Structural Adversity and Life-Course Social Determinants of Stress Regulation and Epigenetic Aging in Midlife Adults

项目总结/摘要 相互交织的结构性条件，包括种族主义和其他压迫制度，造成了结构性逆境 影响健康和预期寿命，特别是对美国黑人和其他种族化社区。的 拟议的混合方法研究将收集新的数据，以补充丰富的现有纵向数据 以前收集的关键发展阶段超过三十年，从两个民族，种族， 来自哈莱姆纵向发展研究的社会经济多样化队列和 社区研究。该样本将包括450名黑人，拉丁裔和白色成年人，此前曾在 儿童期/青春期早期、成年初显期、青年期和中年。拟议的研究， 通过生态系统理论的现象学变体，将量化和语境化 暴露于结构性逆境的关联，即个人层面的逆境生活经历 在整个生命过程中的机构和社会背景之内和之间（例如，污名/歧视、社会经济 劣势）和邻里水平的种族不平等与压力调节，表观遗传修饰 (i.e.,表观遗传年龄），和心理健康（即，心理困扰，抑郁，焦虑，创伤后压力， 基于种族的创伤性压力）。这将使用四种形式的数据来完成，这些数据将被三角化， 优化结果和解释：调查，生物，定性和美国人口普查数据。拟议研究 还将包括创新性地开发和验证一个新的背景下交叉污名工具（ISIC）， 将与现有的羞辱/歧视措施进行比较和对照。定量调查和 生物学数据将有助于全面分析结构性逆境及其 与压力调节、表观遗传衰老和心理健康的关系。这些分析将进一步 通过与从研究队列中选择的有目的的样本进行深入访谈。的 定性数据将创新性地提供对结构性逆境的更深入理解和解释， 生命历程，包括耻辱/歧视、压力、复原力和其他经常被忽视的突出经历 通过定量数据，包括过去几代人的背景信息。此外，这项研究将确定 保护性因素，可以减轻逆境的有害后果，从而突出弹性领域 可以在干预中加以利用。最后，确定种族主义和相互交织的种族主义制度 压迫渗透并复制了在个人和邻里层面表现出来的社会条件， 创造结构性逆境-将检查它与生物应激调节，表观遗传 老化和心理健康。这将是朝着改变政策和制度迈出的关键一步， 实现人人享有最高水平健康的途径，这是《健康宣言》的一个明确目标， 人民倡议。

PROJECT SUMMARY/ABSTRACT Intersecting structural conditions, including racism and other systems of oppression create structural adversity that impacts health and life expectancy, especially for Black Americans and other racialized communities. The proposed mixed-methods research will collect new data to complement a wealth of existing longitudinal data previously collected at key developmental stages over more than three decades from two ethnically, racially, and socioeconomically diverse cohorts from the Harlem Longitudinal Development Study and the Children in the Community Study. The sample will consist of 450 Black, Latinx and white adults previously surveyed in childhood/early adolescence, emerging adulthood, young adulthood, and midlife. The proposed research, informed by the Phenomenological Variant of Ecological Systems Theory, will quantify and contextualize the assocations of exposure to structural adversity, namely individual-level life-course experiences of adversity within and across institutions and social contexts over the life course (e.g., stigma/discrimination, socioeconomic disadvantage) and neighborhood-level ethnic-racial inequality with stress regulation, epigenetic modifications (i.e., epigentic age), and mental health (i.e., psychological distress, depression, anxiety, posttraumatic stress, race-based traumatic stress). This will be accomplished using four forms of data that will be triangulated to optimize results and interpretation: survey, biological, qualitative, and U.S. Census data. The proposed research will also include innovative development and validation of a new Intersectional Stigma in Context tool (ISIC) that will be compared and contrasted with existing stigma/discrimination measures. The quantitative survey and biological data will facilitate comprehensive analysis of racialized differences in structural adversity and its association with stress regulation, epigenetic aging, and mental health. These analyses will be further contextualized through in-depth interviews with a purposive sample selected from the study cohort. The qualitative data will innovatively provide deeper understanding and interpretation of structural adversity over the life course, including stigma/discrimination, stress, resilience, and other salient experiences that are often missed by quantitative data, including contexualized information of past generations. Further, this research will identify protective factors that can mitigate the deleterious sequelae of adversity and thus highlight areas of resilience that can be leveraged in interventions. In conclusion, identifying how racism and intersecting systems of oppression permeate and reproduce social conditions that manifest at the individual and neighborhood levels – creating structural adversity – will be examined for it’s association with biological stress regulation, epigenetic aging, and mental health. This will constitute a crucial step towards changing policies and systems that stand in the way of realizing the attainment of the highest level of health for all people, an explicit goal of the Healthly People initiative.