The Importance of Place in Determining Health and Mortality at Older Ages

U项目摘要 出生地在决定老年人健康和死亡率方面的重要性 老年人健康和死亡率结果方面存在着巨大的空间不平等，这一点已有充分的文献记载。以前的研究 将老年健康与当时的空间环境联系起来。然而，到了老年，超过三分之一的人口- 他们离开了自己的出生地，甚至更多的人离开了他们的出生地，留下了解释。 地理和健康之间的轻蔑联系被内生流动性和忽视所笼罩， 儿童期暴露在整个生命过程中产生健康空间不平等方面的重要性， 进入老年成功地揭示了生命历程的重要性，暴露和决策产生老年 空间不平等有可能为基础科学和政策做出贡献，但努力一直很糟糕， 由于缺乏包含出生地信息的大型数据集，我们的建议利用新的可用性- 在世纪早期到中期出生的500多万美国人的出生地数据， 我们团队的跨学科背景融合了人口学，经济学，人口健康和人口学， 老年发病和死亡过程学。我们的总体目标是揭示 出生率导致了出生队列、种族/民族、性别和受教育程度等方面的老年健康不平等， 在美国的国家实现，并探讨这些关系的机制。我们的重新- 搜索团队将利用新发布的、独特的纵向数据， 数据集包含丰富的老年健康过程和早期疾病暴露机制的测量， 累积的环境劣势和生命历程的流动性。利用这些数据，我们将开展以下工作 aimsU：（1）目标1：创建“出生地对老年人死亡率和死亡率影响地图集”，（2）阻止 按性别、种族/族裔分列的出生地对老年人健康差异和死亡率变化的影响 （3）揭示出生地与后来的出生地之间关系的机制。 通过关注流动性以及早期和累积的暴露，促进健康。这些目标合在一起， 通过将生命过程和空间分析整合到大数据中， 对老年健康和死亡率的模式和机制进行规模分析。

UProject Summary Title: The Importance of Place of Birth in Determining Health and Mortality at Older Ages Substantial spatial inequalities in old age health and mortality outcomes are well documented. Previous studies have linked old age health to contemporaneous spatial context. However, by old age, over a third of the popu- lation has left their state of birth and an even greater share has left their county of birth, leaving the interpreta- tion of contemptuous links between geography and health clouded by endogenous mobility and disregarding the importance of childhood exposures in producing the spatial inequalities in health across the life course and into old age. Successfully unraveling the importance of life course exposures and decisions producing old age spatial inequalities has the potential to contribute to basic science as well as policy, but efforts have been ham- pered by a lack of large datasets with place of birth information. Our proposal takes advantage of newly avail- able data on place of birth for over 5 million Americans born across the early to mid 20PthP century combined with our team's interdisciplinary background merging the demography, economics, population health, and epidemi- ology of old age morbidity and mortality processes. UOur overall aim is to uncover the extent to which place of birth has contributed to old age health inequalities by birth cohort, race/ethnicity, sex, and educa- tional attainment in the US, and to explore the mechanisms underlying these relationshipsU. Our re- search team will leverage newly released and unique longitudinal data on millions of individuals across multiple datasets containing rich measures of health processes in old age and mechanisms of early disease exposures, cumulative contextual disadvantage, and life course mobility. Using these data, we will Upursue the following aimsU: (1) Aim 1: Create an “Atlas of Birth Place Impacts on Mortality and Morbidity at Older Ages”, (2) Deter- mine the Influence of Birth Place on Health Disparities and Mortality Variation at Older Ages by sex, race/eth- nicity, and education and (3) Uncover mechanisms linking the relationship between place of birth and later health by focusing on mobility and early and cumulative exposures. Together, these aims will allow a paradigm shift in how we understand old age health processes by integrating life course and spatial analysis into large scale analyses of the patterns and mechanisms of old age health and mortality.