Akilah Dulin Keita casts a wide net in her research on health disparities, obesity, and cardiovascular health. Her papers and abstracts concern perceptions of neighborhood safety, perceptions of race, southern culture, diet, socioeconomic status, and other factors affecting health in black, Hispanic, and white preteens.
But really, it all comes down to one thing: stress.
“I’m very interested in the social stressor process model to explain racial and ethnic disparities in cardiometabolic risk factors,” said Keita, a newly appointed assistant professor of behavioral and social sciences.
Living in a difficult community context appears to put people — particularly blacks and Hispanics — at increased risk of cardiometabolic syndrome, a cluster of health effects that increase the risk of cardiovascular disease including high blood pressure, obesity, insulin resistance, type II diabetes, high triglycerides, low HDL cholesterol, and inflammation. Tough neighborhoods lack access to fresh produce, and violent crime makes playing outside less desirable; equally tangible, if more subtle, is the physical impact of stress.
Stress may seem like a fuzzy concept — doesn’t everyone think life is stressful? — but Keita tracks biomarkers such as blood serum levels of the stress-related hormone cortisol to make quantitative comparisons. In one study, for example, she examined cortisol levels over a five-year study period and found that black preteens who lived in communities bearing several hallmarks of poverty had lower cortisol levels than those who didn’t (white kids experienced the opposite effect, although not to a statistically significant degree). It’s not that the black kids in poorer neighborhoods were less stressed; they didn’t generate as much of a natural stress response. The study was intriguing because other researchers have shown that cortisol is directly associated with body fat, although not everyone agrees exactly how.
More recently Keita has expanded her focus beyond preteens to study the cardiovascular effects and biomarkers of accumulated and early life stress in people 65 and older. She has worked on a clinical trial of health interventions in the elderly, with a particular interest in why interventions tend to be less successful among black women.
Keita’s own childhood in Mansfield, Ohio, influenced her interests. The Rust Belt town’s steel economy was dying. Jobs that provided people with a living right out of high school were gone. Where the older generation grew up among thriving mills, Keita grew up among teeming prisons. By her count, about 10 correctional facilities of one kind or another were around town.
“There was a gateway straight to the prisons,” she said. “There were just so many people who went straight from high school — or who didn’t finish high school — who went to prison.”
Keita noticed that her community context was not ideal, but as a kid she didn’t think about health. Initially she aspired to become a lawyer. In college at the University of Alabama–Birmingham, however, she studied how bullying affected the mood of bullies and victims alike. A medical sociologist was born.
Keita continued studying medical sociology at Birmingham for her master’s degree in 2005, her Ph.D. in 2007, and a postdoctoral position.
“I was able to have access to great resources and mentors,” she said. “People were very supportive of my work and let me explore what I wanted to explore and get that full research experience.”
For someone with Keita’s research interests, the last decade has been a fortuitous time in Birmingham. In 2003 the city began the HOPE VI project, which replaced rundown public housing in a 12-block area that was deeply and almost universally impoverished into a mixed-use, mixed-income neighborhood with a goal of increasing services such as new schools, stores, and a youth development center.
Plenty of people have already studied the fate of residents who directly undergo such a transition, but Keita became interested in studying the impact on adjoining neighborhoods. She hopes to continue research on the transition even now that she has come to Rhode Island.
As much as she loved Alabama, Keita’s reason for joining the Brown faculty is simple. In the University’s Program in Public Health, she is aptly situated in the Institute for Community Health Promotion.
“Doing this research, with its community context, I needed to come to a place that is based on doing community interventions that are sustainable and meaningful and culturally appropriate,” she said.
Her new job at Brown promises to change her ability to change the lives of others for the better.