ACTUALLY GET

5573
04:04:43,969 --> 04:04:46,538
UNDER THE SKIN THROUGH WHAT

5574
04:04:46,605 --> 04:04:49,274
NANCY KRUEGER ACTUALLY TERMS AS

5575
04:04:49,341 --> 04:04:51,143
BIOLOGICAL EMBODIMENT, WHERE

5576
04:04:51,209 --> 04:04:52,010
INDIVIDUALS INCORPORATE

5577
04:04:52,077 --> 04:04:54,212
BIOLOGICALLY THEIR LIVED

5578
04:04:54,279 --> 04:04:56,848
EXPERIENCES AND SOCIAL SYSTEMS

5579
04:04:56,915 --> 04:04:59,284
AND CONTEXT THROUGH THIS IMAGE.

5580
04:04:59,351 --> 04:05:03,655
SHE TALKED ABOUT DIFFERENT

5581
04:05:03,722 --> 04:05:07,359
PATHWAYS OF -- THE SOCIAL

5582
04:05:07,426 --> 04:05:08,627
ENVIRONMENT, ALL THIS CAN LEAD

5583
04:05:08,693 --> 04:05:11,329
TO BIOLOGICAL STRESS RESPONSES

5584
04:05:11,396 --> 04:05:18,770
AND PHYSIOLOGICAL DYSFUNCTION.

5585
04:05:18,837 --> 04:05:20,806
YET EPIGENETIC MECHANISMS IS ONE

5586
04:05:20,872 --> 04:05:22,607
OF THOSE -- THANKS TO THAT LAST

5587
04:05:22,674 --> 04:05:24,242
SESSION I WILL SLIP THIS SLIDE

5588
04:05:24,309 --> 04:05:25,777
AND TRY AND GET US BACK ON TRACK

5589
04:05:25,844 --> 04:05:27,145
A LITTLE BIT WITH TIME.

5590
04:05:27,212 --> 04:05:29,214
BUT A LOT OF MY WORK IS TRYING

5591
04:05:29,281 --> 04:05:32,617
TO UNDERSTAND HOW THESE

5592
04:05:32,684 --> 04:05:34,019
DISPARATE NEIGHBORHOOD

5593
04:05:34,086 --> 04:05:35,287
ENVIRONMENTS, AS A RESULT OF

5594
04:05:35,353 --> 04:05:37,122
RACIAL RESIDENTIAL SEGREGATION

5595
04:05:37,189 --> 04:05:40,058
AND STRUCTURAL RACISM, IMPACT

5596
04:05:40,125 --> 04:05:41,159
HEALTH INEQUALITIES.

5597
04:05:41,226 --> 04:05:43,261
WHAT'S IMPORTANT HERE IS THAT

5598
04:05:43,328 --> 04:05:45,263
WHEN LOOKING AT THESE AND

5599
04:05:45,330 --> 04:05:46,565
STRATIFYING ON RACE AND

5600
04:05:46,631 --> 04:05:47,666
ETHNICITY, WHAT WE'RE NOT SAYING

5601
04:05:47,732 --> 04:05:48,934
IS THAT THESE GROUPS ARE

5602
04:05:49,000 --> 04:05:49,868
DIFFERENT, BUT THAT THEY HAVE

5603
04:05:49,935 --> 04:05:52,704
THESE DISPARATE EXPOSURES AND

5604
04:05:52,771 --> 04:05:55,674
EXPERIENCES DUE TO LIVING IN

5605
04:05:55,740 --> 04:06:00,812
DIFFERENT OR SEGREGATED AND

5606
04:06:00,879 --> 04:06:04,749
DISINVESTED NEIGHBORHOODS.

5607
04:06:04,816 --> 04:06:06,184
SO THESE DISPARATE NEIGHBORHOOD

5608
04:06:06,251 --> 04:06:07,152
ENVIRONMENTS LEAD TO DIFFERENCES

5609
04:06:07,219 --> 04:06:09,221
IN CHRONIC STRESS, DIFFERENCES

5610
04:06:09,287 --> 04:06:11,022
IN ALTERED DNA METHYLATION,

5611
04:06:11,089 --> 04:06:14,960
WHICH IMPACT OUR GENE

5612
04:06:15,026 --> 04:06:16,495
EXPRESSION, TURNING OUR GENES ON

5613
04:06:16,561 --> 04:06:17,829
AND OFF AND POTENTIALLY

5614
04:06:17,896 --> 04:06:20,999
RESULTING IN HEALTH INEQUALITY.

5615
04:06:21,066 --> 04:06:24,803
SO MY WORK HAS BEEN TRYING TO

5616
04:06:24,870 --> 04:06:26,671
GET AT AND UNDERSTAND HOW THE

5617
04:06:26,738 --> 04:06:27,606
NEIGHBORHOOD ENVIRONMENT OR THE

5618
04:06:27,672 --> 04:06:28,240
NEIGHBORHOOD SOCIAL ENVIRONMENT

5619
04:06:28,306 --> 04:06:30,976
CAN ACTUALLY GET UNDER THE SKIN

5620
04:06:31,042 --> 04:06:34,045
TO PRODUCE EARLY LIFE, DISPARATE

5621
04:06:34,112 --> 04:06:34,846
HEALTH TRAJECTORIES.

5622
04:06:34,913 --> 04:06:37,782
SO IN THE LITERATURE, THERE'S

5623
04:06:37,849 --> 04:06:38,984
BEEN ABOUT EIGHT STUDIES THAT

5624
04:06:39,050 --> 04:06:40,318
HAVE LOOKED AT NEIGHBORHOOD

5625
04:06:40,385 --> 04:06:42,621
ENVIRONMENT IN RELATION TO

5626
04:06:42,687 --> 04:06:45,557
EPIGENETIC MECHANISMS, BUT VERY

5627
04:06:45,624 --> 04:06:46,892
FEW IN EARLY LIFE, THINKING

5628
04:06:46,958 --> 04:06:49,194
ABOUT THESE PRENATAL EXPOSURES

5629
04:06:49,261 --> 04:06:50,862
DURING A PERIOD WHERE WE HAVE

5630
04:06:50,929 --> 04:06:53,798
BOTH A PREGNANT PERSON BEING

5631
04:06:53,865 --> 04:06:55,600
EXPOSED TO THESE ENVIRONMENTAL

5632
04:06:55,667 --> 04:06:58,203
STRESSORS AND THEN AN OFFSPRING

5633
04:06:58,270 --> 04:07:00,605
THAT IS ALSO BEING EXPOSED

5634
04:07:00,672 --> 04:07:02,807
THROUGH THE FETAL ENVIRONMENT.

5635
04:07:02,874 --> 04:07:04,476
AND WHAT THE THREE STUDIES HERE

5636
04:07:04,543 --> 04:07:09,047
THAT I'M SHOWING HAVE LOOKED AT,

5637
04:07:09,114 --> 04:07:10,248
NEIGHBORHOOD POVERTY AND

5638
04:07:10,315 --> 04:07:12,651
DEPRIVATION HAVE BEEN FOUND IN

5639
04:07:12,717 --> 04:07:13,919
THE OFFSPRING -- I THINK ONE OF

5640
04:07:13,985 --> 04:07:16,087
THEM LOOKED AT BUCCAL CELLS, BUT

5641
04:07:16,154 --> 04:07:17,422
HAVE FOUND THAT THOSE LIVING IN

5642
04:07:17,489 --> 04:07:18,690
NEIGHBORHOODS WITH HIGHER

5643
04:07:18,757 --> 04:07:20,625
POVERTY OR DEPRIVATION HAS BEEN

5644
04:07:20,692 --> 04:07:22,060
ASSOCIATED WITH HIGHER GLOBAL

5645
04:07:22,127 --> 04:07:26,765
DNA METHYLATION, HIGHER

5646
04:07:26,831 --> 04:07:29,100
METHYLATION IN IMPRINTED GENES

5647
04:07:29,167 --> 04:07:31,369
SUCH AS MEG3, AS WELL AS

5648
04:07:31,436 --> 04:07:34,673
METHYLATION IN THESE CANDIDATE

5649
04:07:34,739 --> 04:07:35,273
STRESS-RELATED GENES.

5650
04:07:35,340 --> 04:07:37,075
BUT THERE ARE STILL SOME GAPS IN

5651
04:07:37,142 --> 04:07:38,443
THE LITERATURE, MAINLY THAT

5652
04:07:38,510 --> 04:07:39,778
FOCUSING ON THESE CANDIDATE

5653
04:07:39,844 --> 04:07:41,446
GENES OR THESE IMPRINTED GENES

5654
04:07:41,513 --> 04:07:42,948
WERE MISSING MAYBE SOME NOVEL

5655
04:07:43,014 --> 04:07:45,016
MEASURES OR SOME NOVEL

5656
04:07:45,083 --> 04:07:46,017
EPIGENETIC PATHWAYS THAT COULD

5657
04:07:46,084 --> 04:07:47,819
BE AT PLAY HERE.

5658
04:07:47,886 --> 04:07:51,957
ALSO, THESE STUDIES HAVE BEEN --

5659
04:07:52,023 --> 04:07:53,725
INK THINKING OR LOOKING AT THE

5660
04:07:53,792 --> 04:07:54,392
DIFFERENTIAL EFFECTS OF THESE

5661
04:07:54,459 --> 04:07:55,160
DISPARATE EXPOSURES.

5662
04:07:55,227 --> 04:07:58,763
MANY OF THAT IS BECAUSE OF DATA

5663
04:07:58,830 --> 04:08:00,632
AVAILABILITY OR -- DATA

5664
04:08:00,699 --> 04:08:02,400
AVAILABILITY AND LACK OF

5665
04:08:02,467 --> 04:08:03,602
DIVERSITY IN FAMILIES TO BE ABLE

5666
04:08:03,668 --> 04:08:04,803
TO LOOK AT THESE.

5667
04:08:04,869 --> 04:08:06,338
AND THEN ALSO KIND OF PUTTING

5668
04:08:06,404 --> 04:08:07,772
THE PIECES OF THE PUZZLE

5669
04:08:07,839 --> 04:08:09,741
TOGETHER FROM THAT CONCEPTUAL

5670
04:08:09,808 --> 04:08:11,610
MODEL, BUT HOW DO THESE

5671
04:08:11,676 --> 04:08:13,578
NEIGHBORHOOD ENVIRONMENTS AND

5672
04:08:13,645 --> 04:08:14,346
EPIGENETIC MECHANISMS ACTUALLY

5673
04:08:14,412 --> 04:08:15,981
RELATE TO OFFSPRING HEALTH

5674
04:08:16,047 --> 04:08:16,548
OUTCOMES?

5675
04:08:16,615 --> 04:08:19,818
SO THAT'S WHAT THE -- SHOW HERE

5676
04:08:19,884 --> 04:08:26,224
HAVE BEEN TRYING TO ADDRESS.

5677
04:08:26,291 --> 04:08:28,193
SO WE HAVE THIS NEIGHBORHOOD

5678
04:08:28,260 --> 04:08:30,295
EPIGENETIC STUDY, NEWBORN

5679
04:08:30,362 --> 04:08:35,333
EPIGENETIC STUD STUDY SORRY, OR,

5680
04:08:35,400 --> 04:08:36,768
WHICH IS A PROSPECTIVE BIRTH

5681
04:08:36,835 --> 04:08:39,504
COHORT STUDY WITH FOLLOW-UP OF

5682
04:08:39,571 --> 04:08:40,272
OFFSPRING INTO CHILDHOOD AND

5683
04:08:40,338 --> 04:08:40,639
ADOLESCENCE.

5684
04:08:40,705 --> 04:08:43,908
THE STUDY TOOK PLACE FROM 2005

5685
04:08:43,975 --> 04:08:45,210
TO 2011.

5686
04:08:45,277 --> 04:08:48,847
THE STUDY BEGAN WITH ABOUT 2700

5687
04:08:48,913 --> 04:08:52,884
MOTHER-CHILD PAIRS AND LED TO

5688
04:08:52,951 --> 04:08:54,953
SOME FINDINGS WE HAD, 427

5689
04:08:55,020 --> 04:08:56,655
INDIVIDUALS, BOTH MOTHER-CHILD

5690
04:08:56,721 --> 04:08:58,390
PAIRS, WITH DNA METHYLATION

5691
04:08:58,456 --> 04:09:05,697
ACROSS THE GENOME, 450K, WE'RE

5692
04:09:05,764 --> 04:09:08,800
NOW -- ABOUT 900,000 DNA

5693
04:09:08,867 --> 04:09:09,734
METHYLATION SITES, SO THIS IS

5694
04:09:09,801 --> 04:09:15,874
ONE OF THE OLDER WITH ABOUT

5695
04:09:15,940 --> 04:09:16,708
4,050,000 CPG SITES.

5696
04:09:16,775 --> 04:09:18,777
I WILL SAY WHEN THE NEST STUDY

5697
04:09:18,843 --> 04:09:20,779
WAS ORIGINALLY DESIGNED, IT WAS

5698
04:09:20,845 --> 04:09:22,414
MEANT TO LOOK AT DNA METHYLATION

5699
04:09:22,480 --> 04:09:24,949
IN RELATION TO THE CHILDHOOD

5700
04:09:25,016 --> 04:09:27,018
OUTCOMES, NOT WITH A SOCIAL

5701
04:09:27,085 --> 04:09:27,485
QUESTION IN MIND.

5702
04:09:27,552 --> 04:09:31,189
SO IT'S VERY LIMITED IN THE

5703
04:09:31,256 --> 04:09:33,291
INDIVIDUAL LEVEL, SOCIAL FACTORS

5704
04:09:33,358 --> 04:09:37,028
THAT WERE COLLECTED.

5705
04:09:37,095 --> 04:09:39,864
HOWEVER BECAUSE THE PARTICIPANT

5706
04:09:39,931 --> 04:09:41,633
AT ENROLLMENT PROVIDED THEIR

5707
04:09:41,700 --> 04:09:44,836
ADDRESSES, WE'VE BEEN ABLE TO

5708
04:09:44,903 --> 04:09:46,271
MAP ON A LOT OF ENVIRONMENTAL

5709
04:09:46,338 --> 04:09:47,706
STRESSORS BASED ON THEIR

5710
04:09:47,772 --> 04:09:48,873
RESIDENCE AT THE TIME OF ENROLL

5711
04:09:48,940 --> 04:09:50,809
M.

5712
04:09:50,875 --> 04:09:51,142
ENROLLMENT.

5713
04:09:51,209 --> 04:09:57,282
WE LOOKED AT THIS USING BUFFERS

5714
04:09:57,349 --> 04:09:58,717
OF 200 METERS, 600 METERS AROUND

5715
04:09:58,783 --> 04:10:03,088
THE HOUSE AS WELL AS CENSUS

5716
04:10:03,154 --> 04:10:05,256
BLOCK -- THAT MAY NOT MAP ON TO

5717
04:10:05,323 --> 04:10:07,559
HOW WE ARE CONCEPTUALIZING THAT

5718
04:10:07,625 --> 04:10:08,193
NEIGHBORHOOD, BUT WITH THIS

5719
04:10:08,259 --> 04:10:11,563
DATA, WE'VE BEEN ABLE TO MAP ON

5720
04:10:11,629 --> 04:10:14,999
THINGS LIKE CRIME AND POLICING,

5721
04:10:15,066 --> 04:10:15,967
AIR POLLUTION.

5722
04:10:16,034 --> 04:10:18,603
WE HAVE INFORMATION ON USING

5723
04:10:18,670 --> 04:10:21,673
COHORT ISSUES, TRYING TO DEVELOP

5724
04:10:21,740 --> 04:10:23,508
A NEW MEASURE OF REDLINING.

5725
04:10:23,575 --> 04:10:24,409
WE HAVE INFORMATION FROM THE

5726
04:10:24,476 --> 04:10:30,181
CENSUS TO LOOK AT DEPRIVATION.

5727
04:10:30,248 --> 04:10:32,584
AND OTHER MEASURES.

5728
04:10:32,650 --> 04:10:34,452
WE ALSO HAVE INFORMATION ON THE

5729
04:10:34,519 --> 04:10:35,520
OFFSPRING, HEIGHT, WEIGHT AND

5730
04:10:35,587 --> 04:10:36,788
BLOOD PRESSURE, INTO EARLY

5731
04:10:36,855 --> 04:10:40,258
ADOLESCENCE.

5732
04:10:40,325 --> 04:10:41,726
HERE I'M SHOWING SOME OF THE

5733
04:10:41,793 --> 04:10:42,694
CHARACTERISTICS OF THE STUDY

5734
04:10:42,761 --> 04:10:43,795
PARTICIPANTS WITH THE DNA

5735
04:10:43,862 --> 04:10:45,430
METHYLATION AS YOU CAN SEE IT'S

5736
04:10:45,497 --> 04:10:49,200
PRETTY DIVERSE COHORT WITH ABOUT

5737
04:10:49,267 --> 04:10:51,803
48% NON-HISPANIC BLACK, 44%

5738
04:10:51,870 --> 04:10:53,138
NON-HISPANIC WHITE, HIGHLY

5739
04:10:53,204 --> 04:10:56,975
EDUCATED ACTUALLY ABOUT 40%

5740
04:10:57,041 --> 04:10:57,809
HAVE -- ACTUALLY MORE THAN

5741
04:10:57,876 --> 04:10:59,411
THAT -- HAVE A COLLEGE DEGREE,

5742
04:10:59,477 --> 04:11:03,281
AND THEN ALSO OVERWEIGHT/OBESITY

5743
04:11:03,348 --> 04:11:04,516
ARE PRETTY PREVALENT IN THIS

5744
04:11:04,582 --> 04:11:09,087
COHORT, AS EARLY AS AGE 3.

5745
04:11:09,154 --> 04:11:10,188
SO ONE OF THE FIRST THINGS WE

5746
04:11:10,255 --> 04:11:12,724
DID WAS TRY TO ASSESS WHAT

5747
04:11:12,791 --> 04:11:16,995
NEIGHBORHOOD CRIME LOOKS LIKE IN

5748
04:11:17,061 --> 04:11:22,133
THE COHORT.

5749
04:11:22,200 --> 04:11:23,935
SHOWING GESTATIONAL EXPOSURE TO

5750
04:11:24,002 --> 04:11:24,803
NEIGHBORHOOD CRIME DIFFERS BY

5751
04:11:24,869 --> 04:11:25,904
RACE AND ETHNICITY.

5752
04:11:25,970 --> 04:11:29,841
WHAT I'M REALLY TALKING ABOUT IS

5753
04:11:29,908 --> 04:11:34,078
RACIAL SEGREGATION -- WHEN WE

5754
04:11:34,145 --> 04:11:35,547
TALK ABOUT VIOLENT CRIMES, WE'RE

5755
04:11:35,613 --> 04:11:36,548
TALKING ABOUT THINGS THAT

5756
04:11:36,614 --> 04:11:37,315
REQUIRE A RESPONSE.

5757
04:11:37,382 --> 04:11:39,083
YOU HAVE SIRENS, YOU HAVE

5758
04:11:39,150 --> 04:11:39,818
PEOPLE, EMERGENCY RESPONSE IN

5759
04:11:39,884 --> 04:11:44,022
THE AREA, SO THESE ARE THINGS

5760
04:11:44,088 --> 04:11:45,590
LIKE MURDERS, ASSAULT, ROBBERY,

5761
04:11:45,657 --> 04:11:46,691
THINGS OF THAT NATURE.

5762
04:11:46,758 --> 04:11:48,526
SO WHEN WE'RE THINKING ABOUT A

5763
04:11:48,593 --> 04:11:50,295
PREGNANCY, WE SAY EVERYONE MAKES

5764
04:11:50,361 --> 04:11:51,863
TO FULL TERM, WHICH WE KNOW

5765
04:11:51,930 --> 04:11:55,266
THAT'S NOT ACCURATE, BECAUSE

5766
04:11:55,333 --> 04:11:56,935
CERTAIN GROUPS, BLACK AND

5767
04:11:57,001 --> 04:11:58,736
HISPANIC POPULATIONS HAVE

5768
04:11:58,803 --> 04:12:01,840
DELIVERED BABIES EARLIER, BUT

5769
04:12:01,906 --> 04:12:04,042
SAY IT'S 40 WEEKS.

5770
04:12:04,108 --> 04:12:06,878
ON AVERAGE, BLACK PREGNANT

5771
04:12:06,945 --> 04:12:08,079
PEOPLE EXPERIENCE 19 VIOLENT

5772
04:12:08,146 --> 04:12:09,581
CRIMES DURING THE COURSE OF

5773
04:12:09,647 --> 04:12:12,050
THEIR REG SEE IN THIS STUDY.

5774
04:12:12,116 --> 04:12:15,553
24 FOR HISPANIC PEOPLE AND 4 FOR

5775
04:12:15,620 --> 04:12:16,421
WHITE PREGNANT PEOPLE.

5776
04:12:16,488 --> 04:12:18,423
IN A 40-YEAR SPAN, WE'RE TALKING

5777
04:12:18,490 --> 04:12:19,724
ABOUT BLACK AND HISPANIC PEOPLE

5778
04:12:19,791 --> 04:12:21,259
EXPERIENCING A VIOLENT CRIME

5779
04:12:21,326 --> 04:12:23,361
EVERY 1 1/2 TO 2 WEEKS OF THEIR

5780
04:12:23,428 --> 04:12:26,130
PREGNANCY, WHEREAS A WHITE

5781
04:12:26,197 --> 04:12:26,965
PREGNANT PERSON OR OVER THE

5782
04:12:27,031 --> 04:12:28,466
COURSE OF THE ENTIRE PREGNANCY.

5783
04:12:28,533 --> 04:12:30,535
SO WHAT DOES THIS MEAN FOR THE

5784
04:12:30,602 --> 04:12:31,636
OFFSPRING?

5785
04:12:31,703 --> 04:12:33,371
WELL, I KNOW THIS IS VERY

5786
04:12:33,438 --> 04:12:34,973
COMPLICATED, BUT TO POINT YOU TO

5787
04:12:35,039 --> 04:12:37,242
LOOKING AT BLOOD PRESSURE

5788
04:12:37,308 --> 04:12:39,210
PERCENTILES WHERE ABOVE THE

5789
04:12:39,277 --> 04:12:41,779
LINE, ABOVE ZERO IS SYSTOLIC

5790
04:12:41,846 --> 04:12:43,281
BLOOD PRESSURE BEING HIGHER AND

5791
04:12:43,348 --> 04:12:44,582
DIASTOLIC BLOOD PRESSURE BEING

5792
04:12:44,649 --> 04:12:48,520
HIGHER, BELOW IT WILL MEAN IT'S

5793
04:12:48,586 --> 04:12:51,689
NOT AS HIGH.

5794
04:12:51,756 --> 04:12:54,359
WE FOUND GESTATIONAL EXPOSURE TO

5795
04:12:54,425 --> 04:12:55,560
NEIGHBORHOOD CRIME -- WE DIDN'T

5796
04:12:55,627 --> 04:12:57,228
FIND ANYTHING FOR THE CHILDREN

5797
04:12:57,295 --> 04:12:59,631
OF WHITE WOMEN OR THE CHILDREN

5798
04:12:59,697 --> 04:13:00,965
OR HISPANIC WOMEN.

5799
04:13:01,032 --> 04:13:03,034
A LOT OF THESE ARE DUE TO SAMPLE

5800
04:13:03,101 --> 04:13:03,902
SIZES.

5801
04:13:03,968 --> 04:13:06,838
WE DID SEE, IF YOU NOTICE HERE

5802
04:13:06,905 --> 04:13:07,972
EVEN IN THE CHILDREN OF HISPANIC

5803
04:13:08,039 --> 04:13:13,678
WOMEN, WE DO SEE THAT SOME OF

5804
04:13:13,745 --> 04:13:15,413
THE -- ARE ABOVE ZERO BUT WE

5805
04:13:15,480 --> 04:13:17,248
WOULD LOVE TO REPLICATE THIS IN

5806
04:13:17,315 --> 04:13:19,083
A LARGER STUDY AT SOME POINT.

5807
04:13:19,150 --> 04:13:20,084
AND THINKING ABOUT METHYLATION,

5808
04:13:20,151 --> 04:13:24,489
WHAT DOES T IS THIS PATHWAY RELG

5809
04:13:24,556 --> 04:13:25,823
THE NEIGHBORHOOD CRIME EXPOSURE

5810
04:13:25,890 --> 04:13:28,259
TO THESE OFFSPRING HEALTH

5811
04:13:28,326 --> 04:13:28,526
OUTCOMES.

5812
04:13:28,593 --> 04:13:32,230
OVER TO THE LEFT I'M SHOWING A

5813
04:13:32,297 --> 04:13:34,198
TABLE OF THE SPECIFIC CBG SITE

5814
04:13:34,265 --> 04:13:36,634
THAT WERE ASSOCIATED WITH THE

5815
04:13:36,701 --> 04:13:39,470
NEIGHBORHOOD CRIME EXPOSURES TO

5816
04:13:39,537 --> 04:13:40,772
REALLY SUMMARIZE WHAT'S GOING ON

5817
04:13:40,838 --> 04:13:41,205
HERE.

5818
04:13:41,272 --> 04:13:43,841
WHAT WE ESSENTIALLY FOUND IS

5819
04:13:43,908 --> 04:13:46,177
THAT HIGHER EXPOSURE TO

5820
04:13:46,244 --> 04:13:47,045
GESTATIONAL -- HIGHER

5821
04:13:47,111 --> 04:13:48,346
GESTATIONAL EXPOSURE TO

5822
04:13:48,413 --> 04:13:50,481
NEIGHBORHOOD CRIME IS ASSOCIATED

5823
04:13:50,548 --> 04:13:52,350
WITH CPG SITE THAT ARE RELATED

5824
04:13:52,417 --> 04:13:53,985
TO GENES, SO THEY'RE ANNOTATED

5825
04:13:54,052 --> 04:13:56,054
TO GENES THAT ARE ASSOCIATED

5826
04:13:56,120 --> 04:13:59,157
WITH AGING AS WELL AS

5827
04:13:59,223 --> 04:14:01,793
CARDIOMETABOLIC OUTCOMES.

5828
04:14:01,859 --> 04:14:04,729
AND THESE ARE ALL -- I DON'T

5829
04:14:04,796 --> 04:14:06,097
KNOW IF THIS WILL WORK.

5830
04:14:06,164 --> 04:14:09,801
IF YOU LOOK HERE AT THE EFFECT

5831
04:14:09,867 --> 04:14:13,304
SIZES, THEY ARE INVERSELY

5832
04:14:13,371 --> 04:14:14,606
ASSOCIATED WITH GESTATIONAL

5833
04:14:14,672 --> 04:14:15,740
EXPOSURE TO NEIGHBORHOOD CRIME.

5834
04:14:15,807 --> 04:14:17,709
SO GIVING SOME EVIDENCE THAT

5835
04:14:17,775 --> 04:14:21,446
THERE COULD BE SOMETHING ON WITH

5836
04:14:21,512 --> 04:14:23,181
NEIGHBORHOOD CRIME AND --

5837
04:14:23,247 --> 04:14:24,983
POSSIBLY IMPACTING BLOOD

5838
04:14:25,049 --> 04:14:27,285
PRESSURE PERCENTILES, WE HOPE TO

5839
04:14:27,352 --> 04:14:28,820
EVENTUALLY PUT THOSE PIECES OF

5840
04:14:28,886 --> 04:14:32,357
THE PUZZLE TOGETHER AND DO A

5841
04:14:32,423 --> 04:14:32,790
MEDIATION ANALYSIS.

5842
04:14:32,857 --> 04:14:33,992
WE ALSO HAVE LOOKED AT

5843
04:14:34,058 --> 04:14:35,526
NEIGHBORHOOD DEP VISION EXPOSURE

5844
04:14:35,593 --> 04:14:39,130
IN ASSOCIATION WITH THE DNA

5845
04:14:39,197 --> 04:14:39,464
METHYLATION.

5846
04:14:39,530 --> 04:14:41,366
AS I MENTIONED DUE TO

5847
04:14:41,432 --> 04:14:46,170
RESIDENTIAL SEGREGATION, AS WE

5848
04:14:46,237 --> 04:14:46,971
EXPECT NEIGHBORHOOD DEPRIVATION

5849
04:14:47,038 --> 04:14:49,507
DIFFERS BY RACE AND ETHNICITY

5850
04:14:49,574 --> 04:14:50,508
WHERE NEIGHBORHOOD DEP VISION

5851
04:14:50,575 --> 04:14:56,814
DEPRIVATIONSCORE BASED ON THESEE

5852
04:14:56,881 --> 04:14:58,149
INDICATORS, THE PREGNANT PEOPLE

5853
04:14:58,216 --> 04:14:59,751
LIVE DURING PREGNANCY.

5854
04:14:59,817 --> 04:15:03,788
MEDIAN HOUSEHOLD INCOME, THE

5855
04:15:03,855 --> 04:15:05,356
HOME VALUE, PERCENT BELOW

5856
04:15:05,423 --> 04:15:07,692
POVERTY LEVEL, FEMALE HEAD OF

5857
04:15:07,759 --> 04:15:08,526
HOUSEHOLDS, HOME OWNERSHIP, ALL

5858
04:15:08,593 --> 04:15:09,894
THESE CAME TOGETHER TO CREATE

5859
04:15:09,961 --> 04:15:11,095
THIS MEASURE OF NEIGHBORHOOD

5860
04:15:11,162 --> 04:15:13,398
DEPRIVATION WHERE A HIGHER SCORE

5861
04:15:13,464 --> 04:15:15,133
INDICATED MORE OR GREATER

5862
04:15:15,199 --> 04:15:16,334
NEIGHBORHOOD DEPRIVATION.

5863
04:15:16,401 --> 04:15:18,569
AND IN THIS COHORT, BLACK

5864
04:15:18,636 --> 04:15:20,304
INDIVIDUALS HAD HIGHER

5865
04:15:20,371 --> 04:15:22,407
NEIGHBORHOOD DEPRIVATION THAN

5866
04:15:22,473 --> 04:15:23,641
WHITE INDIVIDUALS, AS WELL AS

5867
04:15:23,708 --> 04:15:25,343
THOSE THAT ARE CHARACTERIZED AS

5868
04:15:25,410 --> 04:15:29,981
OTHER.

5869
04:15:30,048 --> 04:15:34,585
NEIGHBORHOOD DEP VISION IN THIST

5870
04:15:34,652 --> 04:15:37,155
VERY UNLIKELY THAT THERE'S ONE

5871
04:15:37,221 --> 04:15:38,690
CPG SITE THAT IS CAUSING THIS

5872
04:15:38,756 --> 04:15:40,224
ARRAY OF OUTCOMES THAT ARE

5873
04:15:40,291 --> 04:15:40,525
ASSOCIATED.

5874
04:15:40,591 --> 04:15:42,660
SO WHAT WE LOOKED AT WERE THESE

5875
04:15:42,727 --> 04:15:44,729
REGIONS OR HOW POTENTIAL CPG

5876
04:15:44,796 --> 04:15:46,798
SITES ARE WORKING TOGETHER TO

5877
04:15:46,864 --> 04:15:49,500
IMPACT HEALTH OR -- YEAH, WHILE

5878
04:15:49,567 --> 04:15:50,034
WORKING TOGETHER.

5879
04:15:50,101 --> 04:15:51,903
SO WITH THESE DIFFERENTIALLY

5880
04:15:51,969 --> 04:15:53,938
METHYLATED REGIONS, WE FOUND

5881
04:15:54,005 --> 04:15:54,806
THAT 12 WERE ASSOCIATED WITH

5882
04:15:54,872 --> 04:15:59,277
NEIGHBORHOOD DEPRIVATION.

5883
04:15:59,343 --> 04:16:02,146
THIS PAPER IS UNDER REVIEW, A

5884
04:16:02,213 --> 04:16:04,115
GOOD REVIEW, I'LL SAY, BUT

5885
04:16:04,182 --> 04:16:04,782
INCREASING NEIGHBORHOOD

5886
04:16:04,849 --> 04:16:09,387
DEPRIVATION SCORE WAS ASSOCIATED

5887
04:16:09,454 --> 04:16:11,289
WITH DIFFERENTIALLY METHYLATED

5888
04:16:11,355 --> 04:16:12,924
REGIONS RELATED TO

5889
04:16:12,990 --> 04:16:15,760
CARDIOMYOPATHY, THESE ARE GENES

5890
04:16:15,827 --> 04:16:17,061
WITH CARDIOMYOPATHY, FAT

5891
04:16:17,128 --> 04:16:18,863
ACCUMULATION AND LIPID

5892
04:16:18,930 --> 04:16:22,033
METABOLISM, OBESITY, METABOLIC

5893
04:16:22,100 --> 04:16:26,137
DISEASE AND ADIPOSE TISSUE

5894
04:16:26,204 --> 04:16:29,207
DYSFUNCTION, A ARTERIOSCLEROSIS

5895
04:16:29,273 --> 04:16:32,710
AND IMMUNE FUNCTION.

5896
04:16:32,777 --> 04:16:36,748
SO -- TO -- EVEN AS EARLY AS THE

5897
04:16:36,814 --> 04:16:37,415
FETAL EXPOSURE.

5898
04:16:37,482 --> 04:16:39,217
AND THIS IS VERY COMPLICATED,

5899
04:16:39,283 --> 04:16:43,387
BUT JUST TO KIND OF -- WE LOOKED

5900
04:16:43,454 --> 04:16:45,056
AT THIS STRATIFIED BY RACE AND

5901
04:16:45,123 --> 04:16:46,491
ETHNICITY TO SEE IF THE CPG

5902
04:16:46,557 --> 04:16:47,792
SITES WE FOUND THAT WERE

5903
04:16:47,859 --> 04:16:48,893
ASSOCIATED WITH NEIGHBORHOOD

5904
04:16:48,960 --> 04:16:51,596
DEPRIVATION DIFFERED BY RACE AND

5905
04:16:51,662 --> 04:16:53,131
ETHNICITY AND FOUND THAT THEY

5906
04:16:53,197 --> 04:16:56,734
DID, WHERE SIGNIFICANT POSITIVE

5907
04:16:56,801 --> 04:16:58,336
EFFECTS ARE FOUND ACROSS CPG

5908
04:16:58,402 --> 04:16:59,871
SITES FOR BLACK AND THOSE

5909
04:16:59,937 --> 04:17:01,506
CATEGORIZED AS OTHER, BUT

5910
04:17:01,572 --> 04:17:03,107
NEGATIVE EFFECTS AMONG WHITE

5911
04:17:03,174 --> 04:17:03,441
PARTICIPANTS.

5912
04:17:03,508 --> 04:17:07,812
AND THEN THE CPT1B GENE FROM THE

5913
04:17:07,879 --> 04:17:10,014
LAST SLIDE IS ASSOCIATED WITH --

5914
04:17:10,081 --> 04:17:12,216
OR RELATED TO FAT ACCUMULATION

5915
04:17:12,283 --> 04:17:15,887
IN LIPID METABOLISM, SO WE'RE

5916
04:17:15,953 --> 04:17:17,922
FINDING THAT THE NEIGHBORHOOD

5917
04:17:17,989 --> 04:17:20,491
DEPRIVATION RELATED GENES OR

5918
04:17:20,558 --> 04:17:22,927
RELATED CPG SITES MIGHT DIFFER

5919
04:17:22,994 --> 04:17:28,599
BY RACE AND ES NIS IT.

5920
04:17:28,666 --> 04:17:31,502
-- DIFFERENTIALLY IMPACTING CPG

5921
04:17:31,569 --> 04:17:32,303
SITES.

