Neighborhood, social connectedness, and allostatic load in US Chinese immigrants

项目摘要 亚裔美国人是美国（US）增长最快的种族/族裔群体， 原产地代表最大的单一美国亚洲亚组。在华裔美国人中，大多数（62%）是 外国出生的虽然中国移民的健康状况比美国出生的移民好，但这则健康广告- Vantage随着居住时间的增加而降低。健康的下降轨迹一直是 主要归因于行为适应，但移民也包括广泛的压力和社会 隔离反过来，社会隔离可能会通过多个系统的失调增加慢性疾病的风险- 神经内分泌、心血管、代谢、炎症、免疫--它们一起指示了变应性 负载（AL）。事实上，对其他美国移民人口（主要是非洲人或拉丁裔）的研究表明， 美国的居住与更高的AL相关。尽管有这些发现，移民的经验是否 社会隔离对疾病风险和健康的影响尚未得到充分研究。社会联系，或者 在某种程度上，一个人认为自己与其他个人，团体， 以及整个社会，是解决社会孤立的一种可能策略，但解决社会孤立的条件和背景 培养社会联系的能力还没有得到很好的理解。生活在少数民族聚居区（即社区， 同一种族的人口比例）可能对中国移民产生积极影响， 更多的社会支持和更少的孤独。有人建议，飞地提供必要的结构， 条件-即物理和社会空间-为社会联系的发展，虽然这还没有 在大规模研究中得到证实。因此，我们建议全面调查以下相互关联的 问题：移民后的社会孤立/联系经历是否与移民的生物学相关？ 外国出生的中国人？种族飞地是否有助于这一人群的社会联系;如果是，如何？ 为了解决这些问题，我们将在费城地区招募600名外国出生的中国人， 包括少数民族聚居区的居民以及缺乏共同民族密度的社区的居民， 认可的飞地资源。具体目标是：（1）检查社会联系的协会， 美国华人移民群体中AL的社会隔离;（2）探讨飞地是否以及如何影响- 与基于飞地的资源的接触和参与与社会联系有关。数据收集 将包括问卷（例如，社会联系、隔离、与飞地资源的接触）、血缘关系 血压、人体测量和空腹血液样本分析AL标志物。 活动的位置（例如，购物，宗教服务）将被地理编码。纵向评估将 在2年随访时获得，以确定AL标志物的变化以及这些指标变化的相关性。 项目调查结果将确定最脆弱的个人和社区，以进行外展， 关键的社区一级的资源，以促进积极的健康轨迹，在这一移民人口。

PROJECT SUMMARY Asian Americans are the fastest-growing racial/ethnic group in the United States (US), and Asians of Chinese origin represent the largest single US Asian subgroup. Among Chinese Americans, the majority (62%) are foreign-born. Although Chinese immigrants report better health than their US-born counterparts, this health ad- vantage decreases over time with increasing duration of residence. The downward health trajectory has been primarily attributed to behavioral acculturation, but immigration also encompasses extensive stress and social isolation. Social isolation, in turn, may increase chronic disease risk through dysregulation in multiple systems – neuroendocrine, cardiovascular, metabolic, inflammatory, immune – which together are indicative of allostatic load (AL). Indeed, studies of other US immigrant populations (mostly African or Latinx) have noted that longer US residence is associated with higher AL. Despite these findings, the question of whether immigrants’ experi- ences of social isolation affect disease risk and health has not been well studied. Social connectedness, or the extent to which one perceives oneself to be closely and meaningfully connected with other individuals, groups, and society as a whole, is a possible strategy to address social isolation, but the conditions and contexts that foster social connectedness are not well understood. Living in ethnic enclaves (i.e. neighborhoods with a greater proportion of people of the same ethnicity) may have positive effects among Chinese immigrants including greater social support and less loneliness. It has been suggested that enclaves provide the necessary structural conditions – namely, physical and social spaces – for social connectedness to develop, although this has yet to be confirmed in large-scale studies. Thus, we propose a comprehensive investigation of the following interrelated questions: Do post-migration experiences of social isolation/connectedness have biologic correlates among foreign-born Chinese? And do ethnic enclaves contribute to social connectedness in this population; if so, how? To address these questions, we will recruit a cohort of 600 foreign-born Chinese across the Philadelphia region, including residents of ethnic enclaves as well as residents of neighborhoods lacking the co-ethnic density and resources of recognized enclaves. Specific aims are to: (1) Examine associations of social connectedness and social isolation with AL in a cohort of US Chinese immigrants; and (2) Explore whether and how enclave resi- dence and engagement with enclave-based resources are associated with social connectedness. Data collection will include questionnaires (e.g., social connectedness, isolation, engagement with enclave resources), blood pressure, anthropometry, and fasting blood samples analyzed for markers of AL. Addresses of residences and locations of activities (e.g., shopping, religious services) will be geocoded. Longitudinal assessments will be obtained at 2-year follow-up to identify changes in markers of AL and correlates of changes in those measures. Project findings will identify the most vulnerable individuals and neighborhoods to target for outreach and pinpoint the critical community-level resources for promoting positive health trajectories in this immigrant population.