Health and Mortality Risks among Co-Resident Grandchildren, Parents, and Grandpar

说明(申请人提供)：该项目将审查共同居住的祖父母、父母(如果有)和孙子孙女的健康和死亡风险，并记录与所有家庭成员健康有关的人口和社会经济因素。尽管同住的祖父母在许多家庭中发挥着核心作用，家庭结构对人们的健康也很重要，但很少有研究调查同住的祖父母家庭与所有家庭成员的健康之间的关系。1970年至2004年间，18岁以下儿童与祖父母同住的比例增加了73%，2000年，近560万祖父母与18岁或18岁以下的孙辈生活在一起。但同住的祖父母和他们的家人很可能生活在贫困中，并将超过30%的收入花在房租上，这表明他们健康状况不佳的风险也可能增加。以前在这一领域的研究往往受到以下数据的限制：种族/族裔或社会经济多样性很少，健康或社会经济变量很少，缺乏关于所有共同居住家庭成员的信息，以及区域样本较少。我们使用了1985-2006年全国健康访谈调查(NHIS)浪潮中具有全国代表性的横断面数据，以及将1986-2000年NHIS数据中18岁及以上的成年人与2002年国家死亡指数(NDI)中的死亡人数联系起来的前瞻性数据。这些数据包含50,894名祖父母(导致7,059人死亡)、51,590名父母(导致1,006人死亡)和59,429名孙辈。对祖父母和父母的分析将检查横断面健康和预期死亡率，但对孙子孙女的分析将只关注横断面健康指标，因为18岁以下的人与死亡率无关，以保护他们的身份(太少孙子孙女年满18岁或以上，无法检查他们的死亡风险)。具体地说，我们的目标是：(1)考察共同居住的孙辈、父母或祖父母的存在是否与其他家庭成员的健康有关；(2)考察祖父母、父母和孙辈之间的家庭结构与健康关系是否存在种族/民族差异；(3)考察家庭的性别构成是否与祖父母、父母和孙辈的健康有关；(4)考察家庭的年龄构成是否与祖父母、父母和孙辈的健康有关；以及(5)研究家庭结构和健康之间的关系是否因祖父母、父母和孙辈的个人和家庭层面的社会经济地位而不同。这项研究的发现将促进我们对大家庭结构与健康之间关系的了解，并可能帮助政策制定者和公共卫生专业人员确定健康状况不佳的风险最大的家庭。这个项目的主要目标是检查共同居住的祖父母、父母(如果有)和孙子孙女的健康和死亡风险，并记录与所有家庭成员的健康相关的社会、人口和经济因素。我们使用具有全国代表性的全国健康访谈调查的数据，该调查调查了抽样家庭中的所有个人；提供了关于健康、社会经济状况和人口背景的详细横截面数据；并通过国家死亡指数与18岁及以上成年人的预期死亡率建立了联系。

DESCRIPTION (provided by applicant): This project will examine the health and mortality risks of co-resident grandparents, parents (if present), and grandchildren, and document the demographic and socioeconomic factors that are associated with the health of all family members. Despite the central role of co-resident grandparents in many families, and the importance of family structure for people's health, little research examines the relationship between families with co-resident grandparents and the health of all family members. Between 1970 and 2004 there was a 73% increase in the percentage of children under age 18 living with their grandparents, and in 2000 nearly 5.6 million grandparents lived with grandchildren aged 18 or younger. But co-resident grandparents and their families are very likely to live in poverty and to spend over 30% of their income on rent, suggesting that they might also be at increased risks of poor health. Prior research in this area is frequently limited by data with little race/ethnic or socioeconomic diversity, few health or socioeconomic variables, lack of information on all co- resident family members, and small, regional samples. We use nationally representative, cross-sectional data from the 1985-2006 waves of the National Health interview Survey (NHIS), and prospective data that links adults aged 18 and older in the 1986-2000 NHIS data to deaths in the National Death Index (NDI) through 2002. These data hold 50,894 grandparents (contributing 7,059 deaths), 51,590 parents (contributing 1,006 deaths), and 59,429 grandchildren. Analyses of grandparents and parents will examine both cross-sectional health and prospective mortality, but analyses of grandchildren will focus only on cross-sectional health measures because those under age 18 are not linked to mortality to protect their identities (too few grandchildren are aged 18 or older to examine their risks of death). Specifically, we aim to (1) examine whether the presence of co-resident grandchildren, parents, or grandparents is associate with the health of other family members; (2) examine whether there are race/ethnic differences in the relationship between family structure and health among grandparents, parents, and grandchildren; (3) examine whether the gender composition of the family is associated with health among grandparents, parents, and grandchildren; (4) examine whether the age composition of the family is associated with health among grandparents, parents, and grandchildren; and (5) examine whether the relationship between family structure and health varies by individual and family level socioeconomic status among grandparents, parents, and grandchildren. The findings from this research will advance our knowledge of the relationship between extended family structures and health, and could help policy makers and public health professionals identify the families that are at greatest risk of poor health. The primary goal of this project is to examine the health and mortality risks of co-resident grandparents, parents (if present), and grandchildren, and to document the social, demographic, and economic factors that are associated with the health of all family members. We use data from the nationally representative National Health Interview Survey that surveys all individuals in sampled households; offers detailed cross-sectional data on health, socioeconomic status, and demographic background; and has links to prospective mortality for adults aged 18 and older via the National Death Index.