Collaborative Research: Factors Affecting Ethnic Differences in Adult Mortality

这是一项关于成人死亡率的种族差异的研究。它将采用人口统计学概念和方法方法来实现针对特定原因和多原因死亡率的三个主要研究目标。首先，它将制定一个比以前提出的更全面的关于危险因素与种族死亡率差别的模型。其次，这项工作将扩大通常在死亡率研究中发现的种族类别的范围。第三，它将采用一个独特的数据库，将详细的人口、社会经济、家庭结构、健康和行为因素与少数民族群体的死亡率联系起来。该项目的具体目标是：(1)汇编和调整一个完整的前瞻性数据库，以便在按死亡原因分析成人死亡率的种族差异时，同时检查人口和社会经济背景因素、家庭结构、健康行为和健康史因素。(2)扩大在死亡率研究中发现的典型种族类别的范围，包括墨西哥人、土著、非洲人、亚洲人和高加索美国人。(3)揭示为什么一些种族，特别是非洲裔美国人，经历了相对较高的循环系统疾病死亡风险。(4)揭示非裔美国人癌症死亡率高得不成比例的原因。(5)说明为什么呼吸道疾病死亡率在美国白人中高得不成比例。(6)阐明为什么墨西哥人、印第安人和非洲裔美国人的糖尿病死亡率相对较高。(7)说明为什么墨西哥人、印第安人和非洲裔美国人死于社会疾病的比例相对较高。(8)扩大死因分析，包括潜在和多种死因。(9)按性别和年龄组说明族裔死亡率模式的差异。（10）使用连续时间风险率模型，允许按种族对死亡风险进行多变量检查。在美国长期存在的种族死亡率差异代表了一个令人不安和具有挑战性的问题。尽管不同群体之间的死亡率差异，特别是非洲裔美国人和白种人美国人之间的死亡率差异，不断得到更好的记录，但对差异的解释一直很薄弱，尤其是在对众多种族群体进行比较时。例如，人们对墨西哥裔美国人的死亡率知之甚少，以至于他们的高死亡率经常被称为“流行病学悖论”。对于亚洲人和美洲原住民所表现出的不同死因模式，我们所知的就更少了。因此，本研究的主要目的是利用一个将人口统计学、社会经济、家庭结构、行为和健康史因素与潜在和多原因死亡率差异联系起来的模型，解释特定原因死亡率的种族差异。一个更全面、更具体的模型将更容易确定社会项目、公共政策、医疗和未来研究可以产生最有利影响的关键领域。

This is a study of ethnic differences in adult mortality. It will employ demographic conceptual and methodological approaches to accomplish three main research goals both for cause-specific and multiple-cause mortality. First, it will develop a more comprehensive model relating risk factors to ethnic mortality differentials than has heretofore been presented. Second, the work will broaden the range of ethnic categories typically found in mortality studies. Third, it will employ a unique data base that links detailed demographic, socioeconomic, family structure, health, and behavioral factors to mortality of ethnic groups. The specific aims of the project are to: (1) Assemble and adapt an integral, prospective database that will permit simultaneous examination of demographic and socioeconomic background factors, family structure, health behaviors, and health history factors in an analysis of ethnic variations in adult mortality by cause of death. (2) Broaden the range of ethnic categories typically found in mortality studies to include Mexican, Native, African, Asian, and Caucasian Americans. (3) Uncover why some ethnic groups, notably African Americans, experience relatively high mortality risk from circulatory diseases. (4) Reveal why African Americans suffer disproportionately high rates of cancer mortality. (5) Show why respiratory disease mortality is disproportionately high among Caucasian Americans. (6) Illuminate why Mexican, Native, and African Americans exhibit relatively high rates of diabetes mortality. (7) Illustrate why Mexican, Native, and African Americans die at relatively high rates from social pathologies. (8) Extend the cause of death analysis to include both underlying and multiple causes of death. (9) Account for variations in ethnic mortality patterns by sex and age groupings. (10) Use continuous-time hazard rate models, which allow a multivariate examination of the risk of death by ethnic group. The ethnic differences in mortality that have so long persisted i n the U.S. represent a troubling and challenging question. While mortality differences between groups are continually better-documented, particularly between African and Caucasian Americans, the explanation of differences has been weak, particularly when numerous ethnic groups are compared. For example, so little is known about Mexican American mortality that their favorable mortality rates are often termed an "epidemiological paradox." Even less is known about the differing cause patterns of death exhibited by Asian and Native Americans. Thus, the principal purpose of this research is to explain ethnic differences in cause-specific mortality, using a model that relates demographic, socioeconomic, family structure, behavioral, and health history factors to both underlying and multiple cause mortality differentials. A more comprehensive and more specific model will make it easier to identify key areas where social programs, public policy, medical treatment, and future research can have the most beneficial effects.