Racial and Economic Adversity Differences in Stress Markers and Immune Function Among Urban Adolescents.
Racial and Economic Adversity Differences in Stress Markers and Immune Function Among Urban Adolescents.
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DOI：
10.1097/nnr.0000000000000527
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发表时间：
2021
期刊：
影响因子：
2.5
通讯作者：
Schmeer KK
中科院分区：
文献类型：
--
作者：
Ford JL;Browning CR;Boch SJ;Kertes DA;Tarrence J;Way BM;Schmeer KK
暴露于种族主义和相关的逆境，如贫困，被假设为有助于通过压力和免疫途径在健康方面的种族不平等。此外，逆境的影响可能会更加突出，在敏感的发展时期。我们的研究检查了青春期压力和免疫生物标志物的种族差异，以及在不同发育时期暴露于经济逆境的影响，并累积解释了潜在的种族差异。对青少年健康和发展背景研究进行了二次分析。数据来源于自我管理的调查，访谈，基于智能手机的，地理明确的，生态瞬时评估，压力生物标志物（六个晚上的唾液皮质醇和头发皮质醇），免疫生物标志物（EBV阳性青少年中EB病毒[EBV] DNA的唾液脱落）。目前的社会经济地位（SES）的措施包括家庭年收入和照顾者的教育。照顾者还报告了破产的经历，难以支付账单，收到食品券/补充营养援助计划/电子福利转移，以及当孩子出生时-5岁，6-10岁和11岁或更大时失业。对任何项目的肯定回答被定义为在该发育时期内暴露于经济逆境（是/否）。累积经济逆境指标计算为各发育期暴露的总和（从未暴露= 0至所有时间段暴露= 3）。进行描述性和多变量回归分析，解释协变量。与白色青少年相比，黑人/非裔美国青少年具有更高的唾液皮质醇浓度，更高的头发皮质醇浓度，以及更高的EBV DNA唾液脱落几率。种族差异并没有减弱目前的社会经济地位或经济逆境（发展期或累积）。我们的研究提供的证据表明，早在青春期，压力和免疫生物标志物就因种族而异，这可能是种族主义和相关逆境导致种族健康不平等的一种途径。进一步研究贫困以外的多种逆境对生理压力和健康方面种族不平等的影响，对于有效的预防和干预工作至关重要。
Exposure to racism and associated adversities, such as poverty, are hypothesized to contribute to racial inequities in health via stress and immune pathways. Furthermore, the effects of adversity may be more salient during sensitive developmental periods. Our study examined racial differences in stress and immune biomarkers during adolescence and the effects of exposure to economic adversity at distinct developmental time periods, and cumulatively in accounting for potential racial differences. Secondary analysis of the Adolescent Health and Development in Context study was conducted. Data were derived from self-administered surveys, interviews, smartphone-based, geographic-explicit, ecological momentary assessment, stress biomarkers (evening salivary cortisol over six nights and hair cortisol), immune biomarkers (salivary shedding of Epstein-Barr virus [EBV] DNA among EBV-positive adolescents). Current socioeconomic status (SES) measures included annual household income and caregiver education. Caregivers also reported experiences of bankruptcy, difficulty paying bills, receipt of food stamps/Supplemental Nutrition Assistance Program/ electronic benefit transfer, and job loss when the child was between birth–5 years, 6–10 years, and 11 years or older. An affirmative response to any item was defined as exposure to economic adversity for that developmental time period (yes/no). A cumulative economic adversity measure was calculated as the sum of exposures across developmental periods (never exposed = 0 to exposed across all time periods = 3). Descriptive and multivariable regression analyses were conducted, accounting for covariates. Black/African American adolescents had higher salivary cortisol concentration, higher hair cortisol concentration, and an increased odd of salivary shedding of EBV DNA compared to White adolescents. Racial differences were not attenuated by current SES or economic adversity (developmental period or cumulatively). Our study provides evidence that stress and immune biomarkers differ by race as early as adolescence and may be one pathway through which racism and associated adversities contribute to racial health inequities. Further research on the contribution of multiple adversities beyond poverty to racial inequities in physiologic stress and health is critical for informing effective prevention and intervention efforts.