Understanding Social Status' Impact on Adolescent Health

描述（由申请人提供）：消除社会不平等， 健康是“2010年健康人民”的首要目标之一。过去的工作 社会地位定义为社会经济地位（SES）， 这并不能解释主观的、内在的社会认知， 站着大多数研究也没有解释较低的社会地位如何导致 更差的健康。使用一种新的衡量主观社会地位的方法， 调查小组的成员，这项研究测试了一种新的解释模型， 社会地位对健康的影响。该模型确定了HPA轴， 自主神经系统作为创造社会的关键生物系统 健康不平等。社会地位，环境压力， 刺激这些系统，反过来，导致改变， 社会地位-健康关系的神经激素调节剂。研究 一项新的4年青少年肥胖纵向队列研究结束， 在一个种族和社会经济多样化的学区， 俄亥俄州。这两种疾病都支持这种模式。具体目标是：（1） 描述青少年对社会地位和发展的看法， 在四年的时间里，这些观念发生了变化; 2） 描述社会地位之间的联系，客观地衡量， 和主观上，肥胖和胰岛素抵抗的青少年;和3） 要确定社会地位之间的关系，既要客观衡量 以及社会地位影响的潜在生物介质， 健康为了实现这些目标，每年对青少年的主观 社会地位将会发生。此外，在第1年和第4年， 初级和次级生物介质（胰岛素，DHEA-S，血压， 总胆固醇和HDL胆固醇以及糖化血红蛋白）。 父母将提供有关SES的信息以及他们自己对社会的看法。 站在第一年和第四年。这项研究将提供独特的，基于社区的 社会地位影响的潜在生物介质的信息 健康种群的多样性将使我们能够区分 种族/民族和社会地位。创新的社会计量 地位，包括主观和客观的成分，可以解释 SES与肥胖关系的一些不一致和长期的 肥胖和糖尿病的趋势。这项工作也将奠定基础， 制定有效的初级预防战略， 健康方面的社会不平等现象的形成过程。

DESCRIPTION (provided by applicant): Elimination of social inequalities in health is one of the overarching goals of Healthy People 2010. Most past work has defined social status as socioeconomic status (SES), an external measure that does not account for subjective, internalized perceptions of social standing. Most studies also do not explain how lower social status causes poorer health. Using a new measure of subjective social standing developed by members of the investigative team, this study tests a novel explanatory model of social status' impact on health. The model identifies the HPA axis and autonomic nervous system as critical biologic systems in the creation of social inequalities in health. Social status, an environmental stress, causes stimulation of these systems which, in turn, leads to alterations in neurohormonal mediators of the social status-health relationship. The study dovetails to a new 4-year longitudinal cohort study of adolescent obesity and Type 2 diabetes in a racially and socioeconomically diverse school district in Ohio. Both of these diseases support this model. The specific aims are 1 )To describe adolescents' perceptions of social standing and the developmental changes which occur in these perceptions over a four year period; 2) To characterize the associations between social status, measured both objectively and subjectively, and obesity and insulin resistance among adolescents; and 3) To determine the relationships between social status, measured both objectively and subjectively, and potential biologic mediators of social status' impact on health. To address these aims, yearly assessment of adolescents' subjective social standing will take place. In addition, in Years 1 and 4, potential primary and secondary biologic mediators (insulin, DHEA-S, blood pressure, total and HDL cholesterol, and glycosylated hemoglobin) will be obtained. Parents will provide information on SES and their own perceptions of social standing in Years 1 and 4. This study will provide unique, community-based information on potential biologic mediators of social status' influence on health. The population's diversity will enable us to differentiate the effects of race/ethnicity and social status. The innovative measurement of social status, which includes both subjective and objective components, may explain some of the inconsistency in the SES-obesity relationship and the secular trends in obesity and diabetes. This work will also lay the foundation for creation of effective primary prevention strategies by providing insight into the processes through which social inequalities in health are created.