Psychosocial Factors and the Risk of Incident Asthma in African American Women

非洲裔美国女性的心理社会因素和哮喘发生风险

• 批准号: 8391713
• 负责人: Patricia F Coogan
• 金额: $ 29.6万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-12-05 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8391713
• 关键词: Absenteeism at work; Address; Adolescence; Adult; Adult asthma; African American; Asthma; Biological; Censuses; Characteristics; Child; Childhood; Childhood Asthma; Chronic stress; Cohort Studies; Data; Development; Disadvantaged; Disease; Epidemic; Generations; Health Care Costs; Housing; Incidence; Individual; Intervention; Knowledge; Lead; Life; Light; Link; Measures; Medical History; Mental Depression; Mission; Morbidity - disease rate; Neighborhoods; Obesity; Outcome; Participant; Physiological; Play; Policies; Population; Prevalence; Prevention strategy; Preventive; Prospective Studies; Psychosocial Factor; Public Health; Questionnaires; Reporting; Reproductive History; Research; Risk; Risk Factors; Role; Severities; Smoking; Societies; Socioeconomic Factors; Socioeconomic Status; Stress; Testing; Treatment/Psychosocial Effects; United States; Victimization; Violence; War; Woman; Women' s Health; burden of illness; demographics; density; depressive symptoms; disability; experience; follow-up; inner city; innovation; interest; novel therapeutic intervention; prospective; racism; segregation; stressor

ABSTRACT Asthma has reached epidemic proportions in the United States and African-Americans fare worse than whites on all measures of asthma morbidity. Reasons for the disparity have not been satisfactorily explained. Psychosocial factors like experiences of violence and living in disadvantaged and/or inner city neighborhoods have been found to play a role in childhood asthma prevalence and severity. While the role of psychosocial factors in asthma expression has been studied in children there is little research on such factors in adults. Stress is the putative mechanism and there are plausible biological mechanisms by which it may contribute to the incidence of adult-onset asthma. Psychosocial factors may be of particular importance in asthma incidence in black women because the prevalence of experiences of violence, racism, depression, and living in disadvantaged neighborhoods are higher than in white women. If such experiences increase the risk of adult onset asthma, they may contribute to the racial disparity in asthma morbidity. The objective of this application is to fill this gap in knowledge about the role of psychosocial factors in incident adult-onset asthma in African American women. Our central hypothesis is that individual- and neighborhood-level psychosocial factors that may lead to stress increase the risk of adult-onset asthma in African-American women. The rationale for the proposed research is that the identification of factors that increase the risk of adult-onset asthma is a necessary step in the development of preventive policies and interventions to reduce both levels of adult-onset asthma and the gap in black/white asthma morbidity. The specific aims of this proposal are to 1) estimate the influence of experiences of racism, experiences of violence during childhood and adolescence, and depressive symptoms to asthma incidence and 2) to estimate the influence of neighborhood socioeconomic status (SES), racial segregation, and urbanicity to asthma incidence. We will conduct prospective analyses using data from the Black Women's Health Study (BWHS). The BWHS cohort, assembled in 1995, includes approximately 59,000 African-American women from across the U.S. Detailed information on demographics, medical and reproductive history, and disease endpoints including asthma, was collected at baseline and in biennial follow- up questionnaires. On selected follow-up questionnaires, information was obtained on the psychosocial factors of interest. Participant addresses have been geocoded and linked with census data. Over 16 years of follow-up through 2011, approximately 1800 incident cases of asthma will have been reported. The study is innovative because it will be the first prospective study to consider the effects of the psychosocial exposures of interest on incident adult asthma in African American women. The proposed research is significant because positive results may direct intervention efforts to address stressors like racism and violence and may motivate further mechanistic studies of how chronic stress leads to asthma, which might inform the development of new therapeutic interventions.

抽象的 哮喘在美国已达到流行程度，非洲裔美国人的情况比白人更糟糕 哮喘发病率的所有指标。造成这种差异的原因尚未得到令人满意的解释。 心理社会因素，例如暴力经历以及生活在弱势和/或市中心社区 已发现在儿童哮喘患病率和严重程度中发挥作用。虽然社会心理的作用 已在儿童中研究了哮喘表现的因素，但对成人中此类因素的研究很少。 压力是假定的机制，并且有可能有助于压力的生物学机制 成人哮喘的发病率。心理社会因素在哮喘中可能特别重要 黑人妇女的发病率之所以如此高，是因为暴力、种族主义、抑郁的经历普遍存在，并且生活在黑人妇女中。 弱势社区的比例高于白人女性。如果此类经历会增加成人的风险 哮喘发作时，它们可能会导致哮喘发病率的种族差异。此应用程序的目的 旨在填补关于心理社会因素在非洲成人哮喘事件中的作用的知识空白 美国妇女。我们的中心假设是，个人和社区层面的社会心理因素 压力可能会导致非洲裔美国女性成年后患哮喘的风险增加。理由如下： 拟议的研究表明，确定增加成人哮喘风险的因素是一项 制定预防政策和干预措施以降低成人发病率的必要步骤 哮喘以及黑人/白人哮喘发病率的差距。该提案的具体目标是 1) 估计 种族主义经历、童年和青少年时期的暴力经历以及抑郁的影响 症状对哮喘发病率的影响，2) 估计社区社会经济地位 (SES) 的影响， 种族隔离和城市化对哮喘发病率的影响。我们将使用以下数据进行前瞻性分析 黑人妇女健康研究（BWHS）。 BWHS 队列于 1995 年组建，包括大约 来自美国各地的 59,000 名非裔美国女性有关人口统计、医疗和健康状况的详细信息 在基线和每两年一次的随访中收集生殖史和疾病终点（包括哮喘） 进行问卷调查。在选定的后续调查问卷中，获得了有关心理社会的信息 感兴趣的因素。参与者地址已进行地理编码并与人口普查数据相关联。 16岁以上 到 2011 年为止的多年随访中，将报告大约 1800 起哮喘病例。 这项研究具有创新性，因为它将是第一个考虑社会心理影响的前瞻性研究。 非洲裔美国女性成人哮喘事件的相关暴露。拟议的研究是 意义重大，因为积极的结果可能会指导干预工作，以解决种族主义和暴力等压力源 并可能激发对慢性压力如何导致哮喘的进一步机制研究，这可能为 开发新的治疗干预措施。