Environmental Health Disparities in an Older Population

项目总结/摘要 鉴于人口老龄化程度前所未有，了解老年人在环境健康方面的差异至关重要。 人口，预计到2030年，20%的美国人将超过65岁，老年人口将成为 种族和民族更加多样化。老年人更容易受到环境和社会因素的影响， 由于基线健康、代谢变化或累积暴露量较大而导致的经济状况（SES）因素。 有害的环境暴露，如空气污染，经常发生在面临社会经济地位压力的社区 包括不断恶化的住房、难以获得医疗保健、高失业率、犯罪和贫困， 可能会加剧对健康的负面影响。这种现象在低收入和少数民族中最为明显 社区和基础的健康差距。确定最有害的环境和社会因素， 受影响最严重的老年人群体至关重要。尽管人们普遍认为 尽管有多种环境和社会经济地位因素影响健康，但人们对它们之间复杂的相互作用知之甚少。我们 长期目标是调查环境和社会经济地位因素如何共同导致健康差异 在老年人口中。我们考虑两种独立但相关形式的差异：1）暴露差异 (e.g.,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。这项提案将调查人员与长期的 研究环境健康差异的历史以及相关的高级空间和统计分析。 我们的目标是：1）计算暴露于环境和SES因素的差异，考虑 在密歇根州和北卡罗来纳州，对老年人口（> 65岁）进行个体和集体研究，并构建一个 用于分析的高分辨率时空数据体系结构; 2）计算子群体的差异（例如， 种族/民族、年龄、性别、社会经济地位）之间的联系，环境和社会经济地位因素和原因- 特定的心血管和呼吸系统急诊入院、急诊科就诊，以及 联合收割机将暴露差异和健康反应差异结合起来， 环境卫生差距。环境和某些SES因素代表了可改变的风险， 我们可以改善我们老龄化人口的健康状况。分析将确定最有效的焦点， 通过确定最重要的共同环境贡献者， 老年人的健康差距，从而直接有助于NIEHS的使命，以发现如何 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.