Skin Elasticity and Skin Color: Understanding Health Disparity in Sexual Assault

描述（由申请人提供）：性侵犯是每年影响数百万女性的暴力事件。据估计，在美国每年发生的680万起强奸和人身攻击事件中，260万起将导致女性受伤，近80万起将导致幸存者接受某种形式的医疗保健。众所周知，对性侵犯造成的皮肤损伤的评估在卫生保健和刑事司法系统中发挥着重要作用。最近发表的研究结果表明，与浅色皮肤的妇女相比，经过法医检查的深色皮肤妇女生殖器损伤发生率明显较低。这些发现提出了关于皮肤弹性和肤色之间关系的重要问题，可能表明种族/民族与伤害发生率之间关系的虚假性质。他们证明，肤色而不是种族/民族可能是预测生殖器损伤患病率的重要变量。如果深色皮肤的女性比浅色皮肤的女性更不容易被发现受伤，那么健康上的差距是存在的。人们对皮肤弹性在不同肤色中所起的作用知之甚少，也不知道皮肤弹性的差异是否也可以解释损伤发生率因肤色而异的研究结果。

DESCRIPTION (provided by applicant): Sexual assault is a violent event that affects millions of females each year. Of the estimated 6.8 million rapes and physical assaults annually in the U.S., 2.6 million will result in an injury to a women and almost 800,000 will result in the survivor receiving some type of healthcare. Assessment of injuries to the skin resulting from sexual assault is known to play an important role in the health care and criminal justice systems. Recent published findings indicate that women with dark skin who have a forensic examination have a significantly lower genital injury prevalence as compared to women with light skin. These findings, which raise important questions about the relationship of skin elasticity and skin color, may indicate a spurious nature of the relationship between race/ethnicity and injury prevalence. They demonstrated that skin color rather than race/ethnicity is likely the important variable that predicts genital injury prevalence. If women with dark skin are less likely to have injuries detected than women with light skin, a health disparity exists. Little is known about the role of skin elasticity across the continuum of skin colors, and whether or not differences skin elasticity may also explain the findings that injury prevalence varies by skin color. The overall objective of this pre-doctoral application is to determine if skin elasticity varies by skin color. The applicant proposes an innovative approach to answer the question: Can the previous findings that genital injury prevalence varies by skin color be better understood because skin elasticity varies by skin color? The applicant anticipates that variations in skin elasticity will also be explained by age, body mass index, sun exposure, and health status. The proposed clinical research study and training plan are integral to the applicant's long-term goals, which include elucidation of potential differences in skin physiology related to color and other variables, understanding the protective and injurious mechanisms of the skin, and dissemination of applicable findings to further skin science and reduce health disparities in vulnerable populations. Results obtained during this study, to take place at the University of Pennsylvania, have potentially large scale public health benefits. Findings will provide information that will influence the procedure for forensic examinations after sexual assault and guidelines for evaluating injuries in a legal setting. If skin elasticity is indeed different in women with different skin colors, addressing these differences may improve techniques for the forensic examination and provide the impetus for increased reporting rates following sexual assault.