A Longitudinal Study of Adversity, Stress Processes, and Latinx Health from Adolescence to Young Adulthood

摘要 自2017年初以来，反移民政策的急剧上升，持续的COVID-19大流行，以及长期存在的 拉丁裔歧视和边缘化的经历引起了严重的与压力有关的公共卫生问题， 今天的拉丁裔青年，其中绝大多数是美国公民。长期和/或严重暴露于逆境 可以增加家庭中的压力过程（例如，增加产妇抑郁症），并通过青年的表现 行为健康（例如，不健康的饮食），和生物学（例如，每日皮质醇输出的日斜率更平坦）。这些 压力过程可能会增加心理健康和慢性疾病的风险，并限制拉丁美洲青年的社会流动性 从而过渡到成年期我们建议对Caminos进行重大扩建，这是一个NICHD- 一项受资助的研究，在6个月的滞后期（2018-2021年）收集了547名拉丁裔的不同样本的8个时间点的数据 青少年（88%美国出生）和母亲（80%外国出生）在亚特兰大郊区。就像其他新的定居点一样 在这些地区，格鲁吉亚的拉丁裔青年和家庭面临着一个不那么欢迎的移民接待环境比发生在 建立移民区。拟议的研究将增加五个时间点的年度数据， 测量向成年的过渡，并评估毛发和唾液皮质醇， 压力、腰围、慢性病风险和社会流动性的调查报告。13个时间点 的数据（2018年至2026年）将追溯早在11岁时就开始的行为，以及在此之前，期间， 以及疫情之后和美国移民政治环境变化期间。我们将使用国家的- 使用最新方法对Latinx队列的有意和无意缺失数据进行多重插补， 保留在正在进行的研究中。在家庭压力模型和文化发展理论的指导下， 滞后路径模型和潜在增长混合模型将检验家庭、生物和 行为健康应激过程介导逆境之间的关联（例如，对反 移民行动，流行病相关事件，拉丁裔边缘化）和拉丁裔青年的心理健康风险 （内化和外化症状，物质使用），慢性疾病风险（例如，哮喘、糖尿病），以及 社会流动性（例如，教育程度）。使用适度调解的测试，我们将确定社区， 家庭和个人层面的保护因素，减轻逆境和压力对青年成果的影响。 性别作为一个生物变量将作为一个关键的修改器进行检查。与其他国家和队列研究不同， 拟议的研究将确定如何积累的逆境植根于反移民的经验和 随着时间的推移，流行病塑造了拉丁美洲青年的健康结果和社会流动性。此外，拟议的研究 独特的是坐落在一个新的移民区，并探讨拉丁裔边缘化内外的 居民区使用地理编码的人口普查数据的母亲活动空间。升高平移 影响，调查结果将为拉丁裔青年提供信息，他们可能难以从大流行病中恢复过来， 在他们为成年做准备的过程中与移民有关的逆境。

Abstract The sharp rise in anti-immigrant policy since early 2017, ongoing COVID-19 pandemic, and longstanding experiences of Latinx discrimination and marginalization raise serious stress-related public health concerns for today’s Latinx youth, the vast majority of whom are U.S. citizens. Chronic and/or severe exposure to adversity can elevate stress processes in the family (e.g., increased maternal depression) and manifest through youth’s behavioral health (e.g., unhealthy diet), and biology (e.g., flatter diurnal slopes of daily cortisol output). These stress processes can increase mental health and chronic disease risks and limit social mobility for Latinx youth making the consequential transition to adulthood. We propose major expansions to Caminos, an NICHD- funded study collecting 8 time points of data at 6-month lags (2018-2021) for a diverse sample of 547 Latinx adolescents (88% U.S. born) and mothers (80% foreign born) in suburban Atlanta. As in other new settlement areas, Georgia’s Latinx youth and families face a less welcoming immigrant context of reception than occurs in established immigrant areas. The proposed study will add five time points of annual data, extending current measures into the transition to adulthood and assessing hair and salivary cortisol indicating chronic and acute stress, waist circumference, and survey reports of chronic disease risk and social mobility. The 13 time points of data (2018 to 2026) will trace the onset of behaviors from as early as age 11 and occurring before, during, and after the pandemic and during a changing U.S. immigrant political environment. We will use state-of-the- art methods to multiply impute intentionally and unintentionally missing data for a Latinx cohort with high retention in the ongoing study. Guided by family stress models and cultural-developmental theory, cross- lagged path models and latent growth mixture models will test the hypothesis that family, biological, and behavioral health stress processes mediate associations between adversities (e.g., responses to anti- immigrant actions, pandemic-related events, Latinx marginalization) and Latinx youth’s mental health risks (internalizing and externalizing symptoms, substance use), chronic disease risks (e.g., asthma, diabetes), and social mobility (e.g., educational attainment). Using tests of moderated mediation, we will identify community-, family-, and individual-level protective factors that mitigate impacts of adversity and stress on youth outcomes. Sex as a biological variable will be examined as a key modifier. Unique from other national and cohort studies, the proposed research will identify how accumulated adversities rooted in anti-immigrant experiences and the pandemic shape Latinx youth’s health outcomes and social mobility over time. In addition, the proposed study is uniquely situated in a new immigrant area and examines Latinx marginalization within and outside of the residential neighborhood by using geocoded census data on mother activity spaces. Elevating translational impacts, findings will inform programs for Latinx youth who may struggle to recover from pandemic and immigration-related adversities as they prepare for adulthood.