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Understanding the impact of structural racism on racial/ethnic inequities in mortality: The Multiethnic Cohort Study

了解结构性种族主义对种族/民族死亡率不平等的影响：多民族队列研究

基本信息

批准号：
10531782
负责人：
Iona C Cheng
金额：
$ 56.77万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-24 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10531782
关键词：
Address Adult Alaska Native Alcohol consumption Alcohols Alzheimer&apos s Disease American American Indians Asian Americans Attention Black Populations Black race California Cardiovascular Diseases Cause of Death Censuses Cessation of life Chronic Cities Cohort Studies Communities Community Surveys Criminal Justice Data Development Diabetes Mellitus Diet Discrimination Disease Education Employment Environment Environmental Hazards Ethnic Origin Ethnic group Exposure to Geography Hawaii Hawaiian population Health Health behavior Healthcare Hispanic Housing Individual Institution Intervention Investigation Japanese American Knowledge Latino Life Longevity Malignant Neoplasms Measures Mediating Methods Native Hawaiian Neighborhoods Not Hispanic or Latino Outcome Pacific Islander Participant Physical activity Policies Policy Maker Politics Population Population Study Premature Mortality Prospective Studies Race Research Research Personnel Respiratory Disease Scientist Smoking Social support Socioeconomic Status Source Structural Racism Subgroup System Tobacco cohort comorbidity density experience follow-up health inequalities improved indexing mortality mortality risk multi-ethnic multidisciplinary novel racial and ethnic residential segregation segregation sex socioeconomic disadvantage socioeconomics years of life lost

项目摘要

ABSTRACT Structural racism is a fundamental cause of the persistent and pervasive racial/ethnic inequities in mortality. Minoritized racial/ethnic groups experience structural racism via a system of mutually reinforcing institutions that perpetuates inequities in health through policies, practices, and norms across the domains of housing, education, employment, criminal justice, political participation, and healthcare. Yet, few studies have investigated the contribution of mutually reinforcing institutions across multiple domains of structural racism on inequities in mortality for multiple minoritized racial/ethnic populations. We propose to investigate the impact of multiple domains of structural racism on racial/ethnic-specific mortality for Black (n=30,834), Hispanic/ Latino (n=43,538), Japanese American (n=45,115) and Native Hawaiian (n=8,202) adults in the Multiethnic Cohort (MEC) Study using novel, racial/ethnic-specific composite measures of structural racism at the geographic level of city, town, or Census designated place. The composite measure will include indicators from multiple domains including housing, education, employment, criminal justice, political participation and health care. Specifically we aim to examine the impact of these composite measures of structural racism on all- cause mortality (Aim 1) and cause-specific mortality (Aim 2) for Black, Hispanic/Latino, Japanese American, and Native Hawaiian participants in the MEC and estimate years of life lost due to structural racism. In addition, we will use causal inference methods to investigate whether neighborhood disinvestment, discrimination, social support, health behaviors, and comorbidities mediate the associations between structural racism and mortality, and investigate these associations across subgroups defined by sex, life stage, and socioeconomic status. We will seek guidance from a multidisciplinary External Advisory Board and regional and racial/ethnic-specific Community Advisory Boards in the development of composite measures of structural racism, interpretation of study findings, and dissemination of the study measures and results. The findings from the proposed study will provide key evidence of the specific interacting institutions that should be targeted to improve the lifespan for Black, Hispanic/Latino, Japanese American, and Native Hawaiian populations. The impact of this research is high as it will have translational relevance in providing empirical evidence for community stakeholders, policy makers, and implementation scientists to direct interventions for reducing premature mortality specific to minoritized racial/ethnic groups.

摘要