Explanations of Racial Disparities in Active Life

描述(由申请人提供)：我建议建立并解释预期寿命的种族差异(ALE)。长期以来，人口学家和社会科学家一直对健康和死亡率方面的种族差异感兴趣，众所周知，非白人的健康状况比白人差，死亡率比白人高。ALE是一种将健康和死亡信息结合在一起的衡量标准，它简明扼要地总结了人们可以预期无残疾生活的剩余寿命。最近的研究调查了ALE的种族差异，但在几个方面受到了严重限制。首先，研究没有研究老年痴呆的生命过程模式；相反，研究集中在一个特定年龄(例如，65岁)的不平等。然而，有理论上的理由可以预期ALE的差异会随着年龄的变化而变化(例如，异质性和选择性)。其次，对ALE中种族不平等的研究并不是统计学上的。现有的方法只为ALE产生点数估计。然而，鉴于大多数健康和残疾数据来自抽样调查，不同种族的ALE的有效比较必须是统计的。第三，部分由于无法进行统计比较，在当代研究中，对ALE中种族不平等的解释仍然完全没有得到调查。我建议通过使用最近开发的贝叶斯方法来弥补这些缺点，以生成多状态生命表，该方法允许包括协变量并能够构建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中总体种族差异的区间估计。其次，作为这一过程的一部分，我将检查ALE种族不平等的年龄模式，以确定白人和非白人ALE的估计在中年后是趋同还是背离。第三，我将通过考虑社会经济地位的中介作用来开始解释ALE中的种族差异，并将扩大调查范围，以解释ALE中种族不平等的年龄模式。这项工作将作为对更一般的研究的初步调查，这些研究考察了其他衡量晚年健康的指标。我打算申请R01拨款，以便研究更普遍的“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。除了没有残疾的余生之外，很少有人研究其他现象，但研究应该开始调查更普遍的健康余生，或者没有特定慢性病或疾病的余生。

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 one 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 one 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.