A natural experimental study of the impact of education on physiologic health, stress, and resilience and the role of socioemotional factors.

关于教育对生理健康、压力和复原力的影响以及社会情感因素的作用的自然实验研究。

• 批准号: 10717659
• 负责人: MITCHELL David WONG
• 金额: $ 52.23万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10717659
• 关键词: 21 year old; Admission activity; Adolescence; Adolescent; Adult; Affect; Age; Aging; Alcohol consumption; Alcohol dependence; Antiviral Response; Anxiety; Biological Aging; Biological Assay; Biological Markers; Blood Pressure; Blood specimen; Body mass index; C-reactive protein; Characteristics; Chronic stress; Cognitive; Cohort Studies; DNA Methylation; Decision Making; Development; Education; Epigenetic Process; Experimental Designs; Exposure to; Family; Feeling hopeless; Female; Follow-Up Studies; Future; Gene Expression Profile; Genetic Transcription; Hair; Health; Health Insurance; Health behavior; Healthcare Systems; Hydrocortisone; Improve Access; Inequity; Inflammation; Interferon Type I; Intervention; Knowledge acquisition; Life Cycle Stages; Link; Measures; Mediating; Mental Depression; Methods; Natural experiment; Neighborhoods; Neurobiology; Obesity; Observational Study; Outcome; Outcome Measure; Overweight; Participant; Patient Self-Report; Personal Satisfaction; Physiological; Policies; Poverty; Process; Public Health; Quality of Care; Randomized; Relative Risks; Reporting; Resources; Risk Reduction; Role; Schools; Secondary Schools; Self Care; Sex Differences; Shapes; Signal Transduction; Social Network; Standardization; Stress; Student recruitment; Students; Substance Use Disorder; Sympathetic Nervous System; Testing; adolescent health; alcohol use disorder; cognitive skill; cohort; college; early childhood; educational atmosphere; emerging adult; emotional factor; experience; experimental study; fighting; follow-up; gender difference; graduate school; high school; improved; literacy; male; mathematical ability; matriculation; mortality; peer; physical conditioning; public health intervention; public health relevance; resilience; response; retention rate; school environment; social; socioeconomics; substance use; teacher

ABSTRACT Education impacts health by improving access to socioeconomic resources and high-quality care (SES mechanism) and by improving literacy and numeracy, which aids in self-care and navigating the healthcare system (cognitive mechanism). But education does not just involve the acquisition of knowledge or cognitive skills. Education encompasses the experiences of being in a school environment, shaped by teachers, peers, and the “culture” of the school. Also referred to as school climate, these characteristics shape socioemotional factors that influence resilience and one's health trajectory (resilience mechanism). Almost all prior studies of education and health have relied on observational methods. In 2013, we began the Reducing Inequities through Social and Educational Change Follow-up (RISE Up) Study, a natural experiment using the admissions lottery of several high-performing public charter high schools to identify comparable groups of adolescents “randomized” into high- and lower-performing schools. We recruited students upon high school entrance and continue to follow this cohort currently (now age 22) with average annual retention rates of 96%. We found the impact of schools on self-reported health and health behaviors was immediate, substantial, and persistent beyond adolescence. By age 21, those who had attended a high-performing high school had a 50% lower rate of alcohol use disorder, 40% reduction in reporting fair or poor physical health, and 33% reduction in obesity/overweight. However, the improvements in physical health and obesity were only among males. Among females, attending a high-performing schools was associated with lower rates of alcohol use disorder, but substantially worse physical health and obesity. Surprisingly, intermediate academic outcomes (high school graduation, grade point average, test scores, and college matriculation) did not explain the impact of high-performing schools on substance use or physical health outcomes. Understanding how education influences health will inform the development of future interventions and school policies to make schools “healthier” for all students. Furthermore, our results to date are based on self-report. Thus, we proposed to follow the RISE Up cohort from age 23-28 to better understand how schools impact physiologic health perhaps through changes in socioemotional factors and resilience. We will measure blood pressure and body mass index and obtain blood samples to measure glycohemoglobin and C-reactive protein. We will examine epigenetic aging (DNA methylation), chronic stress (hair cortisol), and physiologic resilience using the Conserved Transcriptional Response to Adversity (CTRA). CTRA is a gene expression profile activated by fight-or-flight signaling from the sympathetic nervous system and related to greater inflammation and lower Type I interferon innate antiviral responses. Furthermore, we will explore sex differences in the relationship between education and physiologic health, stress, and resilience.

摘要 教育通过改善获得社会经济资源和高质量护理的机会来影响健康 机制）和提高识字和算术能力，这有助于自我保健和导航医疗保健 认知机制（Cognitive Mechanism）但教育不仅仅涉及知识的获取或认知 skills.教育包括在学校环境中的经历，由老师，同龄人， 学校的“文化”。这些特征也被称为学校氛围， 影响复原力和健康轨迹的因素（复原力机制）。 几乎所有以前的教育和健康研究都依赖于观察方法。2013年，我们开始 通过社会和教育变革后续研究减少不平等现象，一项自然实验 利用几所表现出色的公立特许高中的招生抽签， 一群青少年被“随机”分配到高水平和低水平的学校。我们在高中招收学生 入学率，并继续跟踪这一群体目前（现在22岁）的平均年保留率 的96%。我们发现学校对自我报告的健康和健康行为的影响是直接的， 青春期后的持续性。到21岁时，那些参加过高绩效高中的人 学校的酒精使用障碍率降低了50%，报告身体健康状况一般或较差的人数减少了40%， 肥胖/超重减少33%。然而，在身体健康和肥胖方面的改善仅仅是 在男性中。在女性中，就读于高绩效学校与较低的酒精率有关 使用障碍，但实质上更糟的身体健康和肥胖。令人惊讶的是，中级学术 结果（高中毕业，平均成绩，考试成绩和大学录取）并不能解释 高绩效学校对物质使用或身体健康结果的影响。 了解教育如何影响健康将为未来的干预措施和学校的发展提供信息。 让学校对所有学生来说都更“健康”。此外，我们迄今为止的结果是基于自我报告。 因此，我们建议跟踪23-28岁的RISE Up队列，以更好地了解学校如何影响 生理健康可能通过社会情绪因素和弹性的变化。我们将测量血液 血压和体重指数，并获取血液样本以测量糖化血红蛋白和C反应蛋白。 我们将检查表观遗传老化（DNA甲基化），慢性压力（头发皮质醇）和生理弹性 逆境保守转录反应（Conserved Transcriptional Response to Adversity，CTRA）CTRA是一种基因表达谱 由交感神经系统发出的“战或逃”信号激活，并与更严重的炎症有关 和较低的I型干扰素先天抗病毒应答。此外，我们将探讨性别差异， 教育与生理健康、压力和恢复力的关系。