Increasing Economic Resources and Obesity: A Quasi-Experimental Study

描述（由申请人提供）：在美国，肥胖是发病率和死亡率的主要原因，与经济资源呈负相关。尽管个人和社区经济资源减少与肥胖增加之间存在充分的相关性，但很少有现有研究能够将经济资源对肥胖的因果影响归因于经济资源对肥胖的影响，特别是在儿童中。确定经济资源在多大程度上是体重相关健康结果的因果前因，对于为改善人口健康的结构性方法提供信息至关重要。我正在寻求独立之路奖，以获得实现我的职业目标所需的额外培训：建立一个独立的研究项目，严格调查社会经济对健康的影响，并有效地将流行病学、营养学、公共卫生、经济学和社会心理学联系起来。该项目的培训部分包括正式课程、指导阅读、参加学术研讨会、学徒和指导职业建设活动，以获得以下关键领域的技能：1)经济学和计量经济学，2)ses -健康关系的社会心理学理论，3)原始数据收集和定性数据分析。新获得的知识和技能将应用于该项目的研究部分。该项目的研究部分提出了一种准实验方法，以检查经济资源增加与母亲体重增加和儿童肥胖之间的关联程度。我认为，将赌场式游戏引入美洲印第安部落土地提供了一个独特的机会，可以确定外生的、持续流入美洲印第安社区的经济资源如何影响人口健康。我们将利用现有的地理关联的生命记录和学校健康测试记录，结合加利福尼亚州赌场开业的时空变化来实现以下具体目标：1)确定外源性经济资源增加的影响程度：a)妊娠体重增加过多，b)胎龄婴儿出生体重过大，c)儿童肥胖；2)通过收集形成性的定性数据，评估来自赌场的经济资源如何影响与体重相关的健康；3)收集定量数据，以评估外源经济资源与体重相关健康之间的中介或调节机制。培训和研究活动将纳入出版物和会议报告，并将为我在项目的R00阶段成功竞争R01资金做好准备。

DESCRIPTION (provided by applicant): Obesity is a leading cause of morbidity and mortality and is inversely associated with economic resources in the US. Despite the well-documented correlation between decreased individual- and community-level economic resources and increased obesity, few existing studies have been capable of attributing a causal impact to the effect of economic resources on obesity, particularly among children. Determining the extent to which economic resources are causal antecedents to weight-related health outcomes is vitally important for informing structural approaches for improving population health. I am seeking the Pathway to Independence Award in order to gain the additional training required to accomplish my career goal: to establish an independent pro- gram of research that rigorously investigates socioeconomic inputs to health and productively bridges epidemiology, nutrition, public health, economics, and social psychology. The training portion of this project includes formal courses, directed readings, attendance of scholarly seminars, apprenticeships, and mentored career building activities to gain skills in the following key areas: 1) economics and econometrics, 2) social psycho- logical theories of SES-health relationships, 3) primary data collection and qualitative data analysis. The newly acquired knowledge and skills will be applied in the research component of the project. The research component of this project proposes a quasi-experimental approach to examine the extent to which increased economic resources are associated with maternal weight gain and childhood obesity. I propose that the introduction of casino-style gaming to American Indian tribal lands offers a unique opportunity to determine how an exogenous, sustained influx of economic resources to American Indian communities impacts population health. We will leverage existing geographically-linked vital records and school fitness testing records in combination with space-time variation in casino openings in the state of California to accomplish the following specific aims: 1) Determine the extent to which an exogenous increase in economic resources affects: a) excessive gestational weight gain, b) large-for-gestational-age infant birth weight, and c) child obesity; 2) Assess how economic resources stemming from casinos may affect weight-related health through the collection of formative, qualitative data; 3) Collect quantitative data in order to assess mediating or moderating mechanisms between exogenous economic resources and weight-related health. The training and research activities will feed into publications and conference presentations, and will prepare me to compete successfully for R01 funding during the R00 phase of the project.