When Is Hope Enough? Hopefulness, Discrimination and Racial/Ethnic Disparities in Allostatic Load
When Is Hope Enough? Hopefulness, Discrimination and Racial/Ethnic Disparities in Allostatic Load
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DOI：
10.1080/08964289.2020.1729086
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发表时间：
2020-10-01
影响因子：
2.3
通讯作者：
Nguyen, Ann W.
中科院分区：
文献类型：
--
作者：
Mitchell, Uchechi A.;Dellor, Elinam D.;Nguyen, Ann W.
希望与更好的健康有关，可能是适应压力和恢复力的组成部分。有限的研究前瞻性地考察了满怀希望是否能防止生理失调，或者对美国白人、黑人和西班牙裔人是否有类似的作用。我们使用健康与退休研究（n = 8,486）的数据检验了基线希望与未来适应负荷之间的关系，并根据种族/民族和歧视经历评估了这种关系的差异。四个项目测量希望和适应负荷是七个生物标志物的计数，被调查者的测量值被认为是疾病的高风险。二分类变量评估受访者在其一生中是否至少经历过一次主要的歧视行为。我们使用泊松回归来检验希望和适应负荷之间的关系，并包括一个乘法交互项来检验这种关系中的种族/民族差异。随后的分析按种族/民族分层，并在每个种族/民族群体中测试希望和歧视之间的相互作用。希望与较低的适应负荷得分有关，但其影响因种族/民族而有显著差异。种族分层分析表明，希望在白人中具有保护作用，而在西班牙裔中与适应负荷无关，无论是否经历过歧视。在报告歧视的黑人中，希望与较低的适应负荷有关，而在没有报告歧视的黑人中，希望与较高的适应负荷有关。研究结果表明，希望在老年白人、黑人和西班牙裔人中扮演着不同的角色，对黑人来说，它对生理失调的保护作用与他们遭受歧视的经历有着复杂的联系。
Hopefulness is associated with better health and may be integral for stress adaptation and resilience. Limited research has prospectively examined whether hopefulness protects against physiological dysregulation or does so similarly for U.S. whites, blacks and Hispanics. We examined the association between baseline hopefulness and future allostatic load using data from the Health and Retirement Study (n = 8,486) and assessed differences in this association by race/ethnicity and experiences of discrimination. Four items measured hopefulness and allostatic load was a count of seven biomarkers for which a respondent's measured value was considered high-risk for disease. A dichotomous variable assessed whether respondents experienced at least one major act of discrimination in their lifetime. We used Poisson regression to examine the association between hopefulness and allostatic load and included a multiplicative interaction term to test racial/ethnic differences in this association. Subsequent analyses were stratified by race/ethnicity and tested the interaction between hopefulness and discrimination within each racial/ethnic group. Hopefulness was associated with lower allostatic load scores, but its effects varied significantly by race/ethnicity. Race-stratified analyses suggested that hopefulness was protective among whites and not associated with allostatic load among Hispanics irrespective of experiencing discrimination. Hopefulness was associated with lower allostatic load among blacks reporting discrimination but associated with higher allostatic load among those who did not. Findings suggest that hopefulness plays differing roles for older whites, blacks and Hispanics and, for blacks, its protective effects on physiological dysregulation are intricately tied to their experiences of discrimination.