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

描述（由申请人提供）：性侵犯是一种暴力事件，每年影响数百万女性。在美国每年约680万起强奸和人身攻击事件中，2.6 100万人将导致一名妇女受伤，近80万人将导致幸存者接受某种医疗保健。众所周知，评估性攻击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，与浅色皮肤的妇女相比，接受法医检查的深色皮肤的妇女生殖器损伤发生率明显较低。这些研究结果提出了关于皮肤弹性和皮肤颜色之间关系的重要问题，可能表明种族/民族与损伤患病率之间关系的虚假性质。他们证明，肤色而不是种族/民族可能是预测生殖器损伤患病率的重要变量。如果深色皮肤的妇女比浅色皮肤的妇女更不容易被发现受伤，那么就存在健康差异。人们对皮肤弹性在皮肤颜色连续体中的作用知之甚少，皮肤弹性的差异是否也可以解释损伤患病率因皮肤颜色而异的研究结果。 这个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：由于皮肤弹性因肤色而异，是否可以更好地理解先前的发现，即生殖器损伤患病率因肤色而异？申请人预期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。拟议的临床研究和培训计划是申请人长期目标的组成部分，其中包括阐明与颜色和其他变量相关的皮肤生理学的潜在差异，了解皮肤的保护和伤害机制，以及传播适用的发现，以促进皮肤科学和减少弱势群体的健康差距。 在宾夕法尼亚大学进行的这项研究中获得的结果具有潜在的大规模公共卫生效益。调查结果将提供信息，将影响程序的法医检查后，性侵犯和准则，评估伤害在法律的设置。如果不同肤色的女性皮肤弹性确实不同，解决这些差异可能会改善法医检查技术，并为增加性侵犯后的报告率提供动力。

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.