Project Summary The overall objective of this project is to determine the impact of social stressors on epigenetic age acceleration and chronic health disparities and to test whether the social environment, individual health behaviors, and race/geography/SES modify or mediate the association between traumatic stress and health (disparities), directly or indirectly through biologic age acceleration. We expect that the trauma burden will impact chronic diseases through DNA methylation (DNAm) age acceleration. The WaTCH cohort is an important, highly trauma- exposed sample of women uniquely poised for a third wave of data collection that continues assessing trauma exposure, depression, PTSD, social context, physical health, and collection of an additional blood specimen eight years after the baseline to examine of DNAm age. Aim 1 will investigate disparities in psychological health (PTSD, depression), physical health (diabetes, hypertension, and cancer), and DNAm age acceleration as women age, particularly as influenced by cumulative trauma burden. Aim 2 will examine the influences of contextual variables, including social capital and financial strain, that may mediate or moderate the effects of cumulative trauma burden on adverse psychological and physical health outcomes. Aim 3 will explore the mediating effects of DNAm age acceleration on physical and mental health outcomes. The proposed study will use the WaTCH cohort of 2800 women exposed to the Deepwater Horizon Oil Spill in coastal Louisiana in 2010. It will entail the third wave of data and biospecimen collection and incorporate data already gathered through two previous waves of data collection. Self-reported health data on demographic, income and financial stressors, oil spill exposure, neighborhood context, social capital, health behaviors, trauma history, psychological symptoms, and physical health will be collected through telephone interviews. Repeat blood samples will be collected from up to 1058 women with baseline samples.