Cardiovascular Risk Disparities: Socioemotional Pathways

描述(由申请人提供)：少数族裔和低社会经济地位(SES)人群表现出不成比例的心血管疾病(CVD)发病率和死亡率，消除这些差异是2010年健康人的优先目标。先前的研究表明，除了许多其他变量外，心理社会因素也可能导致心血管疾病的差异。这项拟议的研究将使用储备能力模型(Gallo和Matthews，2003)作为一个概念框架，通过该模型在社区随机抽样的中年、墨西哥裔美国人和非拉丁裔白人妇女中研究压力、心理社会资源和情绪因素在SES和种族心血管疾病差异中的作用(N=300)。储备能力模型假设，社会地位较低的个人(低社会地位、少数族裔)可能会因为在多个领域经历的压力而遭受负面的情绪和身体健康后果。应激可能对行为和生理风险过程产生直接影响，也可能影响情绪变量，而情绪变量本身就是心血管疾病的危险因素。此外，社会地位低的人可能会保持较少的弹性心理社会资源来管理压力，使他们特别容易受到随之而来的身体和精神上的磨损。在拉丁裔妇女中，低SES的影响可能被放大(即协同效应)。然而，墨西哥裔美国妇女也可以受益于具有弹性的社会文化资源，这些资源在一定程度上保护她们免受压力。在目前的研究中，女性将接受SES、心理社会因素、生理和行为风险因素以及心血管生物标记物的全面评估，并将参与为期两天的动态血压评估和通过生态瞬时评估评估的心理社会体验。通过检查潜在的可改变的心理社会变量作为心血管疾病差异的潜在途径，这项研究试图为了解和消除健康差异的努力提供信息。

DESCRIPTION (provided by applicant): Minority and low socioeconomic status (SES) populations show disproportionate rates of cardiovascular disease (CVD) morbidity and mortality, and eliminating these disparities is a priority objective of Healthy People 2010. Previous research suggests that in addition to many other variables, psychosocial factors may contribute to CVD disparities. The proposed research will use the Reserve Capacity Model (Gallo and Matthews, 2003) as a conceptual framework through which to examine the roles of stress, psychosocial resources, and emotional factors in SES and ethnic CVD disparities, in a community-based random sample of middle-aged, Mexican-American and non-Latino White women with relatively low and high SES (N=300). The Reserve Capacity Model posits that individuals with lower social status (low SES, minority ethnicity) may suffer negative emotional and physical health consequences due to stress experienced across multiple domains. Stress may exert direct effects on behavioral and physiological risk processes, or it may influence emotional variables which are themselves putative CVD risk factors. In addition, persons with low social status may maintain a smaller bank of resilient psychosocial resources with which to manage stress, making them especially vulnerable to concomitant physical and emotional wear and tear. The effects of low SES may be amplified in Latino women (i.e., synergistic effects). However, Mexican-American women could also benefit from resilient, socio-cultural resources that protect them, to some extent, from stress. In the current study, women will undergo a comprehensive assessment of SES, psychosocial factors, physiological and behavioral risk factors, and CVD biomarkers, and will participate in a two-day evaluation of ambulatory blood pressure and psychosocial experiences assessed via ecological momentary assessment. By examining potentially modifiable psychosocial variables as a pathway underlying CVD disparities, this study seeks to inform efforts to understand and eliminate health disparities.