Department of Family & Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA.
Cancer Prevention, Control & Population Health, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Int J Environ Res Public Health. 2022 Mar 17;19(6):3580. doi: 10.3390/ijerph19063580.
Allostatic load (AL)-the biological assessment of long-term exposure to stress-may explain mortality-rate disparities among non-Hispanic Black (Black) men. We aimed to investigate AL among Black men with equivalent education status after controlling for income. A cross-sectional study was employed to investigate AL among 4113 Black men who participated in the National Health and Nutrition Examination Survey between 1999-2018. A summation of 8 biomarker factors were used to compute AL, differences in socio-demographic characteristics by education status were evaluated, and health behaviors that may influence AL were examined. To determine the high-risk thresholds for each AL component, we examined each component's distribution among NHB men for whom complete biomarker data were available in the NHANES sample. High-risk thresholds were determined as either (1) above the 75th percentile for body mass index (BMI), diastolic blood pressure (DBP), glycated hemoglobin, systolic blood pressure (SBP), total cholesterol, and serum triglycerides; or (2) below the 25th percentile for serum albumin and serum creatinine. Modified Poisson regression models were used to estimate prevalence ratios and their associated 95% confidence intervals for high AL risk while adjusting for potential confounders. Black men with a high school diploma/GED had a greater prevalence of high AL compared with Black men who had other levels of education, and a slightly higher prevalence of high AL compared with Black men who had less than a high school education. Black men with college degrees had a lower prevalence of high AL than Black men with the lowest levels of educational attainment. Researchers must further examine the hidden costs stemming from the interplay between discrimination associated with being Black in America and systemic racism in the educational system-which may be preventing Black men from achieving optimal health.
应激长期暴露的生物学评估——身体应激水平（allostatic load，AL）——可能可以解释非裔美国人（Black）男性死亡率差异的原因。本研究旨在在控制收入的情况下，调查具有同等受教育程度的黑人男性的 AL。本研究采用横断面研究调查了参加了 1999-2018 年国家健康和营养检查调查（National Health and Nutrition Examination Survey，NHANES）的 4113 名黑人男性的 AL。使用 8 种生物标志物因素的总和来计算 AL，评估了不同教育程度的社会人口特征差异，并检查了可能影响 AL 的健康行为。为了确定每个 AL 成分的高风险阈值，我们检查了 NHANES 样本中具有完整生物标志物数据的非裔男性中每个成分的分布。高风险阈值被定义为：（1）BMI、舒张压（diastolic blood pressure，DBP）、糖化血红蛋白、收缩压（systolic blood pressure，SBP）、总胆固醇和血清甘油三酯高于第 75 百分位数；或（2）血清白蛋白和血清肌酐低于第 25 百分位数。调整潜在混杂因素后，使用修正泊松回归模型估计高 AL 风险的患病率比及其相应的 95%置信区间。与具有其他受教育程度的黑人男性相比，具有高中文凭/普通教育发展（General Educational Development，GED）的黑人男性 AL 高的比例更大，与受教育程度较低的黑人男性相比，AL 高的比例略高。具有大学学历的黑人男性 AL 高的比例低于受教育程度最低的黑人男性。研究人员必须进一步研究源自在美国身为黑人所遭受的歧视与教育系统中系统性种族主义相互作用的潜在代价——这可能阻止了黑人男性获得最佳健康。
