Childhood and Adult Psychosocial Stress and the Association with Disparities in Adult Cardiometabolic Health

项目摘要 生命过程流行病学将注意力集中在童年经历和 越来越多的研究表明，许多最严重的慢性病 在全球范围内都植根于童年。研究表明，经历四种或四种以上类型的成年人 不良童年经历（ACE）（即，潜在的创伤性事件或儿童 环境破坏他们的安全感和稳定性）有大约两倍的几率肥胖 和心血管疾病-甚至更大的几率为高风险的健康行为-相对于 在童年没有经历过逆境的成年人。这种关系正在蓬勃发展，并仍在- 在不同年龄组，社会经济地位（SES）和种族/民族之间进行了探索。此外 对于ACE，成年人经历的压力与健康状况不佳的风险增加有关 结果。此外，SES和非白人种族也与ACE患病率较高相关 心脏代谢疾病的危险因素增加。然而，人们对如何做到这一点知之甚少。 累积应力（即，成人、急性和慢性应激源的组合）影响 心脏代谢疾病的风险。“综合生命过程方法， 支持心肺疾病流行病学研究的生物学和数字表型分析” 父母补助金的重点是加强收集传统和 心脏和肺部疾病的新风险因素。拟议补充研究的目标是 转化父母补助金的活动，并确定早期生命风险因素-及其与 成年期经历的其他心理社会压力-心脏代谢的多代人 这将有助于预防和控制这些疾病，最终支持减少高危人群中这些风险因素的工作。 因此，本研究的目的如下：（目的1）调查种族/民族和 儿童心理社会压力的地理/人口预测因素-及其与 社会经济地位-成年妇女;（目标2）查明社区经济地位如何与成年妇女联合收割机结合， 压力的经验，以预测心脏代谢疾病，并检查累积的程度， 压力导致心脏代谢疾病风险因素的种族差异;以及（目标3） 了解可能减少或加剧心理社会之间联系的背景因素 压力源和心脏代谢结果，通过智能手机数字表型和收集 分析地理空间数据集。拟议的补充研究具有重要的公共卫生 影响

PROJECT SUMMARY Life-course epidemiology directs attention to the connection between childhood experiences and adult health, and increasing research indicates that many of the most burdensome chronic diseases globally are rooted in childhood. Research shows adults who experience four or more types of adverse childhood experiences (ACEs) (i.e., potentially traumatic events or aspects of a child’s environment that undermine their sense of safety and stability) have roughly twice the odds of obesity and cardiovascular disease — and even greater odds for high-risk health behaviors—relative to adults who did not experience adversity in childhood. This relation is burgeoning and remains under- explored among different age groups, socio-economic status (SES), and race/ethnicities. In addition to ACEs, stressors experienced as an adult have been linked to increased risk of poor health outcomes. Also, SES and non-white race have been associated with higher ACE prevalence as well as increased presence of risk factors for cardiometabolic disease. However, less is known about how cumulative stress (i.e., the combination of adult, acute, and chronic stressors) influences cardiometabolic disease risk over a period of time. The “Integrating Lifecourse Approaches, Biological, and Digital Phenotyping in Support of Heart and Lung Disease Epidemiologic Research” parent grant focuses on strengthening infrastructure necessary to collect data on traditional and emerging risk factors for heart and lung diseases. The goal of the proposed supplemental research is to translate the activities of the parent grant and identify early life risk factors – and their interplay with other psychosocial stressors experienced in adulthood -- in multiple generations for cardiometabolic disease, ultimately supporting work towards reducing these risk factors among high-risk populations. As such, the research aims are as follows: (Aim1) To Investigate racial/ethnic and geographic/demographic predictors of childhood psychosocial stress – and their interactions with socio-economic status (SES) – among adult women; (Aim2) To identify how ACEs combine with adult experiences of stress to predict cardiometabolic disease and examine the extent to which cumulative stress contributes to racial disparities in the risk factors of cardiometabolic disease; and (Aim3) To understand contextual factors that might reduce or exacerbate the association between psychosocial stressors and cardiometabolic outcomes, through smartphone digital phenotyping and the collection and analysis of geospatial datasets. The proposed supplemental research has important public health implications.