Neighborhood-level Structural Racism and Cardiovascular Health Among African American Youth and Young Adults

非裔美国青年和年轻人的社区结构性种族主义和心血管健康

• 批准号: 10794928
• 负责人: Michelle A. Chen
• 金额: $ 7.16万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10794928
• 关键词: Address; Adolescent; Adolescent and Young Adult; Adult; Affect; African American; African American population; Age; Area; Biological Markers; Blood Pressure; Cardiovascular Diseases; Childhood; Cholesterol; Clinical; Data; Development; Disease Progression; Disparity; Education; Employment; Endothelium; Event; Exposure to; Functional disorder; Future; Glucose; Goals; Health; Housing; IL8 gene; Immunology; Imprisonment; Individual; Inflammation; Inflammatory; Interleukin-1 beta; Interleukin-10; Interleukin-6; Laboratories; Law Enforcement; Life; Link; Literature; Longevity; Longitudinal Studies; Measures; Mediating; Mediator; Metabolic syndrome; Myocardial Infarction; Neighborhoods; Not Hispanic or Latino; Obesity; Outcome; Ownership; Participant; Pathogenesis; Process; Production; Public Health; Punishment; Race; Research; Risk Factors; Sampling; Schools; Social Environment; Social Mobility; Statistical Methods; Structural Racism; System; TNF gene; Testing; Time; Training; Training Programs; Triglycerides; Unemployment; United States; Universities; Work; Youth; adolescent health; biobehavior; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; cytokine; disease disparity; experience; health disparity; health inequalities; high risk; knowledge base; microbial; mortality; outcome disparities; post-doctoral training; prospective; racial difference; racial discrimination; racial disparity; racial population; segregation; skills; social; waist circumference; young adult

Project Summary/Abstract Cardiovascular disease (CVD) is a leading cause of adult mortality and health inequity in the U.S, with African Americans carrying a significantly higher risk for CVD compared to non-Hispanic Whites. Given that disparities in risk factors for CVD development are already present in childhood, there is a large public health need for research on factors that can contribute to CVD risk disparities among youth. Notably, exposure to racial discrimination leads to increased risk of cardiovascular events and CVD among African Americans. Furthermore, among African American youth, racial discrimination predicted elevated levels of inflammation in adulthood. However, up to this point, research on racial discrimination and CVD risk has focused on individual-level experiences of racial discrimination, while more broad-ranging aspects of structural racism have been understudied. Structural racism, defined as the macrolevel systems and social forces that impact inequities among racial groups, includes issues related to education, employment, housing, and law enforcement. One previous study identified that individuals living in states with higher structural racism had higher rates of myocardial infarction, highlighting a need for more research in this area. Examining the relationship between structural racism and biobehavioral processes involved in early CVD progression among African American youth has potential to provide significant impacts in terms of the prevention of CVD in future work. To address these gaps in the literature, the proposed project aims to assess how structural racism may be associated with CVD risk among African American youth and young adults. Using neighborhood-based indicators of structural racism (i.e., neighborhood-level racial disparities in education, employment, housing, and law enforcement) from publicly available data, the research will 1) examine the association between structural racism and cardiometabolic health, reflected by signs of metabolic syndrome and endothelial function, among African American youth and young adults over time, 2) examine the association between structural racism and another marker of CVD risk, inflammation, among African American youth and young adults over time, and 3) test inflammation as a mediator between structural racism and cardiometabolic health among African American youth and young adults over time. The research will utilize two studies, including the sponsor’s R01 data and the National Longitudinal Study of Adolescent to Adult Health to determine whether findings replicate and generalize. The proposed research is part of a broader post-doctoral training program, whose goal is to prepare the applicant for a career as a PI at a major research university, focused on understanding disparities related to CVD pathogenesis in youth. In addition to the research outlined above, the applicant will complete coursework on the pathophysiology of CVD, immunology, statistical methods, and adolescent health disparities, gain experience measuring inflammatory and cardiometabolic biomarkers, and develop a knowledge base about analyzing large- scale neighborhood-level data to better understand the social environment contributors to CVD disparities.

项目摘要/摘要 心血管疾病（CVD）是美国成人死亡率和健康不平等的主要原因， 与非西班牙裔白人相比，非裔美国人的CVD风险明显更高。鉴于 CVD开发危险因素的差异已经存在于儿童时期，这有很大的公共卫生 需要研究可能导致青年人中CVD风险分布的因素。值得注意的是，接触种族 歧视导致非裔美国人中心血管事件和CVD的风险增加。此外， 在非裔美国人青年中，种族歧视预测成年后的炎症水平升高。 但是，到目前为止，对种族歧视和CVD风险的研究一直集中在个人级别上 种族歧视的经历，而结构性种族主义的更广泛方面已经存在 研究了。结构性种族主义，定义为影响不平等的宏观系统和社会力量 在种族群体中，包括与教育，就业，住房和执法部门有关的问题。一 先前的研究表明，生活在结构性种族主义较高州的个人的率更高 心肌梗塞强调了在这一领域进行更多研究的需求。研究 非裔美国人青年早期CVD发展涉及的结构性种族主义和生物行为过程 有可能在未来工作中预防CVD方面产生重大影响。 为了解决文献中的这些差距，拟议的项目旨在评估结构性种族主义如何 与非裔美国人青年和年轻人的CVD风险有关。使用基于邻里的 结构性种族主义的指标（即教育，就业，住房中的邻里水平种族分布 执法）从公开可用的数据中，研究将1）检查结构之间的关联 种族主义和心脏代谢健康，以代谢综合征和内皮功能的迹象反映出 随着时间的流逝，非裔美国人青年和年轻人，2）检查结构种族主义与 随着时间的推移，非裔美国人青年和年轻人的CVD风险，感染的另一个标志，3） 在非裔美国人中，测试炎症是结构性种族主义与心脏代谢健康之间的调解人 年轻人和年轻人随着时间的流逝。该研究将利用两项研究，包括赞助商的R01数据和 国家对成人健康的纵向研究，以确定发现是否复制和普遍。 拟议的研究是更广泛的博士后培训计划的一部分，其目标是准备 在一所大型研究大学的PI职业生涯中，申请人专注于了解与CVD相关的分布 青年发病机理。除了上面概述的研究外，申请人还将完成有关 CVD，免疫学，统计方法和青少年健康差异的病理生理学，获得经验 测量炎症性和心脏代谢生物标志物，并建立有关分析大型知识的知识基础 扩展社区级别的数据，以更好地了解社会环境导致CVD差异。