About

Krista M. Perreira, Ph.D., is a health economist and Professor of Social Medicine in the School of Medicine at the University of North Carolina at Chapel Hill. Her research focuses on disparities in health, education, and economic well-being, as well as the inter-relationships between family, health, and social policy. She concentrates particularly on children in immigrant families, employing both qualitative and quantitative methodologies to study migration from Latin America and the health and educational consequences of migration. Through her work, she aims to develop programs and policies that improve the well-being of immigrant families and their children.

Research topics

• Medicine
• Environmental health
• Sociology
• Psychiatry
• Political Science
• Demography
• Virology
• Internal medicine
• Psychology
• Nursing
• Endocrinology
• Clinical psychology
• Family medicine
• Developmental psychology
• Social psychology
• Gerontology
• Economic growth
• Statistics
• Physical therapy
• Pathology
• Mathematics

Selected publications

• Within-person trends in anxiety, depression, and social isolation among first-year college students before and after the onset of the COVID-19 pandemic.

  American Journal of Orthopsychiatry · 2026-05-18

  articleOpen accessSenior author

  The present study aimed to differentiate groups based upon the ways undergraduate students at a large public university in the southeastern United States experienced depressive symptoms, anxiety symptoms, and social isolation before the start of the COVID-19 pandemic and how their experiences changed as the pandemic progressed. Specifically, current analyses examined within-person trends in mental health baseline and change values, identities of most likely class members, and associations among coping strategies used and latent profiles. First-year students were surveyed both before (October 2019 to February 2020) and after (June/July 2020) the start of the COVID-19 pandemic. Baseline values and change scores in depression, anxiety, and social isolation were used as indicators in a latent profile analysis, which yielded a six-class solution. Additionally, associations among latent mental health profiles and coping strategies used during lockdown were examined. While most of the sample remained in the same moderate or low severity range in which they started, profiles also emerged in which students (a) began with low severity across indicators and increased substantially, (b) began in high distress and remained that way, and (c) began in extremely high distress and decreased to moderate levels of distress. Latent profile associations with coping strategy and identity revealed modest associations between the latent profiles with increasing distress and coping via substance use and negative emotion expression. Avoidance was the most widely endorsed coping strategy. Campus responses should consider tiered or flexible approaches to support a high degree of heterogeneity among student mental health presentations and coping strategies and prepare to swiftly enact a needs assessment to guide resource allocation in times of collective crisis, in addition to ongoing assessment and conversation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Self-Reported HIV Testing and Diagnosis Prevalence Among US Hispanic or Latino Adults

  JAMA Internal Medicine · 2026-05-18

  articleOpen access

  This cohort study assesses HIV testing, test positivity, and cultural and personal factors associated with these outcomes among adults of Hispanic or Latino ethnicity in the US.

  PublisherOA PDFDOI

• Abstract 4349002: Association of Life’s Essential 8 Cardiovascular Health Scores with Pre-Heart Failure in a Hispanic/Latino Population-Based Cohort: Results from the Echocardiographic Study of Latinos (ECHO SOL)

