Psychosocial Factors and the Risk of Incident Asthma in African American Women

非洲裔美国女性的心理社会因素和哮喘发生风险

• 批准号: 8587499
• 负责人: Patricia F Coogan
• 金额: $ 30.52万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-12-05 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8587499
• 关键词: Absenteeism at work; Address; Adolescence; Adult; Adult asthma; African American; Asthma; Biological; Censuses; Characteristics; Child; Childhood; Childhood Asthma; Chronic stress; Cohort Studies; Data; Development; Disadvantaged; Disease; Epidemic; Generations; Health Care Costs; Housing; Incidence; Individual; Intervention; Knowledge; Lead; Life; Light; Link; Measures; Medical History; Mental Depression; Mission; Morbidity - disease rate; Neighborhoods; Obesity; Outcome; Participant; Physiological; Play; Policies; Population; Prevalence; Prevention strategy; Preventive; Prospective Studies; Psychosocial Factor; Public Health; Questionnaires; Reporting; Reproductive History; Research; Risk; Risk Factors; Role; Severities; Smoking; Societies; Socioeconomic Factors; Socioeconomic Status; Stress; Testing; Treatment/Psychosocial Effects; United States; Victimization; Violence; War; Woman; Women' s Health; burden of illness; demographics; density; depressive symptoms; disability; experience; follow-up; inner city; innovation; interest; novel therapeutic intervention; prospective; racism; segregation; stressor

ABSTRACT Asthma has reached epidemic proportions in the United States and African-Americans fare worse than whites on all measures of asthma morbidity. Reasons for the disparity have not been satisfactorily explained. Psychosocial factors like experiences of violence and living in disadvantaged and/or inner city neighborhoods have been found to play a role in childhood asthma prevalence and severity. While the role of psychosocial factors in asthma expression has been studied in children there is little research on such factors in adults. Stress is the putative mechanism and there are plausible biological mechanisms by which it may contribute to the incidence of adult-onset asthma. Psychosocial factors may be of particular importance in asthma incidence in black women because the prevalence of experiences of violence, racism, depression, and living in disadvantaged neighborhoods are higher than in white women. If such experiences increase the risk of adult onset asthma, they may contribute to the racial disparity in asthma morbidity. The objective of this application is to fill this gap in knowledge about the role of psychosocial factors in incident adult-onset asthma in African American women. Our central hypothesis is that individual- and neighborhood-level psychosocial factors that may lead to stress increase the risk of adult-onset asthma in African-American women. The rationale for the proposed research is that the identification of factors that increase the risk of adult-onset asthma is a necessary step in the development of preventive policies and interventions to reduce both levels of adult-onset asthma and the gap in black/white asthma morbidity. The specific aims of this proposal are to 1) estimate the influence of experiences of racism, experiences of violence during childhood and adolescence, and depressive symptoms to asthma incidence and 2) to estimate the influence of neighborhood socioeconomic status (SES), racial segregation, and urbanicity to asthma incidence. We will conduct prospective analyses using data from the Black Women's Health Study (BWHS). The BWHS cohort, assembled in 1995, includes approximately 59,000 African-American women from across the U.S. Detailed information on demographics, medical and reproductive history, and disease endpoints including asthma, was collected at baseline and in biennial follow- up questionnaires. On selected follow-up questionnaires, information was obtained on the psychosocial factors of interest. Participant addresses have been geocoded and linked with census data. Over 16 years of follow-up through 2011, approximately 1800 incident cases of asthma will have been reported. The study is innovative because it will be the first prospective study to consider the effects of the psychosocial exposures of interest on incident adult asthma in African American women. The proposed research is significant because positive results may direct intervention efforts to address stressors like racism and violence and may motivate further mechanistic studies of how chronic stress leads to asthma, which might inform the development of new therapeutic interventions.

抽象的 哮喘在美国和非裔美国人的流行比例比白人差 在所有哮喘发病率的措施上。差异的原因尚未令人满意地解释。 社会心理因素，例如暴力经历和生活在弱势和/或内城社区 已经发现在童年哮喘患病率和严重程度中发挥作用。而心理社会的角色 在儿童中已经研究了哮喘表达的因素，对成年人的这些因素几乎没有研究。 压力是推定的机制，并且存在合理的生物学机制，它可能有助于 成人哮喘的发生率。社会心理因素在哮喘中可能特别重要 黑人妇女的发病率是因为暴力，种族主义，沮丧和生活的经历的流行 处境不利的社区高于白人妇女。如果这种经历增加了成人的风险 哮喘发作可能导致哮喘发病率的种族差异。此应用的目的 是为了填补有关心理因素在非洲人哮喘事件中的作用的知识的差距 美国妇女。我们的核心假设是个人和邻里水平的社会心理因素 可能导致压力增加非裔美国妇女成人哮喘的风险。理由 拟议的研究是，确定增加成人哮喘风险的因素是 制定预防性政策和干预措施以减少两种水平的成人发言权的必要步骤 哮喘和黑/白色哮喘发病率的差距。该提案的具体目的是1）估计 种族主义经历，童年和青春期暴力经历以及抑郁的影响 哮喘发病率的症状和2）估计社区社会经济地位（SES）的影响， 种族隔离和哮喘发病率的城市性。我们将使用来自 黑人妇女健康研究（BWHS）。 BWHS队列于1995年组装，大约包括 来自美国各地的59,000名非裔美国妇女详细信息，有关人口统计学，医疗和 在基线和双年展的后续收集生殖史和包括哮喘在内的疾病终点 - 提出问卷。在选定的后续调查表中，获得了有关社会心理的信息 感兴趣的因素。参与者的地址已被解编码并与普查数据相关联。超过16 到2011年的多年随访，将报告大约1800例哮喘事件。 这项研究具有创新性，因为它将是第一个考虑心理社会影响的前瞻性研究 非洲裔美国妇女对成人哮喘的关注暴露。拟议的研究是 重要的是因为积极的结果可能会指导干预工作，以解决种族主义和暴力等压力源 并可能激发进一步的机理研究，以了解慢性压力如何导致哮喘，这可能会告知 开发新的治疗干预措施。