About

Dr. Bernadette Boden-Albala is the Founding Dean of the UC Irvine Joe C. Wen School of Population & Public Health at the University of California, Irvine. She is also a Professor in the Department of Health, Society and Behavior and the Department of Neurology in the School of Medicine. She is an internationally recognized expert in the social epidemiology of stroke and cardiovascular disease. Over the past 15 years, her research has focused on defining and intervening on social determinants of disease, including the roles of sex, race-ethnicity, socio-economic status, social support, stress, and social networks on disparities and patterns across the U.S. and globally. Since January 2020, under her leadership, Wen Public Health has become a key academic partner for government agencies and community organizations to address COVID-19 in the region, leading efforts in preparedness, response, communication, health behaviors, and testing. She has served as principal investigator on large-scale community COVID-19 serosurveillance projects and is involved in multiple advisory groups guiding COVID-19 response. Dr. Boden-Albala has held leadership positions at NYU, Mount Sinai, and Columbia Mailman School of Public Health, where she earned her MPH and DrPH degrees. Her research portfolio emphasizes reducing health disparities and promoting health equity through community-based interventions, with over 200 publications contributing to community-based stroke and heart disease prevention.

Selected publications

• Abstract TP108: Number of Civic and Social Organizations in a Neighborhood is Associated with Size of Social Network Among Stroke Survivors

  Stroke · 2026-01-29

  articleSenior author

  Introduction: The environment in which we live shapes our relationships and our health. The presence of community resources can foster peer support and recovery. We sought to evaluate whether the number of civic and social organizations was associated with the size of stroke survivors’ social networks. Methods: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention randomized stroke survivors in New York City to skills-based intervention or usual care to improve post-stroke blood pressure. At baseline, participants were asked to identify their social networks (up to five persons or alters) with whom they discuss important matters. We quantified the total number of alters, the number who they talk with at least several times a week, the number of close alters, and the number of alters who they talk with about health matters. Density of civic and social organizations within a participant's census tract (at baseline) was linked from the National Neighborhood Data Archive. The association between deciles of civic and social organizations and the number of alters was modeled using multinomial logistic regression, first unadjusted and then sequentially adjusted for years in the community, age, gender, and race-ethnicity. Categories of the number of alters were often pooled due to small cell sizes and/or consistent associations. Results: Of 546 respondents with geocoded addresses, 33% identified that they had 3-5 alters. Those residing in census tracts in the highest decile of civic and social organizations had higher odds of having more alters with whom they could discuss important matters compared to those in the lowest decile (1-2 alters OR: 1.04; 95% CI: 0.94-1.11; 3-5 alters OR: 1.11; 95% CI: 1.02-1.23). This association was slightly attenuated after adjustment (Table). The results were consistent for health matter alters even after adjustment (4-5 alters OR: 1.11; 95% CI: 1.00-1.23). Conclusion: Greater census tract density of civic and social organizations was associated with having larger social networks among stroke survivors. Providing stroke survivors who live in neighborhoods without many civic/social organizations with additional resources on social support and engagement may be a potential area for intervention.

  PublisherDOI

• Abstract A133: Associations between Dietary and Circulating B-Vitamins and Incident Stroke: Evidence from Two Large Prospective United States Cohorts