  Circulation · 2025-11-03

  article

  Background: Cardiovascular health (CVH) predicts heart failure (HF) risk, but its association with the subclinical HF stage of pre-HF is less understood. We evaluated associations of CVH, measured by AHA’s Life’s Essential 8 (LE8), with prevalent and incident pre-HF in the Hispanic/Latino population. Methods: We analyzed serial echocardiograms from 1643 adults from ECHO-SOL, obtained ~4.3 years apart, to identify pre-HF. Prevalent pre-HF (visit 1, 2011-2014) was defined by ≥1 abnormality: LVEF <50%, global longitudinal strain > -15%, diastolic dysfunction ≥ grade 1, left ventricular mass index >115 in men/>95 in women, relative wall thickness >0.42. Incident pre-HF was assessed at visit 2 (2015-2018) among those free of pre-HF at visit 1, n=486. CVH metrics (diet, physical activity, sleep health, nicotine use, body mass index [BMI], lipids, blood pressure, and glucose) were assessed at baseline cohort visit (2008–2011), and LE8 scores [AHA scoring algorithm, range: 0-100] were categorized as low (0–<50), moderate (50–80), or high (>80–100). Age-and-sex-adjusted logistic regression and splines models evaluated associations of LE8 (total and components) with pre-HF. All analyses accounted for complex survey design. Results: In ECHO-SOL (mean age 55 years, 55% female), only 3.5% had high CVH; 71.5% had moderate and 25.1% had low CVH. Participants with (vs. without) prevalent pre-HF had significantly lower total LE8, diet, physical activity, BMI, glucose and blood pressure scores (p<.0001). Similarly, those with (vs. without) incident pre-HF had significantly lower total LE8, BMI, and glucose scores, Table 1. Compared to high CVH, moderate CVH associated with nearly 3-fold higher adjusted odds of prevalent and incident pre-HF, with even greater odds for low CVH, Figure 1A. Each 10-point increase in LE8 score associated with 41% lower odds of prevalent pre-HF (OR 0.59, 95% CI 0.53–0.67), but not with incident pre-HF, Figure 1B . In splines, LE8 scores >60 were protective for prevalent pre-HF (OR 0.69, 95% 0.64, 0.76), with no association observed for incident pre-HF, Figure 1C-D. Among LE8 metrics, higher diet, blood pressure, and glucose scores were associated with lower odds of prevalent pre-HF, while only higher glucose scores were linked to incident pre-HF (all p<.05), Figure 1B.: Conclusion: Increasing CVH is associated with less prevalent and incident pre-HF. As HF burden grows in diverse groups, optimizing LE8 scores may help stem future HF at the population level.

  PublisherDOI

• 55. DISSECTING THE ANCESTRY-SPECIFIC GENETIC ARCHITECTURE OF ALCOHOL CONSUMPTION IN LATIN AMERICANS

  European Neuropsychopharmacology · 2025-10-01

  articleOpen access

  Genome-wide association studies (GWAS) have made substantial contributions to our understanding of the genetic factors that influence alcohol consumption. However, most efforts have been made in populations of European ancestry, resulting in less representation of other populations, with Latin American (LA) populations among the least represented, comprising less than 2% of the total GWAS participants. LA populations are characterized by varying degrees of genetic admixture from Indigenous American, European, and African ancestries, which creates challenges when modeling the genetic architecture of complex traits. However, recently developed GWAS approaches, such as Tractor, that leverage local ancestry information (defined as the genetic ancestry of an individual at a particular genomic location) could help overcome this challenge. This study, led by members of the Latin American Genomics Consortium (LAGC), is a meta-analysis of GWAS studies of self-reported alcohol consumption in 465,516 individuals from cohorts based in Latin American countries and the United States (US). We also conducted a local ancestry-aware GWAS on 11,655 LA individuals using Tractor. We replicated well-known genetic associations for alcohol consumption in genes that include the ADH locus (lead variant rs1229984, p-value = 1.12e-203) and others associated with psychiatric and behavioral traits, such as CADM2. We also identified a signal in the ALDH2 locus, previously associated only in East Asian populations. Using the local ancestry-aware GWAS, we identified associations in genes previously associated with the number of drinks consumed per week (Drkwk) by the GWAS and Sequencing Consortium of Alcohol and Nicotine use consortium (GSCAN), rs1874323 (p-value = 2.5860e-08) in the MAGI1 gene, and rs6833926 (p-value = 3.00e-08) in the ARAP2 gene. We also identified potential novel associations in the SLIT3 gene (rs73805262, p-value = 9.95e-09 and rs115143510, p-value = 1.23e-08), as well as one intergenic variant (rs3929849, p-value = 2.3930e-09) among segments of African-like ancestry. We also identified associations in intergenic regions of American-like descent (rs4130378, p-value = 9.673e-09; rs536315876, p-value = 4.3640e-09; rs115675116, p-value = 4.3190e-09). Nevertheless, given the small sample size in the local ancestry-aware GWAS, these results required further replication. We also compared the association of the polygenic risk score (PRS) derived from the European population using GSCAN (PRS-EUR) data with the PRS from our large-scale meta-analysis (PRS-LA), examining the relationship with drinks consumed per week in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort, identifying a heterogeneity in the transferability of the PRS across geographical LA subgroups. We identified that both the PRS-EUR and PRS-La were associated with Drkwk in individuals from Puerto Rico (PRS-EUR, p-value = 7.40e-03; PRS-LA, p-value = 1.40e-02); meanwhile, only the PRS-EUR was associated in individuals from Mexico (p-value = 7.41e-3) and Cuba (p-value = 1.31e-02), and only the PRS-LA was associated in individuals from South America (p-value = 3.23e-02) Our study contributes to current efforts to elucidate the genetic architecture of alcohol consumption in Latin American populations, implicating novel genes (such as WRN) and revealing varying performance of PRS across different geographical subgroups.

