Belinda L. Needham
· Chair, EpidemiologyVerifiedUniversity of Michigan · Epidemiology
Active 2004–2026
About
Belinda L. Needham, PhD, MA, is a Chair in Epidemiology and Associate Professor at the U-M School of Public Health. Her work seeks to identify, explain, and reduce health disparities related to race/ethnicity, socioeconomic status, gender, and sexual orientation. Her primary research goals involve using novel approaches to assess disparities across the life course and to identify the social structural, psychological, behavioral, and physiological mechanisms by which social disadvantage leads to poor health. Dr. Needham's research interests include social epidemiology, health disparities, biodemography, aging, and the life course. Her projects utilize data from sources such as NHANES to examine DNA methylation as a mechanism underlying racial/ethnic disparities in cardiovascular mortality, and from birth records, newborn dried bloodspots, electronic surveys, and social media to study the impact of indirect exposure to the Flint Water Crisis on Black-White disparities in birth outcomes in Michigan. Additionally, she investigates how state-level racially discriminatory laws influence cardiovascular health disparities using data from the Behavioral Risk Factor Surveillance System. Her educational background includes a PhD and MA from the University of Texas at Austin, and a BS from Texas A&M University. Dr. Needham's work is focused on understanding and addressing health inequities through social epidemiology and related fields.
Research topics
- Sociology
- Medicine
- Demography
- Geography
- Political Science
- Computer Science
- Law
- Psychology
- Psychiatry
- Biology
- Internal medicine
- Endocrinology
- Medical education
- Nursing
- Pediatrics
- Gender studies
- Gerontology
- Family medicine
- Genetics
- Environmental health
Selected publications
Journal of Racial and Ethnic Health Disparities · 2026-04-14
articleOpen accessStructural racism is a key driver of health inequities among Black Americans, yet its measurement remains inconsistent. This study introduces a multigenerational model of exposure to structural racism across five domains—criminal justice, economic opportunity, educational resources, political participation, and residential segregation—among Black women in South Carolina from 1989 to 2020. It addresses key gaps by applying a lifecourse perspective, identifying consistent indicators over time and space, and using latent variables for assessment across two generations. We developed a multigenerational dataset by linking South Carolina birth certificates along the maternal line (1989–2020), focusing on first births among Black mothers with complete structural racism data (n = 75,088 births; 37,544 family trees). Twenty-two indicators were drawn from national and state sources, merged at the county level. Confirmatory factor analysis (CFA) was used to construct latent variables representing structural racism. Measurement invariance testing assessed consistency across generations. The model showed good fit for four domains—criminal justice, economic opportunity, educational resources, and residential segregation. Political participation was excluded due to poor fit. Economic opportunity indicators were significant for mothers but not grandmothers, highlighting generational shifts in indicator relevance. Four key dimensions of structural racism were observed across two generations in Black families in South Carolina, though indicator relevance varied. These findings emphasize the importance of context-specific, temporally aware measures. Future research should link these models to health outcomes to deepen understanding of how structural racism shapes health over time.
Associations of skin cancer, dermatitis and risk factors for skin conditions with epigenetic aging
Journal of the European Academy of Dermatology and Venereology · 2026-05-23
articleThe data underlying this article will be shared on reasonable request to the corresponding author.
