Multi-level predictors of structural racism and discrimination and associations with health and well-being across the life course in diverse families

结构性种族主义和歧视的多层次预测因素以及不同家庭生命历程中与健康和福祉的关联

• 批准号: 10606552
• 负责人: Jerica M Berge
• 金额: $ 65.01万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-08 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606552
• 关键词: Adolescence; Adult; Affect; African American; Biological; Biological Markers; Black race; Blood Pressure; Body mass index; C-reactive protein; Cardiometabolic Disease; Child; Childhood; Communities; Data; Diet; Dietary intake; Discrimination; Ecological momentary assessment; Elements; Ethnic Origin; Event; Exposure to; Family; Geographic Information Systems; Geographic Locations; Glycosylated hemoglobin A; Health; Heart Rate; Hemoglobin C; High Density Lipoprotein Cholesterol; Hispanic; Household; Housing; Immigrant; Individual; Institution; Institutional Racism; Intervention; Life Cycle Stages; Lipids; Longitudinal Studies; Longitudinal cohort study; Longitudinal, observational study; Measures; Mental Depression; Mental Health; Methods; Minnesota; Moods; Native Americans; Neighborhoods; Outcome; Outcome Measure; Parents; Participant; Personal Satisfaction; Persons; Physical activity; Police; Policies; Prevalence; Psyche structure; Public Assistance; Public Health; Race; Refugees; Reporting; Research; Research Design; Research Personnel; Risk Factors; Rural; Safety; Sampling; Schools; Site; Source; Stress; Structural Racism; Surveys; Time; Triglycerides; Unhealthy Diet; United States; Voting; Well in self; Work; anxiety symptoms; behavioral health; cardiometabolic risk; cardiometabolism; career; career development; cytokine; depressive symptoms; design; ethnic diversity; health disparity; health equity; health equity promotion; innovation; killings; multidisciplinary; negative mood; perceived discrimination; perceived stress; physical conditioning; prospective; racial diversity; racism; rural families; rural setting; sedentary lifestyle; segregation; socioeconomics; therapy development; urban setting; waist circumference

ABSTRACT Systemic and structural racism is a public health crisis. However, little is known about the impact of structural racism and discrimination (SRD) on the health and emotional well-being of individuals across the life course. While prior studies have shown associations between discrimination and negative health outcomes in adults (e.g., cardiometabolic disease, depression), these studies have been cross-sectional and primarily examined individual-level sources of racism and discrimination. Much more research is needed to fill gaps in our understanding about the relationship between SRD and health disparities before interventions can be developed. To significantly advance the field regarding SRD and health equity, studies need to include: (1) multi-level measures of SRD including individual (both intrapersonal and interpersonal), neighborhood, institutional, and societal/policy levels; (2) rigorous mixed-methods designs (e.g., ecological momentary assessment (EMA), biological measures, geographic information system (GIS) data, surveys); (3) multi-site samples with urban and rural participants; (4) a life course approach; (5) whole-person outcome measures (i.e., mental, physical, behavioral health); and (6) longitudinal study designs. Including these study elements will allow for comprehensively examining the relationships between SRD and health and emotional well-being to identify mechanisms to target in interventions to mitigate SRD. The main objective of the proposed study is to examine multiple levels (i.e., individual, neighborhood, institutional, societal/policy) of SRD and associations with mental, physical, and behavioral health outcomes across the life course to identify intervention targets to promote health equity. The proposed study is built on a prospective longitudinal cohort study of 627 racially/ethnically diverse families (i.e., African American, Hispanic, Native American, Immigrant/Refugee, White) across the life course (childhood, adolescence, adulthood/parenthood) from urban settings (i.e., Minneapolis, St. Paul). The parent R01 already has three time-points of mixed-methods data (i.e., EMA, GIS, survey) that includes discrimination and neighborhood segregation measures and physical and behavioral health outcomes carried out using a community-based participatory approach. For the proposed study, a sample of 300 racially/ethnically diverse families from rural Georgia (i.e., Athens) will be added to compare SRD experiences in urban versus rural settings. In addition, cardiometabolic and stress biomarker data (i.e., heart rate, blood pressure, waist circumference, lipids, HbA1C, cytokines) and multi-level measures of structural racism (i.e., individual, neighborhood, institutional, societal/policy) will be added at two time points, 18 months apart. The proposed study will be one of the first to prospectively measure multiple levels of SRD using mixed-methods across two sites and associations with mental, physical, and behavioral health disparities across the life course in diverse families. Results of the study will inform the development of an intervention targeting multi-level SRDs to promote health equity.

抽象的 系统性和结构性种族主义是一场公共卫生危机。然而，人们对它的影响却知之甚少 结构性种族主义和歧视（SRD）对个人一生健康和情感福祉的影响 课程。虽然之前的研究表明歧视与负面健康结果之间存在关联 成人（例如心脏代谢疾病、抑郁症），这些研究是横断面的，主要是 审查了个人层面的种族主义和歧视的根源。需要更多的研究来填补空白 干预前我们对 SRD 与健康差异之间关系的理解 可以开发。为了显着推进 SRD 和健康公平领域的发展，研究需要 包括：（1）SRD的多层次测量，包括个人（个人内部和人际）， 邻里、机构和社会/政策层面； （2）严格的混合方法设计（例如生态 瞬时评估（EMA）、生物测量、地理信息系统（GIS）数据、调查）； (3) 城市和农村参与者的多地点样本； (4) 生命历程方法； （5）全人成果 措施（即心理、身体、行为健康）； (6)纵向研究设计。包括这些研究 元素将允许全面检查 SRD 与健康和情绪之间的关系 以确定减轻SRD干预措施的目标机制。该计划的主要目标 拟议的研究旨在检查多个层面（即个人、社区、机构、 SRD 的社会/政策）以及与心理、身体和行为健康结果的关联 确定干预目标以促进健康公平。拟议的研究建立在 对 627 个种族/族裔不同家庭（即非裔美国人、西班牙裔、 美洲原住民、移民/难民、白人）的整个生命历程（童年、青春期、 成年/为人父母）来自城市环境（即明尼阿波利斯、圣保罗）。母版R01已经有3个了 包括歧视和邻里关系的混合方法数据（即 EMA、GIS、调查）的时间点 使用基于社区的方法实施隔离措施以及身体和行为健康结果 参与式方法。对于拟议的研究，样本包括来自农村的 300 个不同种族/民族的家庭 将添加格鲁吉亚（即雅典）来比较城市和农村环境中的 SRD 经验。此外， 心脏代谢和压力生物标志物数据（即心率、血压、腰围、血脂、HbA1C、 细胞因子）和结构性种族主义的多层次措施（即个人、社区、机构、 社会/政策）将在相隔 18 个月的两个时间点添加。拟议的研究将是第一个 使用跨两个地点的混合方法前瞻性地测量 SRD 的多个水平并与 不同家庭在整个生命过程中的心理、身体和行为健康差异。结果 研究将为制定针对多层次SRD的干预措施提供信息，以促进健康公平。