Immunologic Effects and a Structural "Countermarketing" Intervention: Racism, the

描述(由申请人提供) 摘要：本项目的总体目标是探索不同水平的种族主义对城市非裔美国人免疫功能和整体健康的影响，并测试一种新的结构性水平的干预措施，以减少种族主义的负面影响。主要慢性病的显著差异继续描述着非裔美国人目前的健康状况，包括心血管疾病、癌症和超重/肥胖。长期以来，研究人员一直认为应激在负面健康结局中起着关键作用，尤其关注下丘脑-脑下垂体肾上腺皮质(HPA)轴作为一种关键途径。由于种族主义的经历构成了非裔美国人生活中的一个重要压力源，了解种族主义激活该轴心的方式将对解决非裔美国人健康差距的决定因素具有深远的意义。更广泛地说，考虑到HPA轴在许多系统中的作用，拟议的研究有可能揭示关于社交过程对整体身心健康的影响的关键信息，并描绘出大脑-行为关系中未被研究的路径。在两个子研究中，拟议的研究将招募来自纽约市的城市非裔美国人参加纵向调查。研究1是关于社区层面的制度性种族主义和感知到的个人和集体种族主义如何影响免疫和代谢功能以及整体身体健康、心理健康和健康行为的调查。研究2是社区一级的干预，以最大限度地减少种族主义内化的可能性，而不是种族主义的“反营销”运动。户外广告将被用来在以非裔美国人为主的社区传达有关美国人不平等的严酷事实，从而提高人们的意识，并将负面健康后果降至最低。综上所述，这项拟议的研究试图回答生物医学和行为研究中两个关键的悬而未决的问题：1)种族主义是如何进入人体的？2)我们如何应对它？ 公共卫生相关性：尽管众所周知，种族主义是非裔美国人的重要生活压力源，但还没有研究研究种族主义对免疫功能等关键生物途径的影响。此外，尽管种族主义的其他负面影响已经被记录在案，但还没有研究创造出广泛的干预措施来对抗种族主义对非裔美国人生活的压力。拟议的研究将两者兼而有之，这可能对缩小非裔美国人的健康差距产生重大影响。

DESCRIPTION (Provided by the applicant) Abstract: The overall aims of this project are to explore the effects of multiple levels of racism on the immune function, and overall health of urban African Americans, and to test a novel structural-level intervention to reduce the negative impact of racism. Significant disparities in major chronic illnesses continue to describe the current picture of health for African Americans, including cardiovascular disease, cancer, and overweight/obesity. Researchers have long understood stress to play a critical role in negative health outcomes, and particular attention has been paid to the hypothalamic-pituitaryadrenocortical (HPA) axis as a key pathway. Because experiences with racism constitute a significant stressor in the lives of African Americans, understanding the ways in which racism activates the axis will have profound meaning in addressing the determinants of African American health disparities. More broadly, given the role of the HPA axis in many systems, the proposed research has the potential to uncover critical information on the impact of social processes on overall physical and mental health, and to delineate unstudied paths in brain-behavior relationships. In two sub-studies, the proposed research will enroll urban African Americans from New York City in longitudinal investigations. Study 1 is an investigation of how neighborhood-level institutional racism and perceived individual and collective racism affect immune and metabolic function and overall physical health, psychological well-being, and health behaviors. Study 2 is neighborhood-level intervention to minimize the likelihood of internalized racism, vis-¿vis a racism "countermarketing" campaign. Outdoor advertising will be employed to deliver stark facts about American inequality in predominantly African American neighborhoods, thereby raising consciousness and minimizing negative health outcomes. Taken together, the proposed research attempts to answer two critical unanswered questions in biomedical and behavioral research: 1) How does racism get into the body?; and 2) What do we do about it? Public Health Relevance: Although racism is well known to be a significant life stressor for African Americans, no research has studied the effects racism has on critical biological pathways, such as immune function. Additionally, although other negative effects of racism have been documented, no study has yet created a broad-based intervention to counter the stress of racism on African American lives. The proposed study will do both, which could have a major impact on the reduction of African American health disparities.