Racial Disparities in Health: The Roles of Stress, Social Relations and the Cardiovascular System

健康方面的种族差异：压力、社会关系和心血管系统的作用

• 批准号: 9353718
• 负责人: KIRA S BIRDITT
• 金额: $ 74.55万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9353718
• 关键词: Accounting; Address; Adult; Affect; African American; Age; Aging; Ambulatory Monitoring; American; Area; Behavioral; Biological; Blood Pressure; Blood Vessels; Cardiac; Cardiovascular Diseases; Cardiovascular system; Chronic stress; Data; Development; Devices; Dimensions; Electrocardiogram; European; Event; Exposure to; Galvanic Skin Response; Gerontology; Health; Health behavior; Heart Rate; Hypertension; Individual; Individual Differences; Intervention; Laboratories; Laboratory Study; Life; Link; Literature; Longevity; Longitudinal Studies; Monitor; Participant; Patient Self-Report; Pattern; Physiological; Population; Population Heterogeneity; Population Study; Public Health; Race; Reaction; Recording of previous events; Reporting; Research; Respondent; Risk; Role; Sampling; Sampling Studies; Social Network; Stress; Testing; Time; United States; Variant; Vascular resistance; age difference; base; coping; experience; health disparity; heart rate variability; metropolitan; monitoring device; mortality; mortality disparity; psychologic; racial difference; racial disparity; racial health disparity; response; social; stress reactivity; stress resilience; stressor; theories; therapy development

Hypertension is the number one cause of racial group disparities in mortality in the U.S. Thus, understanding the mechanisms by which race is linked with the cardiovascular system is key. African Americans (AA) are exposed to more stress across the lifespan and lifetime adversity is associated with cardiovascular disease (CHD) and hypertension. However, mechanisms accounting for the links between long-term stress exposure, hypertension and CHD remain unclear. Cardiovascular reactivity is hypothesized to be a major contender as it predicts increased risk of cardiac events and mortality, especially among people with hypertension. According to existing theories of racial health disparities, stress, and social relations, racial health disparities are due to variations in long-term exposure to stress and stress reactivity (biological, psychological, behavioral) and those race differences are moderated by social relations and age. In response to the FOA Aging Research on Stress and Resilience to Address Health Disparities in the United States (RFA-AG-16-022), the present study seeks to understand how long-term stress exposure links with stress reactivity among AA and EA adults. This study capitalizes the existing longitudinal Social Relations and Health Study (SRS),a regionally representative panel sample of AA and EA individuals from the Detroit metropolitan area who began participating in 1992 (ages 13 to 93) and completed the third wave in 2015 (ages 30 to 95). The proposed study will incorporates two new studies of short-term stress reactivity: 1) a daily stress study and 2) a laboratory stress study. The daily stress study will target 300 participants (50% AA; 50%EA) and will incorporate a 4 day experience sampling study of self-reported stress exposure and reactivity (psychological, behavioral) as well as two ambulatory monitoring devices to assess biological reactivity: 1) a newly developed non-invasive continuous monitoring ring device that provides estimates of vascular resistance and 2) a watch that assesses heart rate, heart rate variability, and galvanic skin response. In the laboratory study we will examine reactivity to standard laboratory stressors among a sample of 50 AA and 50 EA respondents who completed the daily stress study to examine more thoroughly their physiological responses to stress with the same ambulatory ring and watch as well as established continuous monitors. The proposed research addresses three aims: 1) Test links between long- term stress exposure and short-term stress reactivity among EA and AA adults, 2) Examine age differences in long-term stress exposure and short-term reactivity by race, and 3) Determine how long-term social relationships moderate individual differences in stress exposure and reactivity. This project has public health significance as it will identify individuals who are more reactive to stress and the immediate as well as lifespan factors that are associated with greater stress reactivity. A more nuanced understanding of the psychological and biological implications of stress among diverse populations will lead to the development and testing of interventions for reducing stress, later health problems, and health disparities.

高血压是美国种族死亡率差异的头号原因。因此，理解 种族与心血管系统的联系机制是关键。非洲裔美国人(AA) 在一生中暴露在更大的压力下，一生的逆境与心血管疾病有关 (CHD)和高血压。然而，解释长期应激暴露、 高血压和冠心病仍不清楚。心血管反应性被认为是一个主要的竞争者，因为 预测心脏事件和死亡率的风险增加，特别是在患有高血压的人中。根据 根据现有的关于种族健康差距、压力和社会关系的理论，种族健康差距是由于 长期暴露于压力和应激反应(生物、心理、行为)的变化以及 种族差异受到社会关系和年龄的影响。应对FOA老化的应激研究 和弹性，以解决美国的健康差距(RFA-AG-16-022)，本研究寻求 了解长期应激暴露与AA和EA成人的应激反应之间的关系。本研究 利用现有的纵向社会关系和健康研究(SRS)，这是一个具有区域代表性的小组 底特律大都会地区1992年开始参与的AA和EA个人样本(13岁 至93岁)，并于2015年完成第三次浪潮(30至95岁)。拟议的研究将纳入两个新的 短期应激反应研究：1)日常应激研究和2)实验室应激研究。每天的压力 这项研究将以300名参与者(50%AA；50%EA)为目标，并将纳入4天的体验抽样研究 自我报告的压力暴露和反应性(心理、行为)以及两次动态监测 评价生物反应性的装置：1)新开发的无创连续监测环装置 这提供了对血管阻力的估计，以及2)评估心率、心率变异性、 和电流皮肤反应。在实验室研究中，我们将检查对标准实验室应激源的反应。 在完成每日压力研究的50名AA和50名EA受访者的样本中， 使用相同的活动环和手表彻底完成对压力的生理反应 建立了连续监测机制。拟议的研究旨在解决三个目标：1)测试长期和长期之间的联系 EA和AA成人的长期应激暴露和短期应激反应，2)检查年龄差异 种族的长期压力暴露和短期反应，以及3)决定长期社交 人际关系缓和了个体在压力暴露和反应能力方面的差异。这个项目是公共卫生的 重要性，因为它将识别对压力以及直接和寿命更敏感的个人 与更大的应激反应性相关的因素。对心理学的更细微的理解 不同人群中压力的生物学影响将导致发展和测试 减少压力、后来的健康问题和健康差距的干预措施。