PROJECT SUMMARY The novel coronavirus disease 2019 (COVID-19) global pandemic is arguably one of the most devastating Public Health crises of the last century. In the United States, African-Americans have been disproportionately impacted, with overall rates of infection and mortality 2 to 4 times higher than those observed in Whites. Additionally, as a direct result of closings of non-essential businesses and other entities, rates of unemployment and underemployment have also surged, and African-Americans are significantly more likely than Whites to report being underemployed or furloughed due to the pandemic. Unsurprisingly, given racial disparities in COVID-19 mortality, national polls have also found racial differences in reports of COVID-related loss, with African-Americans more frequently reporting personally knowing someone who has died from COVID-19 than Whites. Because of this, it has been argued that, as a result of COVID-19, African- Americans are experiencing a “pandemic of stress” that will have a “dangerous impact” on their health and well-being long after the virus itself has been contained. Leveraging our previously funded cohort that assessed psychosocial stress and vascular aging in early middle-aged African-American women, we have an unprecedented opportunity to examine the degree to which stressors resulting from, and related to, the COVID-19 pandemic might impact vascular disease—the number 1 killer in the US-in this group. Middle-aged African-American women may be a uniquely important group on which to focus, because: 1) they have increasingly high, but poorly understood, rates of vascular disease relative to other race-gender groups; and 2) the long-term impact of the widespread financial, employment and social stressors resulting from COVID-19 might be particularly deleterious for African-American women, largely due to structural and contextual inequalities that pre-dated the pandemic itself. The proposed project will examine linkages between overall psychosocial stressors (debt, financial stress, job stress, interpersonal incivilities and mistreatment, loneliness), COVID-specific stressors (COVID-related financial difficulties, COVID-specific parenting stressors, COVID-related loss) and prospective changes in vascular aging (ambulatory blood pressure, arterial stiffness, inflammation) over 24 months in a cohort of 350 middle-aged African-American women. Because we have pre-COVID assessments of a range of psychosocial stressors, a major innovation of the proposed work is our ability to examine how pre- versus post-COVID changes in exposure to overall psychosocial stress might prospectively impact vascular aging. Importantly, we will capitalize on the considerable within-group heterogeneity in our cohort, to examine whether any of our hypothesized associations are moderated by pre- COVID assessed sociodemographic factors that might increase vulnerability (socioeconomic status, single parenthood, marital status) or resilience...