Understanding the role of structural racism and intergenerational wealth on obesity outcome

了解结构性种族主义和代际财富对肥胖结果的作用

• 批准号: 10458274
• 负责人: Shanise Erika Owens
• 金额: $ 4.04万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10458274
• 关键词: Accounting; Address; Adult; Aptitude; Area; Back; Black American; Black race; Body mass index; Cardiovascular Diseases; Categories; Characteristics; Chronic; Chronic Disease; Cohort Effect; Data Set; Degenerative polyarthritis; Depressed mood; Development; Diabetes Mellitus; Discrimination; Economic Policy; Environment; Family; Federal Government; Future Generations; Generations; Geography; Goals; Health; Health Policy; Healthcare; Healthcare Systems; Home; Household; Hypertension; Income; Individual; Inequality; Institutional Racism; Intervention; Kidney Diseases; Knowledge; Lead; Life Cycle Stages; Link; Literature; Longevity; Malignant Neoplasms; Mediating; Mediation; Mentorship; Natural experiment; Nature; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Outcome; Pathway interactions; Plant Roots; Play; Policies; Policy Maker; Process; Property; Public Health; Quasi-experiment; Race; Research; Research Personnel; Risk; Risk Factors; Role; Socioeconomic Status; Specific qualifier value; Stroke; Structural Racism; Testing; Training; United States; Woman; base; caucasian American; cost; deprivation; econometrics; economic determinant; ethnic minority; experience; health data; health disparity; high risk; intergenerational; middle age; minority communities; mortality; obesity risk; obesogenic; panel study of income dynamics; prevent; preventable death; racial disparity; racial health disparity; racial minority; racism; segregation; skills; social; social determinants; social health determinants; trend

PROJECT SUMMARY/ABSTRACT Obesity is a preventable cause of early mortality and poses a significant cost burden to public health and health care systems. Obesity increases risk for several chronic conditions including kidney disease, hypertension, diabetes, cardiovascular disease, osteoarthritis, stroke, and preventable cancers. Disparities in obesity by racialized groups are marked, yet only a small body of literature has interrogated the role of structural racism in the creation of obesity disparities. This research aims to determine the plausible causal role that one form of structural racism—“redlining”, or the process of categorizing neighborhoods into race-based credit risk levels instigating discriminatory mortgage lending practices–plays in creating wealth inequality and obesity disparities over the life course. Using the geographical nature of Home Owners’ Loan Corporation (HOLC) racialized mortgage credit risk categories (e.g., redlined areas) provides an opportunity for a good natural experiment to evaluate the plausible causal impacts of the manifestation of neighborhood-level structural racism and its long-term consequences. Our specific aims are: 1) To identify the impact of neighborhood-level structural racism and intergenerational wealth accumulation; 2) To test the effect of structural racism on obesity over multiple generations; and 3) To test the mediating role of intergenerational wealth on the causal relationship between structural racism and obesity outcomes in adults. Our overarching hypothesis is that federally supported racialized “redlining” policies effectively prohibited Black Americans from building wealth in their homes, leading to decades of divestment in predominately Black neighborhoods and contributing to the development of obesogenic environments, and ultimately obesity risk over the life course. We leverage the longitudinal nature of the Panel Study for Income Dynamics (PSID) to implement a life course approach for assessing generational wealth inequality and obesity disparities and use a quasi-experimental design which circumvents the use of random assignment of the exposure variable. Aims 1 and 2 will use the actual boundaries of the “redlined” neighborhoods to conduct a geographical regression discontinuity (GRD) which addresses endogeneity of neighborhood characteristics by specifying a spatial or geographical boundary split with a marked threshold. Aim 3 will investigate the indirect effects of each generation of wealth accumulation on neighborhood-level structural racism and body mass index (BMI) outcomes. Results will contribute to understanding why health disparities exist for racialized minority communities by identifying how specific pathways operate through structural racism to create racialized inequities in obesity outcomes. Implications from this research will help identify consequences of structural racism and can help to lead to full accounting of the impacts, as well as identify corrective economic and health policy interventions that address inequalities in wealth and obesity disparities in middle-aged adults.

项目总结/摘要 肥胖是一种可预防的早期死亡原因，并对公共卫生和 医疗保健系统。肥胖会增加患包括肾脏疾病在内的多种慢性疾病的风险， 高血压、糖尿病、心血管疾病、骨关节炎、中风和可预防的癌症。差距 肥胖的种族化群体是显着的，但只有一小部分文献已经询问的作用， 结构性种族主义在肥胖差异的形成中的作用。本研究旨在确定合理的因果关系 一种形式的结构性种族主义-“红线”，或分类的过程中，以种族为基础的社区， 信贷风险水平煽动歧视性抵押贷款做法-在创造财富不平等和 肥胖在生命过程中的差异。利用自置居所贷款公司的地理性质 （HOLC）种族化的抵押贷款信用风险类别（例如，红线区域）提供了一个良好的机会， 自然实验，以评估邻里水平的表现的合理因果影响， 结构性种族主义及其长期后果。我们的具体目标是：（1）确定 邻里层面的结构性种族主义和代际财富积累; 2）测试的效果， 多代人肥胖的结构性种族主义;和3）测试代际的中介作用， 财富之间的因果关系结构性种族主义和肥胖的结果在成年人。我们的总体 一种假设是，联邦政府支持的种族化“红线”政策有效地禁止了美国黑人 在他们的家中积累财富，导致几十年来在黑人占主导地位的社区撤资， 导致肥胖环境的发展，并最终导致整个生命过程中的肥胖风险。 我们利用收入动态小组研究（PSID）的纵向性质来实施生命历程 评估代际财富不平等和肥胖差异的方法，并使用一个准实验 避免使用暴露变量随机分配的设计。目标1和2将使用 “红线”附近的实际边界，以进行地理回归不连续性（GRD） 其通过指定空间或地理边界来解决邻域特征的内边界化 以一个明显的阈值分裂。目标3将调查每一代财富的间接影响 社区层面的结构性种族主义和身体质量指数（BMI）结果的积累。结果将 通过确定如何帮助理解种族化少数群体社区存在健康差异的原因 具体途径是通过结构性种族主义造成肥胖结果方面的种族不平等。 这项研究的意义将有助于确定结构性种族主义的后果，并有助于导致全面的 对影响进行核算，并确定纠正性的经济和卫生政策干预措施， 中年人的财富不平等和肥胖不平等。