Understanding Social Status' Impact on Adolescent Health

描述(申请人提供)：消除健康方面的社会不平等是2010年健康人的首要目标之一。大多数过去的工作 将社会地位定义为社会经济地位(SES)，这是一种外部衡量标准 这并不能解释主观的、内化的社会认知。 站着。大多数研究也没有解释较低的社会地位是如何导致 健康状况更差。使用一种新的主观社会地位衡量标准 调查小组成员，这项研究测试了一种新的解释模型 社会地位对健康的影响。该模型确定了HPA轴和 自主神经系统作为社会创造中的关键生物系统 健康方面的不平等。社会地位、环境压力、原因 刺激这些系统，进而导致 社会地位-健康关系的神经激素介体。这项研究 与一项新的为期4年的青少年肥胖症和青少年肥胖纵向队列研究相吻合 在一个种族和社会经济多元化的学区发生2型糖尿病 俄亥俄州。这两种疾病都支持这种模式。具体目标是：1) 描述青少年对社会地位和发展的看法 这些观念在四年内发生的变化；2) 描述社会地位之间的联系，客观地衡量两者 主观上，青少年肥胖和胰岛素抵抗；以及3) 确定社会地位之间的关系，客观地衡量两者 和主观上，和潜在的生物中介的社会地位对 健康。为了达到这些目标，每年对青少年的主观评价 社会地位将会发生变化。此外，在第一年和第四年，潜在的 初级和次级生物介质(胰岛素、脱氢表雄酮-S、血压、 将获得总胆固醇和高密度脂蛋白，以及糖化血红蛋白)。 家长将提供有关SES的信息和他们自己对社会的看法 站在一年级和四年级。这项研究将提供独特的、基于社区的 关于社会地位影响的潜在生物媒介的信息 健康。种群的多样性将使我们能够区分影响 种族/民族和社会地位。创新的社会衡量标准 身份既包括主观因素，也包括客观因素，这可以解释 SES-肥胖关系和长期肥胖关系中的一些不一致 肥胖和糖尿病的趋势。这项工作也将为 通过提供对以下方面的洞察，制定有效的初级预防战略 造成健康方面的社会不平等的过程。

DESCRIPTION (provided by applicant): Elimination of social inequalities in health is one of the overarching goals of Healthy People 2010. Most past work has defined social status as socioeconomic status (SES), an external measure that does not account for subjective, internalized perceptions of social standing. Most studies also do not explain how lower social status causes poorer health. Using a new measure of subjective social standing developed by members of the investigative team, this study tests a novel explanatory model of social status' impact on health. The model identifies the HPA axis and autonomic nervous system as critical biologic systems in the creation of social inequalities in health. Social status, an environmental stress, causes stimulation of these systems which, in turn, leads to alterations in neurohormonal mediators of the social status-health relationship. The study dovetails to a new 4-year longitudinal cohort study of adolescent obesity and Type 2 diabetes in a racially and socioeconomically diverse school district in Ohio. Both of these diseases support this model. The specific aims are 1 )To describe adolescents' perceptions of social standing and the developmental changes which occur in these perceptions over a four year period; 2) To characterize the associations between social status, measured both objectively and subjectively, and obesity and insulin resistance among adolescents; and 3) To determine the relationships between social status, measured both objectively and subjectively, and potential biologic mediators of social status' impact on health. To address these aims, yearly assessment of adolescents' subjective social standing will take place. In addition, in Years 1 and 4, potential primary and secondary biologic mediators (insulin, DHEA-S, blood pressure, total and HDL cholesterol, and glycosylated hemoglobin) will be obtained. Parents will provide information on SES and their own perceptions of social standing in Years 1 and 4. This study will provide unique, community-based information on potential biologic mediators of social status' influence on health. The population's diversity will enable us to differentiate the effects of race/ethnicity and social status. The innovative measurement of social status, which includes both subjective and objective components, may explain some of the inconsistency in the SES-obesity relationship and the secular trends in obesity and diabetes. This work will also lay the foundation for creation of effective primary prevention strategies by providing insight into the processes through which social inequalities in health are created.