A Social Demography of Racial Health Disparities

描述（由申请人提供）：健康差距是一个棘手的，但不是美国分层系统的必然特征。受贫困、边缘化劳动、歧视、工资差距和种族隔离影响最大的亚人口群体也受健康状况不佳的影响最大（威廉姆斯和柯林斯，1995年）。美国人生活的这一方面导致人们越来越关注健康差距;事实上，《2010年健康人》（HP 2010）为我们国家的健康提出了两个崇高的目标。虽然在实现2010年保健计划的第一个目标-提高健康生活的质量和年数-方面取得了许多进展，但在实现第二个目标-消除健康差距方面取得的进展微不足道（2000年人口与健康调查）。实现这一目标的主要障碍之一肯定是我们不了解哪些社会进程造成健康差距，以及这些差距如何在发病率和死亡率下降的情况下持续存在。很明显，遗传学并没有为持续差异的问题提供完整的答案（LaVeist 1994，库珀1986，弗兰克2007）。因此，调查可能的社会，经济和结构的解释是必要的，以更好地了解现代健康差距的起源和原因。关于健康差距的最令人不安的发现之一是健康，死亡率和发病率的持续种族差距。这一建议是一个系统的和雄心勃勃的尝试，既要理解和解释这些模式如何随着时间的推移而持续和波动。通过结合人口统计学，公共卫生和社会学的理论和方法，我们建议批判性地研究种族健康差距的动态模式，特别是集中在“黑/白色”的健康差距，同时估计年龄，时期和队列的贡献随着时间的推移对健康趋势的影响。具体而言，该研究项目将通过研究年龄，时期和队列效应以及它们如何随着时间的推移产生健康差异和健康差异的变化，对健康差异采取雄心勃勃的人口统计学方法。这一方法可能是对目前只注重调查对象个人影响的方法的一个重大补充。

DESCRIPTION (provided by the applicant): Health disparities are an intractable, but not inevitable feature of the American stratification system. Sub-population groups that bear the brunt of poverty, marginalized labor, discrimination, wage gaps, and segregation---also bear the brunt of poor health (Williams and Collins 1995). This facet of American life has led to an increased focus on health disparities; in fact, Healthy People 2010 (HP2010) has put forth two lofty goals for the health of our nation. While many gains have been made for HP2010's first goal, to increase quality and years of healthy life---negligible gains have been made to meet the second goal---to eliminate health disparities (DHHS 2000). One of the primary impediments for reaching this goal is most certainly our lack of understanding of which social processes generate health disparities and how these disparities persist amidst declining morbidity and mortality rates. It is clear that genetics does not offer a complete answer to the question of persistent disparities (LaVeist 1994, Cooper 1986, Frank 2007). Consequently, investigations into possible social, economic, and structural explanations are necessary in order to better understand the origin and cause of modern health disparities. One of the most disconcerting finding with regards to health disparities is the persistent racial gap in health, mortality, and morbidity. This proposal represents a systematic and ambitious attempt to both understand and explain how these patterns have both persisted and fluctuated over time. By combining demographic, public health, and sociological theory and methods we propose to critically examine the dynamic patterns of racial health disparities, focusing specifically on the "Black/White" health gap, by simultaneously estimating the contribution of age, period, and cohort effects on health trends over time. Specifically, this research project will take an ambitious demographic approach to health disparities by looking at age, period, and cohort effects and how they change temporally to produce health disparities and changes in health disparities over time. This approach could prove to be a major addition to current approaches that simply focus on individual-level effects of survey respondents.