Aging · 2026-02-12
articleOpen accessAmerican Journal of Clinical Nutrition · 2025-05-31 · 10 citations
articleOpen accessRacial and Social Inequities in Weathering: the ELSA-Brasil Cohort
Journal of Racial and Ethnic Health Disparities · 2025-12-05
articleAJE Advances Research in Epidemiology · 2025-10-01 · 1 citations
articleOpen accessAbstract Regular engagement in physical activity is a vital component of healthy aging, and epigenetic clocks are powerful biomarkers of biological aging. However, the extent to which physical activity and fitness influence epigenetic aging in diverse populations remains unclear. We harnessed 2346 participants (50-84 years of age) from the National Health and Nutrition Examination Survey 1999-2000 and 2001-2002 cycles. We examined associations of self-reported physical activity (moderate, vigorous, and muscle strengthening), metabolic equivalent time, walking speed, and knee extensor strength with epigenetic age acceleration (EAA) measures from 6 epigenetic clocks using adjusted survey-weighted generalized linear regression. A 40 N-m increase in peak knee extension torque was associated with lower EAA for PhenoAge (−1.09 years; 95% CI, −1.74 to −0.44), GrimAge2 (−0.72 years; 95% CI, −1.14 to −0.30), and DunedinPoAm (−0.015; 95% CI, −0.023 to −0.007) in fully adjusted models. Shorter time to complete a 20-ft walk and self-reported physical activity were also associated with lower EAA across several clocks, although these associations attenuated after adjusting for smoking, self-reported health, height, and waist circumference. Greater knee extensor strength is associated with reduced epigenetic aging across several next-generation clocks in the general US population, while associations related to self-reported physical activity tended to attenuate after adjusting for health and behavioral factors.
SSM - Population Health · 2025-10-11
articleOpen accessA negative wealth shock (i.e., a sudden large loss in wealth) represents a stressful life event that threatens older adults’ mental health. This study examines whether a negative wealth shock is associated with both 12-month major depressive episodes and 1-week depressive symptoms over time among older adults, compared to positive wealth without a shock. This study also examines whether baseline net worth moderates the association between a negative wealth shock and depressive symptoms. The study utilized a national sample of 15,660 individuals from six waves of the Health and Retirement Study (2008 to 2018). We estimated mixed-effects models based on respondents’ self-reported wealth and depressive symptoms. A negative wealth shock was defined as a loss of 75% in total wealth compared to the previous wave. We applied inverse probability weighting to account for potential selection bias. A negative wealth shock was associated with 1.30 times higher odds of having major depressive episodes compared to positive wealth. Both a negative wealth shock (incidence rate ratio [IRR] = 1.30, 95% Confidence Interval [CI]: 1.06 – 1.60) and baseline negative wealth (IRR = 1.05, 95% CI: 1.01 – 1.09) were associated with a higher rate of depressive symptoms compared to positive wealth. No interaction effects between baseline net worth and a negative wealth shock on depressive symptoms were observed. A negative wealth shock in mid-to-late life has detrimental effects on both 12-month and past-week depressive symptoms, providing implications for mental health programs for older adults at financial risk. • A negative wealth shock is associated with both 12-month major depressive episodes and past-week depressive symptoms. • Zero/negative wealth at baseline is linked to past-week depressive symptoms, but not related to major depressive episodes. • No interaction effects between baseline net worth and a negative wealth shock are observed on both major depressive episodes and depressive symptoms.
American Journal of Epidemiology · 2025-11-19
articleThis study examines whether exposure to structural racism (SR) is associated with subjective cognitive decline (SCD) among older adults. Data were from the 2010 Structural Racism-Related State Laws Database and the 2015-2016 Behavioral Risk Factor Surveillance System (N = 184 731). Exposure was an index of 22 state laws related to criminal justice, economics, healthcare, housing, immigration, and political participation. Subjective cognitive decline was self-reported. In the full sample, results from the adjusted mixed-effects logistic regression model did not provide strong evidence of a difference in the odds of SCD for a two-unit greater SR value (OR = 1.00; 95% CI, 0.99-1.01). Similarly, results derived from the effect measure modification models, including product terms between SR and race/ethnicity, did not provide strong evidence of a difference in odds of SCD for White (OR = 0.99; 95% CI, 0.97-1.02) and Black (OR = 1.00; 95% CI, 0.97-1.02) respondents for a two-unit greater SR value. Conversely, Hispanic (OR = 0.91; 95% CI, 0.88-0.93), and multiracial (OR = 0.95; 95% CI, 0.93-0.97) adults had lower odds of SCD for a two-unit greater SR value. Age-related differences in the association between SR and SCD were observed, with younger Native Hawaiian/Other Pacific Islanders (OR = 0.91; 95% CI, 0.88-0.94) and older American Indian/Alaska Natives (OR = 0.92; 95% CI, 0.89-0.94) experiencing lower odds of SCD for a two-unit greater SR value.