  PublisherDOI

• Step-Based Metrics and Translations of Physical Activity Guidelines among Adults in the HCHS/SOL

  UNC Libraries · 2025-09-27

  articleOpen access

  PURPOSE: In a cross-sectional sample of US Hispanic/Latino adults, we aimed to describe step-based metric distributions, estimate their associations with activity counts and self-report, and calibrate step-based translations of current (2018) US physical activity (PA) guidelines, that is, ≥150 min·wk -1 moderate-to-vigorous PA (MVPA) from accelerometer counts and self-report. METHODS: The Hispanic Community Health Study/Study of Latinos enrolled 16,415 Hispanic/Latino adults 18-74 yr from four US cities (2008-2011). Participants completed the Global PA Questionnaire and 1 wk of Actical accelerometer wear ( n = 12,528). Weighted medians were used to describe step-based metrics, and Spearman correlations estimated their relationships with count-based and self-reported PA indicators. Receiver operator characteristic curve analyses were used to examine the ability of each step-based metric to classify participants meeting PA guidelines. RESULTS: Overall, US Hispanic/Latino adults accumulated medians of 6770 steps per day and 6, 18, 236, and 630 min·d -1 at ≥100, ≥70, 1-69, and 0 steps per minute, respectively. Count-based time in MVPA, light PA, and sedentary behavior were most strongly correlated ( rs = 0.79-0.85) with times ≥70, 1-69, and 0 steps per minute, respectively, whereas self-reported MVPA had similar correlations with steps per day and times ≥40 and ≥70 steps per minute ( rs = 0.28-0.29). Time ≥70 steps per minute had the greatest capacity to classify participants meeting PA guidelines with both measures of MVPA. CONCLUSIONS: This study provides the first normative values (based on percentiles) of step-based metrics for US Hispanic/Latino adults, which can facilitate surveillance, program planning, research, and data interpretation. Our finding that PA guidelines corresponded to 6000-7000 steps per day or ~20 min·d -1 at ≥70 steps per minute with an Actical accelerometer can be considered alongside dose-response relationships with health outcomes to develop step-based recommendations that are consistent with and better communicate PA guidelines.

  PublisherDOI

• Mental Health Symptoms Among US College Students Before, Early, and Late Into the COVID-19 Pandemic: A Longitudinal Analysis

  UNC Libraries · 2025-11-08

  articleOpen access1st authorCorresponding
  PublisherDOI

• Association Between Hypertensive Disorders of Pregnancy and Interval Neurocognitive Decline: An Analysis of the Hispanic Community Health Study/Study of Latinos

  Obstetric Anesthesia Digest · 2025-11-18

  article

  ( Obstet Gynecol . 2024;143(6):785-793. doi: 10.1097/AOG.0000000000005571) Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of complications beyond the peripartum period. About a decade ago, it was hypothesized that severe episodes of hypertension in pregnancy were associated with increased reports of cognitive impairment (CI). Subsequent studies suggested HDP was associated with longer-term decreased cognitive processing speed, working memory, verbal learning, and brain volume on MRI. Improved understanding of the relationship between HDP and CI is essential to design interventions to improve outcomes in these patients. Because of the multifactorial nature of CI, it is critical for the research to include large diverse populations. This study focused on the risk of neurocognitive decline associated with the Hispanic/Latino population following pregnancies affected by hypertensive disorders.

