Why Place Matters

为什么地点很重要

• 批准号: 9752278
• 负责人: KITTY S. CHAN
• 金额: $ 18.73万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9752278
• 关键词: Affect; Area; Attention; Caring; Characteristics; Communities; Complex; Development; Disadvantaged; Ethnic Origin; Ethnic group; Female; Health; Health Communication; Health Services Accessibility; Healthcare; Healthcare Systems; Hispanics; Income; Individual; Intervention; Language; Linguistics; Link; Low income; Mediating; Mental Health Services; Minority; Minority Groups; Modeling; Neighborhoods; Persons; Physicians; Policies; Primary Health Care; Provider; Race; Research; Resources; Role; Services; Specialist; Testing; base; black/white disparity; care outcomes; data resource; ethnic minority population; experience; health care availability; health care disparity; health care quality; health care service utilization; health disparity; minority communities; minority health; mortality; multilevel analysis; programs; racial and ethnic; rurality; secondary analysis; segregation

PROJECT SUMMARY Place matters for health. Residential segregation has been linked to higher mortality, poorer access and lower quality of health care for racial/ethnic minorities. However, much remains unknown about the why place matters. In particular, the role of place-based characteristics such as rurality and income segregation in health care disparities is not well studied. A better understanding of how these place-based characteristics intersect with residential segregation by race-ethnicity to influence health care access, quality and disparities could be essential for developing interventions and policy solutions that are attentive to the local context. Our studies under the Why Place Matters research program found residents of minority communities had lower access to primary care and specialists and reduced use of physician, non-physician and mental health services compared to residents of majority white communities. Leveraging the comprehensive data resources developed through our research program, our team will conduct secondary analyses to explore the role of several important, but understudied, place characteristics on health care disparities. Specifically, our study will examine the associations of: 1) rurality, 2) income segregation, and 3) language segregation on minority health care access and utilization. We will examine these relationships for different race-ethnic groups (e.g., Blacks, Hispanics) and on care disparities between race-ethnic minority groups with Whites. We will also test whether provider availability or quality mediates these relationships. Finally, we will explore the interaction of these community characteristics with race-ethnic composition on health care access and utilization of Blacks. Descriptive, bivariate, stratified analysis, and regression models, including multilevel models will be used to examine the relationship of each place characteristic with area-level healthcare resource availability and quality and with minority health care access and use. This project will continue the research program Why Place Matters to understand the role of place on health care disparities. A better understanding of the experiences of minorities living in complex environmental contexts, with varying mix of privileges or disadvantages, could inform the development of accurately targeted health communications or interventions. This project fits within sociocultural and healthcare system domains at both individual and community levels of influence of the NIMHD Minority Health and Health Disparities Research Framework.

项目总结 地点对健康很重要。居住隔离与更高的死亡率、更难获得的机会和更低的水平有关 少数族裔/少数民族的医疗保健质量。然而，原因何在仍是个未知数。 事情。特别是，乡村和收入隔离等以地点为基础的特征在健康方面的作用 护理差异没有得到很好的研究。更好地理解这些基于地点的特征是如何相交的 由于按种族划分的居住隔离影响了医疗保健的获得，质量和差异可能会 对于制定关注当地情况的干预措施和政策解决方案至关重要。 我们在为什么地方重要研究项目下进行的研究发现，少数族裔社区的居民 获得初级保健和专家，减少对医生、非医生和精神卫生服务的使用 与白人占多数的社区的居民相比。充分利用综合数据资源 通过我们的研究计划，我们的团队将进行二次分析，以探索 有几个重要的但未被充分研究的问题是医疗保健差距的特点。具体来说，我们的研究将 考察：1)农村，2)收入隔离，3)语言隔离对少数民族健康的影响 关爱、获取和利用。我们将研究不同种族-民族群体(例如，黑人、 拉美裔美国人)以及少数族裔群体与白人之间的护理差距。我们还将测试 提供商的可用性或质量是这些关系的中介。最后，我们将探讨这些因素之间的相互作用 黑人卫生保健获取和利用的种族-民族构成的社区特征。 将使用描述性、双变量、分层分析和回归模型，包括多水平模型 检查每个地点特征与地区级医疗资源可用性和质量的关系 以及少数人获得和使用医疗保健的机会。 该项目将继续研究为什么地点很重要，以了解地点对健康的作用 护理方面的差距。更好地了解生活在复杂环境中的少数民族的经历 具有不同优势或劣势的上下文可以帮助开发准确定向的 健康沟通或干预。该项目符合社会文化和医疗保健系统的要求。 NIMHD少数民族健康和健康在个人和社区层面的影响领域 差异研究框架。