Socioeconomic Status, Stress & Asthma Biological Markers

描述（由申请人提供）：低社会经济地位（SES）对整个生命周期的身体健康结果有着深远的影响。例如，最常见的儿童慢性健康状况，哮喘，在低SES儿童中更为严重。因此，了解低SES儿童患哮喘的原因具有重要的公共卫生意义。这个拟议的项目旨在更深入地了解心理和生物学途径，这可能有助于解释将低SES与哮喘严重程度增加联系起来的流行病学发现。重点将是SES对压力和生物系统的影响，这些系统与哮喘急性发作有关。本建议的具体目标包括：1）考察社会经济地位的维度（声望SES，资源SES，相对SES）与哮喘的生物学过程，并考虑这些协会的含义，我们如何理解SES影响哮喘;（2）确定哪些压力分量（压力暴露、压力解释、压力反应）形成SES与哮喘生物学过程之间的心理通路;和3）确定心理因素，表征一个亚组的脆弱儿童（低SES）谁是弹性（有良好的哮喘档案）。最后一个目标将需要评估儿童的特点（例如，控制）以及社会网络因素作为SES和哮喘关系的潜在缓冲。我们将招募120名患有持续性哮喘的儿童（13-18岁）。孩子们将接受关于生活压力的采访，父母将接受关于家庭SES的采访。与哮喘有关的生物学过程，包括免疫标志物（例如，细胞因子）和神经内分泌激素（唾液皮质醇），以及哮喘结果（例如，肺功能）进行评估。儿童将在2年内接受5次测试，以跟踪压力和哮喘的变化。这个项目的结果将使我们能够开始开发更大的社会环境如何影响儿童哮喘临床过程的模型。

DESCRIPTION (provided by applicant): Low socioeconomic status (SES) has a profound influence on physical health outcomes throughout the lifespan. For example, the most common childhood chronic health condition, asthma, is more severe in low SES children. Understanding the reasons why low SES children suffer from worse asthma thus has important public health implications. This proposed project seeks a more thorough understanding of both psychological and biological pathways that could help to explain epidemiological findings linking low SES with increased asthma severity. The focus will be on the effects of SES on stress and biological systems that have been implicated in asthma exacerbations. The specific aims of this proposal include: 1) Examining the dimensions of SES (prestige SES, resource SES, relative SES) that are associated with asthma biological processes, and considering the implications of these associations for our understanding of how SES impacts asthma; 2) Determining which components of stress (stress exposure, stress interpretations, stress reactivity) form psychological pathways between SES and asthma biological processes; and 3) Identifying psychological factors that characterize a subgroup of vulnerable children (low SES) who are resilient (have good asthma profiles). This last aim will entail assessing child characteristics (e.g., control) as well as social network factors as potential buffers of the SES and asthma relationship. We will recruit a sample of 120 children (ages 13-18) with persistent asthma. Children will be interviewed about life stresses and parents interviewed about family SES. Biological processes implicated in asthma, including immune markers (e.g., cytokines) and neuroendocrine hormones (salivary cortisol), as well as asthma outcomes (e.g., pulmonary function) will be assessed. Children will be tested 5 times over a 2-year period to track changes in stress and asthma. The results from this project will allow us to begin developing models of how the larger social environment comes to affect a child's clinical course of asthma.