Early and Mid-Life Social Determinants of Racial Disparities in Late-Life Health

描述（由申请人提供）：拟议研究的总体目标是检查老年黑人和白人之间健康差异的童年和中年成年期社会决定因素。该研究将评估四项生物指标在晚年健康方面的种族差异：血压、血糖控制、亚临床脑血管疾病和炎症。选择这些结果是因为它们与健康和预防晚年残疾和认知障碍方面的种族差异有关。该研究将侧重于个人社会资源（例如，教育、职业地位）和居住环境社会条件（例如，出生县的社会经济地位水平，成年期间的邻里隔离），并检查这些社会资源和条件在老年之前经历的程度在多大程度上解释了晚年健康的种族差异。该研究还将测试种族差异是否存在于这些人群的晚年健康血液样本中，这些样本需要获得血糖控制的测量。尽管美国老年人的整体健康状况普遍改善，但晚年健康方面的种族差异仍然很大且普遍存在。在生命早期阶段社会资源和条件的种族差异可能是减轻这些差异的一个重要因素。这项研究的结果将有助于更好地了解导致老年健康方面种族差异的社会和生物学机制，为减少并最终消除老年黑人和白人之间的健康差异的政策和战略奠定基础。公共卫生相关性：尽管美国老年人的整体健康状况普遍改善，但晚年健康方面的种族差异仍然很大且普遍存在。晚年健康的种族差异可能取决于早期生活中所经历的社会资源和条件，但对预防老年残疾和认知障碍很重要。这项研究的一个重要优势是，它将利用大多数感兴趣的社会和生物因素的详细信息。这一信息来自一项正在进行的队列研究，研究对象是大量老年黑人和白人。这项研究的结果有望更好地了解导致晚年健康中种族差异的社会和生物学机制，为减少并最终消除老年黑人和白人之间的健康差异的政策和战略奠定基础。

DESCRIPTION (provided by applicant): The overall goal of the proposed study is to examine childhood and mid-life adulthood social determinants of health disparities between older blacks and whites. The study will assess racial disparities in late-life health in four biological outcomes: blood pressure, glycemic control, sub-clinical cerebrovascular disease, and inflammation. These outcomes were selected because of their relevance for racial disparities in health and the prevention of late-life disability and cognitive impairment. The study will focus on personal social resources (e.g., education, occupational status), and residential environment social conditions (e.g., birth county level of socio-economic status, neighborhood segregation during adulthood), and examine the degree to which these social resources and conditions experienced prior to older age account for racial disparities in late-life health. The study will also test whether racial disparities in late-life health ablood specimens in this population which are needed to obtain a measure of glycemic control. Despite general improvements in overall health among older adults in the US, racial disparities in late-life health continue to be large and pervasive. Racial differences in social resources and conditions in earlier stages of life are likely to be an important factor in alleviating these disparities. Findings from this study will provide a better understanding of the social and biological mechanisms that contribute to racial disparities in late-life health, creating a foundation for policies and strategies to reduce and ultimately eliminate health disparities between older blacks and whites. PUBLIC HEALTH RELEVANCE: Despite general improvements in overall health among older adults in the US, racial disparities in late-life health continue to be large and pervasive. Racial differences in late- life health are likely to depend on social resources and conditions experienced earlier in life, butmportance to the prevention of disability and cognitive impairment in old age. An important strength of the study is that it will take advantage of the availability of detailed information on most social and biological factors of interest. This information is derived from an ongoing cohort study in a large population of older blacks and whites. Findings from this study are expected to provide a better understanding of the social and biological mechanisms that contribute to racial disparities in late-life health, creating a foundation for policies and strategies to reduce and ultimately eliminate health disparities between older blacks and whites.