The Loved Ones Left Behind: Examining the Health Implications of Racial Inequities in Mortality

留下的亲人：审视种族死亡率不平等对健康的影响

• 批准号: 10650251
• 负责人: Angela R Dixon
• 金额: $ 13.21万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-19 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10650251
• 关键词: Achievement; Adoption; Adult; Age; Bereavement; Black Populations; COVID-19; COVID-19 mortality; COVID-19 stress; Cessation of life; Child; Communities; Complex; Data; Demography; Disparity; Equation; Exposure disparity; Exposure to; Extended Family; Family; Family Leave; Family health status; Family member; Feedback; Generations; Health; Health Insurance; Health Status; High Prevalence; Household; Household and Family; Individual; Inequality; Inequity; Insurance Coverage; Intervention; Interview; Kinship Networks; Knowledge; Latin America; Left; Life Cycle Stages; Life Expectancy; Link; Literature; Mediating; Mental Health; Mentors; Methodology; Methods; Michigan; Modeling; Nuclear Family; Outcome; Pathway Analysis; Pathway interactions; Play; Policies; Population; Prevalence; Psychosocial Stress; Race; Research; Research Personnel; Resources; Rest; Risk; Role; Running; Shapes; Siblings; Social Network; Societies; Socioeconomic Factors; Socioeconomic Status; Sociology; Source; Stressful Event; Structure; Survival Analysis; Survivors; System; Time; Training; Universities; Work; biopsychosocial; black/white disparity; design; economic outcome; evidence base; experience; grandparent; health inequalities; improved; innovation; intergenerational; loved ones; low socioeconomic status; member; mortality; mortality risk; novel; panel study of income dynamics; perceived discrimination; physical conditioning; premature; psychological distress; racial disparity; racial health disparity; racism; social; social epidemiology; social health determinants; social structure; socioeconomic disparity; socioeconomics; theories; tool

PROJECT SUMMARY Blacks are more likely than whites to experience the deaths of multiple family members and experience them at earlier ages. Between 1970-2004, an estimated 2.7 million excess black deaths occurred because of blacks’ elevated mortality rates. Further, the estimated 600,000 COVID-19 deaths in the US as of July 2021 have directly impacted the lives of more than 5.3 million individuals in nuclear families according to a bereavement multiplier, with blacks facing twice the risk of death from COVID-19 as whites. Although experiencing death within a family or network powerfully shapes survivors’ health, we know little about how network death contributes to health inequities. The objective of the proposed study is to quantify black–white disparities in familial and household exposure to deaths and their relationship to disparities in psychological distress and all- cause mortality. My specific aims are to: 1) quantify the prevalence of and racial disparities in network mortality by lifecourse stage and socioeconomic status (SES) for blacks and whites, exploring differences before and during COVID-19; 2) identify key perceived mechanisms through which exposure to death may impact the SES–health feedback loop throughout the lifecourse and intergenerationally for blacks and whites using semi- structured interviews, exploring differences before and during COVID-19; and 3a) estimate the contribution of exposure to premature and cumulative deaths to black–white inequalities in psychological distress, before and during COVID-19, and to all-cause mortality; and 3b) determine the extent to which SES mediates the relationship of network mortality with psychological distress and all-cause mortality for blacks and whites. To do this, I will analyze data from the Panel Study of Income Dynamics (PSID) and conduct semi-structured interviews with black and white adults in Atlanta, GA. This project is innovative in its focus on examining racial disparities in death from broader social network ties including extended kin and household members as well as how network deaths can initiate a cascade of SES consequences that contribute to adverse health for survivors. This K01 project will enhance my prior sociological training in race, racism, socioeconomic inequality, and demography with additional training in: 1) social epidemiology, with a focus on racial health inequities; 2) network analysis, survival analysis, and structural equation modeling; 3) qualitative and mixed methods; and 4) use of PSID data. My access to excellent resources and mentoring at Emory University is supplemented with affiliations at Harvard University and the University of Michigan. Study findings will provide an evidence base for efforts to reform bereavement and family leave policies that do not account for the collateral health effects of individuals embedded in networks beyond the traditional nuclear family. The K01 will facilitate my transition to a scientific leader advancing policy-relevant research examining the degree to which racial health inequalities reverberate across social networks and generations to (re)produce health inequities.

项目摘要 黑人比白人更有可能经历多个家庭成员的死亡，并经历他们 在更早的年龄。在1970年至2004年期间，估计有270万黑人死亡是因为黑人的死亡。 死亡率上升。此外，截至2021年7月，美国估计有60万人死于COVID-19， 根据一份丧亲报告， 乘数，黑人面临的COVID-19死亡风险是白人的两倍。虽然经历了死亡 在一个家庭或网络中，我们对网络死亡如何影响幸存者的健康知之甚少 造成卫生不平等。这项研究的目的是量化黑人和白人之间的差距， 家庭和住户的死亡风险及其与心理痛苦和所有 导致死亡。我的具体目标是：1）量化网络死亡率的普遍性和种族差异 生活过程阶段和社会经济地位（SES）的黑人和白人，探索差异之前， 2）确定暴露于死亡可能影响 SES-健康反馈循环在整个生命过程中，并使用半 结构化访谈，探索COVID-19之前和期间的差异;以及3a）估计 暴露于过早死亡和累积死亡的黑人和白人在心理痛苦方面的不平等， 在COVID-19期间，以及全因死亡率;以及3b）确定SES介导 网络死亡率与黑人和白人的心理困扰和全因死亡率的关系。到 这样做，我将分析来自收入动态小组研究（PSID）的数据，并进行半结构化的 对佐治亚州亚特兰大市黑人和白色成年人的采访。这个项目是创新的，重点是审查种族 更广泛的社会网络关系（包括远亲和家庭成员）造成的死亡差异， 网络死亡如何引发一系列社会经济地位后果，导致不利的健康状况， 幸存者这个K 01项目将加强我以前在种族，种族主义，社会经济学， 不平等和人口学，并在以下方面接受额外培训：1）社会流行病学，重点是种族健康 不公平; 2）网络分析，生存分析和结构方程模型; 3）定性和混合 方法;和4）PSID数据的使用。我在埃默里大学获得优秀的资源和指导， 并与哈佛大学和密歇根大学有联系。研究结果将提供 为改革丧亲假和家事假政策提供证据基础， 嵌入传统核心家庭之外的网络中的个人的附带健康影响。K 01将 促进我向科学领导者的转变，推进与政策相关的研究， 种族健康不平等在社交网络和几代人之间产生反响，（重新）产生健康不平等。