CHANGES IN HEALTH: SOCIO-ECONOMIC STATUS AND PATHWAYS

超出所提供的空间。在美国、英国和其他工业化国家，死亡率、发病率和健康功能方面的社会阶层差异仍然存在。实际上，就死亡率而言，差距可能正在扩大。这种健康方面的社会经济梯度贯穿整个生命周期，一直持续到第八个十年。健康随年龄的变化与重要的环境决定因素具有异质性，其中包括社会经济地位。我们将确定与年龄和社会经济地位有关的健康变化的模式和决定因素。此外，我们将检查个人健康随年龄变化的原因和后果是否与横断面发现的不同。在英国的公务员制度中，发病率和死亡率呈相反的社会梯度。白厅二期研究的长期目标是解释这些健康方面的社会经济差异。WhitehallII对10308名年龄在35-55岁的国家公务员（1985-1988年）进行了研究，以检查具体的社会心理、生活方式、生化和生理因素作为这些不平等的可能解释的作用。这些暴露的真实年龄相关变化，或纵向测量的累积暴露，被假设为预测SES健康差异随年龄的变化。在该队列的10年随访中，NIA支持资助数据收集，以重复健康功能、消化功能、代谢综合征组成部分和ApoE基因分型的结果测量。该提案的目的是：1。描述和解释与社会经济地位有关的健康状况随年龄变化的模式。2. 确定退休前和退休后的健康功能梯度是否不同。3. 探讨社会经济地位与认知功能随年龄变化的关系。4. 通过研究SES随年龄变化的原因和后果，来研究与SES相关的特定生物学途径。针对这些问题，白厅II的研究有其独特之处，它提出：公务员就业等级是衡量SES的绝佳指标；纵向设计，参与者在进入时相对年轻，允许检测变化的前因；暴露的重复测量；广泛的暴露数据；检测与年龄相关的变化及其与SES的相互作用的强大能力；广泛的健康结果，包括健康和认知功能，代谢综合征的组成部分，死亡率，非致命诊断和疾病缺勤。我们现在请求资助，以分析迄今收集的数据，并为该队列15年随访的具体内容作出贡献。在NIA对第7阶段的支持下，我们将能够在白厅II的基础上进行建设。它将使我们能够积累更多的终点，跟踪老年时的健康功能，将它们与早期生活和中年接触的情况联系起来，从而使我们能够确定疾病和健康不平等的社会心理和生物学途径。（组织，城市，州）国际健康与社会中心伦敦大学学院流行病学与公共卫生系1-1!)托灵顿校区的地方伦敦WC1E 6 bt关键人员 ======================================== 节结束 ===========================================

EXCEED THE SPACE PROVIDED. Social class differences in mortality, morbidity and health functioning persist in the USA, UK and other industrialized countries. Indeed for mortality they may be widening. Such socioeconomic (SES) gradients in health are present throughout the lifespan persisting into the eighth decade. Changes of health with age are heterogeneous with important environmental determinants, which include SES. We will establish patterns and determinants of change of health in relation to age and SES. Further, we will examine whether the causes and consequences of within-person changes of health with age are different from those found cross-sectionally. In the British civil service there is an inverse social gradient in morbidity and mortality. The broad long term objective of the Whitehall II study is to explain these socioeconomic differences in health. The WhitehallII study of 10 308 male and female civil servants, aged 35-55 years at sntry (1985-1988), was established to examine role of specific psychosocial, lifestyle, biochemical and physiological factors as possible explanations of these inequalities. True age related changes in these exposures, or cumulative exposure measured longitudinally, are hypothesized to predict changes in SES differences in health with age. At the 10 year follow up of the cohort, NIA support funded collection of data to repeat outcome measures of health functioning, costive functioning, components of the metabolic syndrome and ApoE genotyping. The aims of the proposal are: 1. To describe and explain patterns of change with age in health status in relation to SES. 2. To determine if the gradient in health functioning differs from pre-retirement to retirement. 3. To examinethe relationship between SES and change in cognitive function with age. 4. to investigate specific biological pathways linking SES by examining the causes and consequences of their change with age. The Whitehall II study is uniquely po:ised to address these questions, offering: civil service employment grade as an excellent measure of SES; longitudinal design with participants comparatively young at entry allowingthe detection of antecedents of change; repeated measures of exposures; a wide range of exposure data; substantial power to detect age-related change, and its interaction with SES; wide range of health outcomes includinghealth and cognitive functioning, components of the metabolic syndrome, mortality, non-fatal diagnoses and sickness absence. We now request funding to analyze the data collected to date and to contribute to specific elements of the 15year follow-up of the cohort. With NIA support for Phase 7, we will be able to build on Whitehall II. It will enable us to accumulate more endpoints and track health functioning into older age, relate them to early life and mid-life exposures, and thereby allow us to establish psychosocial and biological pathways of disease and health inequalities. PERFORMANCE S\TG(S)(organization, city, state) International Centre for Health & Society DepC of Epidemiology & Public Health University College London 1-1!) Torrington Place London WC1E 6BT KEY PERSONNEL ========================================Section End===========================================