  Stroke · 2026-01-29

  article

  Introduction: While B-vitamins are promising agents for primary stroke prevention, evidence is largely confined to the homocysteine-lowering effects of folate, pyridoxine, and cobalamin. The roles of other B-vitamins, their interactions, and the relevance of different biomarkers in fortified populations remain unclear. Methods: In two large prospective cohorts of women and men in the United States (US), the Women's Health Initiative (WHI, 154,718 postmenopausal women) and the All of Us Research Program (AoU, 102,680 adults), we investigated the roles of B-vitamins (dietary exposures and plasma biomarkers) in the development of incident stroke using multivariable Cox models. Mendelian randomization (MR), interaction among B-vitamins, mediation by homocysteine and subgroup analyses by known risk factors were also evaluated. Results: In the WHI (7,577 incident strokes in a median follow-up of 19.2 years), higher baseline intakes of thiamin, riboflavin, niacin, pyridoxine, and folate were prospectively and significantly associated with lower stroke risk (hazard ratios [HRs] for highest vs. lowest quintile: 0.86-0.91). In AoU (1,745 incident strokes in a median follow-up of 5.9 years), higher plasma pyridoxine (HR: 0.29; 95% confidence interval [CI]: 0.09, 0.92 for Q5 vs Q1) and folate (HR: 0.79; 95% CI: 0.64, 0.99 for Q4 vs Q1) were associated with lower stroke risk, consistent with MR analysis for small vessel stroke. Antagonistic interactions were observed for some dietary pairs, while the combination of high plasma pyridoxine with folate or cobalamin showed the strongest association with lower risk. Homocysteine lowering pathway mediated only 6% (95% CI: -19%, 57%) of the association between plasma folate and stroke. No significant differences across strata of known risk factors were observed. Conclusions: In two large national cohorts of US adults, we observed consistent and significant associations of plasma levels of folate and pyridoxine with stroke risk, independent of known risk factors as well as the homocysteine-dependent pathway. Thiamin, riboflavin, and niacin were also linked to lower stroke risk, with evidence of interactions among them.

  PublisherDOI

• Abstract DP307: Machine Learning Applications for Stroke Sub-grouped Classification Among Asian Americans

  Stroke · 2026-01-29

  articleSenior author

  Background: Asian Americans (AAs) experience disproportionately higher rates of intracerebral hemorrhage (ICH) compared to other populations. Accurate stroke subtype prediction remains challenging due to complex risk factor interactions that traditional statistical approaches may miss. Early subtype identification optimizes treatment protocols and secondary prevention. This study evaluated machine learning (ML) feasibility for stroke subtype classification among AA patients. Methods: We analyzed electronic health records (EHR) from TriNetX with 54,948 AA stroke patients (2010-2019) across 55 US healthcare organizations. Patients were classified into five stroke subtypes: ischemic stroke (IS), ICH, subarachnoid hemorrhage (SAH), transient ischemic attack (TIA), and multiple stroke types. Predictors included demographics, vitals, lab values, relevant comorbidities and medications. We applied random forest (RF) imputation for missing values, inverse-frequency weights for class imbalance, and Classification and Regression Trees (CART) and RF algorithms with 10-fold cross-validation on 80/20 train-test splits. Results: The cohort comprised 67.2% IS, 11.2% ICH, 10.4% SAH, 6.6% TIA, and 4.6% patients with MS. Mean age was 61.6±14.1 years with 53.4% male. Hypertension (76.9%), hyperlipidemia (61.7%), and diabetes (39.1%) were most prevalent comorbidities. RF outperformed CART with 72.8% vs 68.4% accuracy and 0.875 vs 0.774 AUC. Variable importance analysis identified stroke history (SAH, ICH, IS) as the strongest predictors, followed by diastolic blood pressure variability, HDL cholesterol, and mean diastolic BP. Both models showed high specificity but moderate sensitivity. Conclusion: ML algorithms classified stroke subtypes in AAs with good accuracy and clinical feasibility for improving acute care delivery. Stroke classification directly impacts treatment selection, as different subtypes require distinct therapeutic approaches and have varying prognoses. Our finding that stroke history emerged as the strongest predictor highlights prior cerebrovascular events' importance in subtype determination. Yet, our current EHR-based stroke history definitions (diagnosis before the index event by ≥1 day) may misclassify concurrent events as historical and affect interpretability. ML's ability to capture complex interactions makes it valuable where traditional approaches are inadequate. Future studies may consider temporal validation to develop robust clinical decision tools.

  PublisherDOI

• Association of area-level income with patient reported long-term disability outcomes post-traumatic brain injury