5922
04:17:32,370 --> 04:17:34,138
LASTLY, WE THEN TRIED TO CONNECT

5923
04:17:34,205 --> 04:17:35,573
THE PIECES OF THE PUZZLE AND

5924
04:17:35,640 --> 04:17:39,977
LOOK AT NEIGHBORHOOD DEPRIVATION

5925
04:17:40,044 --> 04:17:41,646
ASSOCIATED CPG SITES IN RELATION

5926
04:17:41,712 --> 04:17:46,984
TO THE OFFSPRING -- AT 6 AND 12

5927
04:17:47,051 --> 04:17:48,786
MONTHS, AND INDEED, DID FIND

5928
04:17:48,853 --> 04:17:54,692
THAT SOME OF THESE CPG SIZE WERE

5929
04:17:54,759 --> 04:17:56,194
ASSOCIATED WITH HIGHER --

5930
04:17:56,260 --> 04:17:57,895
INCLUDING THE ONE HIGHLIGHTED IN

5931
04:17:57,962 --> 04:17:59,997
GREEN, WHICH FREQUENTLY WAS

5932
04:18:00,064 --> 04:18:01,799
MENTIONED RELATED TO FAT

5933
04:18:01,866 --> 04:18:04,235
ACCUMULATION.

5934
04:18:04,302 --> 04:18:06,537
SO JUST SOME KEY TAKEAWAYS TO

5935
04:18:06,604 --> 04:18:08,706
PRESENT HERE, GESTATIONAL

5936
04:18:08,773 --> 04:18:09,974
EXPOSURE TO NEIGHBORHOOD SOCIAL

5937
04:18:10,041 --> 04:18:11,509
STRESSORS ASSOCIATED WITH EARLY

5938
04:18:11,576 --> 04:18:13,277
OFFSPRING HEALTH INEQUALITIES.

5939
04:18:13,344 --> 04:18:14,478
WE'RE PROVIDING SOME EVIDENCE OF

5940
04:18:14,545 --> 04:18:14,912
THAT.

5941
04:18:14,979 --> 04:18:16,047
THAT THE NEIGHBORHOOD SOCIAL

5942
04:18:16,113 --> 04:18:18,583
ENVIRONMENT MAY ALTER DNA

5943
04:18:18,649 --> 04:18:23,287
METHYLATION IN OFFSPRING, AND

5944
04:18:23,354 --> 04:18:25,890
THAT EPIGENETIC MECHANISMS MAY

5945
04:18:25,957 --> 04:18:27,258
SERVE AS A BIOLOGICAL PATHWAY.

5946
04:18:27,325 --> 04:18:28,659
WELL, WHERE DO WE GO WITH THIS

5947
04:18:28,726 --> 04:18:29,760
RESEARCH?

5948
04:18:29,827 --> 04:18:35,833
I THINK AS MENTIONED -- WAS

5949
04:18:35,900 --> 04:18:36,734
ABOUT 427 PARTICIPANTS SO WE

5950
04:18:36,801 --> 04:18:38,135
NEED TO REPLICATE THESE FINDINGS

5951
04:18:38,202 --> 04:18:40,504
IN LARGER RACIALLY AND

5952
04:18:40,571 --> 04:18:43,441
ETHNICALLY DIVERSE COHORTS,

5953
04:18:43,507 --> 04:18:45,109
WE'RE LOOKING AT THE SNAPSHOT OF

5954
04:18:45,176 --> 04:18:46,844
DNA METH LITION AT ONE POINT IN

5955
04:18:46,911 --> 04:18:49,146
TIME.

5956
04:18:49,213 --> 04:18:52,149
I KNOW YOU MENTIONED YOU MIGHT

5957
04:18:52,216 --> 04:18:53,251
HAVE MULTIPLE MANAGERS.

5958
04:18:53,317 --> 04:18:58,656
SO KIND OF LOOKING AT THE CBG

5959
04:18:58,723 --> 04:18:59,523
SITE, IN PARTICULAR WHEN WE'RE

5960
04:18:59,590 --> 04:19:01,592
TALKING ABOUT THIS STUDY BECAUSE

5961
04:19:01,659 --> 04:19:03,895
I'M MEASURING PRENATAL

5962
04:19:03,961 --> 04:19:04,762
ENVIRONMENT, BUT WHAT HAPPENS

5963
04:19:04,829 --> 04:19:05,930
WHEN THEY START TO EXPERIMENT

5964
04:19:05,997 --> 04:19:09,133
THEIR OWN ENVIRONMENT, DO WE SEE

5965
04:19:09,200 --> 04:19:12,103
THAT THESE GPG MARKERS ARE

5966
04:19:12,169 --> 04:19:14,739
RESISTANT, AND THEN ALSO ABLE

5967
04:19:14,805 --> 04:19:16,941
TO -- THEN USING METHODS AROUND

5968
04:19:17,008 --> 04:19:19,777
MEDIATION TO SEE WHAT OR TO

5969
04:19:19,844 --> 04:19:21,913
ESTIMATE THE CONTRIBUTION OF

5970
04:19:21,979 --> 04:19:24,181
THESE EPIGENETIC MECHANISMS SO

5971
04:19:24,248 --> 04:19:29,287
PUTTING THE PETE'SS OF TH THE PE

5972
04:19:29,353 --> 04:19:31,022
TOGETHER, WE HAVE THESE

5973
04:19:31,088 --> 04:19:32,390
STRESSORS, WOULD LOVE TO BE ABLE

5974
04:19:32,456 --> 04:19:33,557
TO LOOK AT HOW THEY ACTUALLY

5975
04:19:33,624 --> 04:19:34,725
IMPACT GENE EXPRESSION AND THEN

5976
04:19:34,792 --> 04:19:36,227
THE HEALTH OUTCOMES, SO REALLY

5977
04:19:36,294 --> 04:19:39,130
LOOKING AT THESE PAST ANALYSES.

5978
04:19:39,196 --> 04:19:40,898
AND THEN INVESTIGATING THIS

5979
04:19:40,965 --> 04:19:43,100
IMPACT OF THE SOCIAL AND

5980
04:19:43,167 --> 04:19:46,837
ENVIRONMENTAL EXPOSURES,

5981
04:19:46,904 --> 04:19:48,072
NEIGHBORHOOD CRIME, THESE

5982
04:19:48,139 --> 04:19:49,273
INDIVIDUALS ARE LIVING IN

5983
04:19:49,340 --> 04:19:50,908
NEIGHBORHOODS ARE PROBABLY BEING

5984
04:19:50,975 --> 04:19:53,210
IMPACTED BY ALL OF THESE

5985
04:19:53,277 --> 04:19:55,913
NEIGHBORHOOD STRESSORS OR NOT IN

5986
04:19:55,980 --> 04:19:57,515
A VACUUM, SO THINKING ABOUT HOW

5987
04:19:57,581 --> 04:20:01,786
WE MEASURE THESE TOGETHER.

5988
04:20:01,852 --> 04:20:05,122
THEN JUST ACKNOWLEDGE THE

5989
04:20:05,189 --> 04:20:06,424
INDIVIDUALS I WAS ABLE TO

5990
04:20:06,490 --> 04:20:07,792
COLLABORATE WITH IN MY LAB AND

5991
04:20:07,858 --> 04:20:10,061
THE FUNDING THAT HAS BEEN SO

5992
04:20:10,127 --> 04:20:12,496
GENEROUS, AS WELL AS THE STUDY

5993
04:20:12,563 --> 04:20:13,164
PARTICIPANTS AND STAFF THAT HAVE

5994
04:20:13,230 --> 04:20:14,332
MADE THIS RESEARCH POSSIBLE.

5995
04:20:14,398 --> 04:20:21,605
THANK YOU.

5996
04:20:21,672 --> 04:20:22,673
>> THAT WAS FANTASTIC.

5997
04:20:22,740 --> 04:20:25,042
THANK YOU, CHANTEL.

5998
04:20:25,109 --> 04:20:32,917
NEXT UP IS NANA MATOBA FROM

5999
04:20:32,984 --> 04:20:33,317
UCSD.

6000
04:20:33,384 --> 04:20:35,653
FETAL ORIGINS OF HEALTH

6001
04:20:35,720 --> 04:20:37,555
DISPARITIES:  TRANS GENERATIONAL

6002
04:20:37,621 --> 04:20:48,032
CONSEQUENCES OF RACISM.

6003
04:21:11,922 --> 04:21:13,290
>> MY NAME IS NANA MATOBA.

6004
04:21:13,357 --> 04:21:15,860
I AM A NEONATOLOGIST AND PEE

6005
04:21:15,926 --> 04:21:17,595
TRISH AND BRADY CHILDREN'S

6006
04:21:17,661 --> 04:21:20,297
HOSPITAL SAN DIEGO, UNIVERSITY

6007
04:21:20,364 --> 04:21:20,998
OF CALIFORNIA SAN DIEGO.

6008
04:21:21,065 --> 04:21:22,700
MY TALK IS FETAL ORIGINS OF

6009
04:21:22,767 --> 04:21:25,302
HEALTH DISPARITIES:  TRANS

6010
04:21:25,369 --> 04:21:26,170
GENERATIONAL CONSEQUENCE OF

6011
04:21:26,237 --> 04:21:29,807
STRUCTURAL RACISM.

6012
04:21:29,874 --> 04:21:37,081
WE'RE DISCUSSING SOME -- SOARNLL

6013
04:21:37,148 --> 04:21:38,783
DETERMINANTS AND STRUCTURAL

6014
04:21:38,849 --> 04:21:40,718
RACISM, USING THE PLACENTA AS A

6015
04:21:40,785 --> 04:21:44,288
MARKER OF DISPARITIES AND

6016
04:21:44,355 --> 04:21:45,723
CHALLENGES AND FUTURE DIRECTIONS

6017
04:21:45,790 --> 04:21:47,625
OF THIS RESEARCH.

6018
04:21:47,691 --> 04:21:50,361
AS A NEONATOLOGIST, I TAKE CARE

6019
04:21:50,428 --> 04:21:53,964
OF SICK TERM INFANTS, PRETERM

6020
04:21:54,031 --> 04:21:56,167
INFANTS -- COMPLICATIONS -- AND

6021
04:21:56,233 --> 04:21:58,302
WHILE ON A DAILY BASIS IN THE

6022
04:21:58,369 --> 04:22:04,775
NEONATAL ICU -- I WITNESSED

6023
04:22:04,842 --> 04:22:08,079
AND -- DISPARITIES IN THE CARE

6024
04:22:08,145 --> 04:22:09,613
THAT WE PROVIDE, IT WAS REALLY

6025
04:22:09,680 --> 04:22:17,955
IN FOLLOW-UP FOR A -- WHEN I

6026
04:22:18,022 --> 04:22:21,425
BECAME INTERESTED IN -- LINE OF

6027
04:22:21,492 --> 04:22:23,694
WORK, BECAUSE THEY WENT FORWARD,

6028
04:22:23,761 --> 04:22:24,695
THEY'RE AT THE SAME STARTING

6029
04:22:24,762 --> 04:22:27,198
LINE, BUT WHAT WE SAW IN CLINIC

6030
04:22:27,264 --> 04:22:31,335
AND WHAT WAS SO CRUSHING WAS THE

6031
04:22:31,402 --> 04:22:34,505
SAME -- SIMILAR COMPLICATIONS

6032
04:22:34,572 --> 04:22:38,209
WOUND UP HAVING WIDELY DIFFERENT

6033
04:22:38,275 --> 04:22:44,648
DEVELOPMENTAL OUTCOMES WHERE --

6034
04:22:44,715 --> 04:22:48,018
WITH PHYSICAL THERAPY -- TO YOUR

6035
04:22:48,085 --> 04:22:55,126
HOME SO [INAUDIBLE].

6036
04:22:55,192 --> 04:23:02,533
ACADEMICALLY, I WAS INSPIRED BY

6037
04:23:02,600 --> 04:23:08,506
DR. JEAN -- AT -- UNIVERSITY --

6038
04:23:08,572 --> 04:23:11,675
BUT HE DESCRIBED 30 YEARS AGO

6039
04:23:11,742 --> 04:23:17,014
ABOUT DIFFERING BIRTH WEA WEIGHF

6040
04:23:17,081 --> 04:23:21,919
INFANTS -- WHERE HE SHOWED THAT

6041
04:23:21,986 --> 04:23:22,786
FOREIGN-BORN BLACK WOMEN WHO

6042
04:23:22,853 --> 04:23:24,021
IMMIGRATE TO THE U.S. FROM

6043
04:23:24,088 --> 04:23:25,623
AFRICA HAVE BIRTH OUTCOMES

6044
04:23:25,689 --> 04:23:28,259
SIMILAR TO THOSE WHITE WOMEN.

6045
04:23:28,325 --> 04:23:31,095
ON THE LEFT GRAPH IS THE

6046
04:23:31,162 --> 04:23:32,530
DISTRIBUTION OF INFANTS' BIRTH

6047
04:23:32,596 --> 04:23:34,431
WEIGHT AND THE BLUE ARROW IS

6048
04:23:34,498 --> 04:23:35,666
POINTING TO THE BIRTH WEIGHT

6049
04:23:35,733 --> 04:23:42,006
DISTRIBUTION OF INFANTS BORN TO

6050
04:23:42,072 --> 04:23:48,245
BLACK WOMEN -- [INAUDIBLE]

6051
04:23:48,312 --> 04:23:50,147
HIGHER THAN THE DOTTED LINE

6052
04:23:50,214 --> 04:23:54,618
WHICH IS THE INFANT BIRTH

6053
04:23:54,685 --> 04:23:56,153
DISTRIBUTION OF BLACK --

6054
04:23:56,220 --> 04:23:58,556
U.S.-BORN BLACK WOMEN.

6055
04:23:58,622 --> 04:24:00,858
HOWEVER, THIS FAVORABLE BIRTH

6056
04:24:00,925 --> 04:24:03,227
OUT COME -- ONE GENERATION FOR

6057
04:24:03,294 --> 04:24:05,095
THE IMMIGRANTS' DAUGHTERS GO ON

6058
04:24:05,162 --> 04:24:07,264
TO BE A BIRTH WEIGHT THAT IS NOW

6059
04:24:07,331 --> 04:24:10,401
LOWER THAN THAT OF WHITE WOMEN

6060
04:24:10,467 --> 04:24:21,178
AND -- EXPERIENCE THIS  IN THIS

6061
04:24:21,745 --> 04:24:24,281
COUNTRY FOR ONE GENERATION.

6062
04:24:24,348 --> 04:24:25,916
TRANS GENERATIONAL FACTORS,

6063
04:24:25,983 --> 04:24:26,917
FACTORS, CONDITIONS AND

6064
04:24:26,984 --> 04:24:27,885
ENVIRONMENTS EXPERIENCED BY ONE

6065
04:24:27,952 --> 04:24:29,620
GENERATION THAT RELATE TO THE

6066
04:24:29,687 --> 04:24:31,155
PREGNANCY OUTCOME OF THE NEXT

6067
04:24:31,222 --> 04:24:32,356
GENERATION.

6068
04:24:32,423 --> 04:24:34,525
THE OTHERS INCLUDE FACTORS SUCH

6069
04:24:34,592 --> 04:24:36,794
AS MOTHER'S OWN PRETERM BIRTH OR

6070
04:24:36,860 --> 04:24:38,128
LIFETIME NEIGHBORHOOD ECONOMICS,

6071
04:24:38,195 --> 04:24:40,965
AND UPWARD AND DOWNWARD ECONOMIC

6072
04:24:41,031 --> 04:24:43,534
MOBILITY.

6073
04:24:43,601 --> 04:24:45,736
AND -- BY BUILDING A TRANS

6074
04:24:45,803 --> 04:24:51,308
GENERATIONAL DATASET -- BETWE

6075
04:24:51,375 --> 04:24:53,844
BETWEEN -- [INAUDIBLE].

6076
04:24:53,911 --> 04:24:56,747
SOCIAL DETERMINANTS IN THESE

6077
04:24:56,814 --> 04:25:00,150
STUDIES INCLUDE THOSE ALREADY --

6078
04:25:00,217 --> 04:25:01,585
GUN VIOLENCE AND REDLINING WHICH

6079
04:25:01,652 --> 04:25:03,387
I'LL BE TALKING ABOUT, TEEN

6080
04:25:03,454 --> 04:25:04,788
BIRTH ACROSS GENERATIONS AND

6081
04:25:04,855 --> 04:25:11,362
SOCIAL AND RACIAL POLARIZATION.

6082
04:25:11,428 --> 04:25:13,831
THE STUDY ON GUN VIOLENCE AND

6083
04:25:13,897 --> 04:25:17,434
BIRTH OW OUTCOMES IN CHICAGO,

6084
04:25:17,501 --> 04:25:19,203
EXPOSURE TO HIGH RATES OF GUN

6085
04:25:19,270 --> 04:25:23,841
VIOLENCE IN THE CITY IMPACT

6086
04:25:23,907 --> 04:25:25,376
MATERNAL STRESS DURING HER

6087
04:25:25,442 --> 04:25:28,012
PREGNANCY, AND THEY AFFECT BIRTH

6088
04:25:28,078 --> 04:25:28,345
OUTCOME.

6089
04:25:28,412 --> 04:25:31,015
SO THESE ARE TWO -- IN THE CITY

6090
04:25:31,081 --> 04:25:31,348
OF CHICAGO.

6091
04:25:31,415 --> 04:25:35,286
THE MAP ON THE LEFT IS

6092
04:25:35,352 --> 04:25:37,788
GUN-RELATED CRIME RATES.

6093
04:25:37,855 --> 04:25:41,058
GUN-RELATED CRIMES IN PUBLIC

6094
04:25:41,125 --> 04:25:46,930
SPACES -- REPRESENTING -- THE

6095
04:25:46,997 --> 04:25:52,903
RED RUP CE REPRESENTS CENSUS TRN

6096
04:25:52,970 --> 04:25:57,908
THAT ROW LATED C RELATED CRIME,]

6097
04:25:57,975 --> 04:26:00,411
AND THE MAP ON THE LEFT SHOWS A

6098
04:26:00,477 --> 04:26:03,047
SIMILAR MAP OF LOW BIRTH WEIGHT

6099
04:26:03,113 --> 04:26:07,051
RATES IN THE CITY, AGAIN, THE

6100
04:26:07,117 --> 04:26:09,253
DARKER, THE HIGHER THE BIRTH

6101
04:26:09,320 --> 04:26:09,887
WEIGHT.

6102
04:26:09,953 --> 04:26:13,090
IT APPEARS TO BE SOMEWHAT ROLL

6103
04:26:13,157 --> 04:26:13,824
OUT.

6104
04:26:13,891 --> 04:26:19,596
SO THESE ARE GEOGRAPHICAL --

6105
04:26:19,663 --> 04:26:26,170
THREE CATEGORIES.

6106
04:26:26,236 --> 04:26:28,038
THERE APPEARS TO BE INCREASING

6107
04:26:28,105 --> 04:26:32,810
TREND IN LOW BIRTH WEIGHT --

6108
04:26:32,876 --> 04:26:35,312
LESS THAN -- 5 POUNDS, 5 1/2

6109
04:26:35,379 --> 04:26:36,413
POUNDS.

6110
04:26:36,480 --> 04:26:38,615
PRETERM BIRTH.

6111
04:26:38,682 --> 04:26:42,319
WE TREAT -- GESTATION AND SMALL

6112
04:26:42,386 --> 04:26:51,228
FOR GESTATIONAL AGE WHICH IS 1

6113
04:26:51,295 --> 04:27:00,537
10% -- BUT WHEN WE STRATIFY --

6114
04:27:00,604 --> 04:27:04,274
[INAUDIBLE] WHEN WE STRATIFY BY

6115
04:27:04,341 --> 04:27:05,442
RACE, THERE WAS VERY LITTLE

6116
04:27:05,509 --> 04:27:08,045
EFFECT OR NONE AT ALL OF GUN

6117
04:27:08,112 --> 04:27:13,517
VIOLENCE, MEANING THAT ACROSS

6118
04:27:13,584 --> 04:27:17,521
LOW VIOLENCE AREAS WHERE -- WERE

6119
04:27:17,588 --> 04:27:18,555
HIGH, AFRICAN AMERICAN WOMEN IN

6120
04:27:18,622 --> 04:27:20,124
THE CITY TEND TO HAVE SIMILAR --

6121
04:27:20,190 --> 04:27:22,459
TWICE THE ODDS RATIO GIVING

6122
04:27:22,526 --> 04:27:26,997
BIRTH TO LOW BIRTH WEIGHT

6123
04:27:27,064 --> 04:27:28,966
INFANTS, PRETERM BIRTH, WHICH IS

6124
04:27:29,032 --> 04:27:31,068
NOT WHAT WE EXPECTED TO FIND,

6125
04:27:31,135 --> 04:27:36,039
BUT I THINK -- EXPLAIN BETTER BY

6126
04:27:36,106 --> 04:27:40,611
THIS MA'AM SHOWING PROPORTION OF

6127
04:27:40,677 --> 04:27:42,379
WHITE IN BLUE AND BLACK IN

6128
04:27:42,446 --> 04:27:45,549
ORANGE AND HISPANIC IN GREY,

6129
04:27:45,616 --> 04:27:46,817
WHEN THEY'RE RESIDING IN THESE

6130
04:27:46,884 --> 04:27:50,120
LOW, MEDIUM AND HIGH GUN

6131
04:27:50,187 --> 04:27:52,289
VIOLENCE TERTILES, AND YOU CAN

6132
04:27:52,356 --> 04:27:55,192
SEE 18% OF THE STUDY POPULATION

6133
04:27:55,259 --> 04:27:59,396
COMPARE TED TO ONLY 2% OF WHITE

6134
04:27:59,463 --> 04:28:05,235
WOMEN, REFLECTING LONG-STAN

6135
04:28:05,302 --> 04:28:06,603
LONG-STANDING -- AND ALSO

6136
04:28:06,670 --> 04:28:08,205
REINFORCING THE IDEA THAT RACE

6137
04:28:08,272 --> 04:28:10,207
IS A PROXY FOR SOCIAL AND

6138
04:28:10,274 --> 04:28:13,243
ENVIRONMENT ASSISTANCE, UNJUST

6139
04:28:13,310 --> 04:28:16,647
PROCESSING INTERACTIONS, LOST

6140
04:28:16,713 --> 04:28:27,224
OPPORTUNITIES, IMPACTED BY --

6141
04:28:31,428 --> 04:28:33,096
RELATIONSHIP BETWEEN REDLINING

6142
04:28:33,163 --> 04:28:39,603
AND BIRTH OUTCOMES HAVE BEEN --

6143
04:28:39,670 --> 04:28:41,438
AFFECTING PHYSICAL AND SOCIAL

6144
04:28:41,505 --> 04:28:44,174
ATTRIBUTES, IMPACTING INDIVIDUAL

6145
04:28:44,241 --> 04:28:45,375
HEALTH CHARACTERISTICS AND

6146
04:28:45,442 --> 04:28:46,910
THEREBY CONTRIBUTING TO HEALTH

6147
04:28:46,977 --> 04:28:50,280
OUTCOMES SUCH AS BIRTH OUTCOMES.

6148
04:28:50,347 --> 04:28:56,053
SO WE CREATED A MAP OF REDLIN

6149
04:28:56,119 --> 04:28:57,621
REDLINING -- IT'S A BIT OLD BUT

6150
04:28:57,688 --> 04:29:06,396
DARKER BLUE SHOWS A HIGHER --

6151
04:29:06,463 --> 04:29:07,364
COMPARED TO WHITE FAMILIES AND

6152
04:29:07,431 --> 04:29:08,765
THEY'RE REALLY INTERSPERSED

6153
04:29:08,832 --> 04:29:12,269
THROUGHOUT THE CITY.

6154
04:29:12,336 --> 04:29:16,406
AND AS THE X AXIS GOES UP, THERE

6155
04:29:16,473 --> 04:29:18,275
IS A SLOW TREND IN INCREASED

6156
04:29:18,342 --> 04:29:19,042
PRETERM BIRTH RATES.

6157
04:29:19,109 --> 04:29:21,345
WE'RE NOT SURE WHAT HAPPENED

6158
04:29:21,411 --> 04:29:24,281
WITH THE --.

6159
04:29:24,348 --> 04:29:26,550
AND PRETERM BIRTH RATE,

6160
04:29:26,617 --> 04:29:28,852
REDLINING CATEGORIES SHOW

6161
04:29:28,919 --> 04:29:32,055
THAT -- LIVING IN REDLINED ARE

6162
04:29:32,122 --> 04:29:33,290
AREAS, THERE IS A SLIGHT

6163
04:29:33,357 --> 04:29:35,292
INCREASE IN -- BIRTH RATE, 18%

6164
04:29:35,359 --> 04:29:39,329
COMPARED TO 17.1% OF ALL AFRICAN

6165
04:29:39,396 --> 04:29:43,000
AMERICAN WOMEN IN NON-REDLINED

6166
04:29:43,066 --> 04:29:47,404
AREAS, ADJUSTED ODDS RATIO WAS

6167
04:29:47,471 --> 04:29:52,276
SMALL -- 1.08.

6168
04:29:52,342 --> 04:29:54,144
CHANGING TO THE IDEA, THE

6169
04:29:54,211 --> 04:29:56,446
PLACENTA AS A MARKER OF

6170
04:29:56,513 --> 04:30:06,924
DISPARITY, -- PLACENTA,

6171
04:30:11,461 --> 04:30:13,030
PRINCIPAL METABOLIC, RESPIRATORY

6172
04:30:13,096 --> 04:30:14,798
ENDOCRINE ORGAN OF THE FETUS, SO

6173
04:30:14,865 --> 04:30:17,301
MANY PREGNANCY COMPLICATIONS

6174
04:30:17,367 --> 04:30:19,269
SUCH AS PRETERM BIRTH ORIGINATE

6175
04:30:19,336 --> 04:30:21,071
FROM ITS DYSFUNCTION, A KEY

6176
04:30:21,138 --> 04:30:22,606
ROUTE BY WHICH EXPOSURES ARE

6177
04:30:22,673 --> 04:30:24,007
TRANSMITTED TO THE FETUS, A

6178
04:30:24,074 --> 04:30:25,442
MARKER OF DIFFERENCES IN

6179
04:30:25,509 --> 04:30:26,944
PRENATAL EXPOSURES THAT DIFFER

6180
04:30:27,010 --> 04:30:27,945
BETWEEN POPULATION AND RACIAL

6181
04:30:28,011 --> 04:30:31,915
GROUPS.

6182
04:30:31,982 --> 04:30:33,116
THE PLACENTA IS A FASCINATING

6183
04:30:33,183 --> 04:30:36,954
ORGAN BUT IT IS HIGHLY AVAILABLE

6184
04:30:37,020 --> 04:30:42,593
BUT ALSO VERY MUCH UNDERUTILIZED

6185
04:30:42,659 --> 04:30:44,261
AND THERE'S A CROSS-SECTION AND

6186
04:30:44,328 --> 04:30:48,532
WHOLE PLA  PLACENTA, SO MANY

6187
04:30:48,599 --> 04:30:51,034
OPPORTUNITIES TO STUDY WHAT WAS

6188
04:30:51,101 --> 04:30:53,604
GOING ON.

6189
04:30:53,670 --> 04:30:56,373
WHAT WE STUDIED WERE FOUR

6190
04:30:56,440 --> 04:30:59,142
DOMAINS OF PLACENTAL HIS POE

6191
04:30:59,209 --> 04:31:00,010
PATHOLOGY.

6192
04:31:00,077 --> 04:31:02,846
ACUTE INFLAMMATION, WHICH --

6193
04:31:02,913 --> 04:31:05,816
CHRONIC INFLAMMATION, MATERNAL

6194
04:31:05,882 --> 04:31:08,986
VASCULAR MALL PERFUSION AND

6195
04:31:09,052 --> 04:31:13,657
FETAL VASCULAR PATHOLOGY.

6196
04:31:13,724 --> 04:31:15,959
IN COMPARING BETWEEN WOMEN IN

6197
04:31:16,026 --> 04:31:18,195
THE STUDY, THERE WERE INCREASED

6198
04:31:18,261 --> 04:31:21,064
INCIDENCE OF ACUTE INFLAMMATION,

6199
04:31:21,131 --> 04:31:22,466
CHRONIC INFLAMMATION AND FETAL

6200
04:31:22,532 --> 04:31:26,536
VASCULAR PATHOLOGY.

6201
04:31:26,603 --> 04:31:31,775
AMONG AFRICAN AMERICAN WOMEN.

6202
04:31:31,842 --> 04:31:38,849
IT SHOWED THAT -- WERE INCREA

6203
04:31:38,915 --> 04:31:40,517
INCREASED -- COMPARED TO WHITE

6204
04:31:40,584 --> 04:31:40,817
WOMEN.

6205
04:31:40,884 --> 04:31:44,354
THE SAME ACROSS MALE SEX AND

6206
04:31:44,421 --> 04:31:46,023
FEMALE SEX AND ACROSS A WIDE

6207
04:31:46,089 --> 04:31:50,093
RANGE OF GESTATIONAL AGE,

6208
04:31:50,160 --> 04:31:57,200
GREATER THAN 28 WEEKS.

6209
04:31:57,267 --> 04:31:59,302
SO HOW THIS ALL COMES TOGETHER

6210
04:31:59,369 --> 04:32:01,672
IS STILL UNCLEAR, ESPECIALLY

6211
04:32:01,738 --> 04:32:03,106
BECAUSE WE DID NOT COLLECT IN

6212
04:32:03,173 --> 04:32:06,743
THE STUDY ANY -- MEASURES OF --

6213
04:32:06,810 --> 04:32:10,747
STRESS, WE DIDN'T COLLECT MANY

6214
04:32:10,814 --> 04:32:12,916
SOCIAL DEMOGRAPHIC BACKGROUNDS

6215
04:32:12,983 --> 04:32:14,851
OR -- CHARACTERISTICS, WE DIDN'T

6216
04:32:14,918 --> 04:32:17,921
COLLECT DATA, AND ADDRESSES THAT

6217
04:32:17,988 --> 04:32:20,791
COULD HAVE HELPED, BUT OTHER

6218
04:32:20,857 --> 04:32:25,662
STUDIES HAVE -- BETWEEN SERUM

6219
04:32:25,729 --> 04:32:30,300
BIOMARKERS OF STRESS SUCH AS C

6220
04:32:30,367 --> 04:32:33,670
CRP, IN ASSOCIATION WITH --

6221
04:32:33,737 --> 04:32:36,707
PLACENTAL INFLAMMATION,

6222
04:32:36,773 --> 04:32:39,443
PLACENTAL TELOMERE LENGTHS,

6223
04:32:39,509 --> 04:32:41,111
SHORTER -- PLACENTAS, AND PEOPLE

6224
04:32:41,178 --> 04:32:45,716
ARE SPENDING DRK MARKERS OF

6225
04:32:45,782 --> 04:32:49,586
PERFUSION.

6226
04:32:49,653 --> 04:32:53,857
AND THE STRESS MODELS FOR THIS

6227
04:32:53,924 --> 04:32:54,958
RELATIONSHIP IN DEVELOPMENTAL

6228
04:32:55,025 --> 04:32:58,562
ORIGINS OF HEALTH AND DISEASE,

6229
04:32:58,628 --> 04:33:01,198
THE WEATHERING HYPOTHESIS,

6230
04:33:01,264 --> 04:33:03,934
ALLOSTATIC LOAD.

6231
04:33:04,000 --> 04:33:05,902
I BELIEVE RESEARCH GAPS ARE --

6232
04:33:05,969 --> 04:33:10,474
WE TALKED ABOUT THR, MORE

6233
04:33:10,540 --> 04:33:12,442
ACCURATE MEASURES OF STRUCTURAL

6234
04:33:12,509 --> 04:33:13,643
RACISM.

6235
04:33:13,710 --> 04:33:15,946
THAT'S WHY THERE NEEDS TO BE A

6236
04:33:16,012 --> 04:33:22,152
STANDARDIZED VIEW SO -- I THINK

6237
04:33:22,219 --> 04:33:24,888
THE -- SETTINGS, LOOKING AT HOW

6238
04:33:24,955 --> 04:33:26,623
HISTORICAL PRACTICES AND

6239
04:33:26,690 --> 04:33:28,024
HISTORICAL INSULTS AFFECT

6240
04:33:28,091 --> 04:33:31,528
CURRENT DISPARITIES.

6241
04:33:31,595 --> 04:33:33,930
IN MEDICINE, THERE IS -- NOT

6242
04:33:33,997 --> 04:33:35,899
HERE, BUT IN GENERAL, RESISTANCE

6243
04:33:35,966 --> 04:33:38,935
TO ACCEPT STRUCTURAL RACISM AS A

6244
04:33:39,002 --> 04:33:42,639
FORCE, WHAT I HAVE BEEN TALKING

6245
04:33:42,706 --> 04:33:46,943
ABOUT AND -- MY COLLEAGUES --

6246
04:33:47,010 --> 04:33:48,411
JUST LIKE LOCKED OUT BECAUSE

6247
04:33:48,478 --> 04:33:52,582
IT'S JUST SO HARD TO ACCEPT TH

6248
04:33:52,649 --> 04:33:52,816
THAT --

6249
04:33:52,883 --> 04:33:55,085
>> [INAUDIBLE]

6250
04:33:55,152 --> 04:33:55,886
[LAUGHTER]

6251
04:33:55,952 --> 04:33:59,356
>> SO HEALTHCARE DISPARITIES AND

6252
04:33:59,422 --> 04:34:01,992
HEALTH DISPARITIES ARE

6253
04:34:02,058 --> 04:34:04,795
DIFFERENT.

6254
04:34:04,861 --> 04:34:07,631
AND UNTIL TODAY, I OFTEN FEEL

6255
04:34:07,697 --> 04:34:11,802
VERY ISOLATED IN MY SEARCH OF

6256
04:34:11,868 --> 04:34:13,970
STUDYING THE PLACENTA AND HEALTH

6257
04:34:14,037 --> 04:34:18,441
DISPARITIES, SO THIS -- WITH

6258
04:34:18,508 --> 04:34:21,178
EPIGENETICS AND INTERVENTIONS

6259
04:34:21,244 --> 04:34:22,679
ARE GREATLY NEEDED.

6260
04:34:22,746 --> 04:34:24,848
THESE ARE SOME OF MY MENTORS AND

6261
04:34:24,915 --> 04:34:25,415
COLLABORATORS.

6262
04:34:25,482 --> 04:34:33,423
THANK YOU VERY MUCH.

6263
04:34:33,490 --> 04:34:34,991
>> FANTASTIC.

6264
04:34:35,058 --> 04:34:35,926
SO WE ARE NOW OPEN FOR QUESTIONS

6265
04:34:35,992 --> 04:34:43,433
FOR THE SPEAKERS.

6266
04:34:43,500 --> 04:34:44,601
I DON'T KNOW IF YOU HAVE

6267
04:34:44,668 --> 04:34:45,435
ANYTHING ONLINE.

6268
04:34:45,502 --> 04:34:46,970
YES, ANY QUESTIONS ONLINE?

6269
04:34:47,037 --> 04:34:47,404
NOT YET?

6270
04:34:47,470 --> 04:34:50,240
PEOPLE ARE STILL THINKING.

