Racial Disparities in Health: The Roles of Stress, Social Relations and the Cardiovascular System

高血压是美国种族群体死亡率差异的头号原因。 种族与心血管系统联系的机制是关键。非裔美国人（AA） 在一生中暴露于更多的压力和一生的逆境与心血管疾病有关 (CHD)和高血压。然而，解释长期压力暴露之间联系的机制， 高血压和冠心病仍不清楚。假设心血管反应性是一个主要的竞争者， 预测心脏事件和死亡率的风险增加，特别是在高血压患者中。根据 根据现有的种族健康差异、压力和社会关系的理论，种族健康差异是由于 长期暴露于压力和压力反应（生物，心理，行为）的变化以及 种族差异受到社会关系和年龄的调节。FOA老龄化压力研究 和弹性，以解决健康差距在美国（RFA-AG-16-022），本研究旨在 了解AA和EA成年人的长期压力暴露与压力反应之间的联系。本研究 利用现有的纵向社会关系和健康研究（SRS），一个区域代表小组 从1992年开始参加的底特律大都会区AA和EA个体样本（13岁 至93岁），并于2015年完成第三波（30至95岁）。拟议的研究将包括两个新的 短期应激反应性的研究：1）日常应激研究和2）实验室应激研究。日常压力 研究将针对300名参与者（50% AA; 50% EA），并将纳入为期4天的经验抽样研究， 自我报告的压力暴露和反应性（心理，行为）以及两个动态监测 评估生物反应性的装置：1）新开发的无创连续监测环装置 它提供血管阻力的估计，2）评估心率，心率变异性， 和皮肤电反应。在实验室研究中，我们将检查对标准实验室压力源的反应 在50名AA和50名EA受访者中，他们完成了日常压力研究， 彻底的生理反应，以压力与相同的流动戒指和手表，以及 建立了连续监测。拟议的研究旨在实现三个目标：1）测试长期- EA和AA成年人的长期应激暴露和短期应激反应，2）检查 长期压力暴露和短期反应的种族，和3）确定如何长期的社会 关系缓和压力暴露和反应的个体差异。这个项目有公共卫生 重要性，因为它将确定谁是更积极的反应，以压力和直接以及寿命的个人 这些因素与更大的压力反应有关。对心理学的更细致的理解 压力在不同人群中的生物学意义将导致开发和测试 干预措施，以减少压力，以后的健康问题和健康差距。

Hypertension is the number one cause of racial group disparities in mortality in the U.S. Thus, understanding the mechanisms by which race is linked with the cardiovascular system is key. African Americans (AA) are exposed to more stress across the lifespan and lifetime adversity is associated with cardiovascular disease (CHD) and hypertension. However, mechanisms accounting for the links between long-term stress exposure, hypertension and CHD remain unclear. Cardiovascular reactivity is hypothesized to be a major contender as it predicts increased risk of cardiac events and mortality, especially among people with hypertension. According to existing theories of racial health disparities, stress, and social relations, racial health disparities are due to variations in long-term exposure to stress and stress reactivity (biological, psychological, behavioral) and those race differences are moderated by social relations and age. In response to the FOA Aging Research on Stress and Resilience to Address Health Disparities in the United States (RFA-AG-16-022), the present study seeks to understand how long-term stress exposure links with stress reactivity among AA and EA adults. This study capitalizes the existing longitudinal Social Relations and Health Study (SRS),a regionally representative panel sample of AA and EA individuals from the Detroit metropolitan area who began participating in 1992 (ages 13 to 93) and completed the third wave in 2015 (ages 30 to 95). The proposed study will incorporates two new studies of short-term stress reactivity: 1) a daily stress study and 2) a laboratory stress study. The daily stress study will target 300 participants (50% AA; 50%EA) and will incorporate a 4 day experience sampling study of self-reported stress exposure and reactivity (psychological, behavioral) as well as two ambulatory monitoring devices to assess biological reactivity: 1) a newly developed non-invasive continuous monitoring ring device that provides estimates of vascular resistance and 2) a watch that assesses heart rate, heart rate variability, and galvanic skin response. In the laboratory study we will examine reactivity to standard laboratory stressors among a sample of 50 AA and 50 EA respondents who completed the daily stress study to examine more thoroughly their physiological responses to stress with the same ambulatory ring and watch as well as established continuous monitors. The proposed research addresses three aims: 1) Test links between long- term stress exposure and short-term stress reactivity among EA and AA adults, 2) Examine age differences in long-term stress exposure and short-term reactivity by race, and 3) Determine how long-term social relationships moderate individual differences in stress exposure and reactivity. This project has public health significance as it will identify individuals who are more reactive to stress and the immediate as well as lifespan factors that are associated with greater stress reactivity. A more nuanced understanding of the psychological and biological implications of stress among diverse populations will lead to the development and testing of interventions for reducing stress, later health problems, and health disparities.