Household income, financial stress and physiologic aging markers in low income adults across the life course

三分之一的美国成年人是低收入者，比收入较高的同龄人衰老得更早，但目前尚不清楚 增加家庭收入可以改善他们的健康状况。据信，早期衰老部分是由于， 经济压力，或因收入不足以满足基本需求而引起的压力。然而，生理反应， 财务压力未经测试。这一领域的研究需要了解健康差异和生物学方面的知识。 老龄化，并提出了独特的方法学挑战。由于不可能随机分配成年人 不同的收入或财政压力水平，必须使用创新的方法来评估其影响。的 拟议的研究概述了三个利用现有生理生物标志物数据的自然实验， 以人口为基础的样本，问不同的，但相关的问题，测试理论概念的'风化' 在成年人的生命周期中。 第一个实验检验了这样一个假设，即压力敏感的生物标志物在压力较高的时候更高。 通过利用生物标志物，70-79岁低收入老年人的常规月末财务压力 数据来自健康，老龄化和身体成分研究和每月社会保障支付时间。的 第二个实验量化了皮质醇对非常规来源的财务压力（即， 对个人的财务状况构成风险），使用MIDUS II数据， 基于四天的重复皮质醇样本和每日日记数据，考虑到混杂因素。第三 实验利用2009年的政策变化，扩大了补充营养援助计划（SNAP） 资格和福利（参与增加3%，福利增加16%），为一些，但不是全部，低收入， 成年人测试压力和营养敏感的生物标志物对收入增加的反应。生物标志 将比较18-59岁的年轻和中年低收入成年人随时间的变化， 并且没有资格获得增加的收入。 在约翰霍普金斯大学肥沃而适宜的环境中，该申请提出了培训， (1)将衰老生物学知识添加到我现有的健康差异知识中，使我能够对 通过在这两个研究领域的交叉点进行创新研究，以及（2）增加 培训开发和评估自然实验使用传统的临床试验方法，因果推理 和计量经济学模型，我现有的流行病学培训，装备我独立调查 非随机风险，如收入和财务压力，并制定有效的干预措施， 改善低收入成年人的生活。拟议的研究和培训响应了NIA的呼吁， 造成整个生命周期差异的机制。

One-third of US adults are low-income and age earlier than their higher income peers, but it is not clear if increasing available household income could improve their health. Earlier aging is believed to be due, in part, to financial stress, or stress induced by insufficient income for basic needs. However, physiologic response to financial stress is untested. Research in this area requires knowledge of both health disparities and biology of aging and poses unique methodological challenges. Since it is not possible to randomly assign adults to differing income or financial stress levels, innovative methodologies must be used to evaluate their effect. The proposed research outlines three natural experiments leveraging existing physiologic biomarker data from population-based samples to ask distinct, but related, questions testing the theoretical concept of ‘weathering’ over the adult life-cycle. The first experiment tests the hypothesis that stress-sensitive biomarkers are higher during times of higher routine end-of-the-month financial stress in low-income older adults aged 70-79 by capitalizing on biomarker data from the Health, Aging and Body Composition Study and monthly Social Security payment timing. The second experiment quantifies cortisol response to a non-routine source of financial stress (i.e. an event that poses a risk to an individual’s financial situation) in low-income middle-aged adults, using MIDUS II data, based on four days of repeated cortisol samples and daily diary data, accounting for confounding. The third experiment exploits 2009 policy changes that expanded Supplemental Nutrition Assistance Program (SNAP) eligibility and benefits (participation increased 3% and benefits increased 16%) for some, but not all, lowincome adults to test stress- and nutrition-sensitive biomarker response to increased income. Biomarker changes over time will be compared in young and middle-aged low-income adults aged 18-59 who likely were and were not eligible for increased income. Within the fertile and well-suited environment of Johns Hopkins University, the application proposes training to (1) add biology of aging knowledge to my existing health disparities knowledge, enabling me to respond to an NIA priority area by conducting innovative research at the intersection of these two fields of study, and (2) add training developing and evaluating natural experiments using traditional clinical trial methods, causal inference and econometric modeling to my existing epidemiologic training, equipping me to independently investigate non-randomized exposures, such as income and financial stress, and develop effective interventions to improve the lives of low-income adults. The proposed research and training respond to NIA’s call to elucidate mechanisms contributing to disparities across the life-cycle.