# The impact of structural racism during pregnancy on future cardiopulmonary health

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $602,099

## Abstract

Project Summary
Cardiovascular disease (CVD) is the leading cause of death in women in the United States, with profound
racial-ethnic disparities present. Mounting evidence suggests that pregnancy is a key window when
cardiovascular (CV) health is eroded, increasing future CVD risk. Further, the link between CV and lung health
is well-established, and the critical prenatal period may influence multiple future morbidities simultaneously.
Exposure to place-based structural racism may result in a pro-inflammatory state during pregnancy and impair
postpartum cardiopulmonary health (CV and lung health) setting the stage for future chronic disease risk. For
instance, evidence from our pregnancy cohort (Generation C) in NYC found that racial-economic segregation,
a measure of place-based structural racism, was associated with preterm birth which separately has been
linked to a life course two-fold risk of CVD and respiratory mortality. To better understand the effect of place-
based structural racism during pregnancy on future cardiopulmonary health, we propose Gen C Mamas, a
mixed-method longitudinal study of 440 underrepresented and understudied Black, Hispanic, and Asian
(Global Majority) women from the Generation C cohort, initially recruited during pregnancy in 2020-2022 in
New York City. We will use a framework that incorporates theories of structural racism, the life course model of
multimorbidity, resilience, and weathering in our proposed Gen C Mamas study. First, we will assess the
association between place-based structural racism and cardiopulmonary health (e.g., systolic and diastolic
blood pressure, lung function, and hemoglobin A1c) in 440 women measured at 3 and 5 years postpartum.
Then we will leverage previously collected data to examine how mid-pregnancy inflammation is associated with
place-based structural racism during pregnancy and cardiopulmonary health. Finally, we will select 30 women
from this subgroup and invite them to participate in Photovoice data collection. We will hold focus group
sessions where participants will narrate the stories of their photo choices, and these stories will be analyzed for
themes and then mapped to our theoretical framework. Our findings can be used to develop novel prevention
strategies that disrupt or mitigate structural racism during pregnancy. Because of the central role of
inflammation in health, our findings may provide a model that can be extended to additional chronic conditions
understudied in women.

## Key facts

- **NIH application ID:** 10879900
- **Project number:** 1R01HL173843-01
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Teresa Janevic
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $602,099
- **Award type:** 1
- **Project period:** 2024-08-01 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10879900

## Citation

> US National Institutes of Health, RePORTER application 10879900, The impact of structural racism during pregnancy on future cardiopulmonary health (1R01HL173843-01). Retrieved via AI Analytics 2026-06-16 from https://api.ai-analytics.org/grant/nih/10879900. Licensed CC0.

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