AGING AND HEALTH TRAJECTORIES AMONG BLACK & WHITE ADULTS

描述(改编自申请人的摘要)：这项研究的总体目标是系统地检查20年来白人和非裔美国成年人的健康轨迹和住院之间的关系。众所周知，非洲裔美国人比白人美国人有更多的健康问题，这在大多数发病率和死亡率指标上都有体现。最近的纵向研究还表明，非裔美国人的健康轨迹下降得更快。这份申请描述了一个竞争性的延续项目的工作，该项目旨在研究黑人和白人成年人的住院模式，以更好地了解美国社会中的健康不平等以及健康状况更快下降的机制。 这项研究利用了国家健康和营养检查调查I：流行病学随访研究(NHEFS)。NHEFS是一项对美国成年人进行的为期20年的小组研究。研究对象在1971-1975年间首次接受采访，1982-1984年、1987年和1992年(基线N=6913)再次接受采访。有关医院事件的信息来自20年来医院设施的记录。前瞻性研究设计用于评估黑人和白人男性和女性的健康轨迹和住院情况。具体目标是： 1.检查黑人和白人成年人住院模式的差异；结果包括住院风险、住院时间、再次住院和潜在的可避免的住院。 2.用选择偏差模型(即Heckman模型)模拟黑人和白人受试者20年来住院与健康轨迹之间的关系，同时考虑损耗。 3.评估黑人和白人成年人的社会经济和健康状况、健康行为和住院经历对死亡率的相对影响。特别注意在生命的最后一年出院不稳定和住院的差异。 拟议分析的数据为科学界提供了迄今为止无法获得的信息，以了解黑人和白人成年人成年和晚年的健康轨迹和住院情况。

DESCRIPTION (Adapted from the Applicant's Abstract): The overall aim of this study is to systematically examine the relationship between health trajectories and hospitalization among White and African-American adults over a 20-year period. It is well known that African Americans have more health problems than White Americans as manifested on most indicators of morbidity and mortality. Recent longitudinal studies also show that the health trajectories of African Americans decline more rapidly. This application describes work for a competing continuation project to examine patterns of hospitalization among Black and White adults to better understand health inequality in American society and the mechanisms for the more rapid health declines. The research makes use of the National Health and Nutrition Examination Survey I: Epidemiologic Follow-up Study (NHEFS). The NHEFS is a 20-year panel study of adult Americans. The subjects studied were first interviewed during 1971-1975 and re-interviewed in 1982-1984, 1987, and 1992 (N=6,913 at baseline). Information on hospital episodes is drawn from hospital facility records over the 20 years. A prospective research design is used to evaluate health trajectories and hospitalization among Black and White men and women. Specific aims are to: 1. To examine differences in the patterns of hospitalization for Black and White adults; outcomes include risk of hospitalization, length of stay, rehospitalization, and potentially avoidable hospitalizations. 2. To model the relationship between hospitalization and health trajectories over 20 years among Black and White subjects while accounting for attrition with selection bias models (i.e., Heckman models). 3. To assess the relative influence of socioeconomic and health status, health behavior, and hospitalization experiences on mortality for Black and White adults. Special attention is given to differences in discharge instability and hospitalization during the last year of life. The data for the proposed analyses provide the scientific community with hitherto unavailable information for understanding health trajectories and hospitalization in adulthood and later life among Black and White adults.