Diversity Supplement to Psychosocial Stress due to COVID-19 and Vascular Aging in African-American Women

项目摘要 2019年新型冠状病毒病（COVID-19）全球大流行可以说是最具破坏性的疾病之一 上个世纪的公共卫生危机。在美国，非洲裔美国人不成比例地 受影响，总体感染率和死亡率比白人高2至4倍。 此外，由于非必要企业和其他实体的关闭， 失业和就业不足也大幅上升，非洲裔美国人更有可能 而不是白人报告由于大流行而就业不足或休假。毫不奇怪，由于种族 尽管COVID-19死亡率存在差异，但全国民意调查还发现，COVID-19相关报告存在种族差异。 损失，非洲裔美国人更频繁地报告亲自认识死于 COVID-19比白人。因此，有人认为，由于COVID-19，非洲- 美国人正在经历一场“压力大流行”，这将对他们的健康产生“危险的影响” 以及在病毒被控制后的很长一段时间内的健康。利用我们以前资助的队列， 评估了早期中年非洲裔美国妇女的心理社会压力和血管老化，我们有一个 这是一个前所未有的机会，可以检查压力源产生的程度，以及与之相关的程度， COVID-19大流行可能会影响这一群体的血管疾病-美国的头号杀手。 中年非洲裔美国妇女可能是一个独特的重要群体，值得关注，因为：1）她们 相对于其他种族-性别群体，血管疾病的发病率越来越高，但人们对此知之甚少; 以及2）由以下因素造成的广泛的金融、就业和社会压力的长期影响： COVID-19可能对非洲裔美国妇女特别有害，这主要是由于结构性和 在大流行病本身之前就存在的背景不平等。拟议的项目将审查以下方面的联系： 总体心理社会压力源（债务、经济压力、工作压力、人际关系不礼貌和虐待， 孤独），COVID特定的压力源（COVID相关的经济困难，COVID特定的养育压力源， COVID相关损失）和血管老化的预期变化（动态血压，动脉僵硬度， 炎症）在350名中年非洲裔美国妇女的队列中进行了24个月的研究。因为我们有 新冠肺炎前对一系列心理社会压力源的评估，拟议工作的一个主要创新是 我们有能力研究新冠肺炎前后在整体心理社会压力下的变化 可能会影响血管老化。重要的是，我们将利用集团内部的大量 在我们的队列异质性，以检查是否有任何我们假设的协会是由前调节， COVID评估了可能增加脆弱性的社会人口因素（社会经济地位、单身 父母身份、婚姻状况）或复原力（例如，生活目标、乐观、掌握、社会支持）， 社会心理压力，以便为短期和长期预防工作提供信息。

PROJECT SUMMARY The novel coronavirus disease 2019 (COVID-19) global pandemic is arguably one of the most devastating Public Health crises of the last century. In the United States, African-Americans have been disproportionately impacted, with overall rates of infection and mortality 2 to 4 times higher than those observed in Whites. Additionally, as a direct result of closings of non-essential businesses and other entities, rates of unemployment and underemployment have also surged, and African-Americans are significantly more likely than Whites to report being underemployed or furloughed due to the pandemic. Unsurprisingly, given racial disparities in COVID-19 mortality, national polls have also found racial differences in reports of COVID-related loss, with African-Americans more frequently reporting personally knowing someone who has died from COVID-19 than Whites. Because of this, it has been argued that, as a result of COVID-19, African- Americans are experiencing a “pandemic of stress” that will have a “dangerous impact” on their health and well-being long after the virus itself has been contained. Leveraging our previously funded cohort that assessed psychosocial stress and vascular aging in early middle-aged African-American women, we have an unprecedented opportunity to examine the degree to which stressors resulting from, and related to, the COVID-19 pandemic might impact vascular disease—the number 1 killer in the US-in this group. Middle-aged African-American women may be a uniquely important group on which to focus, because: 1) they have increasingly high, but poorly understood, rates of vascular disease relative to other race-gender groups; and 2) the long-term impact of the widespread financial, employment and social stressors resulting from COVID-19 might be particularly deleterious for African-American women, largely due to structural and contextual inequalities that pre-dated the pandemic itself. The proposed project will examine linkages between overall psychosocial stressors (debt, financial stress, job stress, interpersonal incivilities and mistreatment, loneliness), COVID-specific stressors (COVID-related financial difficulties, COVID-specific parenting stressors, COVID-related loss) and prospective changes in vascular aging (ambulatory blood pressure, arterial stiffness, inflammation) over 24 months in a cohort of 350 middle-aged African-American women. Because we have pre-COVID assessments of a range of psychosocial stressors, a major innovation of the proposed work is our ability to examine how pre- versus post-COVID changes in exposure to overall psychosocial stress might prospectively impact vascular aging. Importantly, we will capitalize on the considerable within-group heterogeneity in our cohort, to examine whether any of our hypothesized associations are moderated by pre- COVID assessed sociodemographic factors that might increase vulnerability (socioeconomic status, single parenthood, marital status) or resilience (e.g., purpose in life, optimism, mastery, social support) to psychosocial stress, in order to inform short- and long-term prevention efforts.