Social stressors and inflammation: A mixed methods approach to preterm birth

摘要 黑人女性比白人更容易患上COVID-19，许多人报告了差异 城市包括我们的站点之一底特律。黑人妇女在低工资的基本劳动力中所占比例过高 并且更有可能生活在弱势社区（例如，面临社会问题的挑战 疏远黑人的储蓄更少，雇主的灵活性也可能低于白人， 经济困难的风险（例如，失业）。黑人妇女在获得 为自己和家人提供COVID-19症状的检测和医疗护理。由于“庇护到位” 随着大流行的政策和失业，黑人妇女也可能与她们的伴侣发生更多的冲突。 亲密伴侣暴力（IPV）的发生率更高，因为家庭几乎花费了所有的清醒和睡眠时间 一起种族差异--在COVID-19患病率和死亡率、就业、邻里条件、 经济困难，IPV，以及测试和医疗保健中的歧视-都可能增加心理压力。 遇险（例如，抑郁症（Black women）然而，没有发表的研究已经检查了黑色 妇女在我们现在所经历的病毒大流行期间的经历。我们假设布莱克 女性将经历更多的歧视，经济困难，与伴侣的冲突，IPV和心理 疫情期间的困境以及支持水平低于疫情前。 我们的队列是由658名黑人妇女从底特律，密歇根州和哥伦布，俄亥俄州的大都市地区。 作为R 01研究的一部分，妇女在怀孕期间（T1=大流行前）完成问卷调查。为 在这项补充研究中，女性将在智能手机上完成在线调查（T2=大流行期间）， 另一个装置。T2调查将包括T1调查的关键领域（例如，抑郁症状，社会 支持，IPV），并在大流行的背景下提供第二个关键时间点。我们期望一些域 特别是受流行病影响的人（例如，歧视、压力）。我们还添加了一些项目， COVID-19具体问题，包括其网络内的经历（例如家庭成员患病），以及 作为与情况相关的措施（例如，社会隔离）。一部分妇女将参加 定性访谈，以深入了解他们的经验。我们的目标是：（1）审查协会 贫困社区，种族歧视和经济困难， 两个时间点（T1和T2）;（2）检查是否与伴侣的关系，IPV和心理困扰 通过比较大流行前和大流行期间的时间点， 社会隔离和社会支持与伴侣关系、IPV和心理困扰的关系 （4）探讨孕妇在COVID-19大流行期间的经历， 定性访谈。黑人妇女在这一流行病期间特别脆弱。时间敏感性 COVID-19大流行需要立即探索妇女的经验。

ABSTRACT Black women are more likely to become ill with COVID-19 than Whites, with disparities reported in many cities including Detroit, one of our sites. Black women are overrepresented in the low-wage essential workforce and more likely to live in disadvantaged neighborhoods (e.g., crowded housing) facing challenges in social distancing. Blacks have less in the way of savings and possibly less flexible employers than Whites, increasing risks for economic hardship (e.g., loss of jobs). Black women may experience discrimination in obtaining testing and medical care for COVID-19 symptoms for themselves and their families. Due to “shelter in place” policy and job losses with the pandemic, Black women may also experience increased conflict with their partner and higher rates of intimate partner violence (IPV) due to families spending nearly all waking and sleeping time together. Racial disparities -- in COVID-19 prevalence and death rates, employment, neighborhood conditions, economic hardship, IPV, and discrimination in testing and medical care -- may all increase psychological distress (e.g., depressive symptoms) for Black women. However, no published research has examined Black women’s experiences during a viral pandemic such as we are now experiencing. We hypothesize that Black women will experience more discrimination, economic hardship, conflict with partner, IPV and psychological distress as well as lower levels of support during the pandemic than pre-pandemic. Our cohort is comprised of 658 Black women from the Detroit, MI and Columbus, OH metropolitan areas. As part of the R01 study, women completed questionnaires during their pregnancies (T1=pre-pandemic). For this supplemental study, women will complete an online survey (T2= during the pandemic) on a smart phone or another device. The T2 survey will include key domains from the T1 survey (e.g., depressive symptoms, social support, IPV) and provide a second critical time point in the context of the pandemic. We expect some domains to be especially impacted by the pandemic (e.g., discrimination, stress). We also added items to capture COVID-19 specific issues, including experiences within their network (e.g. family members sickened), as well as measures pertinent to the situation (e.g., social isolation). A subsample of women will participate in qualitative interviews for an in-depth understanding of their experiences. We aim to: (1) Examine associations of disadvantaged neighborhoods, racial discrimination and economic hardship with psychological distress at both time points (T1 and T2); (2) Examine whether relationship with the partner, IPV, and psychological distress are impacted by the pandemic by comparing the pre-pandemic and during pandemic time points; (3) Examine how social isolation and social support relate to relationship with the partner, IPV, and psychological distress during the pandemic; and (4) Explore pregnant women’s experiences during the COVID-19 pandemic through qualitative interviews. Black women are especially vulnerable during the pandemic. The time-sensitive nature of the COVID-19 pandemic demands the immediate exploration of women’s experiences.