Previous studies by the HCHDS used an innovative approach to explore race-related health disparities by studying variations in risk factors and poor health outcomes in an integrated community of lower-SES whites and blacks (specifically EHDIC-SWB). This approach addresses two important limitations in current health disparities research: the confounding of race and residential segregation and the confounding of race and SES. This integrated community study design allows for substantive control of often overlooked and/or unmeasured confounding variables. In this study we seek to expand on the Exploring Health Disparities in Integrated Communities Prince Georges (EHDIC-PG) Study. We will examine the role of John Henryism (a strategy for coping with prolonged exposure to stress;James, et al., 1994;1983) to determine the physical, mental and physiological health impacts of stress and discrimination on high-SES African Americans. We will call upon a complementary set of physical and mental health indicators including a novel Biomapping Method that allows for continuous ambulatory measures of physiological characteristics potentially linked to health disparities. Much of the research on health disparities has been limited to poor and underserved populations, but this study expands on current research and uses cutting edge methodology and novel applications of existing conceptual frameworks to understand health disparities among higher SES blacks and whites. The three specific aims of this study follow:
Specific Aim 1) To estimate the relationship between John Henryism and poorer health outcomes, including elevated blood pressure, self-reported physical and mental health problems, as well as increased rates of obesity, and lower cardio vascular fitness among affluent African Americans and whites.
Specific Aim 2) To estimate the relationship between discrimination and health among affluent African Americans and whites.
Specific Aim 3) To identify racial variation in ambulatory physiological measures of health and stress using an innovative biomapping protocol.

Public Health Relevance

This study will be the first to ascertain objective, real-world measures of physiological state and physiological fluctuations to explore disparities in health and well-being. This speaks to both the innovation and significance of this research. If, in fact, African Americans have elevated physiological markers of stress, these markers become potential targets for future preventive interventions that high-risk individuals can be trained to down regulate using a biofeedback model.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Comprehensive Center (P60)
Project #
5P60MD000214-12
Application #
8487442
Study Section
Special Emphasis Panel (ZMD1-RN)
Project Start
Project End
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
12
Fiscal Year
2013
Total Cost
$112,765
Indirect Cost
$43,157
Name
Johns Hopkins University
Department
Type
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
LaVeist, Thomas A; Thorpe Jr, Roland J; Pierre, Geraldine et al. (2014) THE RELATIONSHIPS AMONG VIGILANT COPING STYLE, RACE, AND DEPRESSION. J Soc Issues 70:241-255
Smolen, J R; Thorpe Jr, Roland J; Bowie, J V et al. (2014) Health insurance and chronic conditions in low-income urban whites. J Urban Health 91:637-47
Wilson-Frederick, Shondelle M; Thorpe Jr, Roland J; Bell, Caryn N et al. (2014) Examination of race disparities in physical inactivity among adults of similar social context. Ethn Dis 24:363-9
Martínez, Airín D; Juon, Hee-soon; Levine, David M et al. (2014) The association between nutrition transition score and measures of obesity: results from a cross-sectional study among Latina/o immigrants in Baltimore. Global Health 10:57
Pierre, Geraldine; Thorpe Jr, Roland J; Dinwiddie, Gniesha Y et al. (2014) Are there racial disparities in psychotropic drug use and expenditures in a nationally representative sample of men in the United States? Evidence from the Medical Expenditure Panel Survey. Am J Mens Health 8:82-90
Njie-Carr, Veronica (2014) Violence experiences among HIV-infected women and perceptions of male perpetrators' roles: a concurrent mixed method study. J Assoc Nurses AIDS Care 25:376-91
Thorpe Jr, Roland J; Szanton, Sarah L; Bell, Caryn N et al. (2013) Education, income and disability in African Americans. Ethn Dis 23:12-7
Dinwiddie, Gniesha Y; Gaskin, Darrell J; Chan, Kitty S et al. (2013) Residential segregation, geographic proximity and type of services used: evidence for racial/ethnic disparities in mental health. Soc Sci Med 80:67-75
Jackson, Chandra L; Szklo, Moyses; Yeh, Hsin-Chieh et al. (2013) Black-white disparities in overweight and obesity trends by educational attainment in the United States, 1997-2008. J Obes 2013:140743
Bower, Kelly M; Thorpe Jr, Roland J; LaVeist, Thomas A (2013) Perceived racial discrimination and mental health in low-income, urban-dwelling whites. Int J Health Serv 43:267-80

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