Neighborhood-level Structural Racism and Cardiovascular Health Among African American Youth and Young Adults

项目摘要/摘要 心血管疾病(CVD)是美国成年人死亡和健康不平等的主要原因， 与非西班牙裔白人相比，非裔美国人患心血管疾病的风险明显更高。考虑到 心血管疾病发展的风险因素的差异在儿童时期就已经存在，有很大的公共卫生 需要对可能导致青年心血管疾病风险差异的因素进行研究。值得注意的是，暴露在种族歧视中 歧视导致非裔美国人心血管事件和心血管疾病风险增加。此外， 在非裔美国青年中，种族歧视预示着成年后炎症水平的上升。 然而，到目前为止，关于种族歧视和心血管疾病风险的研究主要集中在个人层面。 种族歧视的经历，而结构性种族主义的更广泛方面 未得到充分研究。结构性种族主义，定义为影响不平等的宏观制度和社会力量 在种族群体中，包括与教育、就业、住房和执法有关的问题。一 先前的研究发现，生活在结构性种族主义较高的州的个人患上 心肌梗死，突出了在这一领域进行更多研究的必要性。考察两者之间的关系 结构性种族主义和生物行为过程参与了非裔美国青年的早期心血管疾病进展 有可能在今后的工作中对预防心血管疾病产生重大影响。 为了解决文献中的这些空白，拟议的项目旨在评估结构性种族主义如何 与非裔美国青年和年轻人中的心血管疾病风险有关。使用基于邻居的 结构性种族主义指标(即邻里一级的教育、就业、住房和住房方面的种族差距 执法)从可公开获得的数据中，研究将1)检查结构之间的关联 种族主义与心脏代谢健康，反映在代谢综合征和内皮功能的迹象中 随着时间的推移，非洲裔美国青年和年轻人，2)审查结构性种族主义和 另一个心血管疾病风险的标志，炎症，随着时间的推移，在非裔美国青年和年轻人中，3) 在非裔美国人中测试炎症在结构性种族主义和心脏代谢健康之间的中介作用 随着时间的推移，年轻人和年轻人。这项研究将利用两项研究，包括赞助商的R01数据和 全国青少年到成人健康的纵向研究，以确定研究结果是否具有重复性和推广性。 这项拟议的研究是一个更广泛的博士后培训计划的一部分，该计划的目标是为 申请在一所主要研究型大学担任PI的申请人，重点是了解与心血管疾病相关的差异 青年发病机制。除了以上概述的研究外，申请者还将完成 心血管疾病的病理生理学、免疫学、统计学方法和青少年健康差距，获得经验 测量炎症和心脏代谢的生物标志物，并开发关于分析大型 扩大邻里层面的数据，以更好地了解社会环境对心血管疾病差异的影响。

Project Summary/Abstract Cardiovascular disease (CVD) is a leading cause of adult mortality and health inequity in the U.S, with African Americans carrying a significantly higher risk for CVD compared to non-Hispanic Whites. Given that disparities in risk factors for CVD development are already present in childhood, there is a large public health need for research on factors that can contribute to CVD risk disparities among youth. Notably, exposure to racial discrimination leads to increased risk of cardiovascular events and CVD among African Americans. Furthermore, among African American youth, racial discrimination predicted elevated levels of inflammation in adulthood. However, up to this point, research on racial discrimination and CVD risk has focused on individual-level experiences of racial discrimination, while more broad-ranging aspects of structural racism have been understudied. Structural racism, defined as the macrolevel systems and social forces that impact inequities among racial groups, includes issues related to education, employment, housing, and law enforcement. One previous study identified that individuals living in states with higher structural racism had higher rates of myocardial infarction, highlighting a need for more research in this area. Examining the relationship between structural racism and biobehavioral processes involved in early CVD progression among African American youth has potential to provide significant impacts in terms of the prevention of CVD in future work. To address these gaps in the literature, the proposed project aims to assess how structural racism may be associated with CVD risk among African American youth and young adults. Using neighborhood-based indicators of structural racism (i.e., neighborhood-level racial disparities in education, employment, housing, and law enforcement) from publicly available data, the research will 1) examine the association between structural racism and cardiometabolic health, reflected by signs of metabolic syndrome and endothelial function, among African American youth and young adults over time, 2) examine the association between structural racism and another marker of CVD risk, inflammation, among African American youth and young adults over time, and 3) test inflammation as a mediator between structural racism and cardiometabolic health among African American youth and young adults over time. The research will utilize two studies, including the sponsor’s R01 data and the National Longitudinal Study of Adolescent to Adult Health to determine whether findings replicate and generalize. The proposed research is part of a broader post-doctoral training program, whose goal is to prepare the applicant for a career as a PI at a major research university, focused on understanding disparities related to CVD pathogenesis in youth. In addition to the research outlined above, the applicant will complete coursework on the pathophysiology of CVD, immunology, statistical methods, and adolescent health disparities, gain experience measuring inflammatory and cardiometabolic biomarkers, and develop a knowledge base about analyzing large- scale neighborhood-level data to better understand the social environment contributors to CVD disparities.