6271
04:34:50,307 --> 04:34:55,345
I HAD A QUESTION THAT I THINK

6272
04:34:55,412 --> 04:34:56,346
THAT SOMEBODY MENTIONED IT, I

6273
04:34:56,413 --> 04:34:59,282
CAN'T REMEMBER WHICH ONE, BUT

6274
04:34:59,349 --> 04:35:02,185
ESPECIALLY IN PREGNANCY, WHETHER

6275
04:35:02,252 --> 04:35:03,720
OR NOT THERE'S ANY DIFFERENCE IN

6276
04:35:03,787 --> 04:35:04,487
ANY OF THE OUTCOMES THAT YOU'RE

6277
04:35:04,554 --> 04:35:05,889
LOOKING AT, IF YOU'VE LOOKED AT

6278
04:35:05,956 --> 04:35:07,891
THE SEX OF THE FETUS, IF IT

6279
04:35:07,958 --> 04:35:10,026
MATTERED FOR EITHER MATERNAL

6280
04:35:10,093 --> 04:35:13,563
HEALTH OUTCOMES OR BABY'S

6281
04:35:13,630 --> 04:35:16,066
DEVELOPMENTAL OUTCOMES RELATED

6282
04:35:16,132 --> 04:35:22,105
TO ANY OF THE RACES AND

6283
04:35:22,172 --> 04:35:22,639
MARGINALIZATION OUTCOMES.

6284
04:35:22,706 --> 04:35:24,741
>> SO I DIDN'T GET TO PRESENT

6285
04:35:24,808 --> 04:35:26,610
THAT, BUT ONE OF THE -- IN THE

6286
04:35:26,676 --> 04:35:29,512
STUDY ON GESTATIONAL EXPOSURE TO

6287
04:35:29,579 --> 04:35:34,317
NEIGHBORHOOD CRIME AND

6288
04:35:34,384 --> 04:35:35,285
EPIGENETIC -- METHYLATION MARKS,

6289
04:35:35,352 --> 04:35:38,088
WE DID STRATIFY ABOUT OFFSPRING

6290
04:35:38,154 --> 04:35:42,592
SEX AND SAW SIGNIFICANT CPG

6291
04:35:42,659 --> 04:35:46,062
SITES OR DNA METH L METHYLATIONS

6292
04:35:46,129 --> 04:35:48,498
ONLY IN THE FEMALE OFFSPRING,

6293
04:35:48,565 --> 04:35:49,866
NONE WERE SIGNIFICANT IN THE

6294
04:35:49,933 --> 04:35:50,634
MALE OFFSPRING.

6295
04:35:50,700 --> 04:35:52,903
SO THE RESULTS THAT I SHOWED FOR

6296
04:35:52,969 --> 04:35:57,507
THAT STUDY WERE DRIVEN BY THE

6297
04:35:57,574 --> 04:36:00,677
FEMALE OFFSPRING.

6298
04:36:00,744 --> 04:36:02,178
AND SO WE'VE BEEN THINKING A LOT

6299
04:36:02,245 --> 04:36:04,147
ABOUT THAT BECAUSE, YOU KNOW,

6300
04:36:04,214 --> 04:36:07,150
STRESS RESPONSE PATHWAYS AND

6301
04:36:07,217 --> 04:36:08,151
STRESS DIFFERS, AND WE DIDN'T

6302
04:36:08,218 --> 04:36:12,088
EXPECT TO SEE THAT SO EARLY,

6303
04:36:12,155 --> 04:36:13,623
ESPECIALLY IN THE EPIGENETIC

6304
04:36:13,690 --> 04:36:14,291
MARKS.

6305
04:36:14,357 --> 04:36:17,627
SO THE SAMPLE SIZE -- WHEN WE

6306
04:36:17,694 --> 04:36:19,396
STRATIFIED, I THINK WE'RE

6307
04:36:19,462 --> 04:36:22,866
LOOKING AT 56 FEMALE OFFSPRING

6308
04:36:22,933 --> 04:36:25,669
AND MAYBE 70 MALE OFFSPRING.

6309
04:36:25,735 --> 04:36:27,437
SO WE'RE NOT ABLE TO REALLY DIG

6310
04:36:27,504 --> 04:36:28,838
TOO MUCH ABOUT THAT BUT IT

6311
04:36:28,905 --> 04:36:30,240
SOMETHING WE'VE BEEN THINKING A

6312
04:36:30,307 --> 04:36:31,641
LOT ABOUT WITH THOSE RESULTS.

6313
04:36:31,708 --> 04:36:34,544
THANK YOU.

6314
04:36:34,611 --> 04:36:36,246
>> THANK YOU VERY MUCH FOR YOUR

6315
04:36:36,313 --> 04:36:37,814
TALK.

6316
04:36:37,881 --> 04:36:45,989
SO ONE THING WE KNOW IS THAT

6317
04:36:46,056 --> 04:36:47,791
MORE FETAL OUTCOMES, WHEN WE

6318
04:36:47,857 --> 04:36:51,461
LOOK AT PARTICULARLY BLACK WOM

6319
04:36:51,528 --> 04:36:56,599
WOMEN, THE RATES ARE HIGHER OF

6320
04:36:56,666 --> 04:36:58,134
ADVERSE -- WHEN YOU ADJUST FOR

6321
04:36:58,201 --> 04:36:59,436
SOCIAL ECONOMICS, IT ONLY

6322
04:36:59,502 --> 04:37:01,604
IMPROVES JUST A LITTLE.

6323
04:37:01,671 --> 04:37:03,173
DO THE EPIGENETIC CHANGES VARY

6324
04:37:03,239 --> 04:37:06,943
AS YOU LOOK AT THAT -- IN OTHER

6325
04:37:07,010 --> 04:37:08,578
WORDS, IS THERE SOME ADDITIONAL

6326
04:37:08,645 --> 04:37:10,113
EPIGENETIC CHANGE THAT WE SEE

6327
04:37:10,180 --> 04:37:14,317
RELATED TO SORT OF SES?

6328
04:37:14,384 --> 04:37:18,088
>> THAT'S A GREAT QUESTION.

6329
04:37:18,154 --> 04:37:22,392
SO WHEN OUR STUDIES ADJUSTED FOR

6330
04:37:22,459 --> 04:37:24,060
SES, WE DIDN'T STRATIFY BY SES

6331
04:37:24,127 --> 04:37:27,030
TO SEE IF THEY DIFFERED BY

6332
04:37:27,097 --> 04:37:29,799
INDIVIDUAL LEVEL SES, AS I

6333
04:37:29,866 --> 04:37:32,435
MENTIONED EARLIER, THE STUDY DID

6334
04:37:32,502 --> 04:37:34,838
NOT COLLECT -- THERE IN NO

6335
04:37:34,904 --> 04:37:35,939
SOCIAL EPIDEMIOLOGISTS ON THE

6336
04:37:36,006 --> 04:37:37,073
STUDY TEAM WHEN THEY ORIGINALLY

6337
04:37:37,140 --> 04:37:39,275
DESIGNED THIS, BUT THERE'S

6338
04:37:39,342 --> 04:37:40,377
DEFINITELY SEVERAL STUDIES THAT

6339
04:37:40,443 --> 04:37:44,180
HAVE SHOWN SES RELATED

6340
04:37:44,247 --> 04:37:45,682
EPIGENETIC MARKS, PARTICULARLY

6341
04:37:45,749 --> 04:37:48,318
IN INFLAMMATION-RELATED

6342
04:37:48,385 --> 04:37:50,620
PATHWAYS.

6343
04:37:50,687 --> 04:37:54,424
USING THE VERY LIMITED SES DATA

6344
04:37:54,491 --> 04:37:57,160
THAT WE HAVE, WHICH IS

6345
04:37:57,227 --> 04:37:58,461
EDUCATION, WE DO HAVE SOME CRUDE

6346
04:37:58,528 --> 04:38:00,096
MARKS OF, LIKE, OCCUPATION THAT

6347
04:38:00,163 --> 04:38:04,100
WE MIGHT BE ABLE TO UTILIZE.

6348
04:38:04,167 --> 04:38:07,670
WE DO -- ACTUALLY WE DID LOOK AT

6349
04:38:07,737 --> 04:38:11,408
GESTATIONAL AGING, SO THESE

6350
04:38:11,474 --> 04:38:13,810
EPIGENETIC AGING MARKS TO

6351
04:38:13,877 --> 04:38:15,111
PREDICT EPIGENETIC AGING, AND

6352
04:38:15,178 --> 04:38:18,548
DID FIND SOME ASSOCIATIONS WITH

6353
04:38:18,615 --> 04:38:19,883
SES, BUT WE HAVEN'T KIND OF

6354
04:38:19,949 --> 04:38:21,317
LOOKED AT THIS INTERACTION

6355
04:38:21,384 --> 04:38:29,225
BETWEEN THE MATERNAL

6356
04:38:29,292 --> 04:38:29,893
CHARACTERISTICS AND INDIVIDUAL

6357
04:38:29,959 --> 04:38:30,226
SES.

6358
04:38:30,293 --> 04:38:31,995
THAT'S A GREAT QUESTION.

6359
04:38:32,062 --> 04:38:33,296
>> THANK YOU BOTH FOR YOUR TALK

6360
04:38:33,363 --> 04:38:34,497
TODAY.

6361
04:38:34,564 --> 04:38:38,802
I THINK I LEARNED A LOT.

6362
04:38:38,868 --> 04:38:43,506
FOR DR. MARTIN, IN YOUR LAST

6363
04:38:43,573 --> 04:38:45,175
ANSWER, WHEN YOU SHOWED THE DATA

6364
04:38:45,241 --> 04:38:46,209
COMPARING BLACK VERSUS WHITE,

6365
04:38:46,276 --> 04:38:49,045
ARE THERE OTHER FACTORS THAT YOU

6366
04:38:49,112 --> 04:38:50,814
WOULD CONSIDER THAT COULD BE

6367
04:38:50,880 --> 04:38:52,549
DISTINGUISHING TO START TO

6368
04:38:52,615 --> 04:38:54,150
EXPLAIN THAT BLACK VERSUS WHITE

6369
04:38:54,217 --> 04:38:54,484
DIFFERENCE?

6370
04:38:54,551 --> 04:38:56,019
AND IT SOUNDS LIKE MAYBE FOR

6371
04:38:56,086 --> 04:38:57,654
THIS STUDY THAT YOU SHARED WITH

6372
04:38:57,720 --> 04:38:59,823
US TODAY, THAT WASN'T COLLECTED.

6373
04:38:59,889 --> 04:39:03,526
SO ARE THERE THINGS LOOKING AT

6374
04:39:03,593 --> 04:39:04,761
COLLECTING FOR FUTURE STUDIES SO

6375
04:39:04,828 --> 04:39:08,865
THAT THERE COULD BE MORE NUANCE

6376
04:39:08,932 --> 04:39:14,237
IN TERMS OF PLAINING OF EXPLAINT

6377
04:39:14,304 --> 04:39:14,838
RACIAL DIFFERENCE?

6378
04:39:14,904 --> 04:39:15,805
>> THANK YOU FOR THAT QUESTION.

6379
04:39:15,872 --> 04:39:16,940
ONE OF THE THINGS WE TRY TO BE

6380
04:39:17,006 --> 04:39:18,808
CAREFUL ABOUT WHEN WE ADJUST OR

6381
04:39:18,875 --> 04:39:20,343
TRY TO ACCOUNT FOR WHAT MIGHT BE

6382
04:39:20,410 --> 04:39:21,911
GOING ON IS THAT WE'RE NOT

6383
04:39:21,978 --> 04:39:24,214
ADJUSTING FOR THINGS THAT ARE

6384
04:39:24,280 --> 04:39:30,019
ACTUALLY -- ON THE MEDIAN

6385
04:39:30,086 --> 04:39:31,421
PATHWAY, SO THAT MIGHT BE

6386
04:39:31,488 --> 04:39:32,856
DOWNSTREAM OF THESE NEIGHBORHOOD

6387
04:39:32,922 --> 04:39:34,157
CHARACTERISTICS, BUT THINGS THAT

6388
04:39:34,224 --> 04:39:35,692
ARE IMPACTING LIVING IN THESE

6389
04:39:35,758 --> 04:39:37,160
TYPES OF NEIGHBORHOODS.

6390
04:39:37,227 --> 04:39:43,299
SO WE ACCOUNT FOR FACTORS LIKE

6391
04:39:43,366 --> 04:39:45,335
THE MOTHER'S AGE, EDUCATION,

6392
04:39:45,401 --> 04:39:48,171
EMPLOYMENT STATUS, MARITAL

6393
04:39:48,238 --> 04:39:49,405
STATUS, THINGS THAT MIGHT

6394
04:39:49,472 --> 04:39:50,507
PREDICT WHY SOMEONE LIVES IN A

6395
04:39:50,573 --> 04:39:53,343
CERTAIN NEIGHBORHOOD.

6396
04:39:53,409 --> 04:39:57,914
KNOW THATNOW THAT WE HAVE SOME O

6397
04:39:57,981 --> 04:40:00,216
LOOK AT THINGS THAT PRECEDE OR

6398
04:40:00,283 --> 04:40:02,519
MAYBE POLICIES THAT WOULD PUT

6399
04:40:02,585 --> 04:40:04,020
PEOPLE OR SORT PEOPLE INTO

6400
04:40:04,087 --> 04:40:05,622
CERTAIN NEIGHBORHOODS, SO

6401
04:40:05,688 --> 04:40:07,056
THINKING ABOUT HISTORICAL

6402
04:40:07,123 --> 04:40:12,562
REDLINING OR HISTORICAL -- WE'VE

6403
04:40:12,629 --> 04:40:14,097
HAD SOME DISCUSSIONS ABOUT

6404
04:40:14,164 --> 04:40:15,331
SHOULD WE BE ACCOUNTING FOR

6405
04:40:15,398 --> 04:40:17,300
THOSE TYPE OF FACTORS, FACTORS

6406
04:40:17,367 --> 04:40:18,535
LIKE MATERNAL HEALTH OUTCOMES

6407
04:40:18,601 --> 04:40:21,237
WHERE WE CAN LOOK AT THOSE AS

6408
04:40:21,304 --> 04:40:22,772
POTENTIAL EXPLANATORY FACTORS

6409
04:40:22,839 --> 04:40:24,507
BECAUSE WE DO BELIEVE THAT'S

6410
04:40:24,574 --> 04:40:25,875
NEIGHBORHOOD ENVIRONMENTS MIGHT

6411
04:40:25,942 --> 04:40:27,577
BE IMPACT BEING THE MATERNAL

6412
04:40:27,644 --> 04:40:29,646
HEALTH WHICH THEN MIGHT BE

6413
04:40:29,712 --> 04:40:30,847
IMPACT THE THE EPIGENETIC

6414
04:40:30,914 --> 04:40:31,915
MECHANISMS POTENTIALLY.

6415
04:40:31,981 --> 04:40:33,917
AND SO WE DIDN'T HAVE ENOUGH OF

6416
04:40:33,983 --> 04:40:35,285
THOSE OUTCOMES IN OUR SAMPLE TO

6417
04:40:35,351 --> 04:40:36,886
LOOK AT THE MATERNAL HEALTH

6418
04:40:36,953 --> 04:40:37,620
FACTORS.

6419
04:40:37,687 --> 04:40:39,022
OH, AND WE ALSO ACCOUNTED FOR

6420
04:40:39,088 --> 04:40:39,923
BEHAVIORAL FACTORS, SO

6421
04:40:39,989 --> 04:40:44,060
DIFFERENCES IN MATERNAL SMOKING,

6422
04:40:44,127 --> 04:40:47,430
DIFFERENCES IN -- MAYBE I THINK

6423
04:40:47,497 --> 04:40:48,531
WE HAVE PHYSICAL ACTIVITY?

6424
04:40:48,598 --> 04:40:51,367
I MIGHT BE THINKING OF ANOTHER

6425
04:40:51,434 --> 04:40:53,203
STUDY, BUT THESE MATERNAL

6426
04:40:53,269 --> 04:40:58,208
BEHAVIORAL FACTORS STILL SEE

6427
04:40:58,274 --> 04:40:58,541
THESE.

6428
04:40:58,608 --> 04:40:59,876
DOES THAT ANSWER YOUR QUESTION?

6429
04:40:59,943 --> 04:41:00,543
OKAY.

6430
04:41:00,610 --> 04:41:05,548
>> SO A COUPLE QUESTIONS FROM

6431
04:41:05,615 --> 04:41:05,815
THE ZOOM.

6432
04:41:05,882 --> 04:41:07,183
THANK YOU FOR SUCH AN

6433
04:41:07,250 --> 04:41:07,917
INTERESTING PRESENTATION.

6434
04:41:07,984 --> 04:41:10,353
DID YOU CONSIDER ADJUSTING FOR

6435
04:41:10,420 --> 04:41:11,854
MATERNAL METABOLIC STATUS GIVEN

6436
04:41:11,921 --> 04:41:13,156
RECENT ASSOCIATIONS BETWEEN THAT

6437
04:41:13,223 --> 04:41:16,993
AND DNA METHYLATION?

6438
04:41:17,060 --> 04:41:23,199
AND OFFSPRING ADIPOSITY WHICH

6439
04:41:23,266 --> 04:41:29,539
SUPPORTS WORK -- IN PROMOTING --

6440
04:41:29,606 --> 04:41:32,041
>> SO I THINK -- WE DID NOT

6441
04:41:32,108 --> 04:41:35,345
ADJUST FOR THEM, AND BECAUSE WE

6442
04:41:35,411 --> 04:41:37,080
WERE KIND OF WORRIED ABOUT KIND

6443
04:41:37,146 --> 04:41:38,448
OF GETTING INTO THE ACCOUNTING

6444
04:41:38,514 --> 04:41:39,215
FOR THEM.

6445
04:41:39,282 --> 04:41:40,083
THINK WHAT WOULD BE INTERESTING

6446
04:41:40,149 --> 04:41:42,151
IS ACTUALLY STRATIFYING THEM,

6447
04:41:42,218 --> 04:41:43,253
THOUGH, TO SEE IF THESE

6448
04:41:43,319 --> 04:41:48,057
ASSOCIATIONS DIFFER BASED ON THE

6449
04:41:48,124 --> 04:41:52,795
MATERNAL OUTCOMES,

6450
04:41:52,862 --> 04:41:53,396
CARDIOMETABOLIC OUT COME AND

6451
04:41:53,463 --> 04:41:55,665
THOSE THAT HAVE MAYBE

6452
04:41:55,732 --> 04:41:59,068
HYPERTENSION OR CHRONIC

6453
04:41:59,135 --> 04:42:00,270
HYPERTENSION, GESTATIONAL

6454
04:42:00,336 --> 04:42:01,771
DIABETES AND THOSE THAT DO NOT.

6455
04:42:01,838 --> 04:42:04,307
I THINK WE HAD PROBABLY 96% DID

6456
04:42:04,374 --> 04:42:05,608
NOT HAVE ANY OF THOSE

6457
04:42:05,675 --> 04:42:06,776
COMPLICATIONS DURING PREGNANCY,

6458
04:42:06,843 --> 04:42:07,877
SO WE WEREN'T ABLE TO KIND OF

6459
04:42:07,944 --> 04:42:09,178
ACCOUNT FOR THOSE IN THIS

6460
04:42:09,245 --> 04:42:12,282
ANALYSIS.

6461
04:42:12,348 --> 04:42:14,417
>> AND THEN ANOTHER QUESTION

6462
04:42:14,484 --> 04:42:15,385
ABOUT CAN THE SPEAKERS PROVIDE

6463
04:42:15,451 --> 04:42:16,919
ANY THOUGHT OF WHETHER THE

6464
04:42:16,986 --> 04:42:18,788
PREDICTORS THEY EXAMINED SUCH AS

6465
04:42:18,855 --> 04:42:20,290
NEIGHBORHOOD CONDITIONS WERE

6466
04:42:20,356 --> 04:42:22,058
CAUSAL FACTORS OR COLLINEAR WITH

6467
04:42:22,125 --> 04:42:23,793
OTHER FACTORS THAT THEY NEED

6468
04:42:23,860 --> 04:42:34,304
MORE PROXIMAL MECHANISMS.

6469
04:42:37,373 --> 04:42:42,478
>>

6470
04:42:42,545 --> 04:42:44,547
>> THE FACTORS THAT WE STUDY,

6471
04:42:44,614 --> 04:42:46,382
GUN VIOLENCE OR REDLINING IS

6472
04:42:46,449 --> 04:42:48,251
JUST ONE OF MANY AND PROBABLY DO

6473
04:42:48,318 --> 04:42:53,923
COEXIST WITH MANY OTHER MEASURES

6474
04:42:53,990 --> 04:42:56,993
OF DISCRIMINATION.

6475
04:42:57,060 --> 04:42:58,328
AS FAR AS THE PLACENTAL

6476
04:42:58,394 --> 04:42:59,595
FUNCTION, AGAIN, IT WAS JUST

6477
04:42:59,662 --> 04:43:04,734
PURELY DIFFERENCES IN PATHOLOGY.

6478
04:43:04,801 --> 04:43:06,669
I THINK THERE COULD BE MORE

6479
04:43:06,736 --> 04:43:08,638
STUDIES LOOKING AT THE SOCIAL

6480
04:43:08,705 --> 04:43:11,941
FORCES AND THE DIFFERENCES IN

6481
04:43:12,008 --> 04:43:17,980
PLACENTAL FUNCTION PATHOLOGY.

6482
04:43:18,047 --> 04:43:18,614
>> ALL RIGHT.

6483
04:43:18,681 --> 04:43:20,216
WITH THAT, CAN WE GIVE ONE MORE

6484
04:43:20,283 --> 04:43:21,651
ROUND OF APPLAUSE FOR THE PANEL?

6485
04:43:21,718 --> 04:43:26,656
[APPLAUSE]

6486
04:43:26,723 --> 04:43:28,091
AND UP NEXT WE HAVE OUR FINAL

6487
04:43:28,157 --> 04:43:38,468
PANEL OF THE DAY.

6488
04:45:02,752 --> 04:45:03,052
>> OKAY.

6489
04:45:03,119 --> 04:45:04,987
SO I'M GOING TO GO AHEAD AND GET

6490
04:45:05,054 --> 04:45:05,888
US STARTED ON OUR LAST SESSION

6491
04:45:05,955 --> 04:45:07,523
OF THE DAY AND I APPRECIATE

6492
04:45:07,590 --> 04:45:08,291
EVERYBODY'S ATTENTION.

6493
04:45:08,357 --> 04:45:12,161
AND I AM EXCITED TO MODERATE

6494
04:45:12,228 --> 04:45:13,095
THIS SESSION ON STRESS

6495
04:45:13,162 --> 04:45:14,831
ALLOSTATIC LOAD AND

6496
04:45:14,897 --> 04:45:16,799
INFLAMMATION-RELATED MECHANISMS.

6497
04:45:16,866 --> 04:45:18,768
AS AN IMMUNOLOGIST DOING

6498
04:45:18,835 --> 04:45:20,403
ENVIRONMENTAL TOXICOLOGY AND I

6499
04:45:20,470 --> 04:45:22,138
FIND THAT IT'S REALLY KEY FOR US

6500
04:45:22,205 --> 04:45:25,441
TO THINK ABOUT THE FACT THAT A

6501
04:45:25,508 --> 04:45:26,075
LOT OF THE COMMUNITIES THAT

6502
04:45:26,142 --> 04:45:26,943
EXPERIENCE ENVIRONMENTAL

6503
04:45:27,009 --> 04:45:28,911
EXPOSURES ARE ALSO ONES WHO

6504
04:45:28,978 --> 04:45:29,912
EXPERIENCE RACISM,

6505
04:45:29,979 --> 04:45:30,546
MARGINALIZATION AND

6506
04:45:30,613 --> 04:45:31,948
DISCRIMINATION AND A LOT OF

6507
04:45:32,014 --> 04:45:34,584
THESE PATHWAYS ARE OVERLAPPING

6508
04:45:34,650 --> 04:45:36,385
AND LIKELY SYNERGISTIC SO WE

6509
04:45:36,452 --> 04:45:37,653
NEED TO WORK TOGETHER MORE AND

6510
04:45:37,720 --> 04:45:39,155
NOT BE SO REDUCTIONIST IN OUR

6511
04:45:39,222 --> 04:45:40,690
APPROACH TO UNDERSTANDING THESE

6512
04:45:40,756 --> 04:45:41,357
MECHANISMS.

6513
04:45:41,424 --> 04:45:43,092
AND WITH THAT, I WOULD LIKE TO

6514
04:45:43,159 --> 04:45:47,730
INTRODUCE OUR FIRST SPEAKER, DRO

6515
04:45:47,797 --> 04:45:49,165
TALK TO US ABOUT DISCRIMINATION

6516
04:45:49,232 --> 04:45:52,835
AS A STRESSOR INFLUENCING

6517
04:45:52,902 --> 04:45:56,038
BRAIN-GUT MICROBIOME

6518
04:45:56,105 --> 04:45:58,040
ALTERATIONS, DYSREGULATION OF

6519
04:45:58,107 --> 04:45:58,508
THE GUT BRAIN SYSTEM.

6520
04:45:58,574 --> 04:45:58,975
>> THANK YOU.

6521
04:45:59,041 --> 04:46:00,643
I WANT TO START OFF BY SAYING

6522
04:46:00,710 --> 04:46:02,211
HOW I REALLY GOT STARTED WITH

6523
04:46:02,278 --> 04:46:02,879
THIS WORK.

6524
04:46:02,945 --> 04:46:05,081
I'M BORN AND RAISED IN -- MY DAD

6525
04:46:05,147 --> 04:46:07,250
STILL LIVES THERE, SO

6526
04:46:07,316 --> 04:46:13,289
INTERSECTING, NAVIGATING -- SO

6527
04:46:13,356 --> 04:46:14,724
I'M VERY PASSIONATE ABOUT THIS

6528
04:46:14,790 --> 04:46:24,901
WORK.

6529
04:46:27,970 --> 04:46:29,772
SO THANKS TO SPEAKERS BEFORE US,

6530
04:46:29,839 --> 04:46:31,774
WE KNOW THAT DISCRIMINATION IS

6531
04:46:31,841 --> 04:46:36,579
RISING, WE KNOW THAT IT HAS

6532
04:46:36,646 --> 04:46:38,548
NEGATIVE EFFECTS, ANXIETY,

6533
04:46:38,614 --> 04:46:43,352
DEPRESSION, AND MORE RECENTLY,

6534
04:46:43,419 --> 04:46:45,121
STUDIES WE'VE SEEN BY OTHER

6535
04:46:45,187 --> 04:46:46,188
SPEAKERS, ASSOCIATING

6536
04:46:46,255 --> 04:46:47,189
DISCRIMINATION WITH PHYSICAL

6537
04:46:47,256 --> 04:46:50,459
HEALTH, THINGS LIKE DIABETES,

6538
04:46:50,526 --> 04:46:51,894
OBESITY, CARDIOVASCULAR DISEASE.

6539
04:46:51,961 --> 04:46:53,429
WHAT'S REALLY NICE IS HOW PEOPLE

6540
04:46:53,496 --> 04:46:55,831
ARE STARTING TO LOOK AT THESE

6541
04:46:55,898 --> 04:46:56,799
BIOMARKERS RELATED TO

6542
04:46:56,866 --> 04:46:58,100
DISCRIMINATION, SO LOOKING AT

6543
04:46:58,167 --> 04:47:02,705
THINGS LIKE INFLAMMATION,

6544
04:47:02,772 --> 04:47:03,239
EPIGENETICS AND CORTISOL.

6545
04:47:03,306 --> 04:47:04,774
AND WE ALSO SEE THAT

6546
04:47:04,840 --> 04:47:05,775
DISCRIMINATION IS ASSOCIATED

6547
04:47:05,841 --> 04:47:07,810
WITH HIGHER RATES OF OBESITY, SO

6548
04:47:07,877 --> 04:47:11,013
WHEN WE LOOK AT NON-RACIAL

6549
04:47:11,080 --> 04:47:11,681
DISCRIMINATION, WE CAN SEE THAT

6550
04:47:11,747 --> 04:47:15,551
THE ODDS OF HAVING OBESITY IS

6551
04:47:15,618 --> 04:47:16,919
THREE TIMES MORE, WHERE WE LOOK

6552
04:47:16,986 --> 04:47:19,855
AT RACIAL-BASED DISCRIMINATION,

6553
04:47:19,922 --> 04:47:27,496
YOU SEE THE ODDS RL 6 TI ARE 6 S

6554
04:47:27,563 --> 04:47:28,064
MORE.

6555
04:47:28,130 --> 04:47:32,101
WHEN WE LOOK FROM 1991 TO 2010,

6556
04:47:32,168 --> 04:47:34,103
WE'VE GONE UP ABOUT 15% TO OVER

6557
04:47:34,170 --> 04:47:36,706
30%, AND BASICALLY IT WENT FROM

6558
04:47:36,772 --> 04:47:38,007
BLUE COUNTRY TO A RED ONE.

6559
04:47:38,074 --> 04:47:40,309
I DON'T MEAN THAT POLITICALLY.

6560
04:47:40,376 --> 04:47:43,913
I KNOW WE'RE IN D.C.  -- AND I

6561
04:47:43,980 --> 04:47:46,015
WANT TO ENCOURAGE FRIENDS RIGHT

6562
04:47:46,082 --> 04:47:48,184
NOW, WE'RE AT ABOUT 42%

6563
04:47:48,250 --> 04:47:50,052
ACCORDING TO THE CDC PROJECTED

6564
04:47:50,119 --> 04:47:53,556
TO BE ABOUT 51% BY 2030.

6565
04:47:53,623 --> 04:47:57,093
SO WE KNOW THAT OUR -- WE WERE

6566
04:47:57,159 --> 04:47:58,794
STILL TALKING ABOUT BEAZ AFTER

6567
04:47:58,861 --> 04:48:02,632
ALLOBESITYAFTER ALL THIS TIME AL

6568
04:48:02,698 --> 04:48:04,300
DON'T FULLY UNDERSTAND WHAT

6569
04:48:04,367 --> 04:48:06,268
THE -- MECHANISMS ARE.

6570
04:48:06,335 --> 04:48:08,437
SO THIS -- WHEN WE LOOK AT

6571
04:48:08,504 --> 04:48:09,905
OBESITY, IT IS A VERY COMPLEX

6572
04:48:09,972 --> 04:48:11,207
DISORDER, IT IS VERY

6573
04:48:11,273 --> 04:48:13,075
HETEROGENEOUS AND IT'S NOT JUST

6574
04:48:13,142 --> 04:48:15,011
ABOUT NEVER EATING, IT'S NOT

6575
04:48:15,077 --> 04:48:16,646
JUST ABOUT WHAT WE'RE PUTTING IN

6576
04:48:16,712 --> 04:48:20,049
OUR MOUTH BUT -- MAYBE RELATED

6577
04:48:20,116 --> 04:48:22,652
TO WHERE -- ENVIRONMENTAL

6578
04:48:22,718 --> 04:48:24,220
FACTORS SUCH AS DISCRIMINATION

6579
04:48:24,286 --> 04:48:24,620
AND STRESS.

6580
04:48:24,687 --> 04:48:26,689
SO WHAT I'M GOING TO TALK MORE

6581
04:48:26,756 --> 04:48:28,658
ABOUT TODAY IS TAKING THIS WHOLE

6582
04:48:28,724 --> 04:48:30,960
PERSON OR THIS SYSTEMS BIOLOGY

6583
04:48:31,027 --> 04:48:36,232
APPROACH BY LOOKING AT THE BR

6584
04:48:36,298 --> 04:48:38,300
BRAIN-GUT MICROBIOME SYSTEM, AND

6585
04:48:38,367 --> 04:48:43,305
HOW IT LEADS TO ALTERED EATING

6586
04:48:43,372 --> 04:48:44,740
BEHAVIORS AND OBESITY.

6587
04:48:44,807 --> 04:48:46,509
SO PEOPLE OFTEN ASK ME, IS THE

6588
04:48:46,575 --> 04:48:48,044
BRAIN AND THE GUT REALLY

6589
04:48:48,110 --> 04:48:50,012
CONNECTED, AND I TELL PEOPLE,

6590
04:48:50,079 --> 04:48:51,981
THINK ABOUT THOSE STRESSFUL

6591
04:48:52,048 --> 04:48:52,581
SITUATIONS.

6592
04:48:52,648 --> 04:48:54,583
LOOK AT US TODAY, ADVANCING

6593
04:48:54,650 --> 04:48:56,018
THESE SLIDES HAS BEEN REALLY

6594
04:48:56,085 --> 04:48:59,922
TRAUMATIC.

6595
04:48:59,989 --> 04:49:03,859
SO -- BUTTERFLIES IN YOUR

6596
04:49:03,926 --> 04:49:05,061
STOMACH, LIGHT-HEADED, STRESSED

6597
04:49:05,127 --> 04:49:06,462
OUT, THAT DOES PROVIDE SOME

6598
04:49:06,529 --> 04:49:08,230
EVIDENCE FOR THIS BRAIN-GUT

6599
04:49:08,297 --> 04:49:08,564
CONNECTION.

6600
04:49:08,631 --> 04:49:10,066
WE KNOW FROM CLINICAL AND

6601
04:49:10,132 --> 04:49:12,601
PRE-CLINICAL STUDIES THAT THERE

6602
04:49:12,668 --> 04:49:15,371
IS THIS -- CONNECTION BETWEEN

6603
04:49:15,438 --> 04:49:19,842
THE BRAIN AND WE HAVE THIS KIND

6604
04:49:19,909 --> 04:49:20,443
OF TOP-DOWN SIGNALING FROM THE

6605
04:49:20,509 --> 04:49:22,578
BRAIN TO THE GUT AND THIS

6606
04:49:22,645 --> 04:49:24,046
SIGNALING TO THE BRAIN.

6607
04:49:24,113 --> 04:49:27,950
WHEN WE THINK ABOUT THIS REALLY

6608
04:49:28,017 --> 04:49:29,218
TIGHTLY REGULATED COORDINATED

6609
04:49:29,285 --> 04:49:30,986
SYSTEM AND WHEN WE THINK ABOUT

6610
04:49:31,053 --> 04:49:32,088
THE USE OF OBESITY, THERE'S THIS

6611
04:49:32,154 --> 04:49:34,724
SHIFT IN HOMEOSTASIS AND YOU

6612
04:49:34,790 --> 04:49:38,661
KIND OF GET THIS DISREGULATED --

6613
04:49:38,728 --> 04:49:41,997
BETWCOMMUNICATION BETWEEN THE BN

6614
04:49:42,064 --> 04:49:44,767
AND GUT.

6615
04:49:44,834 --> 04:49:52,775
SO I IF YOU HAVE A MESSED UP GUT

6616
04:49:52,842 --> 04:49:54,944
MICROBIOME, YOUR -- IS GOING TO

6617
04:49:55,010 --> 04:49:56,145
FALL BUT WE DON'T LIVE IN

6618
04:49:56,212 --> 04:49:57,480
ISOLATION SO OF COURSE THIS

6619
04:49:57,546 --> 04:49:59,882
BRAIN-GUT SYSTEM IS INFLUENCED

6620
04:49:59,949 --> 04:50:04,820
BY ENVIRONMENTAL FACTORS SUCH AS

6621
04:50:04,887 --> 04:50:05,187
DISCRIMINATION.

6622
04:50:05,254 --> 04:50:06,789
I'M GOING TO TALK ABOUT A COUPLE

6623
04:50:06,856 --> 04:50:11,060
STUDIES WHERE WE TALK ABOUT THE

6624
04:50:11,127 --> 04:50:12,561
EFFECT OF -- HOW IT ALTERS THE

6625
04:50:12,628 --> 04:50:15,531
BRAIN IN RESPONSE TO FOOD CUES,

6626
04:50:15,598 --> 04:50:22,838
WE ALSO LOOK AT HOW IT ALTERS --

6627
04:50:22,905 --> 04:50:23,739
AFFECTS THAT CROSSTALK BETWEEN

6628
04:50:23,806 --> 04:50:26,675
THE GRAIN AND BRAIN AND GUT MIC.

