University of Exeter, United Kingdom.
Columbia University, United States.
Soc Sci Med. 2018 May;204:31-38. doi: 10.1016/j.socscimed.2018.02.002. Epub 2018 Feb 3.
The aim of the present study was to test a life course model in which racial disparities in physical health between Caucasian and African Americans are driven by disparities in close relationship functioning. This model also examined relative evidence for intergenerational transmission of relationship functioning and ongoing exposure to prejudice and discrimination as two pathways that might shape adult relationship functioning.
A sample of 523 Caucasian and African American men and women were prospectively tracked from a birth cohort initiated in the 1960s. Reports of parental relationship functioning were obtained from participants and their mothers in adolescence. In midlife, participants completed measures of perceived discrimination (lifetime and everyday discrimination), close relationship functioning (relationship strain and support) and physical health (self-rated health, resting heart rate and systolic blood pressure).
As hypothesized, close relationship functioning was a strong predictor of physical health in adulthood. Furthermore, we observed that perceived discrimination over the life course was linked to impaired relationship functioning. Evidence for intergenerational transmission of relationship functioning was more equivocal.
Racial disparities in physical health may be maintained via social factors throughout the life course. Although such factors have sometimes been considered outside the purview of the medical field, it is vital that researchers and clinicians begin to more fully address the implications of social forces in order to remediate racial health disparities.
本研究旨在检验一个生命历程模型,该模型认为白人和非裔美国人在身体健康方面的种族差异是由亲密关系功能的差异所驱动。该模型还检验了代际传递关系功能以及持续面临偏见和歧视作为两种可能塑造成人关系功能的途径的相对证据。
本研究前瞻性地追踪了一个始于 20 世纪 60 年代的出生队列中的 523 名白人和非裔美国男性和女性。参与者及其母亲在青春期时报告了父母的关系功能。在中年,参与者完成了感知歧视(终生和日常歧视)、亲密关系功能(关系紧张和支持)和身体健康(自我评估的健康状况、静息心率和收缩压)的测量。
正如假设的那样,亲密关系功能是成年后身体健康的强有力预测因素。此外,我们观察到,一生中的感知歧视与受损的关系功能有关。关系功能代际传递的证据更加模棱两可。
通过整个生命历程中的社会因素,可能会维持身体健康方面的种族差异。尽管这些因素有时被认为超出了医学领域的范畴,但研究人员和临床医生开始更充分地了解社会力量的影响,以纠正种族健康差异至关重要。