Social stressors and inflammation: A mixed methods approach to preterm birth

摘要 黑人女性比白人更容易患新冠肺炎，据报道，在许多人中存在差异 包括底特律在内的城市，这是我们的网站之一。黑人妇女在低工资的基本劳动力中的比例过高 更有可能生活在面临社会挑战的弱势社区(例如拥挤的住房) 疏远。与白人相比，黑人的储蓄方式更少，雇主的灵活性也可能更低，越来越多 经济困难的风险(例如，失业)。黑人女性可能在获得 为自己和家人进行新冠肺炎症状检测和医疗护理。由于“避难所已就位” 政策和失业随着疫情的蔓延，黑人女性与伴侣的冲突可能也会增加 亲密伴侣暴力(IPV)的发生率更高，因为家庭几乎所有的醒着和睡觉时间都花在了 在一起。种族差异--新冠肺炎患病率和死亡率、就业、邻里条件、 经济困难、IPV以及检测和医疗保健方面的歧视--所有这些都可能增加心理 黑人妇女的痛苦(例如，抑郁症状)。然而，还没有发表的研究对布莱克进行过研究 妇女在病毒大流行期间的经历，就像我们现在经历的那样。我们假设布莱克 女性将经历更多的歧视、经济困难、与伴侣的冲突、IPV和心理 与大流行前相比，大流行期间的痛苦以及更低的支持水平。 我们的队列由来自密歇根州底特律和俄亥俄州哥伦布大都市的658名黑人女性组成。 作为R01研究的一部分，妇女在怀孕期间完成了问卷调查(T1=大流行前)。为 在这项补充研究中，女性将在智能手机上完成一项在线调查(T2=疫情期间) 另一个设备。T2调查将包括T1调查的关键领域(例如，抑郁症状、社交 并在大流行的背景下提供第二个关键时间点。我们希望有一些域名 特别受到大流行的影响(例如，歧视、压力)。我们还添加了要捕获的项目 新冠肺炎特有的问题，包括他们在网络中的经历(例如，家人生病)，以及 作为与情况相关的措施(例如，社会孤立)。一小部分女性将参加 定性访谈，以深入了解他们的经历。我们的目标是：(1)检查关联 弱势社区、种族歧视和经济困难与心理困扰 两个时间点(T1和T2)；(2)检查与伴侣的关系、IPV和心理痛苦 通过比较大流行前和大流行期间的时间点受到大流行的影响；(3)审查 社会孤立和社会支持与伴侣关系、IPV和心理困扰之间的关系 (4)探讨孕妇在新冠肺炎大流行期间的经历 定性访谈。在大流行期间，黑人妇女尤其容易受到伤害。对时间敏感的天性 新冠肺炎疫情的蔓延要求立即探索女性的经历。

ABSTRACT Black women are more likely to become ill with COVID-19 than Whites, with disparities reported in many cities including Detroit, one of our sites. Black women are overrepresented in the low-wage essential workforce and more likely to live in disadvantaged neighborhoods (e.g., crowded housing) facing challenges in social distancing. Blacks have less in the way of savings and possibly less flexible employers than Whites, increasing risks for economic hardship (e.g., loss of jobs). Black women may experience discrimination in obtaining testing and medical care for COVID-19 symptoms for themselves and their families. Due to “shelter in place” policy and job losses with the pandemic, Black women may also experience increased conflict with their partner and higher rates of intimate partner violence (IPV) due to families spending nearly all waking and sleeping time together. Racial disparities -- in COVID-19 prevalence and death rates, employment, neighborhood conditions, economic hardship, IPV, and discrimination in testing and medical care -- may all increase psychological distress (e.g., depressive symptoms) for Black women. However, no published research has examined Black women’s experiences during a viral pandemic such as we are now experiencing. We hypothesize that Black women will experience more discrimination, economic hardship, conflict with partner, IPV and psychological distress as well as lower levels of support during the pandemic than pre-pandemic. Our cohort is comprised of 658 Black women from the Detroit, MI and Columbus, OH metropolitan areas. As part of the R01 study, women completed questionnaires during their pregnancies (T1=pre-pandemic). For this supplemental study, women will complete an online survey (T2= during the pandemic) on a smart phone or another device. The T2 survey will include key domains from the T1 survey (e.g., depressive symptoms, social support, IPV) and provide a second critical time point in the context of the pandemic. We expect some domains to be especially impacted by the pandemic (e.g., discrimination, stress). We also added items to capture COVID-19 specific issues, including experiences within their network (e.g. family members sickened), as well as measures pertinent to the situation (e.g., social isolation). A subsample of women will participate in qualitative interviews for an in-depth understanding of their experiences. We aim to: (1) Examine associations of disadvantaged neighborhoods, racial discrimination and economic hardship with psychological distress at both time points (T1 and T2); (2) Examine whether relationship with the partner, IPV, and psychological distress are impacted by the pandemic by comparing the pre-pandemic and during pandemic time points; (3) Examine how social isolation and social support relate to relationship with the partner, IPV, and psychological distress during the pandemic; and (4) Explore pregnant women’s experiences during the COVID-19 pandemic through qualitative interviews. Black women are especially vulnerable during the pandemic. The time-sensitive nature of the COVID-19 pandemic demands the immediate exploration of women’s experiences.