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

描述(申请人提供)：性侵犯是一种暴力事件，每年影响数百万女性。据估计，美国每年有680万起强奸和人身攻击事件，其中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，评估性侵犯造成的皮肤损伤在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，与浅色皮肤的女性相比，进行法医检查的深色皮肤女性的生殖器损伤患病率明显较低。这些发现提出了关于皮肤弹性和肤色关系的重要问题，可能表明种族/民族与受伤发生率之间的关系存在虚假性质。他们证明，肤色而不是种族/民族可能是预测生殖器损伤流行率的重要变量。如果深色皮肤的女性比浅色皮肤的女性更不可能被发现受伤，那么就存在健康差距。人们对皮肤弹性在整个肤色中的作用知之甚少，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发现。 这项博士前申请的总体目标是确定皮肤弹性是否因肤色而异。申请人提出了一种创新的方法来回答这个问题：是否可以更好地理解之前的发现，即生殖器损伤患病率因肤色而异，因为皮肤弹性因肤色而异？申请人预计，皮肤弹性的变化也将由年龄、体重指数、阳光照射和健康状况来解释。拟议的临床研究研究和培训计划是申请者长期目标不可或缺的一部分，其中包括阐明与颜色和其他变量相关的皮肤生理学方面的潜在差异，了解皮肤的保护和损伤机制，以及传播适用的研究结果，以促进皮肤科学，减少脆弱人群的健康差距。 在宾夕法尼亚大学进行的这项研究中获得的结果，可能会带来大规模的公共健康益处。调查结果将提供将影响性侵犯后法医检查程序的信息，以及在法律环境中评估伤害的指导方针。如果不同肤色的女性的皮肤弹性确实不同，解决这些差异可能会改进法医检查技术，并为性侵犯后更高的报案率提供动力。

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.