DNA methylation age deviation and cognitive status among older adults in the US, NHANES 1999-2002
medRxiv · 2025-09-18
preprintOpen accessAbstract Biological aging, measured using DNA methylation, is a potential biomarker for cognitive health outcomes. We evaluated associations between DNA methylation measures of aging and cognition in a nationally representative sample of adults aged 60+ in the National Health and Nutrition Examination Survey (NHANES), 1999-2002. Genome-wide DNA methylation data were used to create 13 measures of biological aging trained on different aging phenotypes. Cognition was assessed with the Digit Symbol Substitution Test (DSST). To evaluate associations between each DNA methylation measure and DSST score, survey-weighted linear regression models adjusted for age, sex, race/ethnicity, education, smoking, serum cotinine, and BMI were run. We assessed effect modification by sex, education, and race and ethnicity. Included participants (N=1,463) were an average of 70.5 years old and 82.7% non-Hispanic White. The average DSST score was 46.9 (SD 17.6). Ten of 13 DNA methylation measures were associated with DSST (adjusted p<0.05). One year of GrimAge2 accelerated aging was associated with –0.41 points lower DSST score (95% CI: –0.61, –0.21; adjusted p=5x10 -4 ). In stratified analyses, higher magnitudes of association were observed among male and non-Hispanic White participants across multiple aging measures. DNA methylation may be a useful biomarker of cognitive status among older adults.
Statistics in Medicine · 2025-10-01 · 2 citations
articleIn this work, we are motivated by the problem of estimating racial disparities in health outcomes, specifically the average controlled difference (ACD) in telomere length between Black and White individuals, using data from the National Health and Nutrition Examination Survey (NHANES). To do so, we build a propensity for race to properly adjust for other social determinants while characterizing the controlled effect of race on telomere length. Propensity score methods are broadly employed with observational data as a tool to achieve covariate balance, but how to implement them in complex surveys is less studied-in particular, when the survey weights depend on the group variable under comparison (as the NHANES sampling scheme depends on self-reported race). We propose identification formulas to properly estimate the ACD in outcomes between Black and White individuals, with appropriate weighting for both covariate imbalance across the two racial groups and generalizability. Via extensive simulation, we show that our proposed methods outperform traditional analytic approaches in terms of bias, mean squared error, and coverage when estimating the ACD for our setting of interest. In our data, we find that evidence of racial differences in telomere length between Black and White individuals attenuates after accounting for confounding by socioeconomic factors and utilizing appropriate propensity score and survey weighting techniques. Software to implement these methods and code to reproduce our results can be found in the R package svycdiff, available through the Comprehensive R Archive Network (CRAN) at cran.r-project.org/web/packages/svycdiff/, or in a development version on GitHub at github.com/salernos/svycdiff.
Recent grants
Race/Ethnicity, DNA Methylation, and Disparities in Cardiovascular Mortality: NHANES 1999-2002
NIH · $3.1M · 2017–2025
NIH · $4.1M · 2016
Frequent coauthors
- 45 shared
Teresa E. Seeman
University of California, Los Angeles
- 35 shared
Bhramar Mukherjee
University of Michigan–Ann Arbor
- 30 shared
Jennifer A. Smith
Virginia Tech
- 27 shared
Elissa S. Epel
University of California, San Francisco
- 27 shared
Ana V. Diez Roux
Drexel University
- 22 shared
Nancy E. Adler
- 22 shared
Jue Lin
University of California, San Francisco
- 19 shared
Sharon L. R. Kardia
University of Michigan–Ann Arbor
Education
- 2006
MA, PhD, Sociology
University of Texas at Austin
- 1999
BS, Sociology
Texas A&M University
- Resume-aware match score
- Save to shortlist
- AI-drafted outreach
See your match with Belinda L. Needham
PhdFit ranks faculty by your research interests, methods, and publications — grounded in their actual work, not templates.
- Free to start
- No credit card
- 30-second signup