RACISM AS A CHRONIC STRESSOR: DEPRESSIVE COPING RESPONSE

种族歧视和偏见的紧张经历已被证明对非裔美国人的身心健康状况产生不利影响。再加上每天的压力事件，许多非裔美国人每天都会遇到额外的压力，因为他们每天都在意识到自己是黑人的状态下生活。因此，种族主义的经历和应对可能会增加非裔美国人的疾病风险。种族主义和其他应激源一样，可能会通过激活下丘脑-垂体-肾上腺轴而引发生物反应，从而导致应激激素皮质醇的增加。皮质醇水平的增加被认为是导致脂肪组织直接进入腹内区域的原因。腹内脂肪堆积或内脏肥胖被广泛认为是心血管疾病和关节炎等不良健康后果的危险因素。为了研究种族主义作为一种慢性应激源与内脏肥胖之间的关系，一项针对35-49岁非裔美国女性的横断面研究被提出，她们是子宫肌瘤研究(UFS)的参与者。UFS中的妇女是从一家大型城市健康维护组织中随机挑选出来的。已经完成了关于人口统计学、生活方式和健康的诊所访问、电话采访和邮寄问卷的非裔美国女性将被纳入研究范围。将向这些妇女邮寄一封信，解释这项研究并提供知情同意的信息。在这封信之后，这些女性将被打电话并邀请参加一个20分钟的电话采访，了解她们对种族主义的看法，以及她们对种族主义的情感和行为反应。为了验证关于压力的问卷数据，将对血液和尿液样本进行应激激素皮质醇的检测。内脏肥胖症将使用腰臀比连续和绝对地进行测量。多元线性和Logistic回归模型被用来检验所提出的关系，同时控制潜在的危险因素，如体力活动、体重指数、吸烟、酒精和社会经济地位。重要的是，我们要探索种族主义的压力经历和应对，以便能够采用有效的种族特有的压力管理策略。此外，确定种族主义可能影响内脏肥胖的程度将是了解并最终降低与这一结果相关的高发病率和死亡率的第一步。

The stressful experiences of racial discrimination and prejudice have been shown to adversely affect the physical and mental health status of African Americans. Coupled with daily stressful events, many African Americans encounter the additional stress of living daily in a state of heightened awareness of their "blackness". As a consequence, experiences of and responses to racism may increase the disease risk for African Americans. Racism, like other stressors, may elicit a biological response through the activation of the hypothalamic pituitary adrenal axis that leads to an increase in the stress hormone, cortisol. This increase in cortisol levels is believed to cause adipose tissue to be directed to the intra-abdominal region. Intra-abdominal fat accumulation or visceral obesity is widely accepted as a risk factor for adverse health outcomes such as cardiovascular and arthritis. To examine the relationship between racism as a chronic stressor and visceral obesity, a cross-sectional study of African American women aged 35-49, who are participants in the Uterine Fibroid Study (UFS), is proposed. Women in the UFS have been randomly selected from a large urban health maintenance organization. African American women who have completed a clinic visit, telephone interview, and mail questionnaire on demographics, lifestyle, and health will be included in the study. A letter will be mailed to the women explaining the study and providing information on informed consent. Following the letter, the women will be called and invited to participate in a 20-minute telephone interview about their perceptions of racism and their emotional and behavioral responses to racism. To validate the questionnaire data on stress, blood and urine specimens will be assayed for the stress hormone, cortisol. Visceral obesity will be measured both continuously and categorically using the waist-to-hip ratio. Multiple linear and logistic regression modeling are proposed to examine the proposed relationship while controlling for potential risk factors such as physical activity, body mass index, smoking, alcohol, and socioeconomic status. It is important that we explore the stressful experiences of and responses to racism so that effective-race specific stress-management strategies can be employed. Also, determining the extent to which racism may influence visceral obesity will be the first step toward understanding and ultimately reducing the high morbidity and mortality associated with this outcome.