Multilevel Forms of Structural Racism and Racial Inequalities in ADRD Risk

ADRD 风险中结构性种族主义和种族不平等的多层次形式

• 批准号: 10474847
• 负责人: TAYLOR HARGROVE
• 金额: $ 72万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10474847
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Alzheimer’s disease biomarker; American; Area; Biological; Biological Aging; Biological Markers; Black American; Black race; C-reactive protein; Censuses; Chronology; Communities; County; Criminal Justice; Data; Data Set; Databases; Dementia; Development; Diabetes Mellitus; Diagnosis; Discrimination; Disease; Early Intervention; Economics; Education; Educational Status; Effectiveness; Epigenetic Process; Ethnic group; Expenditure; Exposure to; Geography; Goals; Growth; Health; Health Policy; Hypertension; Incidence; Individual; Inequality; Inflammation; Institution; Interleukins; Intervention; Investigation; Knowledge; Life; Life Cycle Stages; Light; Link; Location; Longitudinal Studies; Measures; Modeling; Motion; Nature; Neurology; Onset of illness; Outcome; Pathway interactions; Physiological; Policies; Politics; Population; Public Health; Public Policy; Race; Research; Respondent; Risk; Risk Factors; Schools; Shapes; Skin; Stroke; Structural Racism; Techniques; Time; United States; Work; black/white disparity; cardiovascular health; causal model; cohort; cost; data repository; dementia risk; early onset; education pathway; experience; experimental study; health inequalities; insight; middle age; models and simulation; multiple data sources; neurofilament; novel; novel marker; population based; prospective; public health intervention; racial and ethnic; racial disparity; racism; residential segregation; school district; school environment; social; stressor; tau Proteins; theories; young adult

Project Summary/Abstract Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD) are on the rise in the United States. Estimates project a 40% increase in AD among older Americans by 2025. This increase, along with its associated economic, social, and health burdens, are likely to have disproportionate impacts, as Black adults have the highest incidence of dementia of any racial/ethnic group in the U.S. Moreover, Black Americans experience higher rates of established biological risk factors for AD/ADRD, including hypertension, diabetes, stroke, inflammation, and biological aging. The expected growth in AD diagnoses, expenditures, and burdens, as well as potentially widening racial inequalities, make it imperative to investigate early risk factors for the development of AD/ADRD and racial inequalities in AD/ADRD. Structural forms of racism are likely important drivers of racial inequalities in AD/ADRD risk. Yet, much of the research in this area focuses on downstream factors, such as exposure to stressors and discrimination, or specific domains of structural racism at one point in time. Missing are longitudinal studies of structural racism and aging-related health inequalities across multiple geographic contexts. Further, there is limited knowledge of how public health and policy interventions addressing structural racism can be utilized to reduce racial inequalities in AD/ADRD. Causal modeling techniques provide opportunities to assess the impact of structural interventions on documented inequalities in biological risk factors for AD/ADRD using observational data. The purpose of this project is twofold: 1) to create a public-use, comprehensive data repository of multilevel and repeated contextual measures of structural racism; and 2) use the new contextual data in combination with existing contextual and individual-level longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine specific pathways linking structural racism and AD/ADRD biological risk among early midlife U.S. adults. Specifically, we will investigate whether structural racism across educational, residential, and criminal justice contexts independently and jointly shape Black-White disparities in biological risk factors for AD/ADRD, including hypertension, diabetes, inflammation, epigenetic aging, and two novel biomarkers of AD/ADRD risk (neurofilament light and total tau). We will also use simulation models to compare the effects of hypothetical population-based policy changes and targeted interventions on racial inequalities in biological risk factors of AD/ADRD risk. Findings from this study will advance our understanding of how structural racism shapes AD/ADRD risk early in the life course. Results from simulation models will also inform the development of population-level, early interventions aimed to slow the progression of AD/ADRD risk and reduce health inequalities in these outcomes.

项目摘要/摘要 阿尔茨海默氏病和阿尔茨海默氏病有关的痴呆症（AD/ADRD）正在统一上升 国家。估计到2025年，美国老年人的广告增加了40％。这增加了 与黑人成年人一样 还有美国任何种族/族裔的痴呆症事件最高 在包括高血压，糖尿病， 中风，炎症和生物衰老。 AD诊断，支出和Burnen的预期增长， 以及潜在地扩大种族不平等的情况，必须调查早期风险因素 AD/ADRD中的AD/ADRD和种族不平等的发展。种族主义的结构形式很重要 AD/ADRD风险中种族不平等的驱动因素。然而，该领域的许多研究都集中在下游 因素，例如暴露于压力源和歧视，或某一时刻的结构种族主义特定领域 及时。缺失的是结构性种族主义和与衰老有关的健康不平等的纵向研究 多个地理环境。此外，了解公共卫生和政策干预措施的知识有限 解决结构性种族主义可以用于减少广告/ADRD中的种族不平等现象。因果建模 技术提供了评估结构干预对记录不平等现象的影响的机会 使用观察数据的AD/ADRD的生物风险因素。该项目的目的是双重的：1）创建 多层和重复的结构性衡量的公共利用，全面的数据存储库 种族主义; 2）将新的上下文数据与现有的上下文和个人级别结合使用 来自国家纵向研究到成人健康（增加健康）的纵向数据以检查 在美国早年成年人早期成年人中，结构性种族主义和AD/ADRD生物学风险联系起来的特定途径。 特别是，我们将调查跨教育，居民和刑事司法的结构性种族主义是否 在AD/ADRD的生物风险因素中，独立和共同塑造黑白分布的环境， 包括高血压，糖尿病，炎症，表观遗传衰老和两个AD/ADRD风险的新型生物标志物 （神经丝的光和总tau）。我们还将使用仿真模型比较假设的影响 基于人群的政策变化和针对种族不平等的针对性干预措施 广告/ADRD风险。这项研究的发现将提高我们对结构种族主义的理解 广告/ADRD在生命课程的早期风险。仿真模型的结果还将告知 人群级别的早期干预措施旨在减缓AD/ADRD风险的进展并降低健康状况 这些结果的不平等。