Network on Life Course Health Dynamics and Disparities in 21st Century America

该提案旨在正式创建一个研究网络，以了解美国如何以及为什么在人口健康的主要指标上越来越落后于几乎所有发达/富裕国家，甚至一些发展中国家，尽管美国在医疗保健和保险方面的支出远远超过任何国家。目前，各国数据可比性的局限性使得难以对这些问题进行比较分析，拟议的网络和其他科学家将努力减轻这些局限性。然而，了解我们的部分人口如何以及为什么表现出健康状况不佳和/或恶化，对于理解美国尽管医疗保健和保险支出迅速增长，但健康状况却出现自相矛盾的下降至关重要。因此，该网络将集中初步努力，在许多现有的数据来源工作，以了解：1）自1980年以来，美国妇女的健康状况如何以及为什么一直在恶化，相对于其他国家的美国男性和女性; 2）如何以及为什么健康方面的社会经济差异，特别是教育，在过去三十年中持续存在，甚至增加; 3）健康方面的种族-民族差异是如何存在和持续存在的，以及为什么存在和持续存在这种差异，同时在最近几十年里也在某些方面有所缓解。这项工作以后将导致网络：1）系统预测过去，现在和特别是未来的趋势在美国人口健康和健康差距和对医疗保健和保险支出的影响;和2）比较研究，以了解什么因素是最重要的美国人口健康恶化相对于其他发达国家/富裕国家。该网络将汇集来自以下三个机构的多学科调查人员小组：密歇根大学、南加州大学/加州大学洛杉矶分校和得克萨斯大学奥斯汀分校，这三个机构在研究人口健康和健康差距的社会和生物医学决定因素方面一直处于领先地位。来自其他机构的主要科学家将加入该网络和/或将进行互动 并通过年度会议和/或正在进行的工作组与之合作。我们寻求产生和传播新的科学分析和发现，并促进发展的方法和数据，可以改善这些分析。

DESCRIPTION (provided by applicant): This proposal seeks to formally create a research network to understand how and why the United States is increasingly falling behind virtually all comparably developed/wealthy nations, and even some developing countries, on major indicators of population health, despite the U.S. spending far more than any nation on health care and insurance. Limitations in data comparability across nations currently make comparative analysis of these issues difficult, and the proposed network and other scientists will be working to alleviate these limitations. However, understanding how and why portions of our population exhibit poor and/or worsening health is crucial to understanding America's paradoxical decline in health despite burgeoning spending for health care and insurance. Thus, the network will focus initial efforts on working across many existing sources of data to understand: 1) how and why the health of American women has been worsening since 1980 relative to both American men and women in other countries; 2) how and why socioeconomic disparities in health, especially by education, have persisted and even increased over the past three decades; and 3) how and why racial-ethnic disparities in health exist and persist, while also alleviating in some ways in recent decades. This work will later lead the network to: 1) systematic projection of past, present and especially future trends in U.S. population health and health disparities and the implications for expenditures on health care and insurance; and 2) comparative research to understand what factors have been most important in the worsening of America's population health relative to other comparably developed/wealthy nations. The network will bring together multidisciplinary teams of investigators from three institutions that have been leaders in research on social and biomedical determinants of population health and health disparities: Univ. of Michigan, Univ of Southern California/UCLA, and the Univ. of Texas at Austin. Key scientists from other institutions will be added to the network and/or will interact and collaborate with it via annual meetings and/or ongoing working groups. We seek to generate and disseminate new scientific analyses and findings, and to facilitate development of methods and data that can improve these analyses.