Project Summary Cancer is a leading cause of morbidity and mortality among Black women with a substantial burden due to alcohol use, smoking, and obesity. Despite growing evidence of the importance of early life adverse experiences on long-term health, little is known about how chronic exposure to adverse experiences across the life course influences cancer risk factors or risk behaviors among Black women. African American women are particularly vulnerable to a higher burden of adverse experiences. Due to high levels of racial residential segregation in the United States, African American women are also more likely than women of other races to live in poor, segregated neighborhoods irrespective of individual education and income. Neighborhood context may exacerbate effects of individual level adverse experiences. There is some evidence suggesting that modifying the neighborhood may attenuate the effects of adverse experiences in early life. We hypothesize that adverse experiences across the life course, compounded by living in a highly racially segregated neighborhood in adulthood will result in a higher risk of unhealthy coping behaviors. Using the Black Women’s Health Study, a cohort of 59,000 African American women (followed from 1995-present), we aim to 1) examine the association between trajectories of adverse experiences in childhood, adolescence, and adulthood and adult alcohol use, smoking, and body size in African American women and 2) determine if the association of adverse experiences with adult alcohol use, smoking, and body size is modified by neighborhood racial segregation and socioeconomic status. This study will fill a critical gap in understanding the influence of early life adverse experiences on cancer risk factors among Black women. Identifying critical periods and intervening earlier in the life course will yield greater gains in reducing cancer disparities in this population. The proposed research incorporates several innovative elements: 1) We are using a large, well powered dataset that was exclusive designed to elucidate the drivers of a multitude of health outcomes among Black women;; 2) by incorporating a trajectory approach we are able to assess how the timing and continuity of adverse experiences influence health behaviors;; 3) By employing multilevel models we can examine the influence of multilevel (both individual and neighborhood) stressors on health behaviors in this population;; 4) we are examining multiple measures of body size including waist-to-hip ratio (WHR) and BMI. The interdisciplinary training environment for this proposal will provide the applicant an opportunity to enhance methodological skills, build research competency, and enhance content expertise, in order to become an expert in the intersection of cancer and social epidemiology.