Dowd Jennifer B, Palermo Tia, Chyu Laura, Adam Emma, McDade Thomas W
CUNY School of Public Health, Hunter College, 2180 Third Avenue, New York, NY 10035, USA; CUNY Institute for Demographic Research (CIDR), One Bernard Baruch Way, New York, NY 10010, USA.
Program in Public Health, Department of Preventive Medicine, Stony Brook University (SUNY), Health Sciences Center 3-071, Stony Brook, NY 11794, USA.
Soc Sci Med. 2014 Aug;115:49-55. doi: 10.1016/j.socscimed.2014.06.011. Epub 2014 Jun 10.
Stress and immune function may be important mediators of the strong association between social factors and health over the life course, but previous studies have lacked the data to fully explore these links in a population-based sample. This study utilizes data from Waves I-IV of the U.S. National Longitudinal Study of Adolescent Health (Add Health) to test the associations of race/ethnicity and socioeconomic status (SES) with levels of perceived stress and exposure to stressful life events (SLE) among 11,050 adult respondents aged 24-32 in 2008-2009. We further tested whether race/ethnicity and SES were associated with Epstein-Barr Virus (EBV) specific IgG antibodies, an indirect marker of cell-mediated immune function. Finally, we tested whether measures of stress were associated with EBV IgG and whether there was evidence that they explain any associations between race/ethnicity, SES and EBV IgG. We found strong associations between lower SES and higher levels of perceived stress (OR 2.07, 95% CI 1.73-2.48 for < high school vs. college or above) and a high level of stressful life events (OR 7.47, 95% CI 5.59-9.98 for < high school vs. college or above). Blacks had higher odds of a high level of stressful life events compared to whites (OR 2.00, 95% CI 1.63-2.47), but not higher perceived stress (OR 1.11, 95% CI 0.96-1.28). Blacks also had significantly higher EBV levels compared to whites (β = 0.136, p < 0.01), but lower SES was not associated with higher EBV IgG. We found no evidence that stressful life events or perceived stress were associated with EBV IgG in this sample, and thus did not account for racial differences in EBV IgG. These results suggest consistent race/ethnic and SES differences in stressful life events, and confirm race/ethnic differences in markers of immune function that may have health implications across the life course.
压力和免疫功能可能是社会因素与一生中健康状况之间紧密关联的重要调节因素，但以往研究缺乏在基于人群的样本中全面探究这些联系的数据。本研究利用美国青少年健康全国纵向研究（Add Health）第一至四波的数据，对2008 - 2009年11,050名年龄在24 - 32岁的成年受访者中种族/族裔和社会经济地位（SES）与感知压力水平及经历应激性生活事件（SLE）之间的关联进行了测试。我们进一步测试了种族/族裔和SES是否与爱泼斯坦 - 巴尔病毒（EBV）特异性IgG抗体相关，这是细胞介导免疫功能的一个间接指标。最后，我们测试了压力指标是否与EBV IgG相关，以及是否有证据表明它们解释了种族/族裔、SES与EBV IgG之间的任何关联。我们发现较低的SES与较高的感知压力水平之间存在强关联（高中以下学历与大学及以上学历相比，OR为2.07，95% CI为1.73 - 2.48）以及高水平的应激性生活事件（高中以下学历与大学及以上学历相比，OR为7.47，95% CI为5.59 - 9.98）。与白人相比，黑人经历高水平应激性生活事件的几率更高（OR为2.00，95% CI为1.63 - 2.47），但感知压力并不更高（OR为1.11，95% CI为0.96 - 1.28）。与白人相比，黑人的EBV水平也显著更高（β = 0.136，p < 0.01），但较低的SES与较高的EBV IgG无关。我们没有发现证据表明在这个样本中应激性生活事件或感知压力与EBV IgG相关，因此也无法解释EBV IgG中的种族差异。这些结果表明在应激性生活事件中存在一致的种族/族裔和SES差异，并证实了免疫功能指标中的种族/族裔差异，这些差异可能在一生中对健康产生影响。
