RUI: Disclosing concealable stigmatized identities: An analysis of intraindividual and sociocultural factors predicting stress reactivity and well-being

被污名化的人经历了美国社会中一些最可怕的健康差距，主流观点认为，这些差距在一定程度上可归因于歧视。然而，越来越多的证据表明，生活在基本上可隐藏的耻辱中的人--以及在很大程度上不受直接歧视的人--也经历了类似的差异。目前的项目考察了人际披露的压力可能是可隐藏的污名影响心理和身体健康的主要途径的可能性，人际披露是生活在可隐藏的污名化身份(即不容易看到的社会贬低的属性)的人中反复出现的独特的压力源。具体地说，这项研究测试了人际关系披露是否有压力，以及个人对污名的长期恐惧和周围社区的偏见是否会加剧这些压力效应和下游的心理和身体健康。这项拟议的研究将大大推进对生活在可隐藏的污名身份的个人的研究，作为一个整体，这些人构成了一个研究不足的美国人口。这一知识有可能为旨在帮助生活在可隐藏的污名化身份的个人缓冲自己免受社会贬值影响的干预措施和方案努力提供信息；政策制定者和社区利益攸关方努力减少偏见；以及公共卫生从业人员实现其减少健康差距的目标。因此，这项拟议的研究有可能有助于实现美国国家科学基金会和美国卫生与公众服务部的目标，即识别和改善导致健康差距的心理社会因素。本提案中概述的研究活动还将通过提供体验式研究和学习机会，极大地改变该国许多未来医疗提供者和社会科学家的培训环境，展示可能影响下游健康差距的复杂生物-心理-社会过程。

Stigmatized individuals experience some of the most formidable health disparities in American society, and prevailing views suggest that these disparities are attributable in part to discrimination. However, growing evidence suggests that individuals living with stigmas that are largely concealable - and who are largely shielded from direct discrimination - also experience similar disparities. The current project examines the possibility that the stress of interpersonal disclosure, a recurrent and unique stressor among people living with concealable stigmatized identities (i.e., socially devalued attributes that cannot readily be seen) may be a primary pathway by which concealable stigmas affect psychological and physical health. Specifically, this research tests whether interpersonal disclosure is stressful and whether individuals' chronic fears of stigmatization and the surrounding community's prejudice exacerbate these stress effects and downstream psychological and physical health. The proposed research will significantly advance the study of individuals living with concealable stigmatized identities, which, as a whole, constitute an understudied population of Americans. This knowledge has the potential to inform intervention and programmatic efforts designed to help individuals living with concealable stigmatized identities to buffer themselves against the effects of social devaluation; policy makers and community stakeholders in their efforts to reduce prejudice; and public health practitioners in their goals to reduce health disparities. As such, the proposed research has the potential to aid in reaching the NSF and U.S. Department of Health and Human Services' goal of identifying and ameliorating the psychosocial factors that contribute to health disparities. Research activities outlined in this proposal will also substantially transform the training environment for many of the country's future medical providers and social scientists by providing experiential research and learning opportunities that demonstrates the complex biopsychosocial processes that could affect downstream health disparities.