  Injury · 2026-01-22

  articleOpen accessSenior author

  BACKGROUND: Traumatic Brain Injury (TBI) affects 64-74 million people annually, often causing long-term disability. The influence of social determinants of health (SDOH), particularly neighborhood and built environments, on functional outcomes post-TBI remains underexplored. This study examines the association between census tract-level median household income- a proxy for area income- and self-reported functional outcomes in TBI-patients seen in a Southern California TBI clinic. METHODS: A retrospective cohort study of Neurology TBI & Concussion Clinic data (9/2022-1/2025) included patients ≥18 years with a known TBI mechanism and neurological symptoms who completed SDOH and functional assessments. SDOH factors included sex, race, ethnicity, insurance status, and median area income, determined by ZIP code using 2023 US census data. Disability was defined as Glasgow Outcome Scale-Extended-score ≤6 at index clinic-visit. Multivariable logistic regression was performed. RESULTS: Among 148 patients (median age 46.5 years; 41% female, 75% mild TBI), the disabled cohort had higher proportions of poor insurance status (38% vs. 8%, p < 0.001), greater injury severity score (ISS) (9.0 vs. 1.0, p = 0.002), and lower median household income ($104,981 vs. $114,747, p = 0.020). Regression analysis showed poor insurance status (OR 5.80, CI 2.01-21.24, p = 0.003) and ISS (OR 1.06, CI 1.01-1.12, p = 0.027) predicted disability, but area income did not (OR 0.93, CI 0.79-1.10, p = 0.387). CONCLUSION: Lower area income was associated with disability in unadjusted analysis but was not an independent predictor after adjusting for insurance and ISS. Findings highlight the need to explore individual and community factors influencing long-term TBI outcomes for targeted screening.

  PublisherOA PDFDOI

• Language justice as an antiracism institutional transformation: Institutional facilitators and barriers for community-engaged cardiometabolic health promotion research

  Journal of Clinical and Translational Science · 2025-01-01 · 2 citations

  articleOpen access

  This article describes lessons learned from the incorporation of language justice as an antiracism praxis for an academic Center addressing cardiometabolic inequities. Drawing from a thematic analysis of notes and discussions from the Center's community engagement core, we present lessons learned from three examples of language justice: inclusion of bilingual team members, community mini-grants, and centering community in community-academic meetings. Facilitating strategies included preparing and reviewing materials in advance for interpretation/translation, live simultaneous interpretation for bilingual spaces, and in-language documents. Barriers included: time commitment and expenses, slow organizational shifts to collectively practice language justice, and institutional-level administrative hurdles beyond the community engagement core's influence. Strengthening language justice means integrating language justice institutionally and into all research processes; dedicating time and processes to learn about and practice language justice; equitably funding language justice within research budgets; equitably engaging bilingual, bicultural staff and language justice practitioners; and creating processes for language justice in written and oral research and collaborative activities. Language justice is not optional and necessitates buy-in, leadership, and support of community engagement cores, Center leadership, university administrators, and funders. We discuss implications for systems and policy change to advance language justice in research to promote health equity.

  PublisherOA PDFDOI

• An Ounce of Prevention

  Neurology · 2025-06-12 · 7 citations

  article

  The global burden of neurologic disorders is rising, driven by aging populations and improved survival following acute neurologic events. As a result, more individuals are living with long-term disabilities from conditions such as stroke, dementia, and other neurodegenerative diseases. Despite significant advances in neurology, there remains an urgent need for a preventive approach to mitigate these trends. Growing evidence highlights the effectiveness of preventive strategies, including lifestyle modifications and risk factor management, in preserving brain health and reducing the risk of stroke, neurodegenerative conditions, and cognitive decline. Preventive neurology operates within a multilevel framework, ranging from direct patient-centered interventions to systemic policy actions requiring organizational and societal support. Neurologists are uniquely positioned as advocates for brain health, promoting preventive strategies in line with the American Academy of Neurology's Brain Health Initiative. This article explores how neurologists can drive change across individual, family, community, and policy levels by leveraging their clinical expertise, community engagement, and health policy influence. Sustainable progress in brain health will also require system-level changes that integrate preventive goals into the fabric of health care delivery, public health infrastructure, and policy frameworks. Special attention is given to underserved populations, who bear a disproportionate burden of neurologic diseases. Through targeted interventions, public health initiatives, and collaborative care models, preventive neurologists can shape brain health outcomes across the lifespan. Training neurologists with a preventive focus will integrate brain health promotion into standard neurology practice, complementing disease management. By addressing the root causes and risk factors of neurologic conditions, preventive neurology provides a pathway to improving quality of life while reducing the global health care burden.

