ABSTRACT – PROJECT 1. In concert with the University of Illinois Chicago Maternal Health Research Center of Excellence (Center) theme to Synergize Systems of Change for Maternal Health Equity, this project aims to characterize how structural racism impacts postpartum women’s health. Black women bear a disproportionate burden of death and are nearly three times as likely to die within one year of pregnancy as White women. Nationally and in Illinois, almost 70% of pregnancy-associated deaths occur postpartum, making this a particularly sensitive period. Women in Chicago have more than two times higher rates of severe maternal morbidity compared to other geographical locations in Illinois. Postpartum women living in Chicago are disparately exposed to structural racism and adverse social and physical conditions. Chronic exposure to structural racism, including neighborhood living conditions such as racial residential segregation, concentrated disadvantage, and violence play an important role in producing and maintaining health disparities and socio-economic disadvantage. Yet, most maternal health research focuses on individual-level risk factors. This project will fill that gap in knowledge by examining the broader contextual experiences of postpartum women. The aims of this project are to: 1) describe the exposure to multilevel (neighborhood, family, and individual) adverse risk factors among urban postpartum women, 2) assess the effect of multilevel (neighborhood, family, and individual) exposures on bio-physical outcomes among urban postpartum women, and 3) understand multilevel (neighborhood, family, and individual) context of daily experience across the life-course of postpartum women using qualitative photovoice methods. These studies will identify molecular indicators of maternal health outcomes to pinpoint neighborhood characteristics that trigger/exacerbate biological pathways resulting in maternal health disparities. This project also will develop new knowledge about women's lived experiences and the impact of structural racism that can inform the design of relevant and meaningful interventions for this population. Data collected from this project will be managed by the Center Data Committee and uploaded to Center Research Resource & Data Repository. This project will rely on the Community Partnership Core and Community Advisory Board to integrate the voice of the community which is integral to maternal health equity research. This project will be linked to Project 3, the prospective intervention study, by providing information about the needs of postpartum women. This project also will serve as an opportunity for trainees in the Training Core to gain valuable research experience in public health, social work, data science, and biology.