6629
04:50:26,742 --> 04:50:34,984
SO WE HAD 107 PARTICIPANTS.

6630
04:50:35,050 --> 04:50:36,952
VALIDATED SCALE WHERE IT ASKED

6631
04:50:37,019 --> 04:50:39,255
ABOUT CHRONIC EXPOSURE TO

6632
04:50:39,321 --> 04:50:40,656
DISCRIMINATION SO YOU ASK

6633
04:50:40,723 --> 04:50:45,895
QUESTIONS ABOUT HOW OFTEN YOU --

6634
04:50:45,961 --> 04:50:49,398
A WHOLE BUNCH OF QUESTIONNAIRE

6635
04:50:49,465 --> 04:50:51,801
BEHAVIORAL DATA, DIET

6636
04:50:51,867 --> 04:50:53,035
INFORMATION, WE PUT IT IN A

6637
04:50:53,102 --> 04:50:54,637
SCANNER AND SHOW PICTURE OF

6638
04:50:54,703 --> 04:50:59,575
FOOD, THEN WE ALSO COLLECTED --

6639
04:50:59,642 --> 04:51:01,177
THEIR METABOLITES.

6640
04:51:01,243 --> 04:51:03,379
WHEN WE STRATIFY BY RACE AND

6641
04:51:03,445 --> 04:51:05,981
ETHNICITY, ALL RACES EXPERIENCE

6642
04:51:06,048 --> 04:51:06,549
DISCRIMINATION.

6643
04:51:06,615 --> 04:51:08,184
LET ME SAY THAT AGAIN.

6644
04:51:08,250 --> 04:51:10,019
ALL RACES EXPERIENCE

6645
04:51:10,085 --> 04:51:14,757
DISCRIMINATION.

6646
04:51:14,824 --> 04:51:16,358
SO YES, YOU CAN SEE THE BLUE BAR

6647
04:51:16,425 --> 04:51:17,927
IS A LITTLE LARGER BUT THERE

6648
04:51:17,993 --> 04:51:20,129
WERE NO SIGNIFICANT DIFFERENCES

6649
04:51:20,196 --> 04:51:24,066
IN DISCRIMINATION BETWEEN THE

6650
04:51:24,133 --> 04:51:25,267
DIFFERENT RACIAL GROUPS,

6651
04:51:25,334 --> 04:51:27,837
HOWEVER, WHAT WAS DIFFERENT WAS

6652
04:51:27,903 --> 04:51:30,806
WHAT THEY ATTRIBUTED

6653
04:51:30,873 --> 04:51:31,507
DISCRIMINATION TO.

6654
04:51:31,574 --> 04:51:33,676
SO FOR EXAMPLE, WHEN YOU LOOK AT

6655
04:51:33,742 --> 04:51:38,280
BLACK, YOU SEE -- ASSOCIATED

6656
04:51:38,347 --> 04:51:41,250
WITH RACE/ETHNICITY OR SKIN

6657
04:51:41,317 --> 04:51:43,652
COLOR, WHEREAS WHEN YOU LOOK AT

6658
04:51:43,719 --> 04:51:46,055
WHITE, YOU SEE THEY ATTRIBUTE TO

6659
04:51:46,121 --> 04:51:48,157
THINGS LIKE GENDER OR RELIGION.

6660
04:51:48,224 --> 04:51:55,798
AND WHAT WE DID WAS WHEN WE

6661
04:51:55,865 --> 04:51:58,901
DIVIDED THE GROUP BY HIGH

6662
04:51:58,968 --> 04:52:02,371
DISCRIMINATION WILLOW -- WE ACTY

6663
04:52:02,438 --> 04:52:05,007
HAVE LOWER LEVELS OF

6664
04:52:05,074 --> 04:52:05,541
SOCIOECONOMIC STATUS.

6665
04:52:05,608 --> 04:52:07,142
THEN WHEN WE WERE TRYING TO LOOK

6666
04:52:07,209 --> 04:52:12,615
AT HOW DISCRIMINATION IMACTS THE

6667
04:52:12,681 --> 04:52:14,016
BRAIN -- WE HAVE THESE HIGH

6668
04:52:14,083 --> 04:52:20,155
CALORIE SA SAVORY FOODS, THEN WE

6669
04:52:20,222 --> 04:52:21,891
HAVE HIGH CALORIE SWEET FOODS,

6670
04:52:21,957 --> 04:52:23,425
THINK ABOUT DESSERTS, CAKES,

6671
04:52:23,492 --> 04:52:25,194
THINGS LIKE THAT, ICE CREAM.

6672
04:52:25,261 --> 04:52:33,602
WE ALSO HAVE LOW CALORIE SWEETS

6673
04:52:33,669 --> 04:52:35,804
LIKE FRUITS AND CONTROL -- WHAT

6674
04:52:35,871 --> 04:52:37,873
WE FOUND IS WHEN THEY WERE

6675
04:52:37,940 --> 04:52:42,912
LOOKING AT THESE HIGH CALORIE --

6676
04:52:42,978 --> 04:52:45,881
DISCRIMINATION TO -- HIGHER

6677
04:52:45,948 --> 04:52:48,384
CRAVINGS BUT SURPRISINGLY OR NOT

6678
04:52:48,450 --> 04:52:49,051
SURPRISINGLY, DISCRIMINATION DID

6679
04:52:49,118 --> 04:52:52,788
NOT HAVE AN AFFECT ON -- HEALTHY

6680
04:52:52,855 --> 04:52:53,022
FOODS.

6681
04:52:53,088 --> 04:52:56,625
WHEN WE LOOKED AT -- WE SAW

6682
04:52:56,692 --> 04:52:59,128
INCREASED ACTIVITY IN THE --

6683
04:52:59,194 --> 04:53:03,732
WHICH IS ASSOCIATED WITH THE --

6684
04:53:03,799 --> 04:53:07,903
AND -- UNHEALTHY SAVORY FOODS WE

6685
04:53:07,970 --> 04:53:11,006
ALSO SAW -- INCREASED ACTIVITY

6686
04:53:11,073 --> 04:53:13,342
IN THE ORBITOFRONTOCORTEX, BUT

6687
04:53:13,409 --> 04:53:14,910
WHAT'S INTERESTING ABOUT THE

6688
04:53:14,977 --> 04:53:16,745
FRONTAL CORTEX IS IT'S ALSO

6689
04:53:16,812 --> 04:53:19,348
RELATED TO EMOTIONAL MEMORY, AND

6690
04:53:19,415 --> 04:53:20,683
THEY WERE LOOKING AT PICTURES OF

6691
04:53:20,749 --> 04:53:23,619
HEALTHY FOODS WE SAW INCREASED

6692
04:53:23,686 --> 04:53:24,420
ACTIVITY IN THE MIDDLE AND

6693
04:53:24,486 --> 04:53:27,056
SUPERIOR FRONTAL GYRUS AND --

6694
04:53:27,122 --> 04:53:29,224
CONTROL ACTIVITY.

6695
04:53:29,291 --> 04:53:32,294
WHEN WE'RE LOOKING AT -- WE SAW

6696
04:53:32,361 --> 04:53:33,295
HOW DISCRIMINATION IS ASSOCIATED

6697
04:53:33,362 --> 04:53:39,068
WITH HIGHER LEVELS OF THE GUT

6698
04:53:39,134 --> 04:53:42,905
METABOLITES, SPECIFICALLY

6699
04:53:42,972 --> 04:53:44,239
GLUTAMATE -- THINGS LIKE

6700
04:53:44,306 --> 04:53:48,310
OXIDATIVE STRESS, INFLAMMATION,

6701
04:53:48,377 --> 04:53:49,945
ACCELERATED AGING.

6702
04:53:50,012 --> 04:53:54,883
THEN WE LOOKED IT LOOKED AT THEK

6703
04:53:54,950 --> 04:53:58,687
BETWEEN THE BRAIN AND THE GUT,

6704
04:53:58,754 --> 04:54:03,192
ONE YOU HEALTHY SWEET, UNHEALTHY

6705
04:54:03,258 --> 04:54:06,261
SAVORY -- DISCRIMINATION IN THE

6706
04:54:06,328 --> 04:54:08,564
BRAIN AND GUT BUT ALSO

6707
04:54:08,630 --> 04:54:09,565
SIGNIFICANT INTERACTION BETWEEN

6708
04:54:09,631 --> 04:54:10,332
THE GUT AND THE BRAIN.

6709
04:54:10,399 --> 04:54:11,934
BUT THIS WAS NOT PRESENT WHEN WE

6710
04:54:12,001 --> 04:54:13,702
WERE LOOKING AT THESE UNHEALTHY

6711
04:54:13,769 --> 04:54:18,107
SWEET FOODS OR THESE HEALTHY

6712
04:54:18,173 --> 04:54:18,974
SAVORY FOODS.

6713
04:54:19,041 --> 04:54:20,743
AND THEN FOR THE SECOND STUDY,

6714
04:54:20,809 --> 04:54:25,347
WE WANTED TO LOOK AT THE

6715
04:54:25,414 --> 04:54:27,750
RELATIONSHIP OF THE BRAIN AND

6716
04:54:27,816 --> 04:54:29,518
GUT MICROBIOME IN BEHAVIORAL

6717
04:54:29,585 --> 04:54:31,053
DATA IN RESPONSE TO

6718
04:54:31,120 --> 04:54:33,555
DISCRIMINATION, SO WE HAD 154

6719
04:54:33,622 --> 04:54:33,989
PARTICIPANTS.

6720
04:54:34,056 --> 04:54:44,400
WE COLLECTED -- DA DATA -- ALSO

6721
04:54:44,466 --> 04:54:45,401
COLLECTED INFLAMMATORY MARKERS.

6722
04:54:45,467 --> 04:54:48,470
AND AS YOU CAN SEE, HIGH DISCELL

6723
04:54:48,537 --> 04:54:52,307
NADISCRIMINATION COMPARED TO LOW

6724
04:54:52,374 --> 04:54:55,344
DISCRIMINATION, PRETTY MUCH --

6725
04:54:55,411 --> 04:54:56,445
ANXIETY, DEPRESSION, MENTAL

6726
04:54:56,512 --> 04:55:00,849
HEALTH, IF PHYSICAL HEALTH SY

6727
04:55:00,916 --> 04:55:02,818
SYMPTOMS, STRESS, CAUSATIVE

6728
04:55:02,885 --> 04:55:03,986
MEASURES, THERE WERE SIGNIFICANT

6729
04:55:04,053 --> 04:55:05,754
DIFFERENCES BETWEEN HIGH

6730
04:55:05,821 --> 04:55:06,221
DISCRIMINATION AND LOW

6731
04:55:06,288 --> 04:55:07,056
DISCRIMINATION GROUP.

6732
04:55:07,122 --> 04:55:08,290
AND THEN IN ORDER TO KIND OF

6733
04:55:08,357 --> 04:55:10,459
LOOK AT HOW THESE DIFFERENT

6734
04:55:10,526 --> 04:55:13,195
DATASETS ACTUALLY KIND OF WORK

6735
04:55:13,262 --> 04:55:14,530
TOGETHER OR COME TOGETHER IN

6736
04:55:14,596 --> 04:55:16,065
RESPONSE TO DISCRIMINATION, WE

6737
04:55:16,131 --> 04:55:18,233
STRATIFIED BY RACE AND ETHNICITY

6738
04:55:18,300 --> 04:55:24,473
AND WE CREATED THESE

6739
04:55:24,540 --> 04:55:25,140
CONNECTOGRAMS, WALK THROUGH THIS

6740
04:55:25,207 --> 04:55:26,341
REALLY QUICKLY.

6741
04:55:26,408 --> 04:55:28,744
SO WE PULLED OUT THE DIFFERENT

6742
04:55:28,811 --> 04:55:32,381
DATASETS AND THEN WE --

6743
04:55:32,448 --> 04:55:33,682
CORRELATION ACROSS THE DATASETS.

6744
04:55:33,749 --> 04:55:36,285
SO IF THERE WAS A POSSIBLE

6745
04:55:36,351 --> 04:55:38,520
CORRELATION TO THE RED LINE,

6746
04:55:38,587 --> 04:55:39,188
NEGATIVE CORRELATION, IT'S A

6747
04:55:39,254 --> 04:55:39,755
BLUE LINE.

6748
04:55:39,822 --> 04:55:44,560
AND WE ALSO PLOTTED THE -- SO

6749
04:55:44,626 --> 04:55:46,428
THE THICKER LINE WITH THE

6750
04:55:46,495 --> 04:55:47,429
GREATER RELATIONSHIP.

6751
04:55:47,496 --> 04:55:52,668
AND WHAT WE FOUND, IF YOU JUST

6752
04:55:52,734 --> 04:55:54,336
LOOK AT THIS -- WE CAN SEE THAT

6753
04:55:54,403 --> 04:55:56,405
THERE ARE LESS LINES, OR LESS

6754
04:55:56,472 --> 04:55:58,707
ASSOCIATIONS WITH THE BLACK

6755
04:55:58,774 --> 04:56:00,876
GROUP THAN THE -- FROM HISPANIC

6756
04:56:00,943 --> 04:56:03,645
TO ASIAN TO WHITE, YOU SEE THOSE

6757
04:56:03,712 --> 04:56:04,179
GREATER CORRELATIONS.

6758
04:56:04,246 --> 04:56:06,048
SO IF WE TAKE A DEEPER DIVE,

6759
04:56:06,115 --> 04:56:07,549
WHAT WE FOUND WITH THE BLACK AND

6760
04:56:07,616 --> 04:56:10,319
THE HISPANIC GROUP WAS THAT

6761
04:56:10,385 --> 04:56:11,854
THERE WERE MORE CORRELATIONS,

6762
04:56:11,920 --> 04:56:14,156
MORE ASSOCIATIONS BETWEEN

6763
04:56:14,223 --> 04:56:18,760
DISCRIMINATION AND METABOLIZE

6764
04:56:18,827 --> 04:56:22,164
THE -- AND -- MARKERS.

6765
04:56:22,231 --> 04:56:23,465
HOWEVER THERE WERE CORRELATIONS

6766
04:56:23,532 --> 04:56:26,201
WITH BRAIN REGIONS.

6767
04:56:26,268 --> 04:56:29,605
THE BRAIN REGIONS THAT WERE

6768
04:56:29,671 --> 04:56:30,572
INVOLVED -- ASSOCIATED WITH

6769
04:56:30,639 --> 04:56:32,241
EXECUTIVE CONTROL AND --

6770
04:56:32,307 --> 04:56:32,674
NETWORK.

6771
04:56:32,741 --> 04:56:33,976
WHAT THAT PROBABLY SUGGESTS IS

6772
04:56:34,042 --> 04:56:36,411
THAT THERE'S THIS TOP-DOWN KIND

6773
04:56:36,478 --> 04:56:40,782
OF -- THAT WENT ON WHICH

6774
04:56:40,849 --> 04:56:42,918
SUGGESTS -- COPING MEMO NIRK OR

6775
04:56:42,985 --> 04:56:53,262
THIMECHANISM --BUT -- DISCRIMIN-

6776
04:56:53,328 --> 04:56:58,901
MANIFESTING MORE AS INFLAMMATORY

6777
04:56:58,967 --> 04:57:00,769
PROCESS -- INFLAMMATORY MARKERS.

6778
04:57:00,836 --> 04:57:03,071
AND WHAT WE SEE WITH BLACK

6779
04:57:03,138 --> 04:57:04,106
INDIVIDUALS IS GREATER

6780
04:57:04,173 --> 04:57:06,041
FORMATIONS IN THINGS LIKE

6781
04:57:06,108 --> 04:57:09,211
ANXIETY, DEPRESSION -- THERE WAS

6782
04:57:09,278 --> 04:57:13,482
ALSO INCREASED BRAIN ACTIVITY

6783
04:57:13,549 --> 04:57:18,554
IN -- REGIONS AND -- AND WITH

6784
04:57:18,620 --> 04:57:20,189
ASIANS, WE ALSO SAW INCREASED

6785
04:57:20,255 --> 04:57:23,392
CORRELATION OF -- DEPRESSION --

6786
04:57:23,458 --> 04:57:24,693
MORE ASSOCIATED WITH

6787
04:57:24,760 --> 04:57:25,894
SOMATOSENSORY REGIONS, SO KIND

6788
04:57:25,961 --> 04:57:31,600
OF LOOKING AT SOCIAL -- REGIONS,

6789
04:57:31,667 --> 04:57:34,903
WE ALSO SAW METABOLITES WERE

6790
04:57:34,970 --> 04:57:37,973
LINKED TO CHOLESTEROL, SO AGAIN,

6791
04:57:38,040 --> 04:57:40,676
THINKING THAT -- MORE OF THE --

6792
04:57:40,742 --> 04:57:42,778
USING FOOD AS A WAY OF COPING

6793
04:57:42,844 --> 04:57:44,546
WITH STRESSFUL RESPONSES.

6794
04:57:44,613 --> 04:57:46,181
THEN WITH THIS STUDY WHAT WE DID

6795
04:57:46,248 --> 04:57:49,851
IS WE LOOKED AT HOW LIVING IN A

6796
04:57:49,918 --> 04:57:51,687
DISADVANTAGED NEIGHBORHOOD

6797
04:57:51,753 --> 04:57:54,223
ACTUALLY IMPACTS THESE WEIGHT

6798
04:57:54,289 --> 04:57:56,592
STRUCTURES AND -- PATTERNS.

6799
04:57:56,658 --> 04:57:58,760
SO -- WE LOOKED AT 17 DIFFERENT

6800
04:57:58,827 --> 04:58:01,830
KIND OF MEASURES, THINGS LIKE

6801
04:58:01,897 --> 04:58:08,203
EDUCATION, -- FOOD, HOW SAFE A

6802
04:58:08,270 --> 04:58:09,171
NEIGHBORHOOD IT IS, AND WE KIND

6803
04:58:09,238 --> 04:58:11,373
OF CALCULATED THIS BASED UPON

6804
04:58:11,440 --> 04:58:11,974
THEIR ZIP CODE.

6805
04:58:12,040 --> 04:58:15,711
AND WHAT WE FOUND WAS THAT THE

6806
04:58:15,777 --> 04:58:18,614
HIGHER OF AREA OF DEPRIVATION,

6807
04:58:18,680 --> 04:58:21,350
THE MORE ALTERATIONS IN THE

6808
04:58:21,416 --> 04:58:24,653
BRAIN, BUT HIGHER EDI WAS ALSO

6809
04:58:24,720 --> 04:58:26,989
ASSOCIATED WITH GREATER BMI, SO

6810
04:58:27,055 --> 04:58:28,824
GREATER OBESITY AND GREATER

6811
04:58:28,890 --> 04:58:30,058
INTAKE OF TRANS FATTY ACIDS

6812
04:58:30,125 --> 04:58:31,460
WHICH IS SOMETHING WE FIND IN

6813
04:58:31,526 --> 04:58:32,027
FAST FOODS.

6814
04:58:32,094 --> 04:58:33,195
SO WHAT DO WE SEE?

6815
04:58:33,262 --> 04:58:35,864
WE SEE THAT THERE ARE NOVEL

6816
04:58:35,931 --> 04:58:36,298
ASSOCIATIONS BETWEEN

6817
04:58:36,365 --> 04:58:38,267
DISCRIMINATION AND LINKED TO

6818
04:58:38,333 --> 04:58:40,335
ALTERATIONS IN THE BRAIN AND THE

6819
04:58:40,402 --> 04:58:41,670
GUT MICROBIOME IMMUNE SYSTEM.

6820
04:58:41,737 --> 04:58:42,938
WE SEE THAT DISCRIMINATION

6821
04:58:43,005 --> 04:58:44,339
THAT'S BASED UPON RACE AND SKIN

6822
04:58:44,406 --> 04:58:47,609
COLOR LEADS TO CHANGES WITHIN

6823
04:58:47,676 --> 04:58:52,547
THOSE BRAIN-GUT -- MORE SKEWED

6824
04:58:52,614 --> 04:58:53,181
TOWARDS INFLAMMATION.

6825
04:58:53,248 --> 04:58:54,616
WE ALSO SEE DISCRIMINATION BASED

6826
04:58:54,683 --> 04:58:57,152
ON OTHER REASONS SUCH AS GENDER

6827
04:58:57,219 --> 04:58:58,553
OR RELIGION WHICH IS NOT AS

6828
04:58:58,620 --> 04:59:03,492
VISIBLE LEADS TO MORE ADVERSE --

6829
04:59:03,558 --> 04:59:05,260
REGIONS, MORE ANXIETY AND

6830
04:59:05,327 --> 04:59:06,161
DEPRESSION, WHICH KIND OF MAKES

6831
04:59:06,228 --> 04:59:07,262
SENSE BECAUSE WHEN YOU'RE

6832
04:59:07,329 --> 04:59:11,633
LOOKING AT THIS -- BASED

6833
04:59:11,700 --> 04:59:14,603
DISCRIMINATION -- RACE AND

6834
04:59:14,670 --> 04:59:16,571
ETHNICITY -- IT CAN GET AWAY

6835
04:59:16,638 --> 04:59:19,641
FROM WHAT'S REALLY VISIBLE, WHEN

6836
04:59:19,708 --> 04:59:21,310
YOU'RE LOOKING AT SOMEBODY LIKE

6837
04:59:21,376 --> 04:59:23,812
GENDER OR RELIGION THAT ISN'T AS

6838
04:59:23,879 --> 04:59:27,649
VIVISIBLE -- AND SO MAYBE THESE

6839
04:59:27,716 --> 04:59:32,154
FINDINGS KIND OF HIGHLIGHT HOW

6840
04:59:32,220 --> 04:59:33,021
DISCRIMINATION ACTUALLY LEADS TO

6841
04:59:33,088 --> 04:59:33,689
HEALTH DISPARITIES.

6842
04:59:33,755 --> 04:59:38,927
WE ALSO SEE THAT -- LEVEL OF

6843
04:59:38,994 --> 04:59:40,128
DISCRIMINATION IS ASSOCIATED

6844
04:59:40,195 --> 04:59:41,163
WITH PROCESSES LEADING TO

6845
04:59:41,229 --> 04:59:42,898
REWARD, TO EXECUTIVE CONTROL.

6846
04:59:42,964 --> 04:59:45,634
BUT THESE ARE VERY DEPENDENT

6847
04:59:45,701 --> 04:59:46,968
UPON THE TYPE OF FOOD WE'RE

6848
04:59:47,035 --> 04:59:47,436
EATING.

6849
04:59:47,502 --> 04:59:51,673
WE ALSO SEE THAT ALTERED

6850
04:59:51,740 --> 04:59:54,209
GLUTAMATE PATHWAY METABOLITES

6851
04:59:54,276 --> 04:59:55,811
CONTRIBUTING TO OXIDATIVE STRESS

6852
04:59:55,877 --> 04:59:57,846
AND INFLAMMATION, ACTUALLY

6853
04:59:57,913 --> 04:59:59,348
ACCELERATED AGING.

6854
04:59:59,414 --> 05:00:01,116
AND THEN THIS BRAIN-GUT

6855
05:00:01,183 --> 05:00:02,417
COMMUNICATION WHERE WE ONLY SEE

6856
05:00:02,484 --> 05:00:04,319
THIS IN FOODS WHICH TO BE HONEST

6857
05:00:04,386 --> 05:00:06,054
MAKES SENSE BECAUSE WE KNOW THAT

6858
05:00:06,121 --> 05:00:07,856
SWEET FOODS ARE HIGHLY

6859
05:00:07,923 --> 05:00:08,724
ADDICTIVE, WE KNOW THAT THEY

6860
05:00:08,790 --> 05:00:09,825
CAUSE INCREASED CRAVINGS.

6861
05:00:09,891 --> 05:00:13,729
IN FACT, IF YOU TRY TO --

6862
05:00:13,795 --> 05:00:15,397
BACTERIA IN FAT, IT WON'T GROW,

6863
05:00:15,464 --> 05:00:17,699
BUT IF YOU TRY TO GROW BA BACTEA

6864
05:00:17,766 --> 05:00:19,000
IN SWEET FOODS, IT WILL GROW.

6865
05:00:19,067 --> 05:00:23,338
SO WE DO THAT WHEN WE SEE THESE

6866
05:00:23,405 --> 05:00:25,707
ALTERATIONS, WHERE AGAIN -- SO

6867
05:00:25,774 --> 05:00:30,212
WITH THAT, WE -- SOME

6868
05:00:30,278 --> 05:00:31,980
PRELIMINARY EVIDENCE OF HOW

6869
05:00:32,047 --> 05:00:35,817
DISCRIMINATION DOES IMPACT --

6870
05:00:35,884 --> 05:00:38,453
MANIFEST IN OUR BODIES, THIS

6871
05:00:38,520 --> 05:00:41,323
KIND OF WHOLE BODY SYSTEM AND

6872
05:00:41,390 --> 05:00:44,292
EVEN GIVES -- TO THE STATEMENT

6873
05:00:44,359 --> 05:00:50,532
THAT RACISM PLAIX ME SICK TO MYY

6874
05:00:50,599 --> 05:00:50,766
STOMACH.

6875
05:00:50,832 --> 05:00:53,034
SO I WANT TO THANK EVERYBODY,

6876
05:00:53,101 --> 05:00:55,470
FOR FUNDING, AND WITH THAT

6877
05:00:55,537 --> 05:00:57,439
SHAMEFUL PITCH, WE WATCHED OUR

6878
05:00:57,506 --> 05:01:00,942
CENTER, OUR GOODMAN LUSKIN

6879
05:01:01,009 --> 05:01:01,877
MICROBIOME CENTER LAST YEAR AND

6880
05:01:01,943 --> 05:01:04,146
WE'RE LOOKING FOR POSTDOCS AND

6881
05:01:04,212 --> 05:01:07,649
WE ALSO HAVE -- [INAUDIBLE].

6882
05:01:07,716 --> 05:01:11,420
SO PLEASE WATCH.

6883
05:01:11,486 --> 05:01:17,192
[APPLAUSE]

6884
05:01:17,259 --> 05:01:17,726
>> THANK YOU VERY MUCH.

6885
05:01:17,793 --> 05:01:22,864
OUR NEXT SPEAKER IS DR. ADOLFO

6886
05:01:22,931 --> 05:01:24,065
CUEVAS, HE WILL BE GIVING A

6887
05:01:24,132 --> 05:01:25,300
DISCUSSION ON DISCRIMINATION

6888
05:01:25,367 --> 05:01:29,337
EXPOSURE AND INFLAMMATION.

6889
05:01:29,404 --> 05:01:33,909
>> GOOD AFTERNOON.

6890
05:01:33,975 --> 05:01:37,546
I RECOGNIZE THAT I AM ACTUALLY

6891
05:01:37,612 --> 05:01:38,680
CARRINGTON AND I ARE BETWEEN YOU

6892
05:01:38,747 --> 05:01:41,683
AND A DRINK.

6893
05:01:41,750 --> 05:01:46,488
SO I'M GOING TO EMBODY MY

6894
05:01:46,555 --> 05:01:50,459
MAIN -- TALK TODAY IN THE SLIDES

6895
05:01:50,525 --> 05:01:55,397
COULD WORK WELL WITH ME.

6896
05:01:55,464 --> 05:02:06,007
[INAUDIBLE] SO I WILL BE TALKING

6897
05:02:09,077 --> 05:02:10,345
ABOUT DISCRIMINATION EXPOSURE

6898
05:02:10,412 --> 05:02:13,148
AND INFLAMMATION, AND I WOULD

6899
05:02:13,215 --> 05:02:18,620
LOVE TO REALLY PROVIDE A --

6900
05:02:18,687 --> 05:02:20,155
DR. MORRIS EARLY THIS MORNING

6901
05:02:20,222 --> 05:02:20,722
PROVIDED A REALLY GOOD

6902
05:02:20,789 --> 05:02:22,357
FOUNDATION FOR WHY WE EVEN STUDY

6903
05:02:22,424 --> 05:02:26,228
DISCRIMINATION AND HOW HEALTH IE

6904
05:02:26,294 --> 05:02:27,696
FIRST PLACE, BUT IF YOU COULD

6905
05:02:27,762 --> 05:02:29,130
BEAR WITH ME, I'D LOVE TO AT

6906
05:02:29,197 --> 05:02:31,233
LEAST TAKE US DOWN MEMORY LANE

6907
05:02:31,299 --> 05:02:33,635
QUICKLY TO REALLY PROVIDE

6908
05:02:33,702 --> 05:02:35,036
FOUNDATION FOR WHY DO WE EVEN

6909
05:02:35,103 --> 05:02:36,271
WANT TO TALK ABOUT

6910
05:02:36,338 --> 05:02:37,873
DISCRIMINATION AS A SOCIAL

6911
05:02:37,939 --> 05:02:40,642
DETERMINANT OF NOT JUST

6912
05:02:40,709 --> 05:02:41,743
INDIVIDUAL HEALTH, POPULATION

6913
05:02:41,810 --> 05:02:43,712
HEALTH, AND ALSO WHY

6914
05:02:43,778 --> 05:02:48,850
INFLAMMATION SHOULD BE -- A

6915
05:02:48,917 --> 05:02:54,155
PARTICULAR -- SHOULD BE LOOKING

6916
05:02:54,222 --> 05:02:54,322
AT.

6917
05:02:54,389 --> 05:02:55,590
I THINK A LOT OF THIS IS

6918
05:02:55,657 --> 05:02:56,791
MOTIVATED BY THE PERSISTENT

6919
05:02:56,858 --> 05:02:58,293
BLACK AND WHITE DISPARITIES THAT

6920
05:02:58,360 --> 05:03:03,698
WE SEE HERE IN THE UNITED STA

6921
05:03:03,765 --> 05:03:04,366
STATES, WHERE BLACK AMERICANS

6922
05:03:04,432 --> 05:03:07,769
HAVE THE HIGHEST MORTALITY RATE,

6923
05:03:07,836 --> 05:03:11,840
EVEN WHEN WE LOOK INTO CHRONIC

6924
05:03:11,907 --> 05:03:13,241
DISEASE BURDEN, BLACK AMERICANS

6925
05:03:13,308 --> 05:03:14,843
REALLY SUFFER HIGHER RATES OF

6926
05:03:14,910 --> 05:03:15,510
CHRONIC DISEASE BURDEN FOR MANY

6927
05:03:15,577 --> 05:03:17,445
OF THE TOP 10 LEADING CAUSES OF

6928
05:03:17,512 --> 05:03:20,849
DEATH, INCLUDING HEART DISEASE,

6929
05:03:20,916 --> 05:03:21,950
DIABETES, ALZHEIMER'S DISEASE.

6930
05:03:22,017 --> 05:03:23,618
AS A RESULT, WHEN WE LOOKED INTO

6931
05:03:23,685 --> 05:03:25,487
LIFE EXPECTANCY, WHAT AMERICANS

6932
05:03:25,554 --> 05:03:27,789
HAVE SHORTER LIFE EXPECTANCY

6933
05:03:27,856 --> 05:03:29,324
COMPARED TO WHITE AMERICANS.

6934
05:03:29,391 --> 05:03:33,261
AND WHILE THERE HAVE BEEN

6935
05:03:33,328 --> 05:03:34,362
SIGNIFICANT GAINS OVER THE LAST

6936
05:03:34,429 --> 05:03:35,797
FEW DECADES, A LOT OF IT HAS

6937
05:03:35,864 --> 05:03:37,899
BEEN WASHED AWAY BY COVID-19 AND

6938
05:03:37,966 --> 05:03:39,668
WE'RE STARTING TO SEE THAT GAIN

6939
05:03:39,734 --> 05:03:41,169
BASICALLY PICK UP AGAIN IN THE

6940
05:03:41,236 --> 05:03:44,406
LAST TWO YEARS, BUT AS WE CAN

6941
05:03:44,472 --> 05:03:47,676
SEE HERE, BLACK AMERICANS TRAIL

6942
05:03:47,742 --> 05:03:49,010
BEHIND.

6943
05:03:49,077 --> 05:03:51,746
AND IT'S NOT SURPRISING THAT

6944
05:03:51,813 --> 05:03:56,251
FROM 1980 TO 1990s,

6945
05:03:56,318 --> 05:03:59,854
SOCIOECONOMIC STATUS IS -- NOT

6946
05:03:59,921 --> 05:04:02,157
JUST LIFE EXPECTANCY BUT CHRONIC

6947
05:04:02,223 --> 05:04:04,492
DISEASE BURDEN, AND THIS WAS --

6948
05:04:04,559 --> 05:04:06,161
AT THAT TIME, GIVEN THAT BLACK

6949
05:04:06,227 --> 05:04:08,463
AMERICANS AND EVEN HISPANIC

6950
05:04:08,530 --> 05:04:09,931
AMERICANS WERE OVERREPRESENTED

6951
05:04:09,998 --> 05:04:11,933
AT THE LOWER END OF THE

6952
05:04:12,000 --> 05:04:12,867
SOCIOECONOMIC STRATA, ESPECIALLY

6953
05:04:12,934 --> 05:04:15,170
IF WE LOOK INTO EDUCATION, WHICH

6954
05:04:15,236 --> 05:04:17,038
IS ONE OF THE STRONGEST

6955
05:04:17,105 --> 05:04:21,443
PREDICTORS OF HEALTH, JU EVEN JN

6956
05:04:21,509 --> 05:04:23,311
LOOKING AT BACHELOR'S DEGREE

6957
05:04:23,378 --> 05:04:23,945
ATTAINMENT, WHITE AMERICANS

6958
05:04:24,012 --> 05:04:26,448
CURRENTLY HAVE ABOUT -- OVER 40%

6959
05:04:26,514 --> 05:04:29,751
OF THEM HAVE A BACHELOR'S DEGREE

6960
05:04:29,818 --> 05:04:32,654
COMPARED TO JUST 26% OF BLACK

6961
05:04:32,721 --> 05:04:35,724
AMERICANS.

6962
05:04:35,790 --> 05:04:38,026
THIS WAS QUICKLY DISPROVEN IN

6963
05:04:38,093 --> 05:04:42,697
WORK BY DAVID WILLIAMS AND PAUL

6964
05:04:42,764 --> 05:04:44,532
BRAVEMAN SHOWING -- IN THIS

6965
05:04:44,599 --> 05:04:46,034
CASE, EDUCATION, WE STILL SEE

6966
05:04:46,101 --> 05:04:47,035
THAT BLACK AMERICANS HAVE

6967
05:04:47,102 --> 05:04:49,337
SHORTER LIFE EXPECTANCY COMPARED

6968
05:04:49,404 --> 05:04:50,939
TO THEIR WHITE COUNTERPARTS.

6969
05:04:51,006 --> 05:04:53,308
AND IN FACT, IN SOME OF THE

6970
05:04:53,375 --> 05:04:55,710
EARLY WORK, BRAVEMAN ACTUALLY

6971
05:04:55,777 --> 05:04:56,745
SHOWED THAT WHITE AMERICANS WITH

6972
05:04:56,811 --> 05:04:59,447
A HIGH SCHOOL DEGREE STILL LIVED

6973
05:04:59,514 --> 05:05:01,416
LONGER LIVES COMPARED TO BLACK

6974
05:05:01,483 --> 05:05:02,684
AMERICANS WITH A COLLEGE DEGREE

6975
05:05:02,751 --> 05:05:03,518
OR HIGHER.

6976
05:05:03,585 --> 05:05:06,921
THERE HAVE BEEN SIGNIFICANT

6977
05:05:06,988 --> 05:05:10,125
GAINS WITH REGARDS TO EDUCATION,

6978
05:05:10,191 --> 05:05:11,292
INCOME AND OCCUPATION WHEN IT

6979
05:05:11,359 --> 05:05:14,629
COMES TO LIFE EXPECTANCY,

6980
05:05:14,696 --> 05:05:16,264
BLACK-WHITE DISPARITIES.

