Improving care. Changing lives.

Physical Health in Midlife

Co-Investigators: Eric Dearing, Ph.D. and Christos Mantzoros, M.D.
Project Director: Cynthia R. Davis, Ph.D.
Project Coordinators: Sarah Trifiletti, Nicole Usher and Lesya Zaichenko

Research Associates: Ayelet Barkai, M.D., Cindy Crowell-Doom, B.A., Claudia Miranda-Julian, M.S., Dorothy Warner, Ph.D., Elizabeth Weber, Ed.M.

Research Assistants:  Sean McCormick, Abby Kim, Gabriella Scimemi, Chelsea Wahl, Jennifer Esdale, Andrew Baker, Jennifer Bowers, and Maria Perfetti

The Physical Health in Midlife project is a continuation of the Paths Over Time and Across Generations project, from which we are recruiting both original participants of the Paths project and a new cohort of demographically-matched participants from European American, African American, and Caribbean American communities in Boston, who we are recruiting through community-based participatory research methods.  In our current phase, we are collaborating with the Beth Israel Deaconess Medical Center to study the ways in which aspects of mental health, relationships, and experiences with adversity – including racial discrimination – influence physical health in midlife.  

We are Currently Recruiting
If you or someone you know may be interested in participating please call us at 888-799-2690 or email us at paths@jbcc.harvard.edu. We would be happy to work with your schedule to find a time that is convenient for you, and in addition to the monetary compensation that is available, we also give you your individual medical test results.

There are also many of our long-time participants who have yet to join us for this phase. We will continue to reconnect with you in the coming months. We are very interested in having you join us for this phase, either individually or with your partners – so if you have not yet participated, please call or email us!

Have you moved?  Has your phone number changed?  Call or send us an email to stay in touch.
 
Metabolic Syndrome
Metabolic syndrome is a condition that involves having multiple risk factors that increase the chances of developing cardiovascular disease, diabetes, or having a stroke.  People are diagnosed with metabolic syndrome if they have three or more of the following signs: 1) blood pressure equal to or greater than 130/85, 2) fasting blood sugar equal to or greater than 100 mg/dL, 3) a Body Mass Index (BMI) of 30 or more OR a large waist circumference (40 inches or more for men, 35 inches or more for women), 4) low HDL cholesterol (under 40 mg/dL for men, under 50 mg/dL for women), or 5) triglycerides equal to or higher than 150 mg/dL.

Although genes, hormonal changes, and aging can all increase risk for metabolic syndrome, other factors are also involved, such as diet and exercise.  By eating healthy foods, exercising, and losing weight if you are overweight, you can reduce your risk for metabolic syndrome – as well as for cardiovascular disease, diabetes, or stroke.

If you have questions or concerns about metabolic syndrome or any aspect of your health, please contact your physician. If you or someone you know would like to participate in the study – and receive test results related to this condition – please contact us at 888-799-2690 or email us at paths@jbcc.harvard.edu.
 
Findings from the Study
This year we continue to analyze our results. We find a cascade effect where early adversity is associated with employment status, which is a risk factor for problematic social functioning, which in turn is associated with a variety of health outcome, but in particular, obesity.  

Because of the increased risks for health that are related to early trauma, it is especially important that researchers continue to seek to understand protective factors and to encourage people at risk to seek care and intervention if needed. Your participation continues to be fundamental to understanding these risks.

We are also interested in religious and spiritual supports. There are established protective factors for African American adults.  Within the current sample, religious supports are important in protecting African American adults from greater depressive symptoms.
 
Helping Participants
One of the most interesting and rewarding parts of the study for us is the chance to meet and talk with participants. Many participants, both long-term and new, have told us that they’ve appreciated the chance to pause from their hectic schedules and take some time to think about themselves and their experiences. Some have told us that “it has been years” since they’d thought about a particular story or memory, and others have told us that they’ve made meaningful connections between past experiences and their current lives that they hadn’t considered before.

This current phase is the first time that we are including medical tests as part of participation in the study. Working closely with the medical team at the Beth Israel Deaconess Medical Center, Dr. Crowell reviews each participant’s medical tests and prepares letters that inform them of the results. We have seen about 190 participants to date, and we have obtained results and sent letters to over half of them so far. We have informed 61.5% of participants in the current phase that they have a problem or potential problems that they had not reported in the medical history.

  • 36.5% had high blood pressure and did not know they had this health problem
  • 35% had previously unknown elevated lipid levels (cholesterol and/or triglycerides)
  • 19% had abnormal fibrinogen or Factor VIII levels (blood components related to blood clotting)
  • 4% had abnormal glucose levels
  • 14% were informed of more than one problem of which they had been unaware

We always encourage participants to share the results with their doctors. In cases as above where participants’ results indicate that they may be at risk for particular issues, such as high blood pressure or diabetes, we emphasize that follow-up with a primary care physician (PCP) is important. We hope that people will use this information to follow-up as many of these problems can be effectively treated.

Some participants have told us that they do not have a PCP, that they have difficulty with their insurance coverage, or that they are interested in talking with a mental health professional regarding some challenges they are facing.  In each of these cases, we’ve worked with participants to help them identify the resources they need. We have helped several participants in these ways.