Social distress in midlife in Arizona: a mixed methods ethnographic case study

亚利桑那州中年社会困境：混合方法民族志案例研究

• 批准号: 1658528
• 负责人: Michelle Parsons
• 金额: $ 14.18万
• 依托单位: Northern Arizona University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1658528&HistoricalAwards=false
• 关键词: Social; distress; midlife; Arizona; mixed

Recently, epidemiologists have uncovered an unwelcome and unusual health trend in the United States: increasing death rates among non-Hispanic whites since 1999. This is a significant and sustained reversal of previous trends. Historically, increases in mortality have rarely occurred outside of war or epidemics. The rise was not seen for any other American ethnic group or in any other high income country. It is most severe among men and women who are 45 to 54 years of age, have a high school education or less, and are living in smaller metro and rural areas in the South and West census regions. It appears to be the result of increases in suicides and drug and alcohol abuse. However, the statistics can only reveal patterns. To get at underlying causes, it is necessary to also have smaller studies of social context and the distress driving the crisis. The research funded by this award addresses this need. Medical anthropologist Dr. Michelle A. Parsons, of Northern Arizona University, will undertake an ethnographic case study of life threatening social distress among middle-aged non-Hispanic whites in Arizona.Dr. Parsons' preliminary hypothesis is that distress is associated with social integration, in particular a feeling of not being needed or not being useful, which is produced through specific political, economic, cultural, and institutional structures. She will explore this hypothesis with a mixed methods ethnographic case study. The research will be carried out among a midlife generation with lower levels of education in Yavapai County, which has one of the highest age-standardized midlife suicide rates in Arizona and is among the top ten highest rates among all U.S. counties. She will draw her sample from employees of the social institutions that are the largest employers in the county: healthcare institutions, government institutions, and social service providers. Methods include secondary analysis of publicly available datasets, participant observation, archival research, key informant interviews (n=40), structured interviews (n=200), and semi-structured in-depth interviews (n=80). A community advisory board will work with the research team and help with dissemination of research results and recommendations to county and state health and government organizations. The broader impacts of the research are threefold. First, findings from the study will improve understanding of midlife distress in an area of the U.S. with a very high rate of midlife suicide. This will enable recommendations for multilevel interventions to reduce distress and mortality. The research also will elucidate the social context of rising mortality, identifying factors potentially related to mortality increases in other areas of the United States. Finally, the project will advance knowledge in medical anthropology, sociology, and other disciplines, including public health, epidemiology, and clinical psychology.

最近，流行病学家发现了美国一个不受欢迎和不寻常的健康趋势：自1999年以来，非西班牙裔白人的死亡率不断上升。 这是对以往趋势的重大和持续逆转。从历史上看，死亡率的增加很少发生在战争或流行病之外。这一增长在任何其他美国族裔群体或任何其他高收入国家都没有出现。在南部和西部人口普查区，45至54岁、高中或以下学历、居住在较小的城市和农村地区的男子和妇女中，这种情况最为严重。这似乎是自杀、吸毒和酗酒增加的结果。 然而，统计数字只能揭示模式。为了找到根本原因，还需要对引发危机的社会背景和痛苦进行较小规模的研究。该奖项资助的研究解决了这一需求。医学人类学家Michelle A.北方亚利桑那大学的帕森斯将对亚利桑那州中年非西班牙裔白人中危及生命的社会困境进行民族志案例研究。帕森斯博士的初步假设是，困境与社会融合有关，特别是通过特定的政治、经济、文化和制度结构产生的不被需要或无用的感觉。她将探索这一假设与混合方法人种学案例研究。这项研究将在亚瓦派县教育水平较低的中年一代中进行，该县是亚利桑那州年龄标准化中年自杀率最高的县之一，也是美国所有县中自杀率最高的前十名。她将从社会机构的雇员中抽取样本，这些机构是该县最大的雇主：医疗机构、政府机构和社会服务提供者。方法包括公开数据集的二次分析，参与者观察，档案研究，关键线人访谈（n=40），结构化访谈（n=200），和半结构化的深入访谈（n=80）。一个社区咨询委员会将与研究小组合作，帮助向县和州卫生和政府组织传播研究结果和建议。这项研究的广泛影响有三个方面。首先，这项研究的发现将提高对美国中年自杀率非常高的地区中年痛苦的理解。这将有助于提出多层次干预建议，以减少痛苦和死亡率。这项研究还将阐明死亡率上升的社会背景，确定与美国其他地区死亡率上升有关的潜在因素。 最后，该项目将推进医学人类学，社会学和其他学科的知识，包括公共卫生，流行病学和临床心理学。

项目成果

Thinking about Social Determinants of Health through the Relationality of Work and Drug Use

通过工作与吸毒之间的关系思考健康的社会决定因素

• DOI: 10.1111/maq.12690
• 发表时间: 2022
• 期刊: Medical Anthropology Quarterly
• 影响因子: 2.2
• 作者: Parsons, Michelle Anne

The US Mortality Crisis: An Examination of Non-Hispanic White Mortality and Morbidity in Yavapai County, Arizona

• DOI: 10.1007/s10900-019-00648-3
• 发表时间: 2019-08-01
• 期刊: JOURNAL OF COMMUNITY HEALTH
• 影响因子: 5.9
• 作者: Parsons, Michelle Anne;Barger, Steven D.
• 通讯作者: Barger, Steven D.