6981
05:05:16,331 --> 05:05:19,134
SPECIFICALLY FOR BLACK MEN WITH

6982
05:05:19,200 --> 05:05:19,801
BACHELOR'S DEGREE AND THOSE

6983
05:05:19,868 --> 05:05:22,971
WITHOUT A BACHELOR'S DEGREE, BUT

6984
05:05:23,038 --> 05:05:25,273
WHAT THIS -- THIS STORY HERE,

6985
05:05:25,340 --> 05:05:27,242
WHICH IS THAT EDUCATION, INCOME

6986
05:05:27,308 --> 05:05:30,879
AND OCCUPATION DOES NOT FULLY

6987
05:05:30,945 --> 05:05:32,747
EXPLAIN BLACK-WHITE DISPARITIES

6988
05:05:32,814 --> 05:05:33,682
IN LIFE EXPECTANCY.

6989
05:05:33,748 --> 05:05:34,616
SO THE QUESTION IS HERE WHAT ARE

6990
05:05:34,683 --> 05:05:36,584
THE DRIVERS OF RACIAL HEALTH AND

6991
05:05:36,651 --> 05:05:38,386
EQUITY ABOVE AND BEYOND INCOME,

6992
05:05:38,453 --> 05:05:41,122
EDUCATION AND OCCUPATION?

6993
05:05:41,189 --> 05:05:44,859
AND I THINK THERE IS A LOT TO BE

6994
05:05:44,926 --> 05:05:46,494
SAID ABOUT POLICIES AND THE

6995
05:05:46,561 --> 05:05:51,099
ABSENCE OF POLICIES, MANY OF US

6996
05:05:51,166 --> 05:05:54,969
HAVE APPROACHED TODAY AND HOW

6997
05:05:55,036 --> 05:05:56,504
THEY HAVE -- I JUST CAN'T GET

6998
05:05:56,571 --> 05:05:59,240
INTO THAT TODAY BUT IF WE COULD

6999
05:05:59,307 --> 05:06:01,242
AT LEAST FOCUS AT THE

7000
05:06:01,309 --> 05:06:02,977
INTERPERSONAL LEVEL AND HOW THAT

7001
05:06:03,044 --> 05:06:04,245
IS A SOCIAL DETERMINANT OF

7002
05:06:04,312 --> 05:06:10,085
HEALTH AND HEALTH DISPARITIES,

7003
05:06:10,151 --> 05:06:12,454
WE SEE MANY OF THESISMS HAVE

7004
05:06:12,520 --> 05:06:14,422
CREATED OR INFLUENCED

7005
05:06:14,489 --> 05:06:15,190
DISCRIMINATION AT THE

7006
05:06:15,256 --> 05:06:17,025
INTERPERSONAL LEVEL.

7007
05:06:17,092 --> 05:06:21,362
AND WHAT WE ALL HAVE IN COMMON,

7008
05:06:21,429 --> 05:06:22,564
DISCRIMINATION BASED ON SEX,

7009
05:06:22,630 --> 05:06:25,600
RACE, SEXUAL ORIENTATION, FILL

7010
05:06:25,667 --> 05:06:26,701
IN THE BLANK, IS THAT

7011
05:06:26,768 --> 05:06:28,670
DISCRIMINATION REALLY CHALLENGES

7012
05:06:28,737 --> 05:06:34,175
A VICTIM'S SENSE OF BELONGING

7013
05:06:34,242 --> 05:06:35,610
AND ACCEPTANCE IN SOCIETY.

7014
05:06:35,677 --> 05:06:37,579
AND BEING JUDGED NEGATIVELY,

7015
05:06:37,645 --> 05:06:38,012
ESPECIALLY BASED ON

7016
05:06:38,079 --> 05:06:38,813
CHARACTERISTICS THAT YOU CANNOT

7017
05:06:38,880 --> 05:06:41,750
CHANGE, CAN LEAD TO FEELINGS OF

7018
05:06:41,816 --> 05:06:44,953
ISOLATION, SENSE OF

7019
05:06:45,019 --> 05:06:46,955
WORTHLESSNESS AND INADEQUACY.

7020
05:06:47,021 --> 05:06:48,790
THIS CAN ACTUALLY, OF COURSE,

7021
05:06:48,857 --> 05:06:52,193
DAMAGE ONE'S SELF-ESTEEM, AND

7022
05:06:52,260 --> 05:06:54,662
CAN ERODE A VICTIM'S

7023
05:06:54,729 --> 05:06:59,033
SELF-CONCEPT OF THEMSELVES.

7024
05:06:59,100 --> 05:07:01,336
THIS IS A PSYCHOLOGICAL SOCIAL

7025
05:07:01,402 --> 05:07:04,539
STRESSOR THAT ACTIVATES STRESS

7026
05:07:04,606 --> 05:07:05,206
PATHWAYS.

7027
05:07:05,273 --> 05:07:06,407
DAVID WILLIAMS REALLY WAS ABLE

7028
05:07:06,474 --> 05:07:10,445
TO SAY THAT THIS FORM OF

7029
05:07:10,512 --> 05:07:11,646
DISCRIMINATION OPERATE LIKE ANY

7030
05:07:11,713 --> 05:07:12,914
OTHER PSYCHOLOGICAL SOCIAL

7031
05:07:12,981 --> 05:07:14,249
STRESSOR, AND THEREFORE, YOU

7032
05:07:14,315 --> 05:07:16,084
COULD CATEGORIZE IT BASED ON

7033
05:07:16,151 --> 05:07:21,156
CHRONIC STRESS AND ACUTE STRESS.

7034
05:07:21,222 --> 05:07:22,824
IT'S A CONSTRUCT THAT TENDS TO

7035
05:07:22,891 --> 05:07:28,096
CAPTURE THE MORE INSISTENT FORMS

7036
05:07:28,163 --> 05:07:28,997
OF DISCRIM NA INTEREST

7037
05:07:29,063 --> 05:07:30,632
EXPERIENCE THAT TEND TO BE

7038
05:07:30,698 --> 05:07:35,003
SUBTLE IN NATURE.

7039
05:07:35,069 --> 05:07:36,337
BEING TREATED WITH LESS RESPECT

7040
05:07:36,404 --> 05:07:37,906
AND LESS CURRENCY.

7041
05:07:37,972 --> 05:07:39,808
WHEREAS MAJOR LIFETIME

7042
05:07:39,874 --> 05:07:41,376
DISCRIMINATION TENDS TO CAPTURE

7043
05:07:41,442 --> 05:07:45,880
MUCH MORAL ACUTE FORMS OF

7044
05:07:45,947 --> 05:07:47,248
DISCRIMINATORY -- THAT ARE

7045
05:07:47,315 --> 05:07:51,519
ANALOGOUS TO MAJOR -- OR BEING

7046
05:07:51,586 --> 05:07:54,355
INVOLVED IN A CAR ACCIDENT.

7047
05:07:54,422 --> 05:07:56,157
WHAT WE FOUND EARLY ON IN A

7048
05:07:56,224 --> 05:07:58,660
NATIONALLY REPRESENTATIVE STUDY

7049
05:07:58,726 --> 05:08:00,328
WAS THAT DISCRIMINATION WAS

7050
05:08:00,395 --> 05:08:02,831
ACTUALLY QUITE COMMON.

7051
05:08:02,897 --> 05:08:05,967
61% OF PARTICIPANTS REPORTED

7052
05:08:06,034 --> 05:08:07,268
EXPERIENCING ONE TYPE OF

7053
05:08:07,335 --> 05:08:09,904
EVERYDAY DISCRIMINATION.

7054
05:08:09,971 --> 05:08:12,173
34% OF PARTICIPANTS REPORTED

7055
05:08:12,240 --> 05:08:13,675
EXPERIENCING AT LEAST ONE TYPE

7056
05:08:13,741 --> 05:08:16,177
OF MAJOR DISCRIMINATION.

7057
05:08:16,244 --> 05:08:17,912
THIS IS NOT SURPRISING TO ANY OF

7058
05:08:17,979 --> 05:08:20,582
US TODAY, BUT THIS WAS PIVOTAL

7059
05:08:20,648 --> 05:08:24,953
WORK BACK IN 1999, THAT ALSO

7060
05:08:25,019 --> 05:08:28,256
SHOWED THAT THOSE WITH

7061
05:08:28,323 --> 05:08:29,757
MARGINALIZED IDENTITIES ARE MORE

7062
05:08:29,824 --> 05:08:35,730
LIKELY TO REPORT MORE -- THOSE

7063
05:08:35,797 --> 05:08:38,566
PRIVILEGED BY IDENTITIES.

7064
05:08:38,633 --> 05:08:41,202
ALSO, THOSE WHO REPORTED GREATER

7065
05:08:41,269 --> 05:08:43,204
MAJOR AND EVERYDAY

7066
05:08:43,271 --> 05:08:44,839
DISCRIMINATION WERE MORE LIKELY

7067
05:08:44,906 --> 05:08:47,375
TO HAVE HIGHER LEVELS OF

7068
05:08:47,442 --> 05:08:48,943
NONSPECIFIC PSYCHOLOGICAL

7069
05:08:49,010 --> 05:08:50,912
DISTRESS, AND MAJOR DEPRESSION.

7070
05:08:50,979 --> 05:08:52,981
THIS IS AFTER ADJUSTING FOR

7071
05:08:53,047 --> 05:08:53,982
SOCIOECONOMIC STATUS.

7072
05:08:54,048 --> 05:08:57,185
SINCE THEN, THERE HAS BEEN A LOT

7073
05:08:57,252 --> 05:08:59,954
OF WORK IN THIS AREA, SHOWING

7074
05:09:00,021 --> 05:09:00,922
THAT DISCRIMINATION IS

7075
05:09:00,989 --> 05:09:03,625
ASSOCIATED WITH A WIDE RANGE OF

7076
05:09:03,691 --> 05:09:04,893
DIFFERENT HEALTH OUTCOMES SUCH

7077
05:09:04,959 --> 05:09:07,862
AS PSYCHOLOGICAL DISTRESS,

7078
05:09:07,929 --> 05:09:11,399
NEGATIVE EMOTIONS AND NEGATIVE

7079
05:09:11,466 --> 05:09:12,500
AFFECTS.

7080
05:09:12,567 --> 05:09:13,668
-- ASSOCIATED WITH COGNITIVE

7081
05:09:13,735 --> 05:09:15,203
FUNCTION.

7082
05:09:15,270 --> 05:09:17,071
THERE HAS BEEN DECENT WORK IN

7083
05:09:17,138 --> 05:09:19,741
THE BEHAVIORAL PATHWAY REALM

7084
05:09:19,807 --> 05:09:22,477
SHOWING THAT DISCRIMINATION IS

7085
05:09:22,543 --> 05:09:25,880
ASSOCIATED WITH POOR SLEEP

7086
05:09:25,947 --> 05:09:27,081
QUALITY, SHORT SLEEP DURATION

7087
05:09:27,148 --> 05:09:28,716
AND EVEN THOSE WHO REPORT

7088
05:09:28,783 --> 05:09:30,518
DISCRIMINATION ARE MORE LIKELY

7089
05:09:30,585 --> 05:09:34,222
TO ENGAGE WITH COMPLEMENTARY AND

7090
05:09:34,289 --> 05:09:35,323
ALTERNATIVE MEDICINE.

7091
05:09:35,390 --> 05:09:36,991
I'M HERE TODAY TO TALK ABOUT

7092
05:09:37,058 --> 05:09:39,294
MORE OF THE BIOLOGICAL PROCESS,

7093
05:09:39,360 --> 05:09:42,797
YOU MAY ALSO FIND -- REALLY

7094
05:09:42,864 --> 05:09:44,866
GREAT WORK ALSO SHOWING THAT

7095
05:09:44,933 --> 05:09:46,567
DISCRIMINATION MAY ACTUALLY

7096
05:09:46,634 --> 05:09:49,938
OPERATE THROUGH CORTISOL AND THE

7097
05:09:50,004 --> 05:09:54,442
ACTIVATION OF THE APA ACCESS

7098
05:09:54,509 --> 05:09:56,711
WHERE PEOPLE HAVE MUCH MORE

7099
05:09:56,778 --> 05:09:58,179
FLATTER CORTISOL RHYTHMS.

7100
05:09:58,246 --> 05:10:01,916
FLOOND' ACTUALLY WHEN SHOWED

7101
05:10:01,983 --> 05:10:03,985
GREAT WORK SHOWING THAT

7102
05:10:04,052 --> 05:10:04,585
DISCRIMINATION IS ASSOCIATED

7103
05:10:04,652 --> 05:10:06,487
WITH WEIGHT GAIN AS WELL.

7104
05:10:06,554 --> 05:10:09,090
BULL IS INFLAMMATION A

7105
05:10:09,157 --> 05:10:09,757
BIOLOGICAL PROCESS THAT WE

7106
05:10:09,824 --> 05:10:11,292
SHOULD BE FOCUSING ON?

7107
05:10:11,359 --> 05:10:16,831
AND I SAY YES.

7108
05:10:16,898 --> 05:10:19,467
BEFORE I GO INTO THIS, I SHOULD

7109
05:10:19,534 --> 05:10:22,937
MENTION THAT WHAT DO WE MEAN BY

7110
05:10:23,004 --> 05:10:24,505
INFLAMMATION, POPULATION HEALTH,

7111
05:10:24,572 --> 05:10:26,374
YOU TEND TO SEE INFLAMMATION AS

7112
05:10:26,441 --> 05:10:27,375
SOMETHING NEGATIVE AND

7113
05:10:27,442 --> 05:10:31,079
ASSOCIATED WITH ADVERSE HEALTH

7114
05:10:31,145 --> 05:10:32,046
OUTCOMES.

7115
05:10:32,113 --> 05:10:34,082
BUT IT'S WORTH NOTING THAT

7116
05:10:34,148 --> 05:10:36,284
INFLAMMATION IS DESIGNED REALLY

7117
05:10:36,351 --> 05:10:39,587
TO PROTECT, AND IT WAS DESIGNED

7118
05:10:39,654 --> 05:10:42,023
TO FIGHT OFF PARASITES,

7119
05:10:42,090 --> 05:10:44,525
INFECTIONS, AND EVEN WOUNDS AND

7120
05:10:44,592 --> 05:10:54,469
OTHER FORMS OF DAMAGES.

7121
05:10:54,535 --> 05:10:58,673
SO THE CLASSIC INFLAMMATORY

7122
05:10:58,740 --> 05:11:00,308
RESPONSE IS TYPICALLY INDUCED BY

7123
05:11:00,375 --> 05:11:02,410
AN INFECTION, IT HAS A TIMELINE,

7124
05:11:02,477 --> 05:11:09,017
SHORT IN DURATION.

7125
05:11:09,083 --> 05:11:10,418
MONOCYTES TEND TO BE ACTIVATED,

7126
05:11:10,485 --> 05:11:13,187
A LOT OF THESE CHEMICAL

7127
05:11:13,254 --> 05:11:15,957
MEDIATORS TO REALLY ADDRESS THE

7128
05:11:16,024 --> 05:11:18,793
INFECTION OR THE 400 REGION THAT

7129
05:11:18,860 --> 05:11:22,964
MIGHT BE FLOATING IN YOUR GUT

7130
05:11:23,031 --> 05:11:23,564
STREAM.

7131
05:11:23,631 --> 05:11:25,366
SO THIS TENDS TO OPERATE FOR

7132
05:11:25,433 --> 05:11:27,435
OLDER ADULTS THE SAME WAY FOR

7133
05:11:27,502 --> 05:11:28,636
YOUNGER ADULTS, SO THERE'S NO

7134
05:11:28,703 --> 05:11:33,307
ASSOCIATION IN TERMS OF AN ACUTE

7135
05:11:33,374 --> 05:11:36,711
IINFLAMMATORY RESPONSE ASSOCIATD

7136
05:11:36,778 --> 05:11:37,812
WITH AGE.

7137
05:11:37,879 --> 05:11:38,613
BUT WE'RE REALLY NOT TALKING

7138
05:11:38,679 --> 05:11:40,448
ABOUT THE ONE ON THE RIGHT SIDE.

7139
05:11:40,515 --> 05:11:44,719
IT'S MUCH MORE SYSTEMIC --

7140
05:11:44,786 --> 05:11:45,553
INFLAMMATION.

7141
05:11:45,620 --> 05:11:46,854
THIS IS NOT NECESSARILY INDUCED

7142
05:11:46,921 --> 05:11:53,327
BY ANY FORM OF INFECTION.

7143
05:11:53,394 --> 05:11:55,196
IT TENDS TO BE LONG IN DURATION,

7144
05:11:55,263 --> 05:11:57,832
AND IT EXTENDS REALLY FOR A LONG

7145
05:11:57,899 --> 05:12:00,168
PERIOD OF TIME BUT ACTUALLY

7146
05:12:00,234 --> 05:12:03,538
CREATES COLLATERAL DAMAGE, WHERE

7147
05:12:03,604 --> 05:12:11,679
DAMAGING -- SO IT TENDS TO BE AT

7148
05:12:11,746 --> 05:12:13,881
THE POPULATION LEVEL ASSOCIATED

7149
05:12:13,948 --> 05:12:17,819
WITH AGE, THAT OLDER ADULT HAS

7150
05:12:17,885 --> 05:12:21,456
HIGH LEVELS OF CHRONIC

7151
05:12:21,522 --> 05:12:22,890
INFLAMMATION, IT'S AT A

7152
05:12:22,957 --> 05:12:24,992
SUBCLINICAL LEVEL.

7153
05:12:25,059 --> 05:12:28,463
IT'S THE -- BUT YET VERY, VERY

7154
05:12:28,529 --> 05:12:29,130
LOW.

7155
05:12:29,197 --> 05:12:34,735
SO WHILE T WHY THEN STUDY INFLAN

7156
05:12:34,802 --> 05:12:35,603
AND DISCRIMINATION?

7157
05:12:35,670 --> 05:12:37,672
WELL, FOR ONE, WE HAVE THESE

7158
05:12:37,738 --> 05:12:38,973
REALLY INTERESTING WHITE BLOOD

7159
05:12:39,040 --> 05:12:39,974
CELLS, MONOCYTES.

7160
05:12:40,041 --> 05:12:42,777
WE HAVE ABOUT FIVE TO 10 OF THEM

7161
05:12:42,844 --> 05:12:47,081
FLO10% OFTHEM FLOATING IN OUR

7162
05:12:47,148 --> 05:12:47,381
BLOODSTREAM.

7163
05:12:47,448 --> 05:12:48,649
THEY PLAY A REALLY INTERESTING

7164
05:12:48,716 --> 05:12:48,850
ROLE.

7165
05:12:48,916 --> 05:12:50,251
IF YOU ACTUALLY HAVE A FAVORITE

7166
05:12:50,318 --> 05:12:52,753
CELL, THIS IS ONE OF MY FAVORITE

7167
05:12:52,820 --> 05:12:54,689
CELLS, AND I THINK IT'S BECAUSE

7168
05:12:54,755 --> 05:12:57,492
IT TENDS TO BE QUITE RESPONSIVE.

7169
05:12:57,558 --> 05:12:59,560
THAT'S A VERY NERDY STATEMENT, I

7170
05:12:59,627 --> 05:13:01,762
RECOGNIZE.

7171
05:13:01,829 --> 05:13:04,098
INTENSITY, QUITE RESPOND SIEVE

7172
05:13:04,165 --> 05:13:08,035
TO WHERE WE BEHAVE, HOW WE

7173
05:13:08,102 --> 05:13:09,570
BASICALLY SEE THE WORLD AROUND

7174
05:13:09,637 --> 05:13:10,571
US.

7175
05:13:10,638 --> 05:13:12,673
THESE MONOCYTES ARE PLAYING A

7176
05:13:12,740 --> 05:13:15,743
REALLY INTERESTING ROLE.

7177
05:13:15,810 --> 05:13:17,278
THEY'RE -- AS ELLIOTT FRIEDMAN

7178
05:13:17,345 --> 05:13:19,747
WOULD SAY, YOU'RE FLOATING

7179
05:13:19,814 --> 05:13:20,715
AROUND THE TRUCK.

7180
05:13:20,781 --> 05:13:23,351
LET'S TRY TO DETECT A FOREIGN

7181
05:13:23,417 --> 05:13:23,751
AGENT.

7182
05:13:23,818 --> 05:13:28,422
AND IF THEY DO DETECT A FOREIGN

7183
05:13:28,489 --> 05:13:30,958
AGENT, THEY BASICALLY DUMP A LOT

7184
05:13:31,025 --> 05:13:32,426
OF THESE CHEMICAL MEDIATORS,

7185
05:13:32,493 --> 05:13:35,596
MANY OF US WOULD RECOGNIZE CRP

7186
05:13:35,663 --> 05:13:38,132
AND IL-6 AS SOME OF THESE

7187
05:13:38,199 --> 05:13:39,567
POTENTIAL MEDIATORS THAT TENDS

7188
05:13:39,634 --> 05:13:41,435
TO EVENTUALLY HEAL THAT WILL

7189
05:13:41,502 --> 05:13:43,838
PARTICULAR WOUND OR ATTACK THAT

7190
05:13:43,905 --> 05:13:46,040
INFECTION.

7191
05:13:46,107 --> 05:13:47,909
NOW, WHAT IS INTERESTING AS I

7192
05:13:47,975 --> 05:13:49,277
MENTIONED IS THAT THESE

7193
05:13:49,343 --> 05:13:51,245
MONOCYTES ARE QUITE SENSITIVE TO

7194
05:13:51,312 --> 05:13:55,716
HOW WE VIEW THE WORLD.

7195
05:13:55,783 --> 05:13:57,585
IN FACT, THEY ARE ACTIVATED BY

7196
05:13:57,652 --> 05:13:58,920
WHETHER WE ACTUALLY VIEW

7197
05:13:58,986 --> 05:13:59,921
SOMETHING IN THEIR ENVIRONMENT

7198
05:13:59,987 --> 05:14:01,122
AS QUITE THREATENING, WHETHER

7199
05:14:01,189 --> 05:14:03,991
IT'S PERCEIVED OR ACTUAL.

7200
05:14:04,058 --> 05:14:11,032
AND A BRAIN TENDS TO -- ON THE

7201
05:14:11,098 --> 05:14:13,434
PHYSIOLOGICAL BIOLOGICAL

7202
05:14:13,501 --> 05:14:16,070
SYSTEMS, PARTICULARLY THE -- AND

7203
05:14:16,137 --> 05:14:18,839
THE IMMUNE SYSTEM ACTIVATES

7204
05:14:18,906 --> 05:14:20,942
THESE MONOCYTES, BUT ONE OF THE

7205
05:14:21,008 --> 05:14:22,877
MORE INTERESTING THINGS AS WELL

7206
05:14:22,944 --> 05:14:24,312
ABOUT THESE MONOCYTES, NOT ONLY

7207
05:14:24,378 --> 05:14:27,448
DO THEY RELEASE THESE CHEMICAL

7208
05:14:27,515 --> 05:14:28,883
MEDIATORS LIKE DENDRITIC CELLS,

7209
05:14:28,950 --> 05:14:31,185
THEY ALSO TEND TO CONVERT

7210
05:14:31,252 --> 05:14:33,854
THEMSELVES INTO MICROPHAGES,

7211
05:14:33,921 --> 05:14:36,591
WHICH IS ACTUALLY PRETTY COOL.

7212
05:14:36,657 --> 05:14:39,627
ONE OF THE THINGS THAT'S

7213
05:14:39,694 --> 05:14:41,329
INFORMATION IS HOW WE VIEW THE

7214
05:14:41,395 --> 05:14:42,964
WORLD AROUND US AS WELL, GREAT

7215
05:14:43,030 --> 05:14:46,701
WORK OUT THERE SHOWING THAT HAVE

7216
05:14:46,767 --> 05:14:48,469
HIGH LEVELS OF INFLAMMATION TEND

7217
05:14:48,536 --> 05:14:51,806
TO VIEW -- WHEN THEY'RE EXPOSED

7218
05:14:51,872 --> 05:14:53,741
TO AN AK BIG WITH US EVENT, THEY

7219
05:14:53,808 --> 05:14:55,910
TEND TO VIEW THOSE AS QUITE

7220
05:14:55,977 --> 05:14:56,210
THREATENING.

7221
05:14:56,277 --> 05:14:58,012
SO THE OTHER REASON WHY I THINK

7222
05:14:58,079 --> 05:15:01,182
WE SHOULD LOOK INTO

7223
05:15:01,249 --> 05:15:04,018
INFLAMMATION, AS MENTIONED, YOU

7224
05:15:04,085 --> 05:15:08,022
BEGIN TO SEE OUR RATIO

7225
05:15:08,089 --> 05:15:09,190
DIFFERENCES REALLY EARLY ON IN

7226
05:15:09,257 --> 05:15:09,657
THE LIFE COURSE.

7227
05:15:09,724 --> 05:15:16,097
THIS IS WORK BY PB LAM, THAT

7228
05:15:16,163 --> 05:15:21,002
SHOWS IN THIS STUDY THAT BLACK

7229
05:15:21,068 --> 05:15:22,937
AMERICANS AS EARLY AS

7230
05:15:23,004 --> 05:15:24,538
ADOLESCENTS BEGIN TO EXHIBIT

7231
05:15:24,605 --> 05:15:26,307
HIGH LEVELS OF CHRONIC

7232
05:15:26,374 --> 05:15:33,047
INFLAMMATION COMPARED TO LIG WHE

7233
05:15:33,114 --> 05:15:33,481
AND ASIAN AMERICANS.

7234
05:15:33,547 --> 05:15:36,317
SO THESE TWO I GUESS FINDINGS

7235
05:15:36,384 --> 05:15:41,122
REALLY DROACH MY TEAM TO CONDUCT

7236
05:15:41,188 --> 05:15:44,225
A SYSTEMATIC REVIEW ON CURRENT

7237
05:15:44,292 --> 05:15:49,297
LITERATURE EX EXAMINING

7238
05:15:49,363 --> 05:15:49,697
INFLAMMATION.

7239
05:15:49,764 --> 05:15:52,400
I'VE GOT ABOUT 26 PAPERS THAT

7240
05:15:52,466 --> 05:15:53,934
EXAMINED THE ASSOCIATION BETWEEN

7241
05:15:54,001 --> 05:15:55,136
DISCRIMINATION AND INFLAMMATION.

7242
05:15:55,202 --> 05:15:55,970
WE FOUND COMPELLING EVIDENCE

7243
05:15:56,037 --> 05:15:57,171
THAT THERE IS AN ASSOCIATION

7244
05:15:57,238 --> 05:15:58,172
HERE.

7245
05:15:58,239 --> 05:16:00,241
ACTUALLY SOME OF THE GREAT WORK

7246
05:16:00,308 --> 05:16:04,478
BY TENE LEWIS SHOWED THAT THERE

7247
05:16:04,545 --> 05:16:07,381
IS BASICALLY A DOSE-RESPONSE

7248
05:16:07,448 --> 05:16:08,382
RELATIONSHIP BETWEEN EVERYDAY

7249
05:16:08,449 --> 05:16:09,817
INFLAMMATION AND C-REACTIVE

7250
05:16:09,884 --> 05:16:10,384
PROTEIN.

7251
05:16:10,451 --> 05:16:13,587
WORK BY ELLIOTT FREED PLAN

7252
05:16:13,654 --> 05:16:18,225
SHOWEFRIEDMAN SHOWEDTHAT SPECIFN

7253
05:16:18,292 --> 05:16:21,095
WHO REPORTED A MORE MAJOR

7254
05:16:21,162 --> 05:16:23,164
LIFETIME EXPOSURE TO

7255
05:16:23,230 --> 05:16:24,165
DISCRIMINATION HAD HIGH LEVELS

7256
05:16:24,231 --> 05:16:32,340
OF SERUM E E-SE ELECTIN.

7257
05:16:32,406 --> 05:16:37,345
SPECIFICALLY FOR THOSE REPORTING

7258
05:16:37,411 --> 05:16:39,513
DISCRIMINATION CONTEMPORANEOUSLY

7259
05:16:39,580 --> 05:16:42,249
BUT ALSO REPORTED EXPERIENCE OF

7260
05:16:42,316 --> 05:16:43,551
DISCRIMINATION IN EARLY LIFE AT

7261
05:16:43,617 --> 05:16:46,921
HIGHER LEVELS OF INFLAMMATION.

7262
05:16:46,987 --> 05:16:52,793
THIS WAS DIFFERENT THAN

7263
05:16:52,860 --> 05:16:53,661
INFLAMMATORY CYTOKINES.

7264
05:16:53,728 --> 05:16:54,895
I SHOULD MENTION THAT THE VAST

7265
05:16:54,962 --> 05:16:56,964
MAJORITY OF THE STUDY THAT FOUND

7266
05:16:57,031 --> 05:17:00,501
IN HIS REVIEW WERE

7267
05:17:00,568 --> 05:17:01,669
CROSS-SECTIONAL.

7268
05:17:01,736 --> 05:17:02,603
THERE'S NOW COMPELLING WORK

7269
05:17:02,670 --> 05:17:04,171
COMING OUT SHOWING THAT

7270
05:17:04,238 --> 05:17:06,540
DISCRIMINATION MAY ACTUALLY

7271
05:17:06,607 --> 05:17:08,075
PRECEDE INFLAMMATION.

7272
05:17:08,142 --> 05:17:13,647
WORK BY CHEN AND THAT -- SHOW

7273
05:17:13,714 --> 05:17:14,749
SPECIFICALLY FOR BLACK BOYS AND

7274
05:17:14,815 --> 05:17:17,151
BOYS OF COLOR, THOSE WHO

7275
05:17:17,218 --> 05:17:18,719
REPORTED DISCRIMINATION OVER

7276
05:17:18,786 --> 05:17:20,287
TIME HAD HIGHER LEVELS OF

7277
05:17:20,354 --> 05:17:24,658
INFLAMMATION OVER TIME.

7278
05:17:24,725 --> 05:17:27,061
NOW HERE'S WHAT WE KNOW THUS FAR

7279
05:17:27,128 --> 05:17:29,363
IN THIS LITERATURE IN

7280
05:17:29,430 --> 05:17:30,064
DISCRIMINATION FOR INFLAMMATION.

7281
05:17:30,131 --> 05:17:31,399
FOR ONE THE VAST MAJORITY OF THE

7282
05:17:31,465 --> 05:17:33,033
STUDIES WERE CROSS-SECTIONAL AND

7283
05:17:33,100 --> 05:17:34,635
THERE IS A POPULAR ASSOCIATION

7284
05:17:34,702 --> 05:17:35,703
BETWEEN DISCRIMINATION AND

7285
05:17:35,770 --> 05:17:36,804
INFLAMMATION FROM MOST OF THESE

7286
05:17:36,871 --> 05:17:38,773
STUDIES.

7287
05:17:38,839 --> 05:17:43,110
CRP AND IL-6 BASICALLY HAVE BEEN

7288
05:17:43,177 --> 05:17:46,380
THE PREDOMINANT OUTCOMES IN THIS

7289
05:17:46,447 --> 05:17:54,522
AREA OF DISCRIMINATION LIMITED

7290
05:17:54,588 --> 05:17:58,692
SUPPORTIVE EVIDENCE, I THINK

7291
05:17:58,759 --> 05:17:59,794
WHAT I FOUND MOST INTERESTING

7292
05:17:59,860 --> 05:18:04,698
FROM OUR REVIEW WAS THAT THERE'S

7293
05:18:04,765 --> 05:18:06,534
REAL STRONG SUPPORT FOR THE

7294
05:18:06,600 --> 05:18:10,371
VULNERABILITY HYPOTHESIS -- NO

7295
05:18:10,438 --> 05:18:11,405
SUPPORT, SUGGESTING THAT THE

7296
05:18:11,472 --> 05:18:18,879
EFFECT OF DISCRIMINATION ON

7297
05:18:18,946 --> 05:18:21,615
INFLAMMATION -- WE FOUND NO

7298
05:18:21,682 --> 05:18:29,757
EVIDENCE FOR THIS HYPOTHESIS.

7299
05:18:29,824 --> 05:18:31,058
I REALLY DO BELIEVE THERE NEEDS

7300
05:18:31,125 --> 05:18:32,326
TO BE A LIFE COURSE APPROACH IN

7301
05:18:32,393 --> 05:18:32,860
THIS AREA.

7302
05:18:32,927 --> 05:18:35,830
A LOT OF THE WORK IN THIS AREA

7303
05:18:35,896 --> 05:18:38,299
HAS MOSTLY FOCUSED ON MIDDLE AGE

7304
05:18:38,365 --> 05:18:40,167
AND OLDER ADULTS.

7305
05:18:40,234 --> 05:18:42,570
I SUSPECT FOR TWO REASONS.

7306
05:18:42,636 --> 05:18:45,239
ONE IS THAT AS I MENTIONED, THIS

7307
05:18:45,306 --> 05:18:48,609
TENDS TO BE ASSOCIATED WITH AGE,

7308
05:18:48,676 --> 05:18:51,045
TENDS TO SEE DISPARITIES MOSTLY

7309
05:18:51,111 --> 05:18:52,746
AROUND MIDDLE AGE AND OLD ARE

7310
05:18:52,813 --> 05:18:54,849
ADULTS, AND I THINK PEOPLE HAVE

7311
05:18:54,915 --> 05:18:55,916
DRAWN THEIR ATTENTION THERE.

7312
05:18:55,983 --> 05:18:58,285
I ALSO SUSPECT IT'S BECAUSE A

7313
05:18:58,352 --> 05:19:03,657
LOT OF PEOPLE USED A RETIREMENT

7314
05:19:03,724 --> 05:19:06,494
STUDY TO EXAMINE THOSE

7315
05:19:06,560 --> 05:19:08,262
QUESTIONS, BUT THAT DOES LEAVE

7316
05:19:08,329 --> 05:19:09,830
DIFFERENT LIFE COURSE STAGES

7317
05:19:09,897 --> 05:19:10,364
UNEXAMINED.

7318
05:19:10,431 --> 05:19:13,234
I REALLY BELIEVE, ESPECIALLY

7319
05:19:13,300 --> 05:19:14,935
KNOWING THAT CHILDREN THAT

7320
05:19:15,002 --> 05:19:15,603
REPORT DISCRIMINATION AS EARLY

7321
05:19:15,669 --> 05:19:17,037
AS 5 YEARS OLD, THAT WE SHOULD

7322
05:19:17,104 --> 05:19:21,275
BE GETTING -- WE SHOULD BEGIN

7323
05:19:21,342 --> 05:19:22,710
EXAMINING THESE QUESTIONS MUCH

7324
05:19:22,776 --> 05:19:24,545
EARLIER IN THE LIFE COURSE.

7325
05:19:24,612 --> 05:19:26,981
I DO BELIEVE THAT WE SHOULD BE

7326
05:19:27,047 --> 05:19:28,082
INCREASING GENERALIZABILITY.

7327
05:19:28,148 --> 05:19:30,184
MOST OF THE RESEARCH HAVE BEEN

7328
05:19:30,251 --> 05:19:33,354
FOCUSING ON BLACK, WHITE, ODD

7329
05:19:33,420 --> 05:19:34,788
DISPARITIES, BUT THERE ARE

7330
05:19:34,855 --> 05:19:36,857
ALSO -- I SHOULD MENTION THAT

7331
05:19:36,924 --> 05:19:39,593
EVEN THEN -- WE SHOULD BE

7332
05:19:39,660 --> 05:19:40,794
FOCUSING ON RACIAL DISPARITIES

7333
05:19:40,861 --> 05:19:44,632
WITHIN THE HISPANIC POPULATION.

