Clinical trial NCT06552702: Race and Socioeconomic Position: Examining Common Social Pathways to Disease Risk
Official title: Race and Socioeconomic Position: Examining Common Social Pathways to Disease Risk
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Healthy Aging
Keywords: socioeconomic status
race
stress
social relationships
ambulatory blood pressure
Lead sponsor: University of Alabama, Tuscaloosa
Sponsor class: OTHER
Collaborators: name: University of Alabama at Birmingham
First posted: 2024-08-14
Enrollment: 32
Sex: ALL
Minimum age (years): 35
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: OTHER
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Recruitment will target Black Americans (8 high SEP, 8 low SEP) and White Americans (8 high SEP, 8 low SEP) between the ages of 35 and 70. Low SEP will be defined as a score of 1 to 3 on the MacArthur (ladder) scale of subjective social status (range 1-10), and high SEP as a score of 8-10 on the same scale.

Brief summary: Black Americans and those of lower socioeconomic position (SEP) are at higher risk for multiple diseases of aging and shorter lifespans, but the psychophysiological mechanisms that may account for these effects are not clear. The overarching objective of this pilot grant is to improve our understanding of the proximal social exposures and subsequent psychobiological processes that contribute to racial and socioeconomic health disparities. Precisely understanding what these mutable social and psychological mechanisms are is necessary in order to identify intervention targets at the level of the individual.

Detailed description: Black Americans and those of lower socioeconomic position (SEP) are at higher risk for multiple diseases of aging and shorter lifespans. Though these disparities are well-documented, the mechanisms that may account for them are still poorly understood. Low income or Black race do not, themselves, cause individuals to become sick. Instead, the social context and exposures associated with these personal attributes give rise to differential risk (1-3). Black race and lower SEP are overlapping in the United States and race and SEP may share common social exposures that contribute to disease risk because both Blacks and individuals of lower SEP are socially marginalized (e.g., devalued, pushed to the lower margins of society) and thus exposed to more stress associated with lower hierarchical rank (4). However, no studies to our knowledge have been designed to examine whether day-to-day social exposures common across race and SEP may contribute to higher overall disease burden in these groups. In this project, investigators examine whether daily social interaction patterns help to explain how race and SEP may be linked with well-established psychobiological pathways to disease (affect, behavior, and physiology). With respect to each of these pathways, investigators examine the extent to which within-person changes in social processes may be associated with effects that mirror (and thus could explain) between-group differences. For example, interactions in which one experiences a higher degree of disrespect may be associated with momentary changes in affect, behavior, and physiology that confer disease risk. Examination of these within-person processes allows for stronger causal inference and is directly relevant to the development of individual-level interventions (e.g., targeting cognitive, behavioral, and affective processes). These findings can directly inform individual and group interventions for stress reduction in health disparity populations.

Eligibility criteria: Inclusion Criteria:

- Black American or White American between the ages of 35 and 70.

Exclusion Criteria:

* Conditions that require immediate treatment (e.g., Stage 2 hypertension; resting blood pressure \> 160/100 mmHg)
* Excessive alcohol consumption (\> 5 portions, \> 3 times per week)
* Frequent illicit drug use
* Schizophrenia or bipolar disorder
* Permanent neurological deficit
* Shift work
* Current pregnancy

Primary outcomes:
measure: Ambulatory Systolic Blood Pressure
timeFrame: during four days of ambulatory monitoring
measure: Ambulatory Diastolic Blood Pressure
timeFrame: during four days of ambulatory monitoring
Secondary outcomes:
Other outcomes:
Locations:
city: Tuscaloosa
country: United States
facility: University of AL Psychology Department
state: Alabama
Study officials:
affiliation: University of Alabama at Birmingham
name: Jenny Cundiff
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Alabama at Birmingham
name: Karlene Ball
role: STUDY_DIRECTOR
References:
citation: Jones CP. Levels of racism: a theoretic framework and a gardener's tale. Am J Public Health. 2000 Aug;90(8):1212-5. doi: 10.2105/ajph.90.8.1212.
citation: Bailey ZD, Krieger N, Agenor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017 Apr 8;389(10077):1453-1463. doi: 10.1016/S0140-6736(17)30569-X.
citation: Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramanian SV. Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project. Am J Public Health. 2005 Feb;95(2):312-23. doi: 10.2105/AJPH.2003.032482.
citation: Williams DR, Mohammed SA. Racism and Health I: Pathways and Scientific Evidence. Am Behav Sci. 2013 Aug 1;57(8):10.1177/0002764213487340. doi: 10.1177/0002764213487340.