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.

项目总结 黑人比白人更有可能经历多个家庭成员的死亡 在年纪较小的时候。在1970-2004年间，估计有270万多黑人死亡是由于黑人的 死亡率上升。此外，截至2021年7月，美国估计有600,000人死于新冠肺炎 根据一次丧亲事件，直接影响了530多万核心家庭成员的生活 乘数效应，黑人死于新冠肺炎的风险是白人的两倍。尽管经历了死亡 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 造成健康不平等。拟议研究的目标是量化黑人和白人在 家庭和家庭对死亡的暴露及其与心理痛苦差异的关系 导致死亡。我的具体目标是：1)量化网络死亡率的流行率和种族差异 根据黑人和白人的生命周期阶段和社会经济地位(SES)，探索之前和 在新冠肺炎期间；2)确定暴露于死亡可能影响 对于黑人和白人来说，在整个生命过程中和代际之间，使用半 结构化访谈，探索新冠肺炎之前和期间的差异；以及3a)评估 暴露于过早死亡和累积死亡，以及心理痛苦中的黑白不平等 在新冠肺炎期间，以及所有原因造成的死亡；以及3b)确定经济学人在多大程度上调节 黑人和白人网络死亡率与心理困扰和全因死亡率的关系。至 为此，我将分析收入动态小组研究(PSID)的数据，并进行半结构化 采访佐治亚州亚特兰大的黑人和白人成年人。这个项目是创新的，它的重点是审查种族 更广泛的社交网络关系导致的死亡差异，包括亲属和家庭成员以及 网络死亡如何引发一系列SES后果，从而对 幸存者。这个K01项目将加强我以前在种族、种族主义、社会经济方面的社会学培训 不平等和人口学方面的培训：1)社会流行病学，重点是种族健康 不平等；2)网络分析、生存分析和结构方程建模；3)定性和混合 方法；4)PSID数据的使用。我在埃默里大学获得优秀资源和指导的途径是 并在哈佛大学和密歇根大学任职。研究结果将提供 改革丧亲和探亲假政策的证据基础，这些政策没有考虑到 传统核心家庭以外的网络中的个人对健康的间接影响。K01将 促进我向科学领导者的转变，推动与政策相关的研究，审查 种族健康不平等在社会网络和世代之间产生反响，(重新)产生健康不平等。