This funding opportunity announcement (FOA) invites mechanistic studies on the impact of social inequality on the brain and on the substance use trajectory. Applications investigating relevant mechanisms at the behavioral, cognitive, neurocircuitry, cellular, genetics, and epigenetics levels are encouraged.
Applications testing a fully conceptualized and hypothesis-based solid premise founded with adequate preliminary data are appropriate for this FOA. Applicants with exploratory and high-risk research projects should consider applying to the companion R01 announcement RFA-DA-22-030.
A well-established and still growing body of literature points to socioeconomic inequality being a major factor in health outcomes, especially so for mental health and substance use disorder (SUD). This point has been reinforced recently because of the ongoing COVID-19 pandemic. Racial and ethnic disparities have been observed in the impact of COVID-19 – non-Hispanic Black/African American, non-Hispanic American Indian/Native Alaskan, and Hispanic populations experience a higher number of cases, hospitalizations, and deaths. Further, psychological distress related to COVID-19, resulting from factors such as loneliness, economic anxiety, and uncertainty about the future, is highest among adults with household income of less than $35,000 per year.
COVID-19 is just one recent public health threat that reveals social inequality-related health disparities in the US. These health disparities are, in fact, pervasive, particularly impacting racial minority groups. For example, racial minority groups are exposed more frequently to race-related stressors, such as discrimination, which are shown to impact neural circuitry relevant to SUD. Further, increasing distress and decreasing psychological well-being has been observed over recent decades in people of low relative socioeconomic status. Together, it is evident that a deeper understanding is needed of how socioeconomic inequality impacts various points in the substance use trajectory, especially on the transition from recreational/medical use to SUD and on relapse/recovery.
Studies on socioeconomic hardship (e.g., poverty) point to acute and chronic effects on cognitive function. In addition, an important process through which social inequality at the population level works through individuals is by affecting subjective social status or how individuals perceive their social status in relation to others. Subjective social status impacts mental health and substance use in a different, and sometimes more potent, manner than objective markers of socioeconomic status, such as household income and parental education. Epidemiological data suggest that relative, as opposed to absolute, poverty has far reaching impact on mental health and social outcomes, and preliminary laboratory studies point to risk-related decision-making being impacted by inequality. Importantly, the neurocognitive mechanisms by which social inequality impacts the substance use trajectory remain poorly understood.
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