  PublisherDOI

• Brain Health and Traumatic Brain Injury (TBI): Relationship Between Brain Care Score and Disability in Subacute-long Term TBI (P10-7.001)

  Neurology · 2025-04-07

  article

  To examine the relationship between brain health-related behaviors/risk factors measured by Brain Care Score (BCS) and self-reported disability in a post-traumatic brain injury (TBI) clinic cohort.

  PublisherDOI

• B – 48 Understanding the relationship between cardiovascular health factors and neuropsychological test performance after traumatic brain injury

  Archives of Clinical Neuropsychology · 2025-09-26

  article

  Abstract Objective The Life’s Essential (LE8) score is a set of eight factors contributing to cardiovascular health including blood pressure, blood glucose, blood lipids, body mass index, diet, physical activity, smoking, and sleep. Research has suggested that higher LE8 scores correlates to fewer dementia events and better neurocognitive health. We explored the association of LE8 score and neuropsychological test performance in a sample of traumatic brain injury (TBI) patients. Method 28 outpatients (M age = 46.5, SD = 15.9; 60.7% females) with mild or moderate TBI underwent neuropsychological assessment in an academic medical setting after a sustaining a TBI. Data were analyzed using correlation and linear regression. The Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Full-Scale IQ (FSIQ) from the Wechsler Adult Intelligence Scale – (WAIS-IV), as well as Montreal Cognitive Assessment (MoCA) were examined. Results The mean LE8 score was 5.45 (SD = 1.26). LE8 was significantly correlated with the WMI (r = .48, p = .027), FSIQ (r = .50, p = .031) and MoCA (r = .76, p = .030). The association between WMI and LE8 remained significant after adjusting for age and sex. VCI and PRI were not associated with LE8. Conclusion This study provides novel insights into various health factors that may influence recovery after TBI. Higher LE8 scores appear to relate to higher scores in overall cognition but also working memory. Our research suggests that modifiable factors may be associated with cognitive performance, which demonstrates promising avenues for intervention in TBI.

  PublisherDOI

• Trajectory of longitudinal lending discrimination modifies the efficacy of a skills-based intervention in stroke survivors

  Journal of Stroke and Cerebrovascular Diseases · 2025-12-20

  articleOpen accessSenior author

  BACKGROUND AND PURPOSE: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) study found that a skills-based intervention on systolic blood pressure (SBP) reduction in a cohort of mild/moderate strokes/transient ischemic attacks (TIA) was only effective at reducing SBP among Hispanics. We sought to better understand the differential ethnic success of DESERVE and determine if the efficacy of the intervention varied by longitudinal mortgage lending discrimination, measured by where they lived and home lending practices. METHODS: We conducted a post hoc analysis using DESERVE, which randomized 552 stroke/TIA survivors to skills-based intervention or usual care for secondary stroke prevention. We geocoded participant addresses to census tract-level historic and present-day lending discrimination. We used a four-level neighborhood longitudinal lending discrimination variable from Home Owners' Loan Corporation redlining data and 2018 Home Mortgage Disclosure Act reports: no discrimination, growing investment, declining investment, and persistent discrimination. We modeled change in SBP by intervention status stratified by longitudinal lending discrimination category linearly with generalized estimating equations, clustering by site with inverse probability weights. RESULTS: In unweighted models, the intervention was most efficacious in growing investment areas (8.65 mmHg reduction; 95 % CI: 0.48, 16.82) vs. usual care and least efficacious in declining investment areas (9.69 mmHg increase; 95 % CI:15.04, -4.34). After weighting to account for selection biases and duration of time lived in the community, conclusions were unchanged. CONCLUSION: The intervention efficacy was impacted by underlying systems of persistent disadvantage, emphasizing the need for contextual factor consideration when designing stroke recovery trials.

  PublisherOA PDFDOI

• Exploratory Analysis of Comprehensive Neurocognitive Testing in Post-traumatic Brain Injury (TBI) Clinic Patients with Primary Cognitive Symptoms (P10-4.004)

  Neurology · 2025-04-07

  article

  To assess differences in formal neurocognitive testing in traumatic brain injury (TBI) clinic patients reporting primary cognitive symptoms and analyze predictors of mild-moderate cognitive disorder diagnosis.

  PublisherDOI

Awards & honors

• Community Hero by the Greater Irvine Chamber (2020)
• Founding Dean Bernadette Boden-Albala appointed chair of AAN…