Multi-level predictors of structural racism and discrimination and associations with health and well-being across the life course in diverse families

结构性种族主义和歧视的多层次预测因素以及不同家庭生命历程中与健康和福祉的关联

• 批准号: 10472238
• 负责人: Jerica M Berge
• 金额: $ 66.69万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-08 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10472238
• 关键词: Adolescence; Adult; Affect; African American; Area; Biological; Biological Markers; Black race; Blood Pressure; Body mass index; C-reactive protein; Cardiometabolic Disease; Child; Childhood; Communities; Data; Diet; Dietary intake; Discrimination; Ecological momentary assessment; Elements; Event; Exposure to; Family; Geographic Information Systems; Geographic Locations; Glycosylated hemoglobin A; Health; Heart Rate; Hemoglobin C; High Density Lipoprotein Cholesterol; Hispanic; Household; Housing; Immigrant; Individual; Institutional Racism; Intervention; Life Cycle Stages; Lipids; Longitudinal Studies; Longitudinal cohort study; Longitudinal observational study; Measures; Mental Depression; Mental Health; Methods; Minnesota; Moods; Native Americans; Neighborhoods; Outcome; Outcome Measure; Parents; Participant; Personal Satisfaction; Persons; Physical activity; Police; Policies; Prevalence; Psyche structure; Public Assistance; Public Health; Refugees; Reporting; Research; Research Design; Research Personnel; Risk Factors; Rural; Safety; Sampling; Schools; Site; Source; Stress; Structural Racism; Surveys; Time; Triglycerides; Unhealthy Diet; United States; Voting; Well in self; Work; anxiety symptoms; base; behavioral health; cardiometabolic risk; cardiometabolism; career; career development; cytokine; depressive symptoms; design; ethnic diversity; health disparity; health equity; health equity promotion; innovation; killings; multidisciplinary; negative mood; perceived discrimination; perceived stress; physical conditioning; prospective; racial and ethnic; racism; rural families; rural setting; sedentary lifestyle; segregation; socioeconomics; therapy development; urban setting; waist circumference

ABSTRACT Systemic and structural racism is a public health crisis. However, little is known about the impact of structural racism and discrimination (SRD) on the health and emotional well-being of individuals across the life course. While prior studies have shown associations between discrimination and negative health outcomes in adults (e.g., cardiometabolic disease, depression), these studies have been cross-sectional and primarily examined individual-level sources of racism and discrimination. Much more research is needed to fill gaps in our understanding about the relationship between SRD and health disparities before interventions can be developed. To significantly advance the field regarding SRD and health equity, studies need to include: (1) multi-level measures of SRD including individual (both intrapersonal and interpersonal), neighborhood, institutional, and societal/policy levels; (2) rigorous mixed-methods designs (e.g., ecological momentary assessment (EMA), biological measures, geographic information system (GIS) data, surveys); (3) multi-site samples with urban and rural participants; (4) a life course approach; (5) whole-person outcome measures (i.e., mental, physical, behavioral health); and (6) longitudinal study designs. Including these study elements will allow for comprehensively examining the relationships between SRD and health and emotional well-being to identify mechanisms to target in interventions to mitigate SRD. The main objective of the proposed study is to examine multiple levels (i.e., individual, neighborhood, institutional, societal/policy) of SRD and associations with mental, physical, and behavioral health outcomes across the life course to identify intervention targets to promote health equity. The proposed study is built on a prospective longitudinal cohort study of 627 racially/ethnically diverse families (i.e., African American, Hispanic, Native American, Immigrant/Refugee, White) across the life course (childhood, adolescence, adulthood/parenthood) from urban settings (i.e., Minneapolis, St. Paul). The parent R01 already has three time-points of mixed-methods data (i.e., EMA, GIS, survey) that includes discrimination and neighborhood segregation measures and physical and behavioral health outcomes carried out using a community-based participatory approach. For the proposed study, a sample of 300 racially/ethnically diverse families from rural Georgia (i.e., Athens) will be added to compare SRD experiences in urban versus rural settings. In addition, cardiometabolic and stress biomarker data (i.e., heart rate, blood pressure, waist circumference, lipids, HbA1C, cytokines) and multi-level measures of structural racism (i.e., individual, neighborhood, institutional, societal/policy) will be added at two time points, 18 months apart. The proposed study will be one of the first to prospectively measure multiple levels of SRD using mixed-methods across two sites and associations with mental, physical, and behavioral health disparities across the life course in diverse families. Results of the study will inform the development of an intervention targeting multi-level SRDs to promote health equity.

摘要