7334
05:19:44,698 --> 05:19:46,400
WE ARE NOW NOTICING IN THE LAST

7335
05:19:46,467 --> 05:19:51,205
FEW YEARS THAT THE DIFFERENCES

7336
05:19:51,272 --> 05:19:53,607
AMONG AFRO LATINOS AND WHITE

7337
05:19:53,674 --> 05:19:58,712
LATINOS BEGINS TO MIRROR THAT OF

7338
05:19:58,779 --> 05:19:59,380
AMERICANS.

7339
05:19:59,446 --> 05:20:01,348
-- THAT MAKES MANY OF THESE

7340
05:20:01,415 --> 05:20:01,815
DIFFERENCES.

7341
05:20:01,882 --> 05:20:05,286
WE DON'T KNOW.

7342
05:20:05,352 --> 05:20:07,588
ALSO APPLYING AN INTERTEXTUAL

7343
05:20:07,655 --> 05:20:09,523
APPROACH EVEN THE CURRENT ERA

7344
05:20:09,590 --> 05:20:10,925
WE'RE IN IS IMPORTANT, GIVEN

7345
05:20:10,991 --> 05:20:16,196
THAT THERE'S MORE RECENT --

7346
05:20:16,263 --> 05:20:18,933
SHOWING THAT THE ASSOCIATION

7347
05:20:18,999 --> 05:20:21,035
BETWEEN INFLAMMATION AND

7348
05:20:21,101 --> 05:20:23,871
DISCRIMINATION IS MUCH -- FOR

7349
05:20:23,938 --> 05:20:24,939
BLACK WOMEN COMPARED TO BLACK

7350
05:20:25,005 --> 05:20:27,207
MEN AND HIGHER SES INDIVIDUALS.

7351
05:20:27,274 --> 05:20:30,110
THIS IS ALL FROM THE MID LIFE OF

7352
05:20:30,177 --> 05:20:31,946
THE UNITED STATES STUDY.

7353
05:20:32,012 --> 05:20:33,414
WHILE THERE ISN'T MUCH SUPPORT

7354
05:20:33,480 --> 05:20:34,615
FOR THE VULNERABILITY

7355
05:20:34,682 --> 05:20:36,150
HYPOTHESIS, THERE IS SUPPORT FOR

7356
05:20:36,216 --> 05:20:38,218
THE DIFFERENTIAL EXPOSURE

7357
05:20:38,285 --> 05:20:40,487
HYPOTHESIS.

7358
05:20:40,554 --> 05:20:42,790
THE HYPOTHESIS IS SUGGESTING

7359
05:20:42,856 --> 05:20:45,526
THAT FOR RACIALLY MINORITIZED

7360
05:20:45,593 --> 05:20:46,994
GROUPS, BECAUSE THEY'RE EXPOSED

7361
05:20:47,061 --> 05:20:49,964
TO DIFFERENT LEVELS OF

7362
05:20:50,030 --> 05:20:51,398
DISCRIMINATION, THAT WOULD BEGIN

7363
05:20:51,465 --> 05:20:52,366
TO EXPLAIN RACIAL DIFFERENCES IN

7364
05:20:52,433 --> 05:20:53,500
HEALTH OUTCOMES, AND IN FACT

7365
05:20:53,567 --> 05:20:58,339
WHAT WE DID FIND APPLYING A

7366
05:20:58,405 --> 05:21:00,074
BLINDER AND COMPOSITION METHOD

7367
05:21:00,140 --> 05:21:03,110
IS THAT LIFETIME DISCRIMINATION

7368
05:21:03,177 --> 05:21:07,815
EXPLAINED ABOUT 18% OF THE

7369
05:21:07,881 --> 05:21:11,018
RACIAL -- FOR SOCIOECONOMIC

7370
05:21:11,085 --> 05:21:12,753
STATUS.

7371
05:21:12,820 --> 05:21:17,424
I BELIEVE WE SHOULD MOVE BEYOND

7372
05:21:17,491 --> 05:21:18,626
CR3 AND IL-6 AT THIS POINT.

7373
05:21:18,692 --> 05:21:21,662
THERE ARE A WIDE RANGE OF

7374
05:21:21,729 --> 05:21:22,296
INFLAMMATORY CYTOKINE THAT HAVE

7375
05:21:22,363 --> 05:21:26,433
NOT BEEN EXAMINED, ESPECIALLY

7376
05:21:26,500 --> 05:21:29,036
ANTI-INFLAMMATORY CYTOKINES LIKE

7377
05:21:29,103 --> 05:21:32,940
IL10 AND IL11.

7378
05:21:33,007 --> 05:21:35,542
TUMOR NECROSIS FACTOR ALPHA,

7379
05:21:35,609 --> 05:21:36,644
THIS PAPER IS UNDER REVIEW, BUT

7380
05:21:36,710 --> 05:21:39,613
WE ACTUALLY FIND USING A LATENT

7381
05:21:39,680 --> 05:21:43,851
CONSTRUCT OF THIS DIT CRIM

7382
05:21:43,917 --> 05:21:46,320
NATION, THAT THE

7383
05:21:46,387 --> 05:21:47,755
COUNTERTERRORISM IS ASSOCIATED

7384
05:21:47,821 --> 05:21:50,591
WITH TNF ALPHA.

7385
05:21:50,658 --> 05:21:55,596
THIS WAS BASICALLY INSPIRED BY

7386
05:21:55,663 --> 05:21:57,131
DR. NORRIS, I WAS ACTUALLY

7387
05:21:57,197 --> 05:21:58,766
SURPRISED HE QUOTED ONE OF MY

7388
05:21:58,832 --> 05:22:01,402
FAVORITE PHILOSOPHERS, AND HE

7389
05:22:01,468 --> 05:22:03,103
HAS SAYING -- HE SAID THAT, IT

7390
05:22:03,170 --> 05:22:05,939
IS NO MEASURE OF HEALTH TO BE

7391
05:22:06,006 --> 05:22:09,009
WELL ADJUSTED IN A PROFOUNDLY

7392
05:22:09,076 --> 05:22:09,977
SICK SOCIETY.

7393
05:22:10,044 --> 05:22:16,450
AND IN FACT, WHAT WE FOCUS ON IS

7394
05:22:16,517 --> 05:22:19,186
INDIVIDUAL LEVELS OF

7395
05:22:19,253 --> 05:22:24,591
DISCRIMINATION, IT ONLY GETS --

7396
05:22:24,658 --> 05:22:28,962
ON -- A LOT OF THESE MEASURES

7397
05:22:29,029 --> 05:22:34,868
DON'T CAPTURE THE HISTORY,

7398
05:22:34,935 --> 05:22:37,171
POLICIES, IN THE SIX STEPS.

7399
05:22:37,237 --> 05:22:38,472
SO WE REALLY SHOULD BE FOCUSING

7400
05:22:38,539 --> 05:22:40,107
ON NOT JUST THE INTERPERSONAL

7401
05:22:40,174 --> 05:22:41,208
FORMS OF DISCRIMINATION BUT ALSO

7402
05:22:41,275 --> 05:22:43,577
THE NEIGHBORHOOD POLICY THAT

7403
05:22:43,644 --> 05:22:45,446
DRIVES POOR HEALTH, AND THIS IS

7404
05:22:45,512 --> 05:22:46,980
OBVIOUSLY WITHIN THE CONTEXT OF

7405
05:22:47,047 --> 05:22:48,716
INFLAMMATION.

7406
05:22:48,782 --> 05:22:54,788
SO I'M LEADING TO R01s RIGHT

7407
05:22:54,855 --> 05:22:56,123
NOW TO ANSWERING MANY OF THESE

7408
05:22:56,190 --> 05:22:56,557
QUESTIONS.

7409
05:22:56,623 --> 05:22:59,626
I'M LOOKING FOR A POSTDOC, SO IF

7410
05:22:59,693 --> 05:23:02,229
THERE ARE ANY WONDERFUL

7411
05:23:02,296 --> 05:23:03,731
CANDIDATES, HAVE THEM CONTACT

7412
05:23:03,797 --> 05:23:04,098
ME.

7413
05:23:04,164 --> 05:23:07,134
I WANT TO THANK SOME OF MY MANY

7414
05:23:07,201 --> 05:23:07,901
COLLABORATORS, AND THANK YOU

7415
05:23:07,968 --> 05:23:08,669
VERY, VERY MUCH.

7416
05:23:08,736 --> 05:23:16,443
[APPLAUSE]

7417
05:23:16,510 --> 05:23:17,311
>> THANK YOU VERY MUCH.

7418
05:23:17,377 --> 05:23:19,646
OUR FINAL SPEAKER OF THE DAY

7419
05:23:19,713 --> 05:23:20,514
WILL BE CARRINGTON MERRITT.

7420
05:23:20,581 --> 05:23:22,149
SHE WILL BE TALKING ABOUT

7421
05:23:22,216 --> 05:23:25,953
INFLAMMATORY MECHANISMS LINKING

7422
05:23:26,019 --> 05:23:29,356
DISCRIMINATION AND HEALTH.

7423
05:23:29,423 --> 05:23:30,758
>> HELLO, EVERYONE.

7424
05:23:30,824 --> 05:23:32,392
THANK YOU FOR BEARING WITH ME

7425
05:23:32,459 --> 05:23:34,962
THESE LAST 15 MINUTES, THEN WE

7426
05:23:35,028 --> 05:23:37,164
CAN KIND OF ENJOY THE REST OF

7427
05:23:37,231 --> 05:23:41,101
OUR EVENINGS.

7428
05:23:41,168 --> 05:23:45,739
LUCKILY DR. CUEVAS SET ME UP

7429
05:23:45,806 --> 05:23:47,941
WELL FOR THIS TO KIND OF CLOSE

7430
05:23:48,008 --> 05:23:58,185
OUT TODAY.

7431
05:23:58,886 --> 05:24:02,923
SO I'LL BE TALKING ABOUT

7432
05:24:02,990 --> 05:24:04,825
INFLAMMATORY MECHANISMS LINKING

7433
05:24:04,892 --> 05:24:05,959
DISCRIMINATION AND HEALTH.

7434
05:24:06,026 --> 05:24:08,896
I'M ACKNOWLEDGING I'M HERE TODAY

7435
05:24:08,962 --> 05:24:15,202
ON BEHALF OF MY ADVISER KEELY

7436
05:24:15,269 --> 05:24:15,369
MU.

7437
05:24:15,435 --> 05:24:15,636
SCATELL.

7438
05:24:15,702 --> 05:24:19,606
I ALONG WITH MANY OTHER GRADUATE

7439
05:24:19,673 --> 05:24:22,376
STUDENTS -- ARE INTERESTED IN

7440
05:24:22,442 --> 05:24:24,711
QUESTIONS OF HOW RACISM CAN

7441
05:24:24,778 --> 05:24:25,379
IMPACT HEALTH.

7442
05:24:25,445 --> 05:24:26,780
NA PARTICULAR, MANY OF US LOOK

7443
05:24:26,847 --> 05:24:28,916
AT THE BRAIN AND BODY MECHANISMS

7444
05:24:28,982 --> 05:24:30,717
THROUGH WHICH THIS HAPPENS.

7445
05:24:30,784 --> 05:24:35,956
SO THIS IS A RECENT REVIEW WE

7446
05:24:36,023 --> 05:24:37,558
WORKED ON TOGETHER SH WHERE WE

7447
05:24:37,624 --> 05:24:38,892
SORT OF WERE SUMMARIZING SOME OF

7448
05:24:38,959 --> 05:24:41,528
THE EC EXISTING WORK IN THIS AR,

7449
05:24:41,595 --> 05:24:43,697
SOME OF THE WORK THAT HAS BEEN

7450
05:24:43,764 --> 05:24:45,332
DONE BY SOME OF THE GREAT

7451
05:24:45,399 --> 05:24:46,200
SCHOLARS IN THE ROOM TODAY.

7452
05:24:46,266 --> 05:24:47,835
I WANT TO HIGHLIGHT THIS FIGURE

7453
05:24:47,901 --> 05:24:49,703
THAT COMES FROM THIS REVIEW,

7454
05:24:49,770 --> 05:24:52,539
SORT OF HELPS TO ILLUSTRATE HOW

7455
05:24:52,606 --> 05:24:54,708
WE ARE -- TO YOU TO SORT OF

7456
05:24:54,775 --> 05:24:56,243
ANSWER THESE QUESTIONS AND HOW

7457
05:24:56,310 --> 05:24:59,847
RACISM AND DISCRIMINATION

7458
05:24:59,913 --> 05:25:02,349
THROUGH BRAIN AND -- MECHANISMS.

7459
05:25:02,416 --> 05:25:03,550
SO WE LOOK AT THE DIFFERENT

7460
05:25:03,617 --> 05:25:04,785
LEVELS OF RACISM, AS WELL AS

7461
05:25:04,852 --> 05:25:06,253
LOOKING AT DIFFERENT BIOLOGICAL

7462
05:25:06,320 --> 05:25:06,787
OUTCOMES.

7463
05:25:06,854 --> 05:25:08,322
SO TODAY I'M GOING TO BE

7464
05:25:08,388 --> 05:25:11,058
SPEAKING TO YOU SPECIFICALLY

7465
05:25:11,124 --> 05:25:13,093
ABOUT INFLAMMATORY PROCESSES

7466
05:25:13,160 --> 05:25:14,094
OBVIOUSLY, BUT I'M SPECIFICALLY

7467
05:25:14,161 --> 05:25:15,195
GOING TO BE SHARING SOME

7468
05:25:15,262 --> 05:25:18,632
FINDINGS ON SOME WORK THAT WE

7469
05:25:18,699 --> 05:25:22,369
RECENTLY PUBLISHED -- AND HOW

7470
05:25:22,436 --> 05:25:25,205
THEY SORT OF IMPACT DOWNSTREAM

7471
05:25:25,272 --> 05:25:27,507
INFLAMMATION OR -- AND HOW THAT

7472
05:25:27,574 --> 05:25:32,946
IS RELATED TO PARTICULAR HEALTH

7473
05:25:33,013 --> 05:25:33,814
CONDITIONS, AS WELL AS

7474
05:25:33,881 --> 05:25:35,782
DISCUSSING THE POTENTIAL

7475
05:25:35,849 --> 05:25:37,084
PROTECTIVE FACTOR THAT MIGHT BE

7476
05:25:37,150 --> 05:25:38,685
RELEVANT IN THIS PARTICULAR

7477
05:25:38,752 --> 05:25:41,154
CONTEXT.

7478
05:25:41,221 --> 05:25:46,593
AND SO AS IT WAS VERY NICELY SET

7479
05:25:46,660 --> 05:25:52,399
UP, WE KNOW THAT THERE ARE A V

7480
05:25:52,466 --> 05:25:54,368
VA -- HELP THE RACIAL GROUPS

7481
05:25:54,434 --> 05:25:55,469
ESPECIALLY BETWEEN BLACK AND

7482
05:25:55,535 --> 05:25:58,639
WHITE AMERICANS, AND I WANT TO

7483
05:25:58,705 --> 05:26:00,173
THEORIZE THAT DISCRIMINATION

7484
05:26:00,240 --> 05:26:02,075
MIGHT BE CONTRIBUTING TO THOSE

7485
05:26:02,142 --> 05:26:04,811
DISPARITIES AND -- MECHANISM

7486
05:26:04,878 --> 05:26:07,414
THAT LINKS DISCRIMINATION AND

7487
05:26:07,481 --> 05:26:10,984
HEALTH OUTCOMES AMONG RACIALLY

7488
05:26:11,051 --> 05:26:11,485
MINORITIZED INDIVIDUALS.

7489
05:26:11,551 --> 05:26:13,120
AND WE HAVE LOTS OF EXISTING

7490
05:26:13,186 --> 05:26:18,926
EVIDENCE THAT IS SUGGESTING THAT

7491
05:26:18,992 --> 05:26:25,098
IS IN LINE WITH THAT IDEA,

7492
05:26:25,165 --> 05:26:27,000
GENERALLY -- SO WE HAVE CRITICAL

7493
05:26:27,067 --> 05:26:29,703
REVIEWS STATING THIS, AND EVEN

7494
05:26:29,770 --> 05:26:31,138
SOME OF THE GRADUATE STUDENTS IN

7495
05:26:31,204 --> 05:26:39,413
OUR LAB NOW, SO CURRENTLY UNDER

7496
05:26:39,479 --> 05:26:44,551
REVIEW, BUT ACROSS 112 --

7497
05:26:44,618 --> 05:26:48,355
EFFECTS LOOKING AT THE IMPACT OF

7498
05:26:48,422 --> 05:26:50,324
DISCRIMINATION AND INFLAMMATION,

7499
05:26:50,390 --> 05:26:52,292
THEY FOUND -- WHERE HIGHER

7500
05:26:52,359 --> 05:26:53,927
LEVELS OF DISCRIMINATION VERSUS

7501
05:26:53,994 --> 05:26:56,596
ENTIRE LEVELS OF INFLAMMATION.

7502
05:26:56,663 --> 05:26:59,433
SO WE KNOW THIS LINK BETWEEN

7503
05:26:59,499 --> 05:27:03,236
DISCRIMINATION IS CLEARLY FAIR,

7504
05:27:03,303 --> 05:27:05,539
AND THIS LINK IS IMPORTANT

7505
05:27:05,605 --> 05:27:09,676
BECAUSE IT IS -- INFLAMMATION IS

7506
05:27:09,743 --> 05:27:11,244
LOCATED IN A NUMBER OF CHRONIC

7507
05:27:11,311 --> 05:27:11,845
CONDITIONS.

7508
05:27:11,912 --> 05:27:13,080
IN THIS PARTICULAR STUDY, I'M

7509
05:27:13,146 --> 05:27:15,515
GOING TO FOCUS ON CARDIOVASCULAR

7510
05:27:15,582 --> 05:27:17,184
CONDITIONS BUT MANY OF YOU ARE

7511
05:27:17,250 --> 05:27:22,322
HERE AND INTERESTED IN THINGS

7512
05:27:22,389 --> 05:27:24,291
LIKE -- METABOLIC CONDITIONS.

7513
05:27:24,358 --> 05:27:25,392
AND DESPITE THE FACT THAT WE

7514
05:27:25,459 --> 05:27:29,663
HAVE THIS REALLY ESTABLISHED

7515
05:27:29,730 --> 05:27:30,530
DISCRIMINATION INFLAMMATION

7516
05:27:30,597 --> 05:27:32,432
LINK, THERE'S ACTUALLY LIMITED

7517
05:27:32,499 --> 05:27:34,935
WORK EMPIRICALLY

7518
05:27:35,002 --> 05:27:36,470
INVESTIGATING -- LINKING

7519
05:27:36,536 --> 05:27:38,705
EXPERIENCE WITH -- SPECIFIC

7520
05:27:38,772 --> 05:27:40,073
HEALTH CONDITIONS.

7521
05:27:40,140 --> 05:27:42,809
ET CETERA, WE HAVE A LOT OF

7522
05:27:42,876 --> 05:27:44,011
RESEARCH THAT SUGGESTS THAT

7523
05:27:44,077 --> 05:27:47,280
BLACK INDIVIDUALS AND PEOPLE

7524
05:27:47,347 --> 05:27:54,121
HAVE NUMEROUS OR NEGATIVE

7525
05:27:54,187 --> 05:27:55,122
IMPACTS OF DISCRIMINATION.

7526
05:27:55,188 --> 05:27:55,789
YET AT THE SAME TIME THERE'S

7527
05:27:55,856 --> 05:27:58,425
LESS WORK LACKING SPECIFICALLY

7528
05:27:58,492 --> 05:28:01,928
AT PROTECTIVE FACTORS, THAT SORT

7529
05:28:01,995 --> 05:28:03,563
OF RELATIONSHIP BETWEEN

7530
05:28:03,630 --> 05:28:04,531
DISCRIMINATION AND INFLAMMATION.

7531
05:28:04,598 --> 05:28:05,832
SO THAT'S WHAT I'M GOING TO BE

7532
05:28:05,899 --> 05:28:08,268
TALKING ABOUT TODAY.

7533
05:28:08,335 --> 05:28:10,804
HOWEVER, DR. -- HOPEFULLY THAT

7534
05:28:10,871 --> 05:28:12,072
MEANS I CAN KIND OF GO THROUGH

7535
05:28:12,139 --> 05:28:14,341
THE RESULTS A LITTLE MORE

7536
05:28:14,408 --> 05:28:15,876
QUICKLY.

7537
05:28:15,942 --> 05:28:17,177
BUT AGAIN SPECIFIC WITH THIS

7538
05:28:17,244 --> 05:28:18,612
STUDY WE WERE LOOKING AT WHETHER

7539
05:28:18,678 --> 05:28:20,447
INFLAMMATION MEDIATED THE

7540
05:28:20,514 --> 05:28:21,448
RELATIONSHIP BETWEEN

7541
05:28:21,515 --> 05:28:22,649
DISCRIMINATION AND

7542
05:28:22,716 --> 05:28:23,784
CARDIOVASCULAR HEALTH CONDITION,

7543
05:28:23,850 --> 05:28:26,019
AND WE'RE ALSO INTERESTED IN

7544
05:28:26,086 --> 05:28:27,654
LOOKING AT A PARTICULAR

7545
05:28:27,721 --> 05:28:32,659
EFFECTIVE FACTOR OF PERCEIVED

7546
05:28:32,726 --> 05:28:35,395
CONTROL -- AND CARDIOVASCULAR

7547
05:28:35,462 --> 05:28:35,629
HEALTH.

7548
05:28:35,695 --> 05:28:37,230
SO BEFORE I GET INTO THE

7549
05:28:37,297 --> 05:28:40,934
FINDINGS,  I'M JUST GOING TO TAK

7550
05:28:41,001 --> 05:28:49,242
A LITTLE ABOUT WHAT -- REFERS TO

7551
05:28:49,309 --> 05:28:50,544
AN INDIVIDUAL'S PERCEPTION THAT

7552
05:28:50,610 --> 05:28:51,545
THEY CAN INFLUENCE WHAT HAPPENS

7553
05:28:51,611 --> 05:28:52,579
IN THEIR LIFE.

7554
05:28:52,646 --> 05:28:53,513
SO THE PARTICULAR MEASURE THAT

7555
05:28:53,580 --> 05:28:57,317
WE USED ASKED QUESTIONS TO

7556
05:28:57,384 --> 05:28:59,519
GATHER INDIVIDUAL' PERCEPTIONS

7557
05:28:59,586 --> 05:29:00,921
OF WHETHER THEY BELIEVE WHAT

7558
05:29:00,987 --> 05:29:02,122
THEY REALLY WANT TO DO

7559
05:29:02,189 --> 05:29:03,223
SOMETHING, THEY CANNOT USUALLY

7560
05:29:03,290 --> 05:29:07,127
FIND A WAY TO SUCCEED AT IT, SO

7561
05:29:07,194 --> 05:29:11,164
GETTING AT ASPECTS -- IT ALSO

7562
05:29:11,231 --> 05:29:13,767
ASKED QUESTIONS THAT BROUGHT OUT

7563
05:29:13,834 --> 05:29:15,202
PERCEPTIONS OF EXTERNAL BARRIERS

7564
05:29:15,268 --> 05:29:18,238
SO HOW MUCH TO THE EXTENT DO YOU

7565
05:29:18,305 --> 05:29:20,240
BELIEVE -- AND WE DECIDED TO

7566
05:29:20,307 --> 05:29:22,175
FOCUS ON PERCEIVED CONTROL FOR A

7567
05:29:22,242 --> 05:29:23,710
NUMBER OF REASONS.

7568
05:29:23,777 --> 05:29:25,345
FIRST THERE'S RESEARCH SHOWING

7569
05:29:25,412 --> 05:29:28,615
THAT IT HAS BEEN POSSIBLY

7570
05:29:28,682 --> 05:29:32,452
ASSOCIATED WITH OTHER

7571
05:29:32,519 --> 05:29:33,220
PHYSIOLOGICAL -- AS WELL AS

7572
05:29:33,286 --> 05:29:35,522
WE'RE SHOWING THE EFFECTS OF

7573
05:29:35,589 --> 05:29:37,591
CHRONIC STRESS HAVE BEEN BEEN

7574
05:29:37,657 --> 05:29:41,528
BUFFERED BUT CONTROL HAVE EARLY

7575
05:29:41,595 --> 05:29:45,465
EFFECTS OF -- LEVELS OF

7576
05:29:45,532 --> 05:29:47,100
PERCEIVED CONTROL.

7577
05:29:47,167 --> 05:29:48,635
AND THERE'S ALSO WORK SHOWING

7578
05:29:48,702 --> 05:29:50,070
THAT INTERVENTION, THAT TARGET

7579
05:29:50,137 --> 05:29:50,704
INCREASING PERCEPTIONS OF

7580
05:29:50,770 --> 05:29:52,472
CONTROL HAVE BEEN BENEFICIAL FOR

7581
05:29:52,539 --> 05:29:54,808
HEALTH MORE BROADLY, SO IT

7582
05:29:54,875 --> 05:29:55,575
SUGGESTS THAT PERCEPTIONS OF

7583
05:29:55,642 --> 05:29:56,443
CONTROL ARE SOMETHING THAT MIGHT

7584
05:29:56,510 --> 05:29:59,813
BE VALUABLE.

7585
05:29:59,880 --> 05:30:03,517
SO IT'S SORT OF -- THE STUDY

7586
05:30:03,583 --> 05:30:04,985
AIMS TO EXAMINE INFLAMMATION AS

7587
05:30:05,051 --> 05:30:07,354
A MECHANISM LINKING CHRIS CRIM

7588
05:30:07,420 --> 05:30:12,259
NATION AND CARDIOVASCULAR HEALTH

7589
05:30:12,325 --> 05:30:16,196
IN MIDDLE AGED BLACK AMERICANS

7590
05:30:16,263 --> 05:30:17,731
AND EMENTABLE INPERCEIVED

7591
05:30:17,797 --> 05:30:18,832
CONTROL AS A PROTECTIVE FACTOR

7592
05:30:18,899 --> 05:30:20,233
IN THE RELATIONSHIP OF

7593
05:30:20,300 --> 05:30:21,234
DISCRIMINATION AND INFLAMMATION,

7594
05:30:21,301 --> 05:30:25,138
AND FINALLY EXAMINING THE LINK

7595
05:30:25,205 --> 05:30:27,407
BETWEEN -- AND CARDIOVASCULAR

7596
05:30:27,474 --> 05:30:30,043
HEALTH INITIATIVE -- SO THIS

7597
05:30:30,110 --> 05:30:34,114
STUDY I'VE COME FROM THE NIDUS

7598
05:30:34,181 --> 05:30:35,549
STUDY, AGAIN A LOT OF RESEARCH

7599
05:30:35,615 --> 05:30:36,917
HAS ALREADY BEEN PUBLISHED

7600
05:30:36,983 --> 05:30:38,585
LOOKING AT DISCRIMINATION,

7601
05:30:38,652 --> 05:30:39,352
INFLAMMATION WITH THIS

7602
05:30:39,419 --> 05:30:40,287
PARTICULAR DATASET.

7603
05:30:40,353 --> 05:30:41,521
I HAVE SOME THOITS ON THAT TOO

7604
05:30:41,588 --> 05:30:42,522
I'LL SHARE TOWARDS THE END BUT

7605
05:30:42,589 --> 05:30:44,257
THIS STUDY IS COMING FROM THAT

7606
05:30:44,324 --> 05:30:47,227
DATABASE WHERE WE LOOKED AT

7607
05:30:47,294 --> 05:30:54,534
347 NON-HIS PAIRK OR LATIN F AND

7608
05:30:54,601 --> 05:30:56,403
OUR MEASURE AT PERCEIVED CONTROL

7609
05:30:56,469 --> 05:30:59,239
WITH ALSO A SELF-REPORT MEASURE.

7610
05:30:59,306 --> 05:31:02,642
AND FOR CARDIOVASCULAR HELP, WE

7611
05:31:02,709 --> 05:31:10,817
USED -- THEN FOR INFLAMMATION,

7612
05:31:10,884 --> 05:31:13,453
OUR PRIMARY ANALYSES FOCUSED ON

7613
05:31:13,520 --> 05:31:14,888
CRP AND IL-6 AGAIN BECAUSE

7614
05:31:14,955 --> 05:31:17,023
THAT'S WHERE THE WORK

7615
05:31:17,090 --> 05:31:18,458
INFLAMMATION HAS FOCUSED ON

7616
05:31:18,525 --> 05:31:19,659
THESE PARTICULAR MARKERS BUT WE

7617
05:31:19,726 --> 05:31:24,664
ALSO DID SOME EXPLORATORY -- I'M

7618
05:31:24,731 --> 05:31:26,533
JUST GOING TO PRESENT THE CRP

7619
05:31:26,600 --> 05:31:27,734
FOR SAKE OF TIME BUT HAPPY TO

7620
05:31:27,801 --> 05:31:28,935
DISCUSS THOSE OTHER MARKERS

7621
05:31:29,002 --> 05:31:30,303
DURING THE Q & A IF THERE'S

7622
05:31:30,370 --> 05:31:32,706
TIME.

7623
05:31:32,772 --> 05:31:35,108
SO FOR OUR FIRST RESULT WE DID

7624
05:31:35,175 --> 05:31:37,177
FIND A SIGNIFICANT MEDIATION OF

7625
05:31:37,244 --> 05:31:39,212
CRP LINKING DISCRIMINATION TO

7626
05:31:39,279 --> 05:31:39,879
CARDIOVASCULAR CONDITIONS.

7627
05:31:39,946 --> 05:31:41,514
AND THEN WHEN WE LOOKED TO SEE

7628
05:31:41,581 --> 05:31:44,251
WHETHER THERE WAS A MODERATION

7629
05:31:44,317 --> 05:31:46,653
HAPPENING BETWEEN DISCRIMINATION

7630
05:31:46,720 --> 05:31:49,055
AND LEVELS OF CRP, WE FOUND

7631
05:31:49,122 --> 05:31:51,992
PERCEIVED CONTROL DID MODERATE

7632
05:31:52,058 --> 05:31:56,129
THE EXROAL BETWEEN -- TO SHOW

7633
05:31:56,196 --> 05:32:00,300
HOW MODERATION IS OPERATING,

7634
05:32:00,367 --> 05:32:01,801
SO -- IF YOU CAN TELL THE COLOR

7635
05:32:01,868 --> 05:32:03,737
DIFFERENCE IS PEOPLE REPORTING

7636
05:32:03,803 --> 05:32:05,505
AVERAGE AND THEN THE BLACK LINE

7637
05:32:05,572 --> 05:32:07,941
IS TIME SO WHAT YOU CAN SEE IS

7638
05:32:08,008 --> 05:32:09,576
ACROSS ALL LEVELS THERE IS THIS

7639
05:32:09,643 --> 05:32:12,112
POSITIVE RELATIONSHIP BETWEEN

7640
05:32:12,178 --> 05:32:12,746
DISCRIMINATION AND INFLAMMATION,

7641
05:32:12,812 --> 05:32:15,448
WIBUT THAT RELATIONSHIP IS ONLY

7642
05:32:15,515 --> 05:32:16,216
SIGNIFICANT AMONG THOSE WHO

7643
05:32:16,283 --> 05:32:18,084
REPORTED LOW OR AVERAGE LEVEL OF

7644
05:32:18,151 --> 05:32:21,021
PERCEIVED CONTROL BUT IT IS NOT

7645
05:32:21,087 --> 05:32:21,721
SIGNIFICANT FOR THOSE REPORTING

7646
05:32:21,788 --> 05:32:24,424
HIGH LEVELS.

7647
05:32:24,491 --> 05:32:28,295
THEN FINALLY MEDIATION ANALYSIS,

7648
05:32:28,361 --> 05:32:30,196
AGAIN CRP WAS A SIGNIFICANT

7649
05:32:30,263 --> 05:32:31,598
MEDIATOR, BUT THIS WAS ONLY TRUE

7650
05:32:31,665 --> 05:32:34,367
FOR THOSE REPORTING LOW OR

7651
05:32:34,434 --> 05:32:36,670
AVERAGE LEVEL.

7652
05:32:36,736 --> 05:32:39,306
THE SAME AS WELL BECAUSE I JUST

7653
05:32:39,372 --> 05:32:39,873
SHARED.

7654
05:32:39,939 --> 05:32:41,274
SO WHAT DOES THIS ALL MEAN?

7655
05:32:41,341 --> 05:32:45,845
THIS OFFERS MORE EMPIRICAL

7656
05:32:45,912 --> 05:32:47,147
SUPPORT THAT INFLAMMATION CAN BE

7657
05:32:47,213 --> 05:32:49,215
A MECHANISM LINKING

7658
05:32:49,282 --> 05:32:50,550
DISCRIMINATION AND

7659
05:32:50,617 --> 05:32:51,418
CARDIOVASCULAR HEALTH.

7660
05:32:51,484 --> 05:32:57,223
SO AGAIN, THERE'S NOT -- I'M

7661
05:32:57,290 --> 05:33:02,762
GOING TO SORT OF ADD TO --

7662
05:33:02,829 --> 05:33:03,263
LITERATURE IN THIS AREA.

7663
05:33:03,330 --> 05:33:04,631
WE ALSO FOUND SUPPORT THAT

7664
05:33:04,698 --> 05:33:05,832
GREATER PERCEPTIONS OF CONTROL

7665
05:33:05,899 --> 05:33:07,033
MAY PROTECT AGAINST THE ILL

7666
05:33:07,100 --> 05:33:08,201
EFFECTS OF DISCRIMINATION.

7667
05:33:08,268 --> 05:33:11,338
THIS MIGHT BE USEFUL IN TERMS OF

7668
05:33:11,404 --> 05:33:14,774
LEVERAGING PERCEIVED CONTROL AS

7669
05:33:14,841 --> 05:33:24,551
A WAAS -- POINTED OUT EARLIER TE

7670
05:33:24,617 --> 05:33:25,318
INDIVIDUAL LEVEL INTERVENTIONS

7671
05:33:25,385 --> 05:33:26,286
OR SOLUTIONS ARE NEVER GOING TO

7672
05:33:26,353 --> 05:33:27,587
BE ENOUGH TO REALLY ADDRESS

7673
05:33:27,654 --> 05:33:30,323
THESE POPULATION-LEVEL NECK QUIT

7674
05:33:30,390 --> 05:33:31,758
WIDTHS, BUT OF COURSE THEY HAVE

7675
05:33:31,825 --> 05:33:37,230
THEIR FACE TOO, SO THERE'S

7676
05:33:37,297 --> 05:33:40,934
IMPORTIMPORTANT WORK TO BE DONE,

7677
05:33:41,000 --> 05:33:42,569
LOOKING AT THESE MORE SYSTEMIC

7678
05:33:42,635 --> 05:33:45,739
LEVELS THAT WE CAN ALSO BE

7679
05:33:45,805 --> 05:33:49,776
INTERVENING ON -- SPECIFIC

7680
05:33:49,843 --> 05:33:51,945
LIMITATIONS OF THE STUDY.

7681
05:33:52,011 --> 05:33:54,481
AGAIN THIS IS SECOND DRILL

7682
05:33:54,547 --> 05:33:59,285
ANALYSIS COMING FROM A PUBLICLY

7683
05:33:59,352 --> 05:34:01,554
AVAILABLE HAS UTILIZED THESE

7684
05:34:01,621 --> 05:34:03,890
LARGE SCALE DATABASES FOR A

7685
05:34:03,957 --> 05:34:04,391
PERFECT REASON.

