 HBCU judges welcome back distinguished interviews and perspectives from leading experts in and around the HBCU community. Today a very special guest, Dr. Cynthia Cullen. She is an associate professor of sociology with an appointment in public health at the Ohio State University and the lead author and researcher on a pretty interesting study recently that makes connections between the health outcomes of black students or black college students and black graduates and whether or not they attend HBCU. So eager, eager, eager to get into this one. So Dr. Cullen, thank you so much for joining us this morning. Thank you for having me. So your research, and this is done in tandem with a postdoc fellow and a graduate student in your department suggests that or at least makes connections between responses of black students from predominantly white institutions and HBCUs. And the takeaway is that black students who have graduated from HBCUs have better health outcomes later on past graduation. Can you kind of explain, and I guess the question that's on everybody's mind, how does where you go to school impact your health? Right, so actually in this study, we were able to use an existing data set which is known in my circles as ad health. So it's the National Longitudinal Survey of Adolescent Health and Well-Being. And what this data set does is it began in the mid-1990s and it interviewed individuals very, very diverse set, racially and ethnically diverse set of individuals who were in grades seven through 12 in the mid-1990s and it's followed them over time. And they've had five interviews now and at the third interview at wave three, they were the age at which most people attend college. So most ad health respondents were in their late teens through their mid-20s. And they collected a lot of information about where they went to school, if they went to school. And we not only had data from the respondents themselves about where they went to college, we also had data from the institutions about various characteristics about those institutions of higher learning. And one of the questions we were able to tap into was if the respondent went to college, did they go to an HBCU or to a PWI, a predominantly white institution? And so we were able to look at a subset of black respondents who either went to an HBCU or to a PWI. And what we found was that African-Americans who went to an HBCU had a 35% lower odds of developing metabolic syndrome in midlife. So not at wave three, but in subsequent waves. And this study, we weren't able to really drill down into exactly why this was happening. Unfortunately, because we were using an existing dataset, we had to go with what was available in the data, but I did have some hypotheses. And the biggest one is that when you go to an HBCU, you are just in an environment where exposure to racial discrimination is likely to not be as prevalent. And not only are you less likely to encounter instances of unfair treatment because of your race and ethnicity, both at the individual level and at the institutional and systemic level, but also at HBCUs, you're able to have access to mentors and faculty and older students, more advanced students who are of the same race and ethnicity as you are. So what we know is that HBCUs are a wonderful driver of upward socioeconomic mobility. And this study suggests there are other benefits of attending an HBCU for African-Americans. Are there any existing or in the works research that talk about the impact of stress in African-Americans and specifically on the different environments in which we live and work? Because I think that that makes a lot of sense. If you're not stressed early, if you're not stressed, you likely won't have intractable diseases because your body's just not reacting to stress. But I find it very, very interesting that this is the second study in a couple of years that says HBCU graduates are happier when they go to HBCUs and now they're healthier when they go to HBCUs. And you're talking about a time in your life where you're young and to be frank, don't care about a lot of that stuff. So why do you think that this data keeps showcasing in different, with different people, different surveys that are kind of all tied back to stress at a young age in life? Yeah, so there's a huge literature in sociology, in public health, in psychology that shows being exposed to discrimination or unfair treatment definitely activates our stress response. And not only does it activate our stress response in that moment, it actually has a long-term effect on our bodies, on our bodies and minds over time. And so it predominantly works through inflammation. So when your stress response is continually activated, let's say because you encounter racial discrimination frequently, it has a hard time shutting off. And because of this, you tend to have inflammation in your body in a more widespread fashion. And this can lead to worse mental and physical health outcomes over time across the life course. And that was one of the things about our study is there are a few studies that have looked at the health of HBCU attendees either in and amongst themselves or comparing them to people who are enrolled at PWIs and looks at their current mental or physical health status while they're in college. Ours is one of the few studies that were able to follow people over time and see compared to African Americans who went to a PWI were African Americans who went to an HBCU, were they less likely to develop worse health outcomes later on over time? How do you counter for or is there any allowance for just the fact that genetics may play a role in the kind of illnesses and diseases you may get? Yeah, so I get this question a lot about genetics. And what I will say is that the science is pretty clear. On the population level, right? When we see an elevated risk of worse health among certain groups of people, especially when we're looking at racial disparities in health, whether it's metabolic syndrome, which we looked at in this paper or other health outcomes, we really can't explain it due to genetic differences, right? When you're looking at an individual's health risk, then genetics in terms of your risk because of your family background, your first degree relatives can come into play. But when we're looking at these population level outcomes, it's not due to genetics. It's due to the environments within which we live. We go to school, we work, right? What do you think that this research or how does it lend itself to more expanded analysis? I know you mentioned before, while this compares black students at PWIs and at HBCUs, is a broader look to just say all students of all races, is it more minorities, or what's the next logical step for the research? Right, so one thing I really wanna do is I wanna drill down into what are the mechanisms, right? What are the pathways that might lead to African-American students at HBCUs having better health over the long term compared to African-American students at PWIs? And as they move through successive life course stages, right? As they move into midlife, maybe as they move into later ages, why? Why is this happening? Is it because of this exposure to racial discrimination? Is it because of being able to be in more supportive environments where they're able to have access to more pathways to upward mobility, right? One thing we know is that the association between socioeconomic status and health is very, very strong. So is this primarily working through SES, or is it working through other mechanisms? And then, how much of it is it being in a supportive environment, right? Where you don't have to doubt yourself or doubt what people are thinking of you day in and day out? And then the final question, obviously your research and as an academic, you're not involved in, oh, how will this impact recruitment? Or how does this impact? What kind of students do different schools recruit? But obviously it's the kind of information that some schools or other schools could use in saying this is how we will persuade or dissuade a student to come to our school or to not go to another school. Do you think that that's a fair usage of the research or the research, or is this just something to understand this is an outcome for black folks when we're talking about college attendance? Or do you look at it as something like, yes, it's a fair point to say this is why one school is better than another? I think when we're looking at sort of overall policies that impact higher education, absolutely should people consider these findings? Yes, for sure. With the obvious caveats, it's one study. It needs to be replicated in different populations and by different researchers. And we have to get a better sense of what is it about the environment at an HBCU that is particularly health protective? But I think when we're talking about large policies, we're having a lot of conversations right now about higher education and how to financially support higher education and where should we put our money in terms of how much bang for our buck we can get? And I think if we can say, look, HBCUs not only are they great drivers of upward mobility along with community colleges, but there might be a health protective effect. That is sort of the gift that keeps on giving in terms of physical health over time. That's a great support and kind of argument for continued support of HBCUs. I think also in terms of kind of public policy, it points to predominantly white institutions doing a better job, not only with recruiting a diverse student body, but supporting them actively, right? Carefully, enthusiastically while they're at college and know that doing so might not only increase and improve outcomes, educational outcomes among a racial and ethnically diverse student body, it might also improve their health over time. Dr. Kohler, Ohio State University, we appreciate your time today. All right, thank you very much for having.