  PublisherDOI

• Association of race, ethnicity, and housing stability with COVID-19 testing method by investigators in underserved populations 2020–2023

  UNC Libraries · 2025-10-10

  articleOpen access

  Background Expanding SARS-CoV-2 testing was a critical part of community-based health efforts during the COVID-19 pandemic. In the RADx-UP consortium, a large NIH-funded network of community-engaged researchers in the United States, investigators were able to choose between PCR- and antigen-based testing strategies in community-based research settings. Data analyzing how COVID-19 diagnostics are chosen and utilized in research of vulnerable and underserved populations is limited. Objectives To examine the association of race, ethnicity, and housing stability with a PCR- or antigen-based testing strategy within COVID-19 testing projects in the RADx-UP consortium. Methods Testing protocols and investigator survey data describing target populations for community-engaged research projects were analyzed for association between race, ethnicity, and housing stability with SARS-CoV-2 test type. Community-engaged research projects were included if they were funded and approved to use PCR- and/or antigen-based COVID-19 testing by the RADx-UP testing core between 2020 and 2023. Multivariable adjustment to assess for confounding was then performed using rurality, project size, pandemic phase, and census region.ResultsSixty-seven projects (representing 479,410 participants) were included in the analysis. Overall, 24 (36%) projects chose an antigen-only testing strategy compared to 43 (64%) that chose a PCR-based strategy. No significant differences in distribution were seen in inclusion of PCR-testing by race (16 of 21 for Black race versus 27 of 46 for non-Black race, p = 0.198), ethnicity (22 of 33 for Hispanic ethnicity versus 21 of 34 for non-Hispanic ethnicity, p = 0.765), or housing stability (10 of 17 for unstable housing versus 33 of 50 for stable housing, p = 0.728) within intended population. Conclusion Race, ethnicity, and housing stability of an underlying vulnerable population was not significantly associated with the decision by community investigators regarding which COVID-19 testing strategy was most appropriate. Future research efforts should remain vigilant to offer emerging diagnostic technologies in the most equitable and appropriate ways.

  PublisherDOI

• Predictors of incident diabetes in two populations: framingham heart study and hispanic community health study / study of latinos

  UNC Libraries · 2025-09-26

  articleOpen access
  PublisherDOI

• Chronic conditions, disability, and COVID-19 testing and vaccination: A national Rapid Acceleration of Diagnostics‐Underserved Populations analysis

  Annals of Epidemiology · 2025-09-25

  article
  PublisherDOI

Recent grants

• NIH Grant R03HS009884

  NIH · $31k · 1999

• NIH Grant R01HL102130

  NIH · $7.5M · 2016

Frequent coauthors

• Martha L. Daviglus

  383 shared

• Linda C. Gallo

  San Diego State University

  188 shared

• Gregory A. Talavera

  175 shared

• Carmen R. Isasi

  Albert Einstein College of Medicine

  166 shared

• Robert C. Kaplan

  145 shared

• Jianwen Cai

  144 shared

• Amber Pirzada

  Office of Minority Health

  143 shared

• Neil Schneiderman

  138 shared

Education

• Ph.D., Health Economics

  Department of Health Policy and Management

Awards & honors

• Young Scholar award from the Foundation for Child Developmen…
• Phillip and Ruth Hettleman Prize for Artistic and Scholarly…
• Edward Kidder Graham Faculty Service Award (2014)