Health implications of enduring and emerging stressors

Abstract

Background: The New Jersey Population Health Cohort (NJHealth) Study aims to delineate the pathways through which stressors influence health and identify novel factors that can mitigate or amplify these effects.

Methods: The NJHealth Study is recruiting 10,000 New Jersey residents aged 14 and older using two sampling strategies. First, 6,000 individuals from across New Jersey are selected through a four-stage probability sample design, oversampling multi-generational families and minoritized racial/ethnic populations, and low-income groups. Second, a non-probability sample of 4,000 individuals is selected from families with at least one first- or second-generation immigrant, recruited via community outreach and respondent-driven methods. Participants will provide multiple consents for study participation, biological assessments, activity measurement, and record linkage.

Building on ecosocial, life course, and stress process models, the NJHealth Study employs multi-modal data collection to comprehensively measure stress-related factors at macro- and micro-levels. Macro-level stressors are measured in participants’ social and physical environments and micro-level stressors are measured using interviews administered in multiple languages and other respondent-level data sources. Interviews also include assessments of potential stress buffers and amplifiers, cognitive function, activity limitations and self-reported health. In addition, salivary DNA, fasting plasma, and actigraphy data will be collected from consenting participants. Participants will also be asked to provide consent to permit the study team to link their data with secondary sources including health insurance and billing records, electronic health records, social service and employment administrative systems, and death records.

Discussion: The NJHealth Study will generate actionable knowledge for improving health and wellbeing under rapid social changes, particularly among multi-generational families, immigrants, people of color, and low-income families, with focuses on both societal and individual stressors. New Jersey's socioeconomic and demographic diversity, along with its strong secondary data infrastructure, make it an exceptional setting for the study. Strong community support and stakeholder engagement will ensure effective translation of research findings into practical policy and programmatic applications.