Cardiovascular Risk Disparities: Socioemotional Pathways

描述（由申请人提供）：少数民族和低社会经济地位（SES）人群显示出不成比例的心血管疾病（CVD）发病率和死亡率，消除这些差异是2010年健康人计划的优先目标。先前的研究表明，除了许多其他变量外，社会心理因素也可能导致心血管疾病的差异。本研究将使用储备能力模型（Gallo and Matthews, 2003）作为概念框架，通过该模型，以社区为基础，随机抽样了相对低SES和高SES的中年、墨西哥裔美国人和非拉丁裔白人妇女（N=300），研究压力、社会心理资源和情感因素在SES和种族CVD差异中的作用。储备能力模型假设社会地位较低的个体（低SES，少数民族）可能由于在多个领域经历的压力而遭受负面的情绪和身体健康后果。压力可能对行为和生理风险过程产生直接影响，也可能影响情绪变量，而情绪变量本身就是假定的心血管疾病风险因素。此外，社会地位较低的人可能拥有较少的弹性心理社会资源来管理压力，使他们特别容易受到随之而来的身体和情感磨损。低社会经济地位的影响可能在拉丁裔妇女中被放大（即协同效应）。然而，墨西哥裔美国女性也可以从弹性的社会文化资源中受益，这些资源在一定程度上保护她们免受压力的影响。在目前的研究中，女性将接受SES、社会心理因素、生理和行为风险因素以及CVD生物标志物的综合评估，并将参加为期两天的动态血压评估和通过生态瞬时评估评估的社会心理体验。通过检查潜在的可改变的社会心理变量作为CVD差异的途径，本研究旨在为理解和消除健康差异提供信息。

DESCRIPTION (provided by applicant): Minority and low socioeconomic status (SES) populations show disproportionate rates of cardiovascular disease (CVD) morbidity and mortality, and eliminating these disparities is a priority objective of Healthy People 2010. Previous research suggests that in addition to many other variables, psychosocial factors may contribute to CVD disparities. The proposed research will use the Reserve Capacity Model (Gallo and Matthews, 2003) as a conceptual framework through which to examine the roles of stress, psychosocial resources, and emotional factors in SES and ethnic CVD disparities, in a community-based random sample of middle-aged, Mexican-American and non-Latino White women with relatively low and high SES (N=300). The Reserve Capacity Model posits that individuals with lower social status (low SES, minority ethnicity) may suffer negative emotional and physical health consequences due to stress experienced across multiple domains. Stress may exert direct effects on behavioral and physiological risk processes, or it may influence emotional variables which are themselves putative CVD risk factors. In addition, persons with low social status may maintain a smaller bank of resilient psychosocial resources with which to manage stress, making them especially vulnerable to concomitant physical and emotional wear and tear. The effects of low SES may be amplified in Latino women (i.e., synergistic effects). However, Mexican-American women could also benefit from resilient, socio-cultural resources that protect them, to some extent, from stress. In the current study, women will undergo a comprehensive assessment of SES, psychosocial factors, physiological and behavioral risk factors, and CVD biomarkers, and will participate in a two-day evaluation of ambulatory blood pressure and psychosocial experiences assessed via ecological momentary assessment. By examining potentially modifiable psychosocial variables as a pathway underlying CVD disparities, this study seeks to inform efforts to understand and eliminate health disparities.