The long-term health effects of the New Deal: An 80 year follow-up of 4 cohorts

7.项目概要/摘要 有大量的不确定性，如何重要的早期生活的家庭和社区条件是为了 晚年慢性病和衰老。虽然一些关于短期有益影响的研究支持 干预早期生活环境以改善健康的重要性，数据的局限性阻碍了长期 长期随访研究，因此，在多大程度上，早期生活政策的变化将导致下降的慢性 疾病和健康的老龄化是不清楚的。此外，一项实际社会政策的影响很少在 儿童期进行评估，这种方法有更明确的机会将这一证据转化为 为当前的社会政策提供信息。我们建议使用四项成熟的队列研究， 实现我们的研究目标的互补优势：1）收入动态的小组研究 （PSID），这是一个多代全国代表性的样本，2）美国铝业的数据，这是一个大的 地理位置多样化和完全保险的制造业工人队列，3）健康和退休研究 (HRS)，它遵循了美国老年人的全国代表性样本，以及4）妇女健康 倡议（WHI），它遵循了一个大的妇女群体。我们将使用这些数据源来检验 新政的工作救济支出对儿童的长期健康结果的成长在伟大的 萧条基于我们先前的研究，我们的中心假设是， 将与儿童慢性病的低水平和低死亡率相关， 家庭，但也适用于生活在获得更多福利的地区的非福利家庭的儿童。 新政资金。为了验证这一假设，我们提出了以下具体目标：目标1：创建样本 PSID、Alcoa、HRS和WHI数据与1940年人口普查样本框架的概率权重， 目标2：评估与研究之间的关联，并产生具有全国代表性的估计值， 父母新政工作救济参与对其子女晚年健康和死亡率的影响，目标3：确定 地区层面新政支出对儿童晚年健康和死亡率的溢出效应，目标4：检验 父母新政工作救济参与和地区一级新政的机制 支出与晚年健康和死亡率有关。我们研究提案的时机至关重要- 我们现在有机会研究新政工作救济对健康结果的长期影响， 这一群体的年龄更大。这可以说是我们了解社会的作用的最好机会之一， 政策可以在整个生命过程中发挥健康老龄化的作用。这一证据将在新的关键时刻提供， 地方和联邦各级正在考虑支出和基础设施的优先事项， 人口老龄化的疾病负担对医疗保健成本提出了新的挑战。

7. PROJECT SUMMARY / ABSTRACT There is substantial uncertainty about how important early life household and community conditions are for later life chronic disease and aging. While a number of studies of short-term beneficial impacts support the importance of intervening on the early life environment to improve health, data limitations have prevented long- term follow-up studies, thus the extent to which early life policy changes would lead to declines in chronic disease and healthier aging is unclear. In addition, it is rare that the impacts of an actual social policy in childhood are evaluated, an approach which has clearer opportunities for translation of this evidence for informing current social policy. We propose to use four well established cohort studies that have complementary strengths for accomplishing our study objective: 1) the Panel Study of Income Dynamics (PSID), which is a multi-generational nationally representative sample, 2) the Alcoa data, which follows a large geographically diverse and fully insured cohort of manufacturing workers, 3) the Health and Retirement Study (HRS), which follows a nationally representative sample of older Americans, and 4) the Women's Health Initiative (WHI), which follows a large cohort of women. We will use these data sources to examine the effects of New Deal work-relief spending on the long-term health outcomes of children growing up during the Great Depression. Our central hypothesis, based on our prior research, is that employment from New Deal programs will be associated with lower levels of chronic disease and lower mortality for both the children in benefitting households, but also for children in non-benefit households living in areas that received greater amounts of New Deal funding. To test this hypothesis we propose the following specific aims: Aim 1: Create sample probability weights for PSID, Alcoa, HRS and WHI data to the 1940 census sample frame to enable comparisons across studies and produce nationally representative estimates, Aim 2: Estimate the association of parental New Deal work-relief participation on their children's later life health and mortality, Aim 3: Determine the spillover effect of area-level New Deal expenditures on children's later life health and mortality, Aim 4: Test the mechanisms through which parental New Deal work-relief participation and area-level New Deal expenditures are associated with later life health and mortality. The timing of our research proposal is critical – we now have the opportunity to examine the long-term effects of New Deal work-relief on health outcomes as this cohort reaches older ages. It is arguably one of our best opportunities to understand the role that social policy can play in healthy aging over the life course. This evidence will be available at a critical time when new priorities for spending and infrastructure are being considered at local and federal levels, and the chronic disease burden of an aging population poses new challenges for medical care costs.