The Importance of Place in Determining Health and Mortality at Older Ages

U项目摘要 出生地在决定老年人健康和死亡率中的重要性 老年、健康和死亡率方面的严重空间不平等是有据可查的。以前的研究 将老年健康与同时代的空间背景联系起来。然而，到了老年，超过三分之一的人口- 他们已经离开了出生地，更多的人离开了出生地，留下了解释-- 地理和健康之间的轻蔑联系因内生的流动性和忽视而蒙上阴影 儿童时期暴露在造成整个生命过程中健康的空间不平等方面的重要性 步入老年。成功地揭示了生命过程的暴露和决定导致衰老的重要性 空间不平等有可能为基础科学和政策做出贡献，但努力一直很有限-- 由于缺乏包含出生地信息的大型数据集，这一问题受到了困扰。我们的建议利用了新的好处- 20世纪初至20世纪中期出生的500多万美国人的出生地点的可靠数据 我们团队的跨学科背景融合了人口学、经济学、人口健康和流行病- 老年发病率和死亡率过程学。我们的总体目标是在多大程度上揭示 出生年龄、种族/民族、性别和受教育程度导致老年健康不平等-- 美国的民族成就，并探索这些关系背后的机制U。我们的再- 搜索团队将利用最新发布的独特纵向数据，这些数据涉及多个领域的数百万人 包含对老年健康过程和早期疾病暴露机制的丰富测量的数据集， 累积的背景劣势和生命过程的流动性。使用这些数据，我们将实现以下目标 目标：(1)目标1：编制“出生地点对老年死亡率和发病率的影响图集”，(2)阻止- 出生地点对不同性别、种族/年龄的高龄人群健康差异和死亡率变化的影响 以及(3)揭示出生地和以后出生地之间的联系机制 通过关注机动性以及早期和累积的暴露来保持健康。总而言之，这些目标将允许一个范例 通过将生命过程和空间分析整合到大范围内，我们对老年健康过程的理解发生了转变 老年健康和死亡率的模式和机制的标度分析。

UProject Summary Title: The Importance of Place of Birth in Determining Health and Mortality at Older Ages Substantial spatial inequalities in old age health and mortality outcomes are well documented. Previous studies have linked old age health to contemporaneous spatial context. However, by old age, over a third of the popu- lation has left their state of birth and an even greater share has left their county of birth, leaving the interpreta- tion of contemptuous links between geography and health clouded by endogenous mobility and disregarding the importance of childhood exposures in producing the spatial inequalities in health across the life course and into old age. Successfully unraveling the importance of life course exposures and decisions producing old age spatial inequalities has the potential to contribute to basic science as well as policy, but efforts have been ham- pered by a lack of large datasets with place of birth information. Our proposal takes advantage of newly avail- able data on place of birth for over 5 million Americans born across the early to mid 20PthP century combined with our team's interdisciplinary background merging the demography, economics, population health, and epidemi- ology of old age morbidity and mortality processes. UOur overall aim is to uncover the extent to which place of birth has contributed to old age health inequalities by birth cohort, race/ethnicity, sex, and educa- tional attainment in the US, and to explore the mechanisms underlying these relationshipsU. Our re- search team will leverage newly released and unique longitudinal data on millions of individuals across multiple datasets containing rich measures of health processes in old age and mechanisms of early disease exposures, cumulative contextual disadvantage, and life course mobility. Using these data, we will Upursue the following aimsU: (1) Aim 1: Create an “Atlas of Birth Place Impacts on Mortality and Morbidity at Older Ages”, (2) Deter- mine the Influence of Birth Place on Health Disparities and Mortality Variation at Older Ages by sex, race/eth- nicity, and education and (3) Uncover mechanisms linking the relationship between place of birth and later health by focusing on mobility and early and cumulative exposures. Together, these aims will allow a paradigm shift in how we understand old age health processes by integrating life course and spatial analysis into large scale analyses of the patterns and mechanisms of old age health and mortality.