7686
05:34:04,457 --> 05:34:12,165
THEY RIN CRED ARE INCREDIBLY VA,

7687
05:34:12,232 --> 05:34:15,668
BUT ANOTHER FINDING OF

7688
05:34:15,735 --> 05:34:18,471
META-ANALYSIS, THERE ARE

7689
05:34:18,538 --> 05:34:21,007
ACTUALLY ONLY 27 REPORTED UNIQUE

7690
05:34:21,074 --> 05:34:22,542
EFFECTS OF DISCRIMINATION AND

7691
05:34:22,609 --> 05:34:25,145
INFLAMMATION, SO AGAIN, WHILE WE

7692
05:34:25,211 --> 05:34:28,415
HAVE THESE -- RELYING ON THESE

7693
05:34:28,481 --> 05:34:29,949
PUBLICLY AVAILABLE DATASETS THAT

7694
05:34:30,016 --> 05:34:32,919
MIGHT SORT OF DISTORT OUR

7695
05:34:32,986 --> 05:34:33,820
IMPRESSIONS OF HOW MUCH IS

7696
05:34:33,887 --> 05:34:35,221
ACTUALLY OUT THERE.

7697
05:34:35,288 --> 05:34:37,624
SO THIS JUST SUGGESTS FOR NEW

7698
05:34:37,690 --> 05:34:42,762
AND VARIED COMPAQS FOR -- THIS

7699
05:34:42,829 --> 05:34:45,732
SAY 'NOTHER CORRELATIONAL OR --

7700
05:34:45,799 --> 05:34:48,368
THAT'S A SORT OF CAUSAL LINK

7701
05:34:48,435 --> 05:34:48,935
BETWEEN DISCRIMINATION AND

7702
05:34:49,002 --> 05:34:52,005
INCREASED INFLAMMATION, SO IT'S

7703
05:34:52,071 --> 05:34:56,142
RELATIVELY UNSUSTAINED, SO AGAIN

7704
05:34:56,209 --> 05:34:58,978
MORE WORK, WE REALLY GETS AT

7705
05:34:59,045 --> 05:35:00,079
THAT REAL CAUSAL ASSOCIATION.

7706
05:35:00,146 --> 05:35:02,916
SOME OF THAT WORK CAN COME

7707
05:35:02,982 --> 05:35:05,318
FROM -- MORE LONGITUDAL

7708
05:35:05,385 --> 05:35:07,287
SETTINGS, BUT I ACTUALLY WANT TO

7709
05:35:07,353 --> 05:35:08,721
TALK ABOUT OUR LAB IS ALSO

7710
05:35:08,788 --> 05:35:12,859
TRYING TO LOOK AT THIS FROM AN

7711
05:35:12,926 --> 05:35:13,626
EXPERIMENTAL STIRMT.

7712
05:35:13,693 --> 05:35:18,431
THAT ACTUALLY GETS US THE LINK

7713
05:35:18,498 --> 05:35:19,098
BETWEEN DISCRIMINATION AND

7714
05:35:19,165 --> 05:35:19,966
INFLAMMATION.

7715
05:35:20,033 --> 05:35:20,633
SO AGAIN THIS IS AN AREA FOR

7716
05:35:20,700 --> 05:35:21,301
FUTURE RESEARCH.

7717
05:35:21,367 --> 05:35:22,268
I'M GOING TO TALK ABOUT WHAT

7718
05:35:22,335 --> 05:35:23,736
WE'RE TRYING TO DO THAT KIND OF

7719
05:35:23,803 --> 05:35:25,338
RESEARCH IN OUR LAB RIGHT NOW.

7720
05:35:25,405 --> 05:35:26,940
BUT I ALSO WANT TO ACKNOWLEDGE

7721
05:35:27,006 --> 05:35:30,276
THAT JUST THE IDEA OF TRYING TO

7722
05:35:30,343 --> 05:35:32,011
CREATE SORT OF LAB MANIPULATED

7723
05:35:32,078 --> 05:35:35,648
EXPERIENCES OF DISCRIMINATION,

7724
05:35:35,715 --> 05:35:37,250
THAT PRIORITIZE THE WELL-BEING

7725
05:35:37,317 --> 05:35:39,052
OF OUR RESEARCH PARTICIPANTS

7726
05:35:39,118 --> 05:35:42,422
WHILE ALSO BE VALID IS A

7727
05:35:42,489 --> 05:35:43,223
CHALLENGE AND ONE THAT SHOULD

7728
05:35:43,289 --> 05:35:48,228
NOT BE TAKEN LIGHTLY, AND SO WE

7729
05:35:48,294 --> 05:35:49,529
RECOGNIZE THAT THIS CAN BE A

7730
05:35:49,596 --> 05:35:50,396
CHALLENGING METHODOLOGICAL AREA

7731
05:35:50,463 --> 05:35:54,133
FOR THIS PARTICULAR RESEARCH, SO

7732
05:35:54,200 --> 05:35:54,701
ONE PARTICULAR TENTH THAT WE

7733
05:35:54,767 --> 05:35:55,635
HAVE MADE WITH OTHER RESEARCH

7734
05:35:55,702 --> 05:35:57,704
THAT IS BEING -- THAT JUST SINCE

7735
05:35:57,770 --> 05:36:01,074
RECENTLY BEEN COLLECTED IN OUR

7736
05:36:01,140 --> 05:36:03,076
LAB IS A PARTICULAR LAB

7737
05:36:03,142 --> 05:36:07,113
MANIPULATION OF A DISCRIMINATION

7738
05:36:07,180 --> 05:36:08,848
RELATED STRESS WITH FIVE YOUNG

7739
05:36:08,915 --> 05:36:10,984
BLACK ADULTS WHERE WE USED A

7740
05:36:11,050 --> 05:36:12,385
MODIFICATION OF A TIERED SOCIAL

7741
05:36:12,452 --> 05:36:12,819
STRESS TEST.

7742
05:36:12,886 --> 05:36:15,455
SO IN OUR LAB, WE ARE TRAINING

7743
05:36:15,522 --> 05:36:18,324
TO BE SOCIAL PSYCHOLOGISTS SO WE

7744
05:36:18,391 --> 05:36:20,727
OFTEN LOOK TO PSYCHOLOGICAL KNOW

7745
05:36:20,793 --> 05:36:22,028
THODZ IN TERMS OF HOW WE

7746
05:36:22,095 --> 05:36:25,098
ACTUALLY TRY TO TEST SOME OF

7747
05:36:25,164 --> 05:36:27,934
THESE THREE RED CAL IDEAS WE'RE

7748
05:36:28,001 --> 05:36:30,136
INTERESTED IN TESTING OUT.

7749
05:36:30,203 --> 05:36:32,205
IT A WELL VALIDATED LABORATORY

7750
05:36:32,272 --> 05:36:35,708
STRESSOR WHERE INDIVIDUALS

7751
05:36:35,775 --> 05:36:38,111
COMPLETE THIS SORT OF ON THE GO

7752
05:36:38,177 --> 05:36:39,445
10-MINUTE SPEECH IN FRONT OF A

7753
05:36:39,512 --> 05:36:42,282
PANEL OF INTERVIEWERS, AND THE

7754
05:36:42,348 --> 05:36:48,154
INTERVIEWERS ARE SUPPOSED TO BE

7755
05:36:48,221 --> 05:36:51,124
STOIC, NONRESPONSIVE, SO IT'S A

7756
05:36:51,190 --> 05:36:53,426
VERY AVERSIVE EXPERIENCE FOR

7757
05:36:53,493 --> 05:36:55,728
THOSE GOING THROUGH IT.

7758
05:36:55,795 --> 05:36:59,432
BUT YEAH, SO IN THE STUDY, WE

7759
05:36:59,499 --> 05:37:04,771
WERE SPECIFICALLY -- WAS ONE WAY

7760
05:37:04,837 --> 05:37:06,439
TO KIND OF GET AT AN EXPERIENCE

7761
05:37:06,506 --> 05:37:10,043
OF DISCRIMINATION.

7762
05:37:10,109 --> 05:37:18,151
SO BASICALLY WE'RE ASKING --

7763
05:37:18,217 --> 05:37:19,252
RELATIVE TO SAME RACE.

7764
05:37:19,319 --> 05:37:20,687
PARTICULARLY WE WERE INTERESTED

7765
05:37:20,753 --> 05:37:22,322
IN WHETHER INDIVIDUALS'

7766
05:37:22,388 --> 05:37:23,623
PERCEPTION OF DISCRIMINATION

7767
05:37:23,690 --> 05:37:25,425
DURING THAT SOCIAL EVALUATION

7768
05:37:25,491 --> 05:37:28,928
WOULD BE PREDICTIVE.

7769
05:37:28,995 --> 05:37:31,097
SO I'M GOING TO WALK THERE YOU

7770
05:37:31,164 --> 05:37:33,600
METHODS OF WHAT WE DID WITH THE

7771
05:37:33,666 --> 05:37:34,033
STUDY.

7772
05:37:34,100 --> 05:37:35,568
BEFORE WE CAME INTO THE LAB, WE

7773
05:37:35,635 --> 05:37:38,838
DID GET MEASURES OF EVERY

7774
05:37:38,905 --> 05:37:39,439
DISCRIMINATION, RACIAL AND

7775
05:37:39,505 --> 05:37:43,109
ETHNICITY, OTHER TYPES OF

7776
05:37:43,176 --> 05:37:50,817
DIFFERENCES, AND SO THEN THEY

7777
05:37:50,883 --> 05:37:54,487
CAME TO THE LAB WHERE THEY WERE

7778
05:37:54,554 --> 05:37:56,022
RANDOMIZED IN FRONT OF A PANEL

7779
05:37:56,089 --> 05:37:58,524
OF TWO BLACK EVALUATORS OR TWO

7780
05:37:58,591 --> 05:38:03,329
WHITE EVALUATORS.

7781
05:38:03,396 --> 05:38:05,298
AGAIN ALL HAD AT LEAST ONE

7782
05:38:05,365 --> 05:38:06,733
FEMALE PRESENTING PARTICIPANT

7783
05:38:06,799 --> 05:38:08,901
AND ONE -- I'M SORRY, ONE MALE

7784
05:38:08,968 --> 05:38:10,236
PRESENTING EVALUATOR, ONE FEMALE

7785
05:38:10,303 --> 05:38:11,004
PRESENTING.

7786
05:38:11,070 --> 05:38:15,608
AND SO WHILE WE LOOKED AT BOTH

7787
05:38:15,675 --> 05:38:16,175
AUTONOMIC AND EFFECTIVE

7788
05:38:16,242 --> 05:38:17,243
REACTIVITY, WHAT WE ARE MOST

7789
05:38:17,310 --> 05:38:18,211
INTERESTED AGAIN OF SORT OF

7790
05:38:18,277 --> 05:38:19,012
WHETHER OR NOT WE SAW

7791
05:38:19,078 --> 05:38:20,246
DIFFERENCES IN TERMS OF

7792
05:38:20,313 --> 05:38:21,748
INFLAMMATORY REACTIVITY, SO WE

7793
05:38:21,814 --> 05:38:22,749
COLLECTED BLOOD SAMPLES

7794
05:38:22,815 --> 05:38:28,755
POTASSBOTHBEFORE AND 60 MINUTESS

7795
05:38:28,821 --> 05:38:30,490
SOCIAL STRESS TASK SO WE'LL BE

7796
05:38:30,556 --> 05:38:32,558
REALLY RECENTLY FINISH

7797
05:38:32,625 --> 05:38:33,660
COLLECTING DATA FOR THIS.

7798
05:38:33,726 --> 05:38:34,560
I DON'T HAVE ANY DATA TO PRESENT

7799
05:38:34,627 --> 05:38:37,296
WITH YOU GUYS TODAY

7800
05:38:37,363 --> 05:38:37,964
UNFORTUNATELY.

7801
05:38:38,031 --> 05:38:43,636
BUT I WANTED TO KIND OF GIVE A

7802
05:38:43,703 --> 05:38:45,471
SAMPLING OF A POTENTIAL METHOD.

7803
05:38:45,538 --> 05:38:47,674
WE ARE ALSO INTERESTED IN GOING

7804
05:38:47,740 --> 05:38:49,008
BEYOND INFLAMMATORY MARKERS

7805
05:38:49,075 --> 05:38:50,109
LOOKING AT WHETHER THE TYPE OF

7806
05:38:50,176 --> 05:38:54,580
STRESS CAN BE -- INFLUENCE OTHER

7807
05:38:54,647 --> 05:38:55,982
ASPECTS OF IMMUNE FUNCTIONING SO

7808
05:38:56,049 --> 05:38:58,418
WE CAN USE SORT OF A NOVEL

7809
05:38:58,484 --> 05:39:00,253
ACTIVATION OF SOMETHING CALLED A

7810
05:39:00,319 --> 05:39:01,354
HISTAMINE SCRATCH TEST, SO

7811
05:39:01,421 --> 05:39:02,455
ESSENTIALLY WE APPLY A SMALL

7812
05:39:02,522 --> 05:39:03,756
AMOUNT OF HISTAMINE TO THE

7813
05:39:03,823 --> 05:39:08,461
PERSON'S SKIN, EVERYONE -- KNOWS

7814
05:39:08,528 --> 05:39:09,862
PEOPLE ARE GOING TO SHOW SOME

7815
05:39:09,929 --> 05:39:11,097
SORT OF RESPONSE TO IT, SO THIS

7816
05:39:11,164 --> 05:39:12,832
WILL OFFER US A METRIC OF HOW

7817
05:39:12,899 --> 05:39:14,867
ROBUST OF AN IMMUNE RESPONSE

7818
05:39:14,934 --> 05:39:15,601
PEOPLE MIGHT BE SHOWING, BOTH

7819
05:39:15,668 --> 05:39:17,370
BEFORE AND AFTER THE STRESS

7820
05:39:17,437 --> 05:39:18,671
MANIPULATION SO WE'RE INTERESTED

7821
05:39:18,738 --> 05:39:22,742
IN SEEING WHAT THIS PARTICULAR

7822
05:39:22,809 --> 05:39:23,710
STRESSOR, PARTICULARLY THOSE WHO

7823
05:39:23,776 --> 05:39:27,847
ARE SORT OF ENDORSING PERCEIVING

7824
05:39:27,914 --> 05:39:30,817
DISCRIMINATION, HOW THAT AFFECTS

7825
05:39:30,883 --> 05:39:31,484
A SORT OF IMMUNE RESPONSE THERE

7826
05:39:31,551 --> 05:39:32,585
IN ADDITION TO LEVELS OF

7827
05:39:32,652 --> 05:39:37,290
INFLAMMATION.

7828
05:39:37,356 --> 05:39:39,125
SO AGAIN, I DON'T HAVE ANY

7829
05:39:39,192 --> 05:39:39,659
SPECIFIC DATA TO SHOW YOU.

7830
05:39:39,726 --> 05:39:40,793
I DID WANT TO HIGHLIGHT, SO

7831
05:39:40,860 --> 05:39:42,028
AFTER THE STUDY COMPLETED, WE

7832
05:39:42,095 --> 05:39:44,564
DID A PRETTY EXTENSIVE

7833
05:39:44,630 --> 05:39:45,865
DEBRIEFING PROCESS WITH ALL OF

7834
05:39:45,932 --> 05:39:47,200
OUR PARTICIPANTS.

7835
05:39:47,266 --> 05:39:48,968
PARTICULARLY BECAUSE ONE, WE

7836
05:39:49,035 --> 05:39:49,969
WERE RECOGNIZING THAT WE WERE

7837
05:39:50,036 --> 05:39:52,138
SORT OF LIKE STILL TRYING TO

7838
05:39:52,205 --> 05:39:53,339
UNDERSTAND WHAT WOULD BE THE

7839
05:39:53,406 --> 05:39:56,342
BEST WAY OF GOING ABOUT DOING

7840
05:39:56,409 --> 05:39:57,777
RESEARCH OF THIS NATURE, SO WE

7841
05:39:57,844 --> 05:40:00,279
WANT TO GET PERSPECTIVES AS TO

7842
05:40:00,346 --> 05:40:01,848
WHETHER THIS WAS AN EXPERIENCE

7843
05:40:01,914 --> 05:40:02,849
THAT MAPPED OUT TO THE

7844
05:40:02,915 --> 05:40:03,950
EXPERIENCE THEY MIGHT HAVE IN

7845
05:40:04,016 --> 05:40:06,552
THE REAL WORLD IN TERMS OF

7846
05:40:06,619 --> 05:40:07,987
EXPERIENCING DISCRIMINATION OR

7847
05:40:08,054 --> 05:40:09,422
RACISM AND STRESS, AS WELL AS

7848
05:40:09,489 --> 05:40:10,957
THEIR THOUGHTS ON HOW THESE

7849
05:40:11,023 --> 05:40:15,094
TYPES OF TASKS WILL BE APPROVED.

7850
05:40:15,161 --> 05:40:16,696
SO I WANTED TO SHOW THESE QUOTES

7851
05:40:16,763 --> 05:40:19,165
TO HIGHLIGHT THAT WHILE WE DON'T

7852
05:40:19,232 --> 05:40:20,600
HAVE A QUANTITY OF DATA TO SPEAK

7853
05:40:20,666 --> 05:40:24,303
TO WHETHER PARTICIPANTS PERCE

7854
05:40:24,370 --> 05:40:27,140
PERCEIVED THE CROSS RANK

7855
05:40:27,206 --> 05:40:28,374
EVALUATION -- WHAT WE ARE SEEING

7856
05:40:28,441 --> 05:40:29,575
IS THAT PEOPLE ARE DEFINITELY

7857
05:40:29,642 --> 05:40:30,543
ENDORSING THINGS THAT SORT OF TO

7858
05:40:30,610 --> 05:40:31,844
ME FEEL LIKE ON THE THEME OF

7859
05:40:31,911 --> 05:40:34,313
SORT OF THIS RACISM-RELATED

7860
05:40:34,380 --> 05:40:37,049
VIGILANCE OR JUST BEING MORE VEG

7861
05:40:37,116 --> 05:40:42,321
LAMOREVIGILANT WITH WHITE INDIV,

7862
05:40:42,388 --> 05:40:43,823
SO I WANTED TO HIGHLIGHT

7863
05:40:43,890 --> 05:40:45,358
SOMETHING THAT MORE WORK WILL

7864
05:40:45,424 --> 05:40:46,559
CERTAINLY BE COMING FROM THIS.

7865
05:40:46,626 --> 05:40:47,894
BUT WE'RE VERY INTERESTED TO SEE

7866
05:40:47,960 --> 05:40:52,365
KIND OF HOW THESE PERCEPTIONS

7867
05:40:52,431 --> 05:40:55,535
ARE SORT OF MAPPING ON TO THEIR

7868
05:40:55,601 --> 05:40:57,737
ACTUAL INFLAMMATORY REACTIVITY.

7869
05:40:57,804 --> 05:41:01,274
SO THANK YOU TO DR. MUSCATELL

7870
05:41:01,340 --> 05:41:06,179
AND THE CHAIR  CAROLINA LAB.

7871
05:41:06,245 --> 05:41:07,680
YOU CAN CHECK OUT THE FULL

7872
05:41:07,747 --> 05:41:15,521
MANUSCRIPT THERE.

7873
05:41:15,588 --> 05:41:16,155
>> ALL RIGHT.

7874
05:41:16,222 --> 05:41:22,562
SO WE ARE OPEN FOR QUESTIONS.

7875
05:41:22,628 --> 05:41:24,230
I HAVE A QUESTION FROM THE ZOOM

7876
05:41:24,297 --> 05:41:24,430
FIRST.

7877
05:41:24,497 --> 05:41:26,265
IS THERE ANY EVIDENCE FOR

7878
05:41:26,332 --> 05:41:28,034
SUBGROUP DIFFERENCES IN LEVEL OF

7879
05:41:28,100 --> 05:41:30,636
SERUM INFLAMMATORY MARKERS, WITH

7880
05:41:30,703 --> 05:41:32,138
SOME GROUPS MORE OR LESS LIKELY

7881
05:41:32,205 --> 05:41:35,741
TO HAVE INFLAMMATORY SYMPTOMS

7882
05:41:35,808 --> 05:41:39,679
BUT NORMAL SYMPTOMS OF

7883
05:41:39,745 --> 05:41:43,716
INFLAMMATORY MARKERS?

7884
05:41:43,783 --> 05:41:45,885
>> I THINK THAT'S A ME QUESTION.

7885
05:41:45,952 --> 05:41:49,488
I DON'T KNOW.

7886
05:41:49,555 --> 05:41:53,092
THE BEST KNOWLEDGE I HAVE OF

7887
05:41:53,159 --> 05:41:56,028
THAT IS MORE AT THE POPULATION

7888
05:41:56,095 --> 05:41:58,631
LEVEL, AND THERE WE ACTUALLY DO

7889
05:41:58,698 --> 05:42:00,399
NOT FIND MUCH OF AN EVIDENCE

7890
05:42:00,466 --> 05:42:02,768
PERTAINING TO THAT.

7891
05:42:02,835 --> 05:42:05,137
BUT MAYBE BASED ON MORE OF LIKE

7892
05:42:05,204 --> 05:42:08,140
AT THE EXPERIMENTAL DESIGN, THEY

7893
05:42:08,207 --> 05:42:10,610
MIGHT BE -- THERE MIGHT BE SOME

7894
05:42:10,676 --> 05:42:13,479
SUBTLE DIFFERENCES THERE.

7895
05:42:13,546 --> 05:42:15,648
>> SO THERE ARE CERTAINLY SOME

7896
05:42:15,715 --> 05:42:17,183
MARKERS THAT TEND TO -- THAT WE

7897
05:42:17,250 --> 05:42:20,019
TEND TO SEE MORE SIGNIFICANT

7898
05:42:20,086 --> 05:42:21,554
EFFECTS FOR IN RESPONSE TO SORT

7899
05:42:21,621 --> 05:42:23,189
OF ACUTE MANIPULATIONS OF STRESS

7900
05:42:23,256 --> 05:42:24,624
RELATIVE TO MORE CHRONIC STRESS.

7901
05:42:24,690 --> 05:42:27,460
SO FOR EXAMPLE, THERE'S META

7902
05:42:27,526 --> 05:42:30,296
EVIDENCE SORT OF SHOWING THAT

7903
05:42:30,363 --> 05:42:32,265
IL-6 IS A PARTICULARLY

7904
05:42:32,331 --> 05:42:35,101
RESPONSIVE TO ACUTE STRESS OF

7905
05:42:35,167 --> 05:42:36,402
SOMETHING LIKE THE STRESS TASK,

7906
05:42:36,469 --> 05:42:39,906
WE DO SEE ROBUST INCREASES IN

7907
05:42:39,972 --> 05:42:44,143
IL-6 BUT NOT SO MUCH THE SORT OF

7908
05:42:44,210 --> 05:42:52,685
THINGS LIKE CRP OR IF ASSOCIATED

7909
05:42:52,752 --> 05:42:54,453
WITH MORE CHRONIC FORMS OF

7910
05:42:54,520 --> 05:42:56,289
STRESS OR MORE CHRONIC

7911
05:42:56,355 --> 05:42:57,056
DISCRIMINATION.

7912
05:42:57,123 --> 05:42:58,691
>> AND THE SECOND QUESTION, I

7913
05:42:58,758 --> 05:43:00,626
THINK THIS ONE IS FOR YOU,

7914
05:43:00,693 --> 05:43:01,193
CARRINGTON.

7915
05:43:01,260 --> 05:43:04,263
HOW DOES ONE TAKE THIS

7916
05:43:04,330 --> 05:43:07,199
INFORMATION, IMPLEMENT IT IN

7917
05:43:07,266 --> 05:43:09,235
REAL LIFE FOR THOSE WITH

7918
05:43:09,302 --> 05:43:11,370
LOWER -- CONTROL -- ESPECIALLY

7919
05:43:11,437 --> 05:43:13,239
IF THEY ARE FROM A MARGINALIZED

7920
05:43:13,306 --> 05:43:15,408
GROUP WHERE THEY MIGHT ACTUALLY

7921
05:43:15,474 --> 05:43:16,742
HAVE THE CONTROL?

7922
05:43:16,809 --> 05:43:17,810
>> YES.

7923
05:43:17,877 --> 05:43:20,212
THIS IS A GREAT QUESTION.

7924
05:43:20,279 --> 05:43:22,348
AS SOMEBODY WHO'S ALSO TRAINING

7925
05:43:22,415 --> 05:43:25,017
AS A CLINICAL PSYCHOLOGIST AND

7926
05:43:25,084 --> 05:43:29,155
INTERESTED IN HOW PSYCHOLOGICAL

7927
05:43:29,221 --> 05:43:29,755
OR PSYCHOTHERAPY INTERVENTIONS

7928
05:43:29,822 --> 05:43:31,257
CAN ALSO BE LEVERAGED TO HELP

7929
05:43:31,324 --> 05:43:35,895
WITH ADDRESSING EXPERIENCES OF

7930
05:43:35,962 --> 05:43:36,562
DISCRIMINATION, I DEFINITELY

7931
05:43:36,629 --> 05:43:39,432
THINK THAT, YOU KNOW, IT'S TRUE

7932
05:43:39,498 --> 05:43:42,134
THAT WE ARE ABLE TO JUST KIND OF

7933
05:43:42,201 --> 05:43:44,003
ALLOW -- IF WE WERE MAGICALLY

7934
05:43:44,070 --> 05:43:46,072
ABLE TO HAVE PEOPLE BE MORE

7935
05:43:46,138 --> 05:43:47,340
RESOURCED AND HAVE MORE ACCESS

7936
05:43:47,406 --> 05:43:48,808
TO RESOURCES, THAT CERTAINLY

7937
05:43:48,874 --> 05:43:52,545
WOULD BE A SIGNIFICANT

7938
05:43:52,611 --> 05:43:54,180
IMPROVEMENT IN THE LIVES OF MANY

7939
05:43:54,246 --> 05:43:55,147
PEOPLE, AND IT TRUE THAT, YOU

7940
05:43:55,214 --> 05:43:57,550
KNOW, PERCEIVED CONTROL IS

7941
05:43:57,616 --> 05:43:59,618
DEFINITELY ASSOCIATED WITH

7942
05:43:59,685 --> 05:44:02,788
ASPECTS OF SOCIOECONOMIC STATUS,

7943
05:44:02,855 --> 05:44:04,123
LIKE EDUCATION AND INCOME, BUT

7944
05:44:04,190 --> 05:44:05,091
THERE'S ALSO WORK SHOWING THAT

7945
05:44:05,157 --> 05:44:06,726
THERE IS STILL A VARIATION OF

7946
05:44:06,792 --> 05:44:08,027
PER ACCEPTINGS OF CONTROL EVEN

7947
05:44:08,094 --> 05:44:12,164
PERCEPTIONS OF CONTROL EVEN AT

7948
05:44:12,231 --> 05:44:13,966
THE LOWER SOCIOECONOMIC STATUS

7949
05:44:14,033 --> 05:44:15,267
END OF THE POLE, SO THAT

7950
05:44:15,334 --> 05:44:16,168
SUGGESTS THAT THAT IS SOMETHING

7951
05:44:16,235 --> 05:44:17,970
THAT CAN STILL BE SORT OF

7952
05:44:18,037 --> 05:44:19,271
INTERVENED UPON EVEN FOR PEOPLE

7953
05:44:19,338 --> 05:44:21,474
WHO ARE LOWER RESOURCED.

7954
05:44:21,540 --> 05:44:24,110
AND SO AGAIN, I THINK THAT PART

7955
05:44:24,176 --> 05:44:25,511
OF BEING ABLE TO INTERVENE ON

7956
05:44:25,578 --> 05:44:26,946
THAT MEANS THAT, YOU KNOW, THERE

7957
05:44:27,013 --> 05:44:30,549
JUST NEEDS TO BE MORE EFFORTS

7958
05:44:30,616 --> 05:44:32,184
AND RESOURCES FOR THOSE WHO ARE

7959
05:44:32,251 --> 05:44:34,153
DOING THAT KIND OF WORK OR FOR

7960
05:44:34,220 --> 05:44:35,588
THOSE WHO ARE IN THOSE POSITIONS

7961
05:44:35,654 --> 05:44:38,290
TO ACCESS THOSE KINDS OF

7962
05:44:38,357 --> 05:44:40,159
INTERVENTIONS, WHETHER IT IS

7963
05:44:40,226 --> 05:44:42,028
PSYCHOLOGICAL OR HOW DO WE MAKE

7964
05:44:42,094 --> 05:44:42,995
THOSE MORE AVAILABLE, I THINK

7965
05:44:43,062 --> 05:44:47,133
THAT'S A QUESTION THAT STILL

7966
05:44:47,199 --> 05:44:48,134
NEEDS WORK BUT I THINK THAT'S

7967
05:44:48,200 --> 05:44:49,869
CERTAINLY SOMETHING THAT CAN BE

7968
05:44:49,935 --> 05:44:53,472
LEVERAGED IN THOSE CONTEXTS

7969
05:44:53,539 --> 05:44:56,208
WHERE BEING ABLE TO ACTUALLY

7970
05:44:56,275 --> 05:44:57,543
INCREASE PHYSICAL RESOURCES IS

7971
05:44:57,610 --> 05:45:01,614
NOT AN OPTION.

7972
05:45:01,680 --> 05:45:03,115
>> I'D LIKE TO ADD TO THAT.

7973
05:45:03,182 --> 05:45:04,784
OF COURSE WE'RE ALL TALKING

7974
05:45:04,850 --> 05:45:06,385
ABOUT POLICY CHANGES, SO IF WE

7975
05:45:06,452 --> 05:45:07,720
CAN IMPLEMENT POLICY THAT WOULD

7976
05:45:07,787 --> 05:45:11,290
BE THE IDEAL SITUATION, BUT I

7977
05:45:11,357 --> 05:45:13,059
KNOW THAT'S GOING TO HAPPEN IN

7978
05:45:13,125 --> 05:45:13,926
MY LIFETIME, I DON'T KNOW IF

7979
05:45:13,993 --> 05:45:15,795
IT'S GOING TO HAPPEN IN MY KIDS'

7980
05:45:15,861 --> 05:45:16,429
LIFETIME.

7981
05:45:16,495 --> 05:45:17,396
BUT WHAT WE CAN DO IS I THINK,

7982
05:45:17,463 --> 05:45:20,366
YOU KNOW, LIKE YOU MENTIONED,

7983
05:45:20,433 --> 05:45:22,001
GIVE THEM SMALL THINGS SO THEY

7984
05:45:22,068 --> 05:45:23,436
FEEL MORE CONTROL, SO WHETHER

7985
05:45:23,502 --> 05:45:25,738
IT'S LIFESTYLE -- I THINK,

7986
05:45:25,805 --> 05:45:26,472
DR. NORRIS, YOU MENTIONED

7987
05:45:26,539 --> 05:45:28,007
WHETHER IT'S LIFESTYLE, WHETHER

7988
05:45:28,074 --> 05:45:29,975
IT'S DIET, WHETHER IT'S PHYSICAL

7989
05:45:30,042 --> 05:45:32,611
ACTIVITY, EVEN SOCIAL

7990
05:45:32,678 --> 05:45:33,913
CONNECTEDNESS, FEELING CONNECTED

7991
05:45:33,979 --> 05:45:36,549
TO PEOPLE CAN BUFFER AGAINST

7992
05:45:36,615 --> 05:45:38,751
NEGATIVE EFFECTS, FEELING THAT

7993
05:45:38,818 --> 05:45:40,252
YOU HAVE -- SOMEBODY HAS YOUR

7994
05:45:40,319 --> 05:45:42,354
BACK, YOU KNOW, SO IF THINGS DO

7995
05:45:42,421 --> 05:45:43,756
GO DOWN, THERE ARE THINGS THAT

7996
05:45:43,823 --> 05:45:46,292
YOU CAN DO.

7997
05:45:46,358 --> 05:45:48,127
I THINK ABOUT THIS, WE TALKED

7998
05:45:48,194 --> 05:45:49,762
ABOUT VITAMIN C, WE USED TO TALK

7999
05:45:49,829 --> 05:45:54,667
ABOUT VITAMIN C AS BEING LIKE

8000
05:45:54,733 --> 05:45:55,568
THAT, THAT PREEIVETS YOU FROM

8001
05:45:55,634 --> 05:45:56,235
GETTING SICK.

8002
05:45:56,302 --> 05:45:57,903
WE'RE SEEING THAT DISCRIMINATION

8003
05:45:57,970 --> 05:45:58,304
DOES MAKE US SICK.

8004
05:45:58,370 --> 05:46:00,473
WE'RE SEEING THAT.

8005
05:46:00,539 --> 05:46:01,574
SO MAYBE SOMETHING RELATED TO

8006
05:46:01,640 --> 05:46:03,742
THAT THAT AT LEAST HELPS US COPE

8007
05:46:03,809 --> 05:46:05,411
IN THE MOMENT.

8008
05:46:05,478 --> 05:46:06,378
WHILE HOPEFULLY THE POLICY STUFF

8009
05:46:06,445 --> 05:46:08,814
IS HAPPENING.

8010
05:46:08,881 --> 05:46:11,183
>> I'M JUST GOING TO ADD TO THAT

8011
05:46:11,250 --> 05:46:13,252
FOR JUST A SECOND BEFORE I TAKE

8012
05:46:13,319 --> 05:46:15,020
THE NEXT QUESTION, AND I JUST

8013
05:46:15,087 --> 05:46:16,755
WANTED TO FIND OUT IN TERMS OF

8014
05:46:16,822 --> 05:46:18,357
SOME LEVELS OF CONTROL, IT MADE

8015
05:46:18,424 --> 05:46:19,692
ME THINK BACK TO THE PANEL WE

8016
05:46:19,758 --> 05:46:21,026
HAD THIS MORNING WITH OUR

8017
05:46:21,093 --> 05:46:24,830
PATIENT ADVOCATES, THE

8018
05:46:24,897 --> 05:46:25,498
ADVOCATES -- COMMUNITY

8019
05:46:25,564 --> 05:46:27,266
ADVOCATES, I THINK HAVING

8020
05:46:27,333 --> 05:46:28,467
SOMEBODY LIKE BOBBY HOWARD TO

8021
05:46:28,534 --> 05:46:30,202
TALK TO YOU AND GIVE YOU SOME

8022
05:46:30,269 --> 05:46:31,737
GUIDANCE AND GIVE YOU A LITTLE

8023
05:46:31,804 --> 05:46:33,472
BIT OF A SENSE OF CONTROL, SO

8024
05:46:33,539 --> 05:46:34,940
HAVING ADVOCATES AT THAT LEVEL,

8025
05:46:35,007 --> 05:46:36,976
I THINK WOULD BE VERY HELPFUL.

8026
05:46:37,042 --> 05:46:40,579
YES, QUESTION IN THE BACK.

8027
05:46:40,646 --> 05:46:41,680
>> THANK YOU FOR THE

8028
05:46:41,747 --> 05:46:42,214
PRESENTATIONS.

8029
05:46:42,281 --> 05:46:43,782
SO DR. GUPTA, I WAS WONDERING

8030
05:46:43,849 --> 05:46:45,618
FROM THE EARLIER SLIDES IN YOUR

8031
05:46:45,684 --> 05:46:46,719
PRESENTATION, IS THERE SOMETHING

8032
05:46:46,785 --> 05:46:49,755
ABOUT PERCEIVING RACE AS A BASIS

8033
05:46:49,822 --> 05:46:51,090
OF DISCRIMINATION THAT LEADS TO

8034
05:46:51,157 --> 05:46:54,260
WORSE OUTCOMES, LIKE WORSE

8035
05:46:54,326 --> 05:46:55,895
INFLAMMATION, AND HEARING WHAT

8036
05:46:55,961 --> 05:46:57,429
WAS REPRESENTED TODAY, I'M

8037
05:46:57,496 --> 05:46:59,498
WONDERING IF IT COULD BE RELATED

8038
05:46:59,565 --> 05:47:00,799
TO PERCEPTION OF CONTROL OR

8039
05:47:00,866 --> 05:47:02,368
VIGILANCE.

