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The scene is a research lab on 91����’s campus in the early 1990s. Psychology student Jennifer McGrath ’95 is checking in with smokers enrolled in a study to help them quit.

One participant says he’s been smoke-free, so McGrath asks him to blow into a cardboard mouthpiece to measure carbon monoxide in his breath — a way to check whether he’s sticking with the program. The participant sheepishly grins and admits he did have a cigarette — in fact, maybe a few. McGrath simply nods; the test results had already given him away.

For McGrath, this began her decades-long pursuit of understanding how health and psychology intersect. Now, as a researcher and professor of psychology at 91����, she’s at the forefront of investigating how children’s early environments and social and economic conditions shape their risk for chronic diseases, particularly heart disease, once thought to emerge only in adulthood.

Taking on this complex challenge has been influenced by McGrath’s experiences, including a National Institute of Mental Health camp for children with attention deficit hyper- activity disorder (ADHD), a clinical internship at Bellevue Hospital in New York City after 9/11, and low-in- come neighborhoods in Pittsburgh where not everyone can afford electricity and the nearest grocery stores require three bus rides to reach. These settings helped hone her perspective on health: considering context, time and daily exposure to stressors and disadvantages.

McGrath’s research aims to distill how the places we live, learn and sleep affect the risk for chronic disease, often long before symptoms appear.

“We usually think of heart disease as something that starts later in life,” McGrath says. “But the foundations are being laid much earlier, through things like disrupted sleep, food insecurity, uncontrollable chaos or not feeling safe at night. These kinds of exposures shape health, and they’re daily realities for many families. They’re present, they’re real and they accumulate.”

To study how environments shape health, McGrath takes an innovative approach, using wearable sensors to track movement, sleep, heart rate, brain waves and blood pressure in daily life. She focuses on small fluctuations in the timing between heartbeats, daily rhythms and sleep as windows into how the body responds to the conditions around us. Her goal is to connect these physiological signals to broader patterns in health, using millisecond-level data to inform population-level insights.

Now back in 91����, McGrath is continuing this work and is already impressed by her hometown’s curiosity, especially the eagerness of local children to take part.

“My early work started by looking at how the heart reacts to stress during the day, and how that reactivity might wear onthe body over time,” McGrath says. “We debated how to show cause and effect; we couldn’t ethically create stress in someone’s life to test our hypothesis. Then we came upon something surprising: sleep deprivation itself is a physiological stressor. It triggers the same shifts in heart rhythm and stress hormones as other life stressors.”

That realization shifted her lens. “We spend a third of our lives asleep, but sleep isn’t passive. It’s when the body is supposed to recover,” she adds. “And for kids growing up in more difficult circumstances, where there’s more unpredictability, less routine or more environmental noise, that sleep is often less restful, more disrupted and not as restorative as it should be.”

This is where wearables come in. By tracking sleep, movement, heart rate and other signals around the clock over several days, McGrath investigates how a child’s environment influences their physiology and how that connects to early signs of cardiovascular health risk, including weight gain, high cholesterol, elevated blood pressure and inflammation.

By bringing wearable research into local communities, McGrath hopes to uncover how broader patterns, like neighborhood noise, access to green space or safety concerns layer onto individual and family experiences.

These insights can help pinpoint where support is most needed and what small changes might make the biggest difference, not just for one child but for entire neighborhoods. That might mean a few more minutes of sleep, taking a breath between tasks, a quiet place to wind down, a comforting moment with a pet, or simply feeling connected to the people around you.

These actions may seem small, but when adopted by many people, they can improve health across entire communities, McGrath points out.

“People often ask me why a psychologist is studying heart disease in children,” she reflects. “But this is exactly what psychology has long done through the field of cardiovascular behavioral medicine, especially when it draws from pediatric health and is informed by the tools of public health.”

McGrath works closely with cardiologists, pediatricians, kinesiologists, engineers and epidemiologists to ask better questions. Psychologists, she says, are trained to understand people, to recognize patterns and to help shift behavior in ways that actually work.

“One-on-one work is powerful. It helps people grow, heal and under- stand themselves,” McGrath says. “But we can also take what we know about individuals and apply it more broadly — to neighborhoods, communities, and populations — to understand how stress and context shape health across time. That’s the kind of work I’m excited to keep advancing.”