Neighborhood, social connectedness, and allostatic load in US Chinese immigrants

项目总结 亚裔美国人是美国增长最快的种族/民族群体，亚洲人是中国人 Origin代表着美国最大的亚洲亚裔群体。在华裔美国人中，大多数(62%)是 在外国出生的。尽管中国移民的健康状况好于他们在美国出生的移民，但这则健康广告-- 优势随着居住时间的延长而降低。健康下降的轨迹一直是 主要归因于行为适应，但移民也包括广泛的压力和社会 与世隔绝。反过来，社会孤立可能会通过多个系统的失调来增加慢性病风险- 神经内分泌、心血管、代谢、炎症、免疫 加载(AL)。事实上，对其他美国移民群体(主要是非洲人或拉丁裔)的研究已经注意到，更长的时间 在美国居住与较高的AL有关。尽管有这些发现，但移民的经验是否- 社会隔离的后果会影响疾病风险和健康，目前还没有得到很好的研究。社会连通性，或 一个人感觉到自己与其他个人、团体、 和整个社会，是解决社会孤立的一种可能的战略，但条件和背景 培养社交联系并没有得到很好的理解。生活在种族飞地(即具有更大 同一种族的人比例)可能对中国移民产生积极影响，包括 更多的社会支持和更少的孤独。有人认为，飞地提供了必要的结构 发展社会联系的条件--即物质和社会空间--尽管这一点尚未实现 在大规模研究中得到证实。因此，我们建议对以下相关问题进行全面调查 问题：移民后的社会孤立/联系经历是否与 外国出生的中国人？种族飞地是否有助于在这个人口中建立社会联系？如果是，如何？ 为了解决这些问题，我们将在费城地区招募600名在外国出生的中国人， 包括民族飞地的居民以及缺乏共同民族密度和 公认飞地的资源。具体目标是：(1)考察社会联系和社会联系之间的联系 在一群美国华裔移民中与AL进行社会隔离；以及(2)探索飞地是否以及如何重新- Dence和对飞地资源的参与与社会联系联系在一起。数据收集 将包括问卷(例如，社会联系、与世隔绝、与飞地资源的接触)、血液 对血压、人体测量和空腹血样进行AL标志物分析。住址和住址 活动地点(如购物、宗教活动)将进行地理编码。纵向评估将是 在两年的随访中获得，以确定AL标记物的变化以及这些指标变化的相关性。 项目调查结果将确定最脆弱的个人和社区作为外展的目标，并准确定位 在这一移民人口中促进积极健康轨迹的关键社区一级资源。

PROJECT SUMMARY Asian Americans are the fastest-growing racial/ethnic group in the United States (US), and Asians of Chinese origin represent the largest single US Asian subgroup. Among Chinese Americans, the majority (62%) are foreign-born. Although Chinese immigrants report better health than their US-born counterparts, this health ad- vantage decreases over time with increasing duration of residence. The downward health trajectory has been primarily attributed to behavioral acculturation, but immigration also encompasses extensive stress and social isolation. Social isolation, in turn, may increase chronic disease risk through dysregulation in multiple systems – neuroendocrine, cardiovascular, metabolic, inflammatory, immune – which together are indicative of allostatic load (AL). Indeed, studies of other US immigrant populations (mostly African or Latinx) have noted that longer US residence is associated with higher AL. Despite these findings, the question of whether immigrants’ experi- ences of social isolation affect disease risk and health has not been well studied. Social connectedness, or the extent to which one perceives oneself to be closely and meaningfully connected with other individuals, groups, and society as a whole, is a possible strategy to address social isolation, but the conditions and contexts that foster social connectedness are not well understood. Living in ethnic enclaves (i.e. neighborhoods with a greater proportion of people of the same ethnicity) may have positive effects among Chinese immigrants including greater social support and less loneliness. It has been suggested that enclaves provide the necessary structural conditions – namely, physical and social spaces – for social connectedness to develop, although this has yet to be confirmed in large-scale studies. Thus, we propose a comprehensive investigation of the following interrelated questions: Do post-migration experiences of social isolation/connectedness have biologic correlates among foreign-born Chinese? And do ethnic enclaves contribute to social connectedness in this population; if so, how? To address these questions, we will recruit a cohort of 600 foreign-born Chinese across the Philadelphia region, including residents of ethnic enclaves as well as residents of neighborhoods lacking the co-ethnic density and resources of recognized enclaves. Specific aims are to: (1) Examine associations of social connectedness and social isolation with AL in a cohort of US Chinese immigrants; and (2) Explore whether and how enclave resi- dence and engagement with enclave-based resources are associated with social connectedness. Data collection will include questionnaires (e.g., social connectedness, isolation, engagement with enclave resources), blood pressure, anthropometry, and fasting blood samples analyzed for markers of AL. Addresses of residences and locations of activities (e.g., shopping, religious services) will be geocoded. Longitudinal assessments will be obtained at 2-year follow-up to identify changes in markers of AL and correlates of changes in those measures. Project findings will identify the most vulnerable individuals and neighborhoods to target for outreach and pinpoint the critical community-level resources for promoting positive health trajectories in this immigrant population.