Environmental Health Disparities in an Older Population

项目摘要/摘要 鉴于老年人前所未有的老龄化，了解老年人的环境健康差距至关重要 人口，预计到2030年，20%的美国人将达到65岁，老年人口将 种族和民族更加多元化。老年人更容易受到环境和社会因素的影响 经济状况(SES)因素，由于基线健康、新陈代谢变化或较大的累积暴露。 有害的环境暴露，如空气污染，经常发生在面临社会经济压力的社区 包括住房恶化、难以获得医疗保健、高失业率、犯罪和贫困，这些问题 可能会加剧对健康的负面影响。这一现象在低收入和少数族裔中最为明显 这是造成健康差距的根本原因。确定最有害的环境和社会因素，并 受影响最大的老年人亚群至关重要。尽管人们普遍认为 多种环境和SES因素影响健康，但对它们之间复杂的相互作用知之甚少。我们的 长期目标是调查环境和SES因素如何共同导致健康差距 在老年人口中。我们考虑两种不同但又相互关联的差异：1)暴露的差异 (例如，污染水平)对环境和SES因素的影响；以及2)健康反应的差异(例如，相对 风险)暴露于环境和SES因素。这项提议将调查人员聚集在一起， 研究环境健康差距以及相关的高级空间和统计分析的历史。 我们的目标是：1)计算暴露于环境和SES因素的差异，考虑到 单独和集体地，为密歇根州和北卡罗来纳州的老年人口(&gt；65Y)，并建立一个 用于分析的高分辨率时空数据体系结构；2)按子群体计算差异(例如， 种族/民族、年龄、性别、社区SES)环境和SES因素与原因之间的联系- 特定的心血管和呼吸系统急诊入院、急诊科就诊和 死亡率；以及3)结合暴露的差异和健康反应的差异来计算总体 环境健康差距。环境和一些SES因素通过以下方式代表可修改的风险 我们可以改善老龄化人口的健康状况。分析将确定以下最有效的重点 通过确定对环境影响最大的共同因素进行干预和政策参与 老年人的健康差距，从而直接促进NIEHS的使命，即发现 环境影响人们，以促进更健康的生活。

Project Summary/Abstract Understanding environmental health disparities for older persons is critical given the unprecedented aging of the population, with 20% of US persons anticipated to be >65y by 2030, and the elder population becoming more racially and ethnically diverse. Older persons can be more affected by environmental and socio- economic status (SES) factors due to baseline health, changing metabolism, or larger cumulative exposures. Harmful environmental exposures, such as air pollution, often occur in communities facing SES stressors including deteriorating housing, poor access to health care, high unemployment, crime, and poverty, which may exacerbate negative health effects. This phenomenon is most pronounced for low income and minority communities and underlies health disparities. Identifying the most harmful environmental and social factors and the subpopulations of elderly that are most affected is of paramount importance. Although it is widely agreed that multiple environmental and SES factors affect health, little is known about their complex interactions. Our long-term objective is to investigate how environmental and SES factors jointly contribute to health disparities in the older population. We consider disparities in two separate but related forms: 1) differences in exposures (e.g., pollution levels) to environmental and SES factors; and 2) differences in health response (e.g., relative risk) from exposures to environmental and SES factors. This proposal brings together investigators with a long history of working on environmental health disparities and related advanced spatial and statistical analyses. Our aims are to: 1) calculate differences in exposures to environmental and SES factors, considered individually and collectively, for an older population (>65y) in Michigan and North Carolina, and to construct a highly resolved spatio-temporal data architecture for analysis; 2) calculate differences by subpopulation (e.g., race/ethnicity, age, sex, community SES) for associations between environmental and SES factors and cause- specific emergency cardiovascular and respiratory hospital admissions, emergency department visits, and mortality; and 3) combine disparities in exposures and disparities in health response to calculate overall environmental health disparities. Environmental and some SES factors represent modifiable risks through which we can improve health in our aging population. Analyses will identify the most effective foci for intervention and policy engagement by identifying the most significant common contributors to environmental health disparities for the elderly, thereby directly contributing to NIEHS's mission to discover how the environment affects people in order to promote healthier lives.