The Influence of Structural Racism on Incidence of Alzheimer's Disease and Related Dementias (ADRD) in Black women

结构性种族主义对黑人女性阿尔茨海默病和相关痴呆症 (ADRD) 发病率的影响

基本信息

批准号：
10474735
负责人：
Lynn Rosenberg
金额：
$ 79.99万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-01 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10474735
关键词：
Address Affect Age Age of Onset Alcohol consumption Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk American Attention Biological Factors Black American Censuses Characteristics Chronic Chronic stress Cohort Effect Complex County Criminal Justice Data Data Collection Data Sources Development Diabetes Mellitus Dietary intake Education Educational Background Employment Enrollment Environmental Exposure Epidemiology Exercise Follow-Up Studies Fostering Funding Geographic Locations Geography Health Health Disparities Research Health Food Healthcare Housing Hypertension Imprisonment Incidence Individual Institutes Investigation Justice Life Life Cycle Stages Link Measurement Measures Mediating Mediation Medicare Methods Minority Groups National Institute on Aging Neighborhoods Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Participant Pathway interactions Pattern Physical activity Physical environment Poverty Publishing Questionnaires Recording of previous events Records Recreation Reporting Research Resources Risk Risk Factors Schools Smoking Social support Societies Structural Racism System Testing Time Unemployment Voting Weight Gain Women&apos s Health Work base black women caucasian American combat comorbidity data resource deprivation experience high risk population human old age (65+)indexing obesogenic policy recommendation protective factors racial discrimination racism social

项目摘要

ABSTRACT Alzheimer’s Disease and related dementias (ADRD) disproportionately affect Black Americans compared to White Americans. Structural racism – the totality of ways by which society fosters racial discrimination and White supremacy through mutually reinforcing, inequitable systems in housing, education, employment, health care, criminal justice and other domains – may drive the constellation of social risk factors and comorbidities that increase the risk of ADRD. The mechanisms and pathways by which structural racism contributes to ADRD in Black Americans are as yet largely unexplored. We propose to assess the influence of structural racism on incidence of ADRD in a high-risk group of Americans, Black women. Our study will be based on participants and data from a 26-year follow-up study of 59,000 Black women from across the U.S., the Black Women’s Health Study (BWHS). We will develop a measure of structural racism that is more comprehensive than most currently in use and test characteristics of this measure against those of several published measures, at the county and state level. Our new measure will use data on unemployment, poverty, level of education, and incarceration; the data needed for its development will be obtained by linking participants’ geocoded addresses from 1995-2021 to appropriate public data sources. We will identify incident cases of ADRD through an already developed and tested method of linkage of BWHS participants aged 65 and older to Medicare data for the years 2008-2022; this will yield an estimated 1,500 incident cases of ADRD in 15,000 to 16,000 BWHS participants. Since enrollment in the BWHS in 1995, the participants have provided information on a large number of health and other factors, which include potential risk factors (e.g., hypertension, diabetes, low level of education) and protective factors (e.g., exercise, social support) for ADRD. The study has collected information at three different times on perceived experiences of interpersonal racism, and these reported experiences have been associated with increased risk of adverse health outcomes (e.g., weight gain) in the BWHS, as expected. Thus, it will be possible to assess the effects of structural racism alone on incidence of ADRD as well as the combined effects of structural and interpersonal racism. We will also study moderation or mediation of effects by a large number of other factors on the association of structural racism with incidence of ADRD. Since data have been collected over a period of 26 years in geographic areas across the U.S., it will be possible to assess effects of structural racism on ADRD incidence over time and place at the county and state level. Thus, the proposed study will provide new and important information on structural racism and ADRD in Black women.

抽象的与美国黑人相比，阿尔茨海默病和相关痴呆症 (ADRD) 对美国黑人的影响尤为严重美国白人。结构性种族主义——社会助长种族歧视和种族歧视的全部方式。通过住房、教育、就业、健康方面相辅相成、不平等的制度实现白人至上护理、刑事司法和其他领域——可能会导致一系列社会风险因素和合并症结构性种族主义导致 ADRD 风险的机制和途径。美国黑人的 ADRD 尚未在很大程度上得到探索，我们建议评估结构性的影响。种族主义对美国黑人女性高危人群 ADRD 发病率的影响我们的研究将基于这一点。参与者和来自对美国各地 59,000 名黑人女性进行的 26 年跟踪研究的数据妇女健康研究（BWHS）我们将制定更全面的结构性种族主义衡量标准。比目前使用的大多数方法都要多，并根据几种已发布的方法测试该措施的特征我们的新措施将使用有关失业、贫困、贫困水平的数据。教育和监禁；其发展所需的数据将通过链接参与者的我们将识别 1995 年至 2021 年的地理编码地址到适当的公共数据源。 ADRD 通过一种已经开发并测试过的方法，将 65 岁及以上的 BWHS 参与者与 2008 年至 2022 年的医疗保险数据将得出估计 15,000 至 1,500 起 ADRD 病例自 1995 年加入 BWHS 以来，已有 16,000 名参与者提供了信息。与大量健康和其他因素有关，其中包括潜在的危险因素（例如高血压、糖尿病、该研究收集了 ADRD 的一些因素（如教育水平低）和保护因素（例如运动、社会支持）。三个不同时间关于人际种族主义感知经历的信息，这些报告经验与不良健康结果（例如体重增加）的风险增加有关 BWHS，正如预期的那样，将有可能单独评估结构性种族主义对发生率的影响。 ADRD 以及结构性种族主义和人际种族主义的综合影响我们还将研究节制或种族主义。大量其他因素对结构性种族主义与种族歧视发生率之间关系的影响的中介作用 ADRD 的数据是在 26 年的时间内在美国各地收集的。可以评估结构性种族主义对县和州不同时间和地点的 ADRD 发病率的影响因此，拟议的研究将为结构性种族主义和 ADRD 提供新的重要信息。黑人女性。