Explanations of Racial Disparities in Active Life

描述（由申请人提供）：我建议建立和解释积极预期寿命（ALE）的种族差异。健康和死亡率方面的种族差异长期以来一直是人口学家和社会科学家普遍感兴趣的问题，众所周知，非白人的健康状况较差，死亡率高于白人。ALE是一种将健康和死亡率信息结合起来的一种措施，它简明扼要地总结了我可以在没有残疾的情况下生活的剩余生命。最近的研究调查了ALE的种族差异，但在几个方面受到严重限制。首先，研究没有考察ALE患者的生命历程模式；相反，研究集中在一个特定年龄（例如，65岁）的不平等。然而，理论上有理由认为ALE差异会随着年龄的变化而变化（例如，异质性和选择）。其次，对ALE中种族不平等的研究还没有统计学意义。现有的方法只能对ALE产生点估计。然而，鉴于大多数健康和残疾数据来自抽样调查，跨种族ALE的有效比较必须是统计上的。第三，部分由于无法进行统计比较，当代研究对ALE中种族不平等的解释仍然完全没有调查。我建议通过使用最近开发的贝叶斯方法来生成多状态生命表来弥补这些缺点，该方法允许包含协变量并能够构建ALE和其他生命表数量的区间估计。使用这种方法，我将首先构建ALE中总种族差异的区间估计。其次，作为这个过程的一部分，我将研究ALE中种族不平等的年龄模式，以确定白人和非白人的ALE估计在中年后是趋同还是分化。第三，我将开始通过考虑社会经济地位的中介作用来解释ALE中的种族差异，并且我将扩大调查以解释ALE中种族不平等的年龄模式。这项工作将作为对更广泛的研究的初步调查，以检验晚年健康的其他指标。我打算申请R01拨款，以研究更普遍的“健康预期寿命”概念，到目前为止，这在很大程度上是ALE的同义词。很少有人调查过没有残疾的剩余寿命以外的现象，但研究应该开始调查更普遍的健康状况良好的剩余寿命，或没有特定慢性病或病症的剩余寿命。

DESCRIPTION (provided by applicant): I propose to establish and explain racial differences in Active Life Expectancy (ALE). Racial disparities in health and mortality have long been of interest to demographers and social scientists more generally, and it is well known that nonwhites have poorer health and higher mortality rates than whites. ALE is a measure that combines both health and mortality information into a concise summary of remaining life that 1 can expect to live free from disability. Recent research has investigated racial differences in ALE but has been severely limited in several ways. First, studies have not examined life course patterns in ALE; instead, research has focused on inequalities at 1 particular age (e.g., at 65). Yet there are theoretical reasons to expect ALE differences to change across age (e.g., heterogeneity and selection). Second, studies of racial inequality in ALE have not been statistical. Extant methods only produce point estimates for ALE. Given that most health and disability data are from sample surveys, however, valid comparisons of ALE across race must be statistical. Third, in part because of the inability to make statistical comparisons, explanations of racial inequalities in ALE remain completely uninvestigated in contemporary research. I propose to remedy these shortcomings by using a recently developed Bayesian approach to generating multi-state life tables that allows the inclusion of covariates and enables the construction of interval estimates of ALE and other life table quantities. Using this approach, I will first construct interval estimates of gross racial differences in ALE. Second, as part of this process, I will examine age patterns in racial inequality in ALE to determine whether white and nonwhite ALE estimates converge or diverge past midlife. Third, I will begin to explain racial differences in ALE by considering the mediating role of socioeconomic status, and I will expand the investigation to explain age patterns in racial inequality in ALE. This work will serve as a preliminary investigation into more general research examining other measures of health in later life. I intend to apply for an R01 grant in order to examine a more general concept of "healthy life expectancy," which, to date, has been largely synonymous with ALE. Few have investigated phenomena other than remaining life spent free from disability, but research should begin investigating remaining life spent more generally in good health, or remaining life spent free from specific chronic diseases or conditions.