Date of Award

December 2023

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Lorraine Halinka Malcoe

Second Advisor

Helen C.S. Meier

Committee Members

Linnea I. Laestadius, Anne Bonds


Stress is a common human experience; however, chronic stress is socially patterned in the United States. Exposure to stress during sensitive periods of development, including adolescence, can result in lifelong negative health outcomes including immune dysregulation, mental health outcomes, and cardiovascular disease. Historic economic and political policies and processes resulting from structural racism have contributed to present-day health inequities, with one prominent example being historic redlining. Historic redlining has shaped the characteristics of present-day neighborhoods. Redlining has resulted in potentially harmful health exposures including reduced residential investment, racial residential segregation, and limited resources in neighborhoods subjected to redlining practices. However, it is not well understood if historical processes of structural racism impact determinants of adolescent stress levels in present-day. This dissertation examined the association between historic structural determinants, specifically redlining practices, and stress outcomes in adolescents. Using data from the Future of Families and Child Wellbeing Study, we sought to: 1) examine the association between historic redlining, one form of structural racism, and perceived stress in adolescents; 2) evaluate the association between historic redlining and biological stress, measured via cortisol output from hair, in adolescents; and 3) determine the association between historic redlining and biological aging, measured via DNA methylation “epigenetic clocks”, in adolescents. This research can help to elucidate pathways through which structural racism gets “under the skin”, leading to health inequities in adolescents. The findings from this dissertation indicate that structural racism, measured via historic redlining is associated with present-day stress outcomes in adolescents. We found that exposure to redlining, particularly high redlining, was associated with subjective and biological measures of stress. We also found evidence that present-day neighborhood sociodemographic characteristics may mediate the relationship between historic redlining and stress. This dissertation used a cross-sectional study design; therefore, future research may consider examining the longitudinal effects of exposure to structural racism or assess whether there are potentially critical or sensitive periods where exposure may be more severe. Implications from the findings of this dissertation help to identify potential upstream determinants which impact adolescent stress measures in present-day. Furthermore, these findings may help to encourage equity-based policy options such as increased equitable lending opportunities in formerly redlined neighborhoods to address the impacts of structural racism and subsequent disinvestment from redlining practices.

Available for download on Monday, January 05, 2026

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Epidemiology Commons