8040
05:47:02,434 --> 05:47:04,403
>> WE CAN SPECULATE ON THAT.

8041
05:47:04,470 --> 05:47:08,240
I THI DIDN'T DIRECTLY MEASURE T.

8042
05:47:08,307 --> 05:47:11,010
I DID A VERY DANGEROUS THING

8043
05:47:11,076 --> 05:47:12,912
THAT I USUALLY DON'T LIKE TO DO,

8044
05:47:12,978 --> 05:47:16,182
WHEN WE STRATIFY BY RACE AND

8045
05:47:16,248 --> 05:47:17,082
ETHNICITY, WE'RE KIND OF

8046
05:47:17,149 --> 05:47:18,083
ATTRIBUTING THAT IT'S A RACE

8047
05:47:18,150 --> 05:47:20,052
BASED OR ETHNICITY BASED VERSUS

8048
05:47:20,119 --> 05:47:21,387
WHAT'S REALLY GOING ON.

8049
05:47:21,453 --> 05:47:22,988
BUT LIKE WE CAN SEE, EVERY

8050
05:47:23,055 --> 05:47:25,724
GROUP, EVERY RACIAL AND ETHNIC

8051
05:47:25,791 --> 05:47:28,861
GROUP ENDORSE DISCRIMINATION BUT

8052
05:47:28,928 --> 05:47:29,428
IT'S DIFFERENT FOR DIFFERENT

8053
05:47:29,495 --> 05:47:29,662
PEOPLE.

8054
05:47:29,728 --> 05:47:31,063
SO IF WE KIND OF COGNITIVELY

8055
05:47:31,130 --> 05:47:32,731
THINK ABOUT IT, YOU KNOW, BLACKS

8056
05:47:32,798 --> 05:47:34,466
AND HISPANICS HAVE BEEN

8057
05:47:34,533 --> 05:47:36,769
EXPERIENCING DISCRIMINATION FOR

8058
05:47:36,835 --> 05:47:37,403
GENERATIONS.

8059
05:47:37,469 --> 05:47:40,139
SO IT'S NOT ONLY BEING -- THE

8060
05:47:40,206 --> 05:47:41,607
BIOLOGICAL EFFECTS ARE NOT ONLY

8061
05:47:41,674 --> 05:47:42,541
BEING TRANSFERRED FROM

8062
05:47:42,608 --> 05:47:43,676
GENERATION TO GENERATION, BUT

8063
05:47:43,742 --> 05:47:45,177
WHEN YOU THINK ABOUT IT, YOU

8064
05:47:45,244 --> 05:47:46,378
EXPERIENCE DISCRIMINATION,

8065
05:47:46,445 --> 05:47:47,580
YOU'RE GOING TO BE LIKE, OKAY,

8066
05:47:47,646 --> 05:47:48,547
HERE WE GO AGAIN.

8067
05:47:48,614 --> 05:47:49,982
SO IT'S KIND OF ALMOST THAT,

8068
05:47:50,049 --> 05:47:51,383
LIKE, ALL RIGHT, I KIND OF

8069
05:47:51,450 --> 05:47:52,918
EXPECTED THAT, WHEREAS SOMEBODY

8070
05:47:52,985 --> 05:47:55,588
WHO EXPERIENCES DISCRIMINATION

8071
05:47:55,654 --> 05:47:57,189
WHICH MIGHT BE A NOVEL

8072
05:47:57,256 --> 05:47:58,757
EXPERIENCE, LIKE OH, MY GOD, WHY

8073
05:47:58,824 --> 05:47:59,925
IS THIS HAPPENING TO ME?

8074
05:47:59,992 --> 05:48:01,327
SO WE KIND OF SEE THAT BASED

8075
05:48:01,393 --> 05:48:04,163
UPON WHAT THEY ATTRIBUTE THE

8076
05:48:04,230 --> 05:48:05,164
DISCRIMINATION TO COULD BE

8077
05:48:05,231 --> 05:48:06,999
RELATED TO THOSE DIFFERENCES IN

8078
05:48:07,066 --> 05:48:09,501
THE BRAIN SIGNATURES AND IN THE

8079
05:48:09,568 --> 05:48:10,402
MICRO BAY ONLY AND THE

8080
05:48:10,469 --> 05:48:11,604
METABOLITES, WHICH ARE MORE

8081
05:48:11,670 --> 05:48:13,772
EXCUSE SCEUD TOWARDS

8082
05:48:13,839 --> 05:48:16,075
INFLAMMATION IN THE BLACK AND

8083
05:48:16,141 --> 05:48:16,742
HISPANICS VERSUS THE OTHER

8084
05:48:16,809 --> 05:48:16,976
GROUPS.

8085
05:48:17,042 --> 05:48:17,710
>> THANK YOU.

8086
05:48:17,776 --> 05:48:19,245
>> DR. NORRIS?

8087
05:48:19,311 --> 05:48:21,146
>> THANKS VERY MUCH FOR A GREAT

8088
05:48:21,213 --> 05:48:22,848
PANEL AND SORT OF WINDING UP THE

8089
05:48:22,915 --> 05:48:25,184
DAY FOR US.

8090
05:48:25,251 --> 05:48:26,986
I HAD A QUESTION.

8091
05:48:27,052 --> 05:48:30,389
SITTING HERE THINKING ABOUT --

8092
05:48:30,456 --> 05:48:32,458
DATASETS, I DON'T KNOW ABOUT --

8093
05:48:32,524 --> 05:48:34,693
I WAS JUST THINKING -- SO LOOK

8094
05:48:34,760 --> 05:48:36,996
AT THE RELATIONSHIP BETWEEN

8095
05:48:37,062 --> 05:48:38,864
DISCRIMINATION AND DIFFERENT

8096
05:48:38,931 --> 05:48:41,600
INFLAMMATORY MARKERS AND

8097
05:48:41,667 --> 05:48:44,436
MEDIATORS, OTHER YO SUBSTANCE, T

8098
05:48:44,503 --> 05:48:48,274
CETERA.

8099
05:48:48,340 --> 05:48:49,808
ONE -- DISCRIMINATION CAN COME

8100
05:48:49,875 --> 05:48:51,076
THIS ONGOING COGNITIVE PROCESS,

8101
05:48:51,143 --> 05:48:53,178
INTO THE EVENING, POOR SLEEP,

8102
05:48:53,245 --> 05:48:57,549
AND SO DO THOSE DATASETS HAVE

8103
05:48:57,616 --> 05:49:00,619
ANY MEASURES OF SLEEP QUALITY

8104
05:49:00,686 --> 05:49:02,354
OR -- I KNOW SOME OF THEM DO AND

8105
05:49:02,421 --> 05:49:05,324
DO YOU KNOW IF ANYBODY HAS USED

8106
05:49:05,391 --> 05:49:08,294
THOSE AS PART OF COVARIATES IN

8107
05:49:08,360 --> 05:49:14,300
MODELING?

8108
05:49:14,366 --> 05:49:17,469
>> WHY THIS DOES -- JACKSON

8109
05:49:17,536 --> 05:49:19,004
HEART STUDY, THEY DO, AND I

8110
05:49:19,071 --> 05:49:24,343
THINK THAT DOES PROVIDE -- THAT

8111
05:49:24,410 --> 05:49:25,344
DOES PROVIDE GREAT OPPORTUNITY

8112
05:49:25,411 --> 05:49:27,212
JUST TO LOOK AT POTENTIAL

8113
05:49:27,279 --> 05:49:28,280
MECHANISMS HERE, BECAUSE

8114
05:49:28,347 --> 05:49:29,048
ACTUALLY THIS ACTUALLY GOES BACK

8115
05:49:29,114 --> 05:49:31,684
TO AN EARLIER DISCUSSION HAD

8116
05:49:31,750 --> 05:49:37,690
WITH DR. JETER ABOUT HOW DOES

8117
05:49:37,756 --> 05:49:39,224
DISCRIMINATION OPERATE, THAT

8118
05:49:39,291 --> 05:49:41,527
IT'S NOT JUST A PSYCHOLOGICAL

8119
05:49:41,593 --> 05:49:43,262
SOCIAL EVENT THAT JUST HAPPENS

8120
05:49:43,329 --> 05:49:44,263
AT ONE TIME POINT.

8121
05:49:44,330 --> 05:49:45,230
THERE IS A LEVEL OF RUMINATION

8122
05:49:45,297 --> 05:49:46,999
THAT OCCURS THAT DOES LEAD TO

8123
05:49:47,066 --> 05:49:49,735
PEOPLE HAVING POOR SLEEP.

8124
05:49:49,802 --> 05:49:51,904
THAT DOES LEAD TO PEOPLE THEN

8125
05:49:51,970 --> 05:49:54,640
HAVING SOME LEVEL OF VIGILANCE.

8126
05:49:54,707 --> 05:49:55,974
THAT DOES CONTRIBUTE TO A WIDE

8127
05:49:56,041 --> 05:49:58,911
RANGE OF DIFFERENT BEHAVIORAL

8128
05:49:58,977 --> 05:50:01,847
RESPONSES THAT ARE CONNECTED TO

8129
05:50:01,914 --> 05:50:03,048
INFLAMMATION.

8130
05:50:03,115 --> 05:50:04,917
I THINK MOST OF THE MODELS, JUST

8131
05:50:04,983 --> 05:50:08,020
KIND OF LIKE LOOKING THROUGH THE

8132
05:50:08,087 --> 05:50:10,856
REVIEW ON

8133
05:50:10,923 --> 05:50:11,423
DISCRIMINATION/INFLAMMATION,

8134
05:50:11,490 --> 05:50:14,660
PEOPLE HAVE ADJUSTED FOR THE

8135
05:50:14,727 --> 05:50:16,328
TRADITIONAL COVARIATES, YOU

8136
05:50:16,395 --> 05:50:19,832
KNOW, AGE, GENDER,

8137
05:50:19,898 --> 05:50:20,165
SOCIOECONOMIC.

8138
05:50:20,232 --> 05:50:22,668
I MEAN, BMI IS ONE OF THE

8139
05:50:22,735 --> 05:50:24,303
BIGGEST -- ONCE YOU ADJUST FOR

8140
05:50:24,370 --> 05:50:27,039
BMI, IT SOMETIMES ATTENUATES THE

8141
05:50:27,106 --> 05:50:28,140
RELATIONSHIP BETWEEN

8142
05:50:28,207 --> 05:50:28,774
DISCRIMINATION AND INFLAMMATION,

8143
05:50:28,841 --> 05:50:30,876
BUT MANY OF THESE BEHAVIORAL

8144
05:50:30,943 --> 05:50:31,643
RESPONSES, PARTICULARLY SLEEP,

8145
05:50:31,710 --> 05:50:33,812
HAVE NOT BEEN EXPLORED AS

8146
05:50:33,879 --> 05:50:35,247
EXTENSIVELY AS THEY SHOULD.

8147
05:50:35,314 --> 05:50:37,983
>> SO I'M MOSTLY HERE TO THANK

8148
05:50:38,050 --> 05:50:39,818
THE PANEL AND GIVE THEM ONE MORE

8149
05:50:39,885 --> 05:50:40,819
ROUND OF APPLAUSE.

8150
05:50:40,886 --> 05:50:47,159
[APPLAUSE]

8151
05:50:47,226 --> 05:50:52,731
AND WELCOME DR. GERMINO TO THE

8152
05:50:52,798 --> 05:50:55,033
STAGE.

8153
05:50:55,100 --> 05:50:57,202
-- LOOKING AT DISPARITIES AND

8154
05:50:57,269 --> 05:50:59,171
SLEEP AND DISCRIMINATION AND

8155
05:50:59,238 --> 05:51:01,707
SOME OF THE SOCIAL TRIGGERS OF

8156
05:51:01,774 --> 05:51:10,048
THAT.

8157
05:51:10,115 --> 05:51:13,252
>> WHAT CAME UP EARLIER, I JUST

8158
05:51:13,318 --> 05:51:14,620
WANT TO EMPHASIZE THE IMPORTANCE

8159
05:51:14,686 --> 05:51:16,455
OF HAVING COMMUNITY MEMBERS AS

8160
05:51:16,522 --> 05:51:18,824
PART OF OUR RESEARCH TEAM.

8161
05:51:18,891 --> 05:51:19,658
IF YOU DON'T HAVE COMMUNITY

8162
05:51:19,725 --> 05:51:20,993
MEMBERS ON YOUR RESEARCH TEAM,

8163
05:51:21,059 --> 05:51:25,230
YOU'RE MISSING AN IMPORTANT

8164
05:51:25,297 --> 05:51:28,267
COMPONENT OF THE INTELLECTUAL

8165
05:51:28,333 --> 05:51:29,301
INPUT THAT YOU NEED ON YOUR

8166
05:51:29,368 --> 05:51:32,571
TEAM.

8167
05:51:32,638 --> 05:51:34,973
WE HAVE TWO TERMS WE USE FOR OUR

8168
05:51:35,040 --> 05:51:37,109
COMMUNITY PARTNERS.

8169
05:51:37,176 --> 05:51:39,611
ONE IS PH.D. TO THE -- AND THE

8170
05:51:39,678 --> 05:51:42,581
OTHER IS CALLED BONUS POINTS FOR

8171
05:51:42,648 --> 05:51:43,248
WMD.

8172
05:51:43,315 --> 05:51:45,150
WHO KNOW WHAT IS THAT MEANS?

8173
05:51:45,217 --> 05:51:46,552
A WHAT MATTERS DEGREE.

8174
05:51:46,618 --> 05:51:51,857
SO MAKE SURE WHEN YOU -- SO MAKE

8175
05:51:51,924 --> 05:51:53,325
SURE YOU GET COMMUNITY PARTNERS

8176
05:51:53,392 --> 05:51:56,361
TO BE ON YOUR TEAM AS WELL.

8177
05:51:56,428 --> 05:51:57,863
>> THANKS, KEITH.

8178
05:51:57,930 --> 05:52:01,433
IT'S AN IMPORTANT PART THAT I'LL

8179
05:52:01,500 --> 05:52:03,168
TOUCH ON IN A SECOND.

8180
05:52:03,235 --> 05:52:05,471
BUT -- HE HAD HIS TALK SHORT.

8181
05:52:05,537 --> 05:52:06,905
I'M STANDING BETWEEN YOU AND THE

8182
05:52:06,972 --> 05:52:08,474
DOOR SO I'M GOING TO KEEP THIS

8183
05:52:08,540 --> 05:52:10,976
REALLY, REALLY -- THEY DID ASK

8184
05:52:11,043 --> 05:52:13,512
ME TO MAKE A FEW WORDS JUST TO

8185
05:52:13,579 --> 05:52:14,746
EMPHASIZE, AGAIN, RE-EMPHASIZE

8186
05:52:14,813 --> 05:52:16,248
JUST HOW IMPORTANT THIS WORK IS

8187
05:52:16,315 --> 05:52:17,249
TO OUR MISSION.

8188
05:52:17,316 --> 05:52:21,653
AS MANY OF YOU MAY HAVE HEARD,

8189
05:52:21,720 --> 05:52:22,855
NIDDK HAS WITHIN ITS MISSION

8190
05:52:22,921 --> 05:52:27,659
SOME OF THE MOST COMMON --

8191
05:52:27,726 --> 05:52:29,127
DISEASES THAT IMPACT THE

8192
05:52:29,194 --> 05:52:30,863
AMERICAN POPULATION, IN FACT

8193
05:52:30,929 --> 05:52:32,064
LOCALLY THESE DAYS, AND WE KNOW

8194
05:52:32,130 --> 05:52:34,600
MANY OF THESE DISPROPORTIONATELY

8195
05:52:34,666 --> 05:52:37,369
AFFECT MARGINALIZED MINORITIZED

8196
05:52:37,436 --> 05:52:39,338
COMMUNITIES, PEOPLE WITH

8197
05:52:39,404 --> 05:52:40,439
RACIAL/ETHNIC BACKGROUNDS.

8198
05:52:40,506 --> 05:52:41,874
THIS IS WHAT WE'VE BEEN TALKING

8199
05:52:41,940 --> 05:52:43,442
ABOUT ALL DAY, SO THIS IS

8200
05:52:43,509 --> 05:52:45,410
OBVIOUSLY AN IMPORTANT PROBLEM.

8201
05:52:45,477 --> 05:52:47,012
JUST LAST WEEK FIRST HAPPENED, I

8202
05:52:47,079 --> 05:52:48,413
WAS OUT IN PHOENIX MEETING WITH

8203
05:52:48,480 --> 05:52:54,052
SOME LEADERS WHERE WE HAVE A --

8204
05:52:54,119 --> 05:52:55,787
OVER THE YEARS LOOKING AT

8205
05:52:55,854 --> 05:52:57,523
DIABETES RISK, AND I WAS MEETING

8206
05:52:57,589 --> 05:52:58,957
WITH ONE OF THE TRIBAL LEADERS

8207
05:52:59,024 --> 05:53:01,593
THERE AND THEY WERE TELLING ME

8208
05:53:01,660 --> 05:53:04,329
THAT THE AVERAGE LIFE EXPECTANCY

8209
05:53:04,396 --> 05:53:09,268
IN THEIR COMMUNITY IS 46.

8210
05:53:09,334 --> 05:53:11,670
THAT'S -- IT REALLY IS JUST,

8211
05:53:11,737 --> 05:53:14,506
AGAIN, STRIKING DISPARITIES.

8212
05:53:14,573 --> 05:53:16,475
AND SO IN 2021, WHEN WE WERE

8213
05:53:16,542 --> 05:53:21,446
DEVELOPING OUR STRATEGIC PLAN,

8214
05:53:21,513 --> 05:53:22,981
OUR FIRST NIDDK STRATEGIC WIDE

8215
05:53:23,048 --> 05:53:25,284
PROGRAM IN ALMOST 20 YEARS, WHAT

8216
05:53:25,350 --> 05:53:28,453
IS IMPORTANT IN OUR REACHING OUR

8217
05:53:28,520 --> 05:53:32,324
EE MENTION, COULD CLEARLY

8218
05:53:32,391 --> 05:53:34,393
DEFINING PATHWAYS, WE WILL NOT

8219
05:53:34,459 --> 05:53:36,728
BE SUCCESSFUL IN OUR MISSION

8220
05:53:36,795 --> 05:53:40,232
UNTIL WE SEUK SEED IN -- AS BEST

8221
05:53:40,299 --> 05:53:41,567
AS WE CAN FOR EVERYBODY.

8222
05:53:41,633 --> 05:53:44,836
AND THIS IS WHAT LED TO OUR

8223
05:53:44,903 --> 05:53:48,073
EFFORT THAT THE CO-CHAIR OUT IN

8224
05:53:48,140 --> 05:53:49,975
THE AUDIENCE AS WELL, WHERE IT

8225
05:53:50,042 --> 05:53:51,577
WAS, AGAIN, A TWO-YEAR EFFORT.

8226
05:53:51,643 --> 05:53:53,478
SOME OF YOU PARTICIPATED IN THIS

8227
05:53:53,545 --> 05:53:56,114
PROCESS THAT WAS AS YOU HEARD

8228
05:53:56,181 --> 05:53:59,585
THIS MORNING, TO SEE HOW WE CAN

8229
05:53:59,651 --> 05:54:02,254
IMPLEMENT OUR PLAN, DEVELOP A

8230
05:54:02,321 --> 05:54:03,021
PLAN, IMPLEMENT A PLAN TO

8231
05:54:03,088 --> 05:54:04,222
ACHIEVE HEALTH EQUITY FOR ALL,

8232
05:54:04,289 --> 05:54:07,392
AND THIS IS WHAT HIS WORKSHOP IS

8233
05:54:07,459 --> 05:54:08,927
AN IMPORTANT ELEMENT IN.

8234
05:54:08,994 --> 05:54:10,095
I WANT TO JUST MAKE A COUPLE OF

8235
05:54:10,162 --> 05:54:11,630
POINTS ABOUT THAT PLAN.

8236
05:54:11,697 --> 05:54:14,199
ONE IS IF YOU HAVEN'T READ IT, I

8237
05:54:14,266 --> 05:54:15,534
ENCOURAGE YOU TO GO TO OUR

8238
05:54:15,601 --> 05:54:16,301
WEBSITE AND READ IT.

8239
05:54:16,368 --> 05:54:17,502
IT HAS A COUPLE IMPORTANT

8240
05:54:17,569 --> 05:54:18,337
ASPECTS TO IT.

8241
05:54:18,403 --> 05:54:19,638
BESIDES HAVING FIVE

8242
05:54:19,705 --> 05:54:21,173
RECOMMENDATIONS THAT WE PURSUE

8243
05:54:21,239 --> 05:54:22,174
AS AN INSTITUTE.

8244
05:54:22,240 --> 05:54:24,009
ONE OF THE IMPORTANT THINGS THAT

8245
05:54:24,076 --> 05:54:27,479
IT HAS A GUIDING PRINCIPLES

8246
05:54:27,546 --> 05:54:29,414
DOCUMENT AS WELL AS A TIPS FOR

8247
05:54:29,481 --> 05:54:30,515
PEOPLE WHO ARE NEW TO THE FIELD

8248
05:54:30,582 --> 05:54:33,218
TO THINK ABOUT HOW THEY SHOULD

8249
05:54:33,285 --> 05:54:34,519
ENGAGE IN THE RESEARCH IN A

8250
05:54:34,586 --> 05:54:35,621
RESPECTFUL AND MEANINGFUL WAY.

8251
05:54:35,687 --> 05:54:37,089
I THINK THE OTHER IMPORTANT

8252
05:54:37,155 --> 05:54:38,857
POINT I WANT TO EMPHASIZE ABOUT

8253
05:54:38,924 --> 05:54:40,392
THAT PLAN IS SOMETHING THAT

8254
05:54:40,459 --> 05:54:41,493
DR. MORRIS JUST MENTIONED WHICH

8255
05:54:41,560 --> 05:54:42,794
IS THE IMPORTANCE OF COMMUNITY.

8256
05:54:42,861 --> 05:54:47,399
WE HAD A WORKING GROUP, JUST

8257
05:54:47,466 --> 05:54:48,600
OF -- AND OUR STEERING

8258
05:54:48,667 --> 05:54:49,134
COMMITTEE.

8259
05:54:49,201 --> 05:54:52,738
THEY WERE AS -- EVERY OTHER

8260
05:54:52,804 --> 05:54:55,474
SCHOLAR THAT PARTICIPATED IN OUR

8261
05:54:55,540 --> 05:54:58,310
WORK, AND THE PLAN REFLECTS

8262
05:54:58,377 --> 05:55:00,946
THEIR INPUT IMPORTANTLY.

8263
05:55:01,013 --> 05:55:02,848
SO WE NEED TO BE SURE THAT WE

8264
05:55:02,914 --> 05:55:04,049
HAVE THE COMMUNITY AS WE GO

8265
05:55:04,116 --> 05:55:05,550
FORWARD, AS WE HAVE TODAY.

8266
05:55:05,617 --> 05:55:07,753
AS YOU HEARD, WE KNOW THAT MANY

8267
05:55:07,819 --> 05:55:10,989
OF THE CONTRIBUTORS TO THE

8268
05:55:11,056 --> 05:55:13,191
DISPARITIES WE SEE IN HEALTH ARE

8269
05:55:13,258 --> 05:55:15,794
RELATED TO STRUCTURAL FACTORS

8270
05:55:15,861 --> 05:55:18,630
LIKE STRUCTURAL RACISM AND

8271
05:55:18,697 --> 05:55:19,831
DIFFERENT SOCIAL DETERMINANTS OF

8272
05:55:19,898 --> 05:55:20,866
HEALTH, AND THE IMPORTANT THING

8273
05:55:20,932 --> 05:55:24,069
IS THAT THESE EXTERNAL FACTORS

8274
05:55:24,136 --> 05:55:26,405
ALL WEIGH IN ULTIMATELY ON

8275
05:55:26,471 --> 05:55:27,606
BIOLOGICAL PATHWAYS OF HEALTH.

8276
05:55:27,673 --> 05:55:28,807
THIS IS HOW WE GET SICK.

8277
05:55:28,874 --> 05:55:30,008
THIS IS WHAT OUR PATHWAYS ARE.

8278
05:55:30,075 --> 05:55:31,843
SO WE NEED TO BE ABLE TO CONNECT

8279
05:55:31,910 --> 05:55:32,944
AND UNDERSTAND THE RELATIONSHIP

8280
05:55:33,011 --> 05:55:34,479
BETWEEN ALL OF THAT ENVIRONMENT

8281
05:55:34,546 --> 05:55:36,715
AROUND US AND HOW TO TURN THAT

8282
05:55:36,782 --> 05:55:38,383
INTO ILLNESS OR HOW WE TURN THAT

8283
05:55:38,450 --> 05:55:39,584
INTO WELLNESS.

8284
05:55:39,651 --> 05:55:43,321
AND AS DR. NORRIS KICKED US OFF

8285
05:55:43,388 --> 05:55:44,923
THIS MORNING WITH HIS TALK, WE

8286
05:55:44,990 --> 05:55:46,425
REALLY NEED TO BE ABLE TO TACKLE

8287
05:55:46,491 --> 05:55:48,126
THE PROBLEM ON BOTH SIDES.

8288
05:55:48,193 --> 05:55:48,794
WE'VE HEARD ABOUT THE STRUCTURAL

8289
05:55:48,860 --> 05:55:50,429
AND POLICY THINGS WE NEED TO DO.

8290
05:55:50,495 --> 05:55:52,164
HOPEFULLY IT WON'T BE TOO

8291
05:55:52,230 --> 05:55:53,432
GENERATIONS BEFORE WE MAKE

8292
05:55:53,498 --> 05:55:56,401
PROGRESS IN THAT SPACE.

8293
05:55:56,468 --> 05:55:57,536
BUT WE NEED IN THE MEANTIME

8294
05:55:57,602 --> 05:55:58,770
STILL TO FIND SOLUTIONS FOR THE

8295
05:55:58,837 --> 05:56:00,539
PEOPLE WHO ARE SUFFERING TODAY

8296
05:56:00,605 --> 05:56:01,673
AND THE PEOPLE WHO MAY BE

8297
05:56:01,740 --> 05:56:03,442
SUFFERING TOMORROW.

8298
05:56:03,508 --> 05:56:06,712
THIS BRINGS ME TO WHAT WAS ONE

8299
05:56:06,778 --> 05:56:10,816
OF OUR STRENGTHS HISTORICALLY AS

8300
05:56:10,882 --> 05:56:14,086
NIDDK, WE HAVE BEEN FOCUSED FOR

8301
05:56:14,152 --> 05:56:16,088
DECADES ON MECHANISMS OF

8302
05:56:16,154 --> 05:56:16,855
DISEASE, BIOLOGICAL PATHWAYS.

8303
05:56:16,922 --> 05:56:18,490
THIS HAS REALLY BEEN OUR

8304
05:56:18,557 --> 05:56:19,558
STRENGTH FOR A LONG TIME.

8305
05:56:19,624 --> 05:56:21,626
WE ALSO KNOW WE'VE HAD A SMALLER

8306
05:56:21,693 --> 05:56:22,828
FOOTPRINT IN THE SOCIAL AND

8307
05:56:22,894 --> 05:56:24,362
BEHAVIORAL RESEARCH COMMUNITIES.

8308
05:56:24,429 --> 05:56:25,664
THIS IS SOMETHING THAT WE NEED

8309
05:56:25,731 --> 05:56:27,933
TO DO TO LEVERAGE -- WE WANT TO

8310
05:56:27,999 --> 05:56:31,303
BE ABLE TO LEVEL OUR INSTRIN

8311
05:56:31,369 --> 05:56:32,604
SICK STRENGTH AS AN INSTITUTE

8312
05:56:32,671 --> 05:56:36,241
THAT'S BEEN FOCUSED ON --

8313
05:56:36,308 --> 05:56:37,375
DISEASE WITH NOW THIS BROADER

8314
05:56:37,442 --> 05:56:37,876
PERSPECTIVE.

8315
05:56:37,943 --> 05:56:39,444
WHICH IS WHY WE HAD THIS

8316
05:56:39,511 --> 05:56:40,645
WORKSHOP, TO BRING DIFFERENT

8317
05:56:40,712 --> 05:56:43,248
COMMUNITIES TOGETHER SO WE CAN

8318
05:56:43,315 --> 05:56:47,619
ACTUACTUALLY -- TO TACKLE THIS

8319
05:56:47,686 --> 05:56:48,820
REALLY DIFFICULT AND COMPLICATED

8320
05:56:48,887 --> 05:56:49,254
PROBLEM.

8321
05:56:49,321 --> 05:56:51,690
A COUPLE IMPORTANT NOTES ABOUT

8322
05:56:51,757 --> 05:56:53,125
THAT, WE ALSO WANT TO BE SURE WE

8323
05:56:53,191 --> 05:56:54,659
RECOGNIZE THE IMPORTANT WORK

8324
05:56:54,726 --> 05:56:56,394
DONE BY THE PIONEERS INCLUDING

8325
05:56:56,461 --> 05:57:02,901
SOME OF YOU WHO ARE -- WHO'S

8326
05:57:02,968 --> 05:57:05,637
BEEN DOING IT, IT OFTEN WAS EVEN

8327
05:57:05,704 --> 05:57:08,607
IN FACT DISPARAGED BY OUTSIDE

8328
05:57:08,673 --> 05:57:09,307
INVESTIGATORS.

8329
05:57:09,374 --> 05:57:11,276
SO I WANT TO BE SURE THAT WE'RE

8330
05:57:11,343 --> 05:57:12,811
MINDFUL OF THE PRECEDENCE, THE

8331
05:57:12,878 --> 05:57:13,912
IMPORTANT PROGRESS OF OTHERS,

8332
05:57:13,979 --> 05:57:16,882
AND MAKE SURE THAT WE LEVERAGE

8333
05:57:16,948 --> 05:57:19,384
THEIR EXPERTISE AS WE GO

8334
05:57:19,451 --> 05:57:19,718
FORWARD.

8335
05:57:19,785 --> 05:57:22,254
I WANT TO THANK TODAY'S

8336
05:57:22,320 --> 05:57:23,922
SPEAKERS.

8337
05:57:23,989 --> 05:57:25,123
FANTASTIC, REALLY

8338
05:57:25,190 --> 05:57:31,463
THOUGHT-PROVOKING, VERY PRO V

8339
05:57:31,530 --> 05:57:32,130
PROVOCATIVE.

8340
05:57:32,197 --> 05:57:33,698
ENCOURAGING FOR TWO REASONS.

8341
05:57:33,765 --> 05:57:35,000
ONE, IT IDENTIFIES THE MANY

8342
05:57:35,066 --> 05:57:36,535
OPPORTUNITIES WE CAN COME IN AND

8343
05:57:36,601 --> 05:57:40,372
INTERSECT AND HOPEFULLY MAKE AN

8344
05:57:40,438 --> 05:57:42,641
EFFECT, AND TWO, IT DOES ALL

8345
05:57:42,707 --> 05:57:45,677
THE -- SOME OF THE STORIES HAVE

8346
05:57:45,744 --> 05:57:46,344
SUGGESTED -- SOME OF THE

8347
05:57:46,411 --> 05:57:47,445
PRESENTATIONS SUGGESTED THERE

8348
05:57:47,512 --> 05:57:50,782
MAY BE ELEMENTS OF REVERSIBILITY

8349
05:57:50,849 --> 05:57:52,717
AND PREVENTABILITY, AND SO AGAIN

8350
05:57:52,784 --> 05:57:54,820
I SEE THAT AS THE ENCOURAGING

8351
05:57:54,886 --> 05:57:55,320
ASPECT OF ALL OF THIS.

8352
05:57:55,387 --> 05:57:56,721
I WANT TO QUICKLY THANK OUR

8353
05:57:56,788 --> 05:57:57,789
COMMUNITY SPEAKERS FROM TODAY.

8354
05:57:57,856 --> 05:57:59,858
AGAIN AS I MENTIONED, THAT IS AN

8355
05:57:59,925 --> 05:58:03,428
IMPORTANT PART OF OUR -- OF OUR

8356
05:58:03,495 --> 05:58:04,996
SCIENCE, AN IMPORTANT WAY OF

8357
05:58:05,063 --> 05:58:06,798
SOLVING THE PROBLEMS, AND AGAIN,

8358
05:58:06,865 --> 05:58:10,702
I THINK AS WE KNOW, THE

8359
05:58:10,769 --> 05:58:11,870
ALTERNATE REASON FOR DOING ALL

8360
05:58:11,937 --> 05:58:14,372
OF THIS IS SO WE CAN MAKE SURE

8361
05:58:14,439 --> 05:58:17,742
WE HAVE PATHWAYS -- STORIES WERE

8362
05:58:17,809 --> 05:58:20,645
SOBERING BUT EMPOWERING AND

8363
05:58:20,712 --> 05:58:21,179
UPLIFT, RESILIENCE AND

8364
05:58:21,246 --> 05:58:22,614
WILLINGNESS TO WORK WITH US AS A

8365
05:58:22,681 --> 05:58:24,149
RESEARCH COMMUNITY TO IMPROVE

8366
05:58:24,216 --> 05:58:26,017
THE LIVES NOT ONLY OF THEMSELVES

8367
05:58:26,084 --> 05:58:27,619
BUT IMPORTANTLY OF OTHERS AROUND

8368
05:58:27,686 --> 05:58:29,888
US AND OUR COMMUNITIES.

8369
05:58:29,955 --> 05:58:32,123
I WANT TO REMIND YOU AGAIN

8370
05:58:32,190 --> 05:58:33,358
TOMORROW, WE HAVE A PACKED

8371
05:58:33,425 --> 05:58:34,326
AGENDA, LOTS OF IMPORTANT WORK

8372
05:58:34,392 --> 05:58:36,528
TO DO, CONTINUE ON TODAY'S

8373
05:58:36,595 --> 05:58:37,262
DISCUSSIONS.

8374
05:58:37,329 --> 05:58:39,231
AND LASTLY, I JUST WANT TO THANK

8375
05:58:39,297 --> 05:58:41,066
THE MANY INTERNAL AND EXTERNAL

8376
05:58:41,132 --> 05:58:42,734
CONTRIBUTORS TO TODAY'S WORKSHOP

8377
05:58:42,801 --> 05:58:44,302
AND TOMORROW'S WORKSHOP, WHO

8378
05:58:44,369 --> 05:58:46,171
HAVE REALLY PUT TOGETHER THIS

8379
05:58:46,238 --> 05:58:48,373
INCREDIBLE SET OF PRESENTATIONS

8380
05:58:48,440 --> 05:58:49,908
AND THOUGHTFUL QUESTIONS, AND

8381
05:58:49,975 --> 05:58:51,910
AGAIN I WANT TO THANK OUR SISTER

8382
05:58:51,977 --> 05:58:55,180
INSTITUTES, CENTERS AND OFFICES,

8383
05:58:55,247 --> 05:58:56,748
FOR THEIR SUPPORT.

8384
05:58:56,815 --> 05:58:58,516
WITH THAT, AGAIN THANK YOU VERY

8385
05:58:58,583 --> 05:58:59,851
MUCH, THANK YOU TO THE

8386
05:58:59,918 --> 05:59:01,920
PARTICIPANTS LISTENING HERE

8387
05:59:01,987 --> 05:59:03,822
ONLINE OR IN THE WORLD, YOUR

8388
05:59:03,889 --> 05:59:05,657
INPUT IS IMPORTANTS A WELL.

8389
05:59:05,724
SO HAVE A GOOD EVENING.