The Neighborhood as Social Exposome: Black Mothers’ Narratives of Chronic Stress as a Consequence of Living in Racially Hypersegregated Neighborhoods on the South Side of Chicago

Background: Structural racism negatively affects the lives of Black women living in hyper segregated neighborhoods on the South Side of Chicago. As a part of emerging research about social exposome's effect on health, this project seeks to understand how the neighborhood context shapes social exposures that often contribute to mental and physical health disparities for Black women. Social exposome is how social experiences can manifest in the body. Materials and Methods: This is a mixed methods study that combines geographic data with interviews from Black 92 mothers to understand their social exposures in their neighborhoods, with particular attention to health domains. The Chicago Health Atlas, a public health dataset created by the City of Chicago, is used to contextualize the women's stories about their lived experiences on the Southside of Chicago. The mothers'one-hour interviews are part of a larger study, "The South Chicago Black Mothers' Resiliency Project," which examined how one's health is affected by neighborhood conditions. The original study results showed that neighborhood conditions significantly affected Black mothers' health outcomes. Results: Multilevel thematic analysis of the in-depth interviews and descriptive analysis of a public health dataset elucidate that racially hypersegregated neighborhoods serve as enclaves of racialized health disparities. As such, Black women are left feeling trapped where they live, due to high levels of community violence exposure, vacant housing, and other forms of structural violence that are associated with diseases and early deaths among Black women. Conclusion: This study turns an intersectional lens on the concept of the social exposome to understand Black women's narratives of the chronic stress resulting from living in racially hypersegregated neighborhoods with high levels of gun violence. These neighborhoods are culturally rich and vibrant. Unfortunately, the health data shows that systemic racism often cuts down the life and potential of so many of the mothers and their family members. As a society, it is critical to identify and eliminate threats to well-being in the exposome. This is especially true of physicians and other healthcare providers. We argue that all healthcare training institutions must train future practitioners to holistically understand the social contexts of their patients' lives, highlighting the need to advance equity as prevention and the holistic healing of individuals.