Explaining Black-White Differences in Avoidable Mortality, 1980-2005

解释 1980 年至 2005 年可避免死亡率方面的黑人与白人差异

• 批准号: 7739110
• 负责人: IRMA T. ELO
• 金额: $ 24.37万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7739110
• 关键词: Address; Area; Behavior; Behavior Therapy; Behavioral; Birth; Caring; Categories; Cause of Death; Censuses; Cessation of life; Characteristics; Complement; Consensus; Country; Data; Data Sources; Death Records; Disease; Education; Future; Goals; Health; Health Resources; Health Services; Health Services Accessibility; Health behavior; Health system; Healthcare; Healthcare Systems; Income; Individual; Investments; Life; Life Expectancy; Light; Link; Literature; Medical; Methods; Monitor; Mortality Decline; National Health Interview Survey; Performance; Play; Policies; Population; Public Health; Public Policy; Race; Role; Socioeconomic Status; Time; Time Factors; United States; Variant; Vital Statistics; base; health disparity; health inequalities; improved; insight; mortality; public health priorities; public health relevance; racial discrimination; social; socioeconomics; trend

DESCRIPTION (provided by applicant): Despite unprecedented mortality declines during the 20th century, black-white disparities in all cause and cause-specific mortality continue to be substantial in the United States. Explanations offered for these disparities include black-white differences in income, education and wealth, racial discrimination, and disparities in access to health care, including differential treatment in the health care system. Despite the vast literature on black-white differences in health and mortality there is little consensus regarding how best to reduce them. This project proposes new ways to analyze black-white mortality disparities in the U.S. between 1980 and 2005 by investigating the contribution of causes of death considered avoidable by (1) high-quality and timely medical care and (2) policy/behavior interventions. Although the study of avoidable mortality (AM) originated in the U.S., it has been applied mainly in other countries as an indicator of health system performance and thus its role in explaining B-W mortality disparities in the U.S. is not known. We will estimate the contribution of various categories of AM and non-AM to black-white differences in life expectancy at birth and to changes therein between 1980 and 2005; investigate the effect of state-level policies, health system and socioeconomic characteristics on state-level variation and black-white differences in various categories of AM and non-AM between 1980 and 2005; and examine effects of individual-level socio-demographic characteristics and health behaviors on black-white differences in various categories of AM and non-AM from 1986 to 2002. The strengths of the study include the use of multiple data sources (vital statistics and census data; state- level policies, health resources, and socio-demographic characteristics; and National Health Interview Survey- Multiple Cause of Death data) and methods (demographic, econometric). The analyses will complement prior individual- and disease-oriented studies of black-white disparities in the leading causes of death by estimating the impact of causes grouped by the main means of reducing them (e.g. medical care, public policy, behavior). PUBLIC HEALTH RELEVANCE: The elimination of race/ethnic health disparities is one of the public health priorities in the United States. The proposed project contributes to this goal by improving our understanding of black-white disparities in mortality due to causes of death that are avoidable by good quality medical care and amenable by policy /behavior interventions. The results will aid in monitoring health inequalities and help guide public investments to areas of greatest need.

描述(申请人提供)：尽管死亡率在20世纪出现了前所未有的下降，但在美国，所有原因和特定原因的死亡率中的黑人和白人的差距仍然很大。对这些差异的解释包括黑人和白人在收入、教育和财富方面的差异、种族歧视以及在获得医疗保健方面的差异，包括医疗保健系统中的差别待遇。尽管有大量关于黑人和白人在健康和死亡率方面的差异的文献，但对于如何最好地减少这些差异，几乎没有达成共识。该项目通过调查被认为可以通过(1)高质量和及时的医疗护理和(2)政策/行为干预来避免的死因的贡献，提出了分析1980年至2005年美国黑人和白人死亡率差异的新方法。虽然对可避免死亡率(AM)的研究起源于美国，但它主要应用于其他国家，作为卫生系统绩效的指标，因此它在解释美国B-W死亡率差异方面的作用尚不清楚。我们将估计1980年至2005年各类AM和非AM对出生时预期寿命的黑白差异的贡献及其变化；调查国家政策、卫生制度和社会经济特征对1980至2005年间各类AM和非AM的州水平差异和黑白差异的影响；以及1986年至2002年个人水平的社会人口学特征和健康行为对各类AM和非AM的黑白差异的影响。这项研究的优势包括使用多种数据来源(重要统计数据和人口普查数据；州一级的政策、卫生资源和社会人口特征；以及国家健康访谈调查--多种死因数据)和方法(人口统计学、计量经济学)。这些分析将补充先前以个人和疾病为导向的研究，通过估计按减少死因的主要手段(如医疗保健、公共政策、行为)分组的原因的影响，对主要死因中的黑人和白人差异进行研究。公共卫生相关性：消除种族/民族健康差异是美国公共卫生的优先事项之一。拟议的项目有助于实现这一目标，因为它提高了我们对黑人和白人死因死亡率差异的理解，这些死因可以通过高质量的医疗保健来避免，也可以通过政策/行为干预来避免。这些成果将有助于监测卫生不平等现象，并有助于引导公共投资流向最需要的领域。