Racial Residential Segregation in Young Adulthood and Brain Integrity in Middle Age: Can We Learn From Small Samples?

Adina Zeki Al Hazzouri, Neal Jawadekar, Katrina Kezios, Michelle R. Caunca, Tali Elfassy, Sebastian Calonico, Kiarri N. Kershaw, Kristine Yaffe, Lenore Launer, Martine Elbejjani, Leslie Grasset, Jennifer Manly, Michelle C. Odden, M. Maria Glymour

Research output: Contribution to journalArticlepeer-review


Racial residential segregation is associated with multiple adverse health outcomes in Black individuals. Yet, the influence of structural racism and racial residential segregation on brain aging is less understood. In this study, we investigated the association between cumulative exposure to racial residential segregation over 25 years (1985-2010) in young adulthood, as measured by the Getis-Ord Gi∗ statistic, and year 25 measures of brain volume (cerebral, gray matter, white matter, and hippocampal volumes) in midlife. We studied 290 Black participants with available brain imaging data who were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a prospective cohort study. CARDIA investigators originally recruited 2,637 Black participants aged 18-30 years from 4 field centers across the United States. We conducted analyses using marginal structural models, incorporating inverse probability of treatment weighting and inverse probability of censoring weighting. We found that compared with low/medium segregation, greater cumulative exposure to a high level of racial residential segregation throughout young adulthood was associated with smaller brain volumes in general (e.g., for cerebral volume, β = -0.08, 95% confidence interval: -0.15, -0.02) and with a more pronounced reduction in hippocampal volume, though results were not statistically significant. Our findings suggest that exposure to segregated neighborhoods may be associated with worse brain aging.

Original languageEnglish (US)
Pages (from-to)591-598
Number of pages8
JournalAmerican journal of epidemiology
Issue number4
StatePublished - Apr 1 2022


  • brain aging
  • epidemiologic methods
  • marginal structural models
  • racism
  • segregation

ASJC Scopus subject areas

  • Epidemiology


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