Older adults in vulnerable communities: Health and quality of life over time

弱势社区的老年人：随着时间的推移健康和生活质量

• 批准号: 10327333
• 负责人: KAREN Ilene FREDRIKSEN-GOLDSEN
• 金额: $ 57.2万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10327333
• 关键词: Accounting; Address; Adult; Affect; African American population; Age; Aging; American; Biological; Biological Markers; Blood Pressure; C-reactive protein; Censuses; Cessation of life; Cholesterol; Chronic; Cognitive; Collaborations; Communities; Community Health; Community Surveys; Cost efficiency; Data; Demographic Factors; Development; Elderly; Ensure; Ethnic Origin; Funding; Gender; Gender Identity; Health; Health Care Costs; Health Expenditures; Health and Retirement Study; Heterogeneity; High Density Lipoprotein Cholesterol; Hispanic Populations; Hydrocortisone; International; Intervention; Journals; Lesbian Gay Bisexual Transgender; Life Cycle Stages; Link; Longitudinal Studies; Longitudinal Surveys; Measures; Mediating; Mental Health; Mentors; Modeling; National Health Interview Survey; Outcome; Parents; Pattern; Peer Review; Personal Satisfaction; Physical activity; Population; Population Study; Predictive Factor; Public Health; Publishing; Quality of life; Race; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Sampling; Sampling Biases; Sex Orientation; Sexual and Gender Minorities; Sexuality; Social Network; Social status; Stress; Subgroup; Surveys; Time; Training; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Universities; Waist-Hip Ratio; Work; aged; allostatic load; barrier to care; base; cohort; cost efficient; course development; design; disability; disadvantaged population; early onset; feasibility testing; follow-up; gender minority group; glycosylated hemoglobin C; health disparity; health disparity populations; health equity promotion; health related quality of life; health service use; high risk; improved; indexing; innovation; marginalized population; multidisciplinary; multiple chronic conditions; physical conditioning; population based; premature; protective factors; recruit; retention rate; sex; sexual identity; sexual minority women; social stigma; success; support network; therapy development; transgender; vulnerable community

The dramatically escalating number and diversity of older adults are defining features of the world-wide population. Research demonstrates that older adults from marginalized and disadvantaged populations are at elevated risk of accelerated aging and premature death. The National Institutes of Health are committed to reducing and eliminating health disparities and have recognized that health disparities among sexual and gender minority people are one of the main gaps in health research. Recent population-based studies have demonstrated that sexual and gender minority older adults are at elevated risks of chronic health conditions, disability, and poor physical and mental health-related quality of life (HRQOL). The proposed longitudinal research will follow more than 2,300 demographically diverse LGBT adults aged 50 or older recruited from all U.S. Census divisions. Based on an innovative health equity promotion framework incorporating a life course development perspective, this study will examine the risk and protective factors affecting the health and well- being of LGBT older adults over time. This multidisciplinary national research team, in collaboration with community-based partner agencies, addresses a critical gap by identifying modifiable mechanisms impacting health and HRQOL over time. Utilizing 8 years of longitudinal survey data and objective data (biomarkers and physical and cognitive measures) and linking with administrative data from Centers for Medicare & Medicaid Services, the primary aims of the project are: 1) Identify at-risk LGBT older adults by investigating trajectories of health outcomes over time, their relationships with stigma, and the mediating roles of stress; 2) Understand modifiable mechanisms accounting for variability in changes in health outcomes by examining the roles of identity management, social networks, physical activity, and barriers to health care as well as health service utilization; and 3) Examine disparities in multimorbidity, disability, and HRQOL by demographic factors (age cohort, sex, gender identity, sexual orientation, and race/ethnicity) and risk and protective factors that account for health disparities. This study also harmonizes with external population-based data including Health and Retirement Study, National Health Interview Survey, and American Community Survey to enhance the study and ensure cost efficiency. As the older adult population increases, the health care costs associated with health disparities will continue to rise. To respond to this growing public health challenge it is imperative to identify groups at high risk of disparities and to determine the modifiable mechanisms impacting their health and well-being as they age. The findings from this research will generate much needed information to directly inform and guide the development of tailored interventions that can be effectively delivered within community- based agency settings to improve the health and quality of life of demographically diverse older adults.

老年人的数量和多样性急剧增加是世界范围内的决定性特征 人口。研究表明，来自边缘化和弱势群体的老年人处于 加速衰老和过早死亡的风险增加。美国国立卫生研究院致力于 减少和消除健康差距，并认识到性别和性别之间的健康差距 性别少数群体是健康研究的主要差距之一。最近基于人群的研究表明 表明性少数群体和性别少数群体老年人患慢性病的风险较高， 残疾以及与身心健康相关的生活质量 (HRQOL) 较差。拟议的纵向 研究将从所有地区招募超过 2,300 名年龄在 50 岁或以上、具有不同人口特征的 LGBT 成年人。 美国人口普查部门。基于纳入生命全程的创新健康公平促进框架 从发展的角度来看，本研究将探讨影响健康和福祉的风险和保护因素 随着时间的推移，LGBT 老年人的数量不断增加。这个多学科国家研究团队与 基于社区的合作伙伴机构，通过确定影响的可修改机制来解决关键差距 随着时间的推移，健康状况和 HRQOL 也会随之变化。利用8年的纵向调查数据和客观数据（生物标志物和 身体和认知测量）并与医疗保险和医疗补助中心的管理数据相关联 服务，该项目的主要目标是： 1) 通过调查轨迹来识别高危 LGBT 老年人 随着时间的推移，健康结果、它们与耻辱的关系以及压力的中介作用； 2）理解 通过检查以下因素的作用来解释健康结果变化的可变性机制 身份管理、社交网络、体育活动以及医疗保健和卫生服务的障碍 利用； 3) 按人口因素（年龄）检查多种疾病、残疾和 HRQOL 的差异 群体、性别、性别认同、性取向和种族/民族）以及风险和保护因素 对于健康差异。这项研究还与外部基于人群的数据相一致，包括健康和 退休研究、全国健康访谈调查和美国社区调查以加强研究 并确保成本效率。随着老年人口的增加，与老年人口相关的医疗费用 健康差距将继续扩大。为了应对这一日益严峻的公共卫生挑战，当务之急是 确定存在差异高风险的群体，并确定影响其健康的可修改机制 以及随着年龄增长的幸福感。这项研究的结果将产生急需的信息，以直接 为制定可在社区内有效实施的量身定制的干预措施提供信息和指导 旨在改善人口多样化老年人的健康和生活质量的机构设置。