Impact of Structural Racism on Racial Disparities in Cognitive Impairment

结构性种族主义对认知障碍种族差异的影响

• 批准号: 10572864
• 负责人: Talha Ali
• 金额: $ 11.71万
• 依托单位: TUFTS UNIVERSITY MEDFORD
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10572864
• 关键词: 3-Dimensional; Accounting; Address; Adopted; Adverse effects; Affect; Age; Age Years; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Area; Belief; Black American; Black Populations; Black race; Buffers; Cause of Death; Censuses; Chronic; Clinical Trials; Cognitive; County; Data; Dementia; Diagnosis; Disease Management; Disparity; Economics; Education; Educational Status; Elderly; Environment; Environmental Risk Factor; Equity; Exposure to; Frequencies; Future; Goals; Health; Health Care Visit; Health Services Research; Health and Retirement Study; Healthcare; Home; Home Care Services; Hospitalization; Housing; Hypertension; Impaired cognition; Impairment; Incidence; Individual; Institution; Intervention; Length of Stay; Life Cycle Stages; Link; Measures; Medicaid; Medicare claim; Mentors; Methods; Modeling; Modification; Neurobiology; Obesity; Observational Study; Outcome; Ownership; Pathogenesis; Pensions; Persons; Policies; Policy Analysis; Policy Maker; Population Research; Public Health Schools; Quality of life; Race; Reduce health disparities; Research; Research Priority; Resources; Risk; Risk Factors; Skilled Nursing Facilities; Social Justice; Social Network; Social support; Source; Statistical Data Interpretation; Stress; Structural Racism; System; Training; United States; Work; black/white disparity; cardiovascular health; caucasian American; cognitive function; dementia care; dementia risk; design; experience; foster care; functional decline; functional disability; health assessment; health care availability; health care service utilization; health disparity; health inequalities; improved; insight; interest; lifestyle factors; negative affect; neuropsychiatric symptom; physical conditioning; pollutant; prevent; protective factors; psychosocial; racial disparity; racism; resilience; socioeconomic disparity; statistics; stressor; toxicant

It cognitive estimated is estimated that 65% of individuals experience some level of cognitive impairment by 70 years of age. Within impairment, Alzheimer's disease and related dementias are a leading cause of death, affecting an 5.8 million Americans.Black Americans are twice as likely as White Americans to be diagnosed with cognitive impairment. And among older adults with cognitive impairment, Black, compared to White, individuals have worse cognitive function, greater functional disability, and more severe neuropsychiatric symptoms, indicating preventable racial disparities. Understanding preventing examining health disparities, using claims data to assess healthcare utilization, and policy analysis, sources of these disparities will provide great insight into and delaying cognitive impairment. The goal of the proposed K01 is to train the candidate in to build on her prior work, which has focused on interpersonal dynamics and social networks of older adults as risk factors for functional decline. practices, opportunities candidate The proposed research focuses on structural racism – the larger system of policies, and institutions that reinforces racial inequality by creating differential access to resources and – as a fundamental cause of racial disparities in cognitive impairment. Through this K01, t he will (1) link data from the US Census, Medicare claims, and the Health and Retirement Study, to examine how structural racism leads to health disparities in cognitive impairment and dementia; (2) develop an understanding of how population-based research can be leveraged to inform policies in health and non-health sectors for older adults; equity, is extensive domains design in across racism utilization and, the solutions training individual-level and (3) complete oursework in neurobiology of dementia, social justice and health methods in health services research, and policy modeling approaches. The Yale School of Public Health a phenomenal environment to pursue this training. The candidate's primary mentor, Dr. Danya Keene, has expertise in how structural racism in the domain of housing policies and practices, intersects with other of structura racism to create health inequalities. Dr. Heather Allore (co-mentor) is an expert in the and statistical analysis o observational studies and clinical trials for older adults, with a special interest racial disparities in the context of dementia. Dr. Belinda Needham (co-mentor) is an expert in health disparities the life course. The proposed project will examine the association between three dimensions of structural and risk of cognitive impairment, including dementia, and racial disparities in these outcomes; health care among individuals with cognitive impairment; and assess whether s ocial support, at the individual level, Medicaid expansion, at the structural-level, modify the adverse effects of structural racism. Consistent with research priorities of NIA, findings f rom this work will inform future multi-level interventions and policy to reduce health disparities in cognitive impairment (RFA: PA-15-349). Further, the combination of and research will serve as a spring board for the candidate's long-term goal to move the field beyond risk factors to evaluate and address structural-level risk factors for cognitive impairment. c l f

它 认知 估计 据估计，到70岁时，65%的人会经历某种程度的认知障碍。在 损伤、阿尔茨海默病和相关的痴呆症是主要的死亡原因，影响 580万美国人。美国黑人被诊断出患有癌症的可能性是白人的两倍 认知障碍。在有认知障碍的老年人中，黑人与白人相比， 有更差的认知功能，更大的功能残疾，更严重的神经精神症状， 这表明种族差距是可以预防的。理解 预防 检查健康差距，使用索赔数据评估医疗保健利用率，以及政策分析， 这些差异的来源将为我们提供对 并延缓认知障碍。拟议的K01的目标是培训应聘者 在此基础上继续发展 她之前的工作重点是老年人的人际动态和社会网络作为风险因素 对于功能衰退。 实践， 机遇 候选人 拟议的研究重点是结构性种族主义--更大的政策体系， 以及通过创造不同的资源和资源获取机会来加强种族不平等的机构 --这是造成认知障碍种族差异的根本原因。通过这个K01，他 将(1)将来自美国人口普查、联邦医疗保险索赔以及健康和退休研究的数据链接到 研究结构性种族主义如何导致认知障碍和痴呆症的健康差异；(2)制定 了解如何利用以人口为基础的研究为健康和非健康政策提供信息 针对老年人的部门； 股权， 是 广延 网域 设计 在……里面 横穿 种族主义 利用 和, 这个 解决方案 培训 个人层面 以及(3)完成痴呆的神经生物学、社会正义和健康方面的工作 卫生服务研究的方法，以及政策建模方法。耶鲁大学公共卫生学院 追求这一培训的非凡环境。这位候选人的主要导师丹娅·基恩博士 在住房政策和做法领域的结构性种族主义如何与其他 一种结构性种族主义，以制造健康不平等。希瑟·阿洛尔博士(共同导师)是 对老年人的观察性研究和临床试验的统计分析，特别感兴趣 痴呆症背景下的种族差异。贝琳达·李约瑟博士(共同导师)是健康差距方面的专家 生命的历程。拟议的项目将检查结构的三个维度之间的关联 和认知障碍的风险，包括痴呆症，以及这些结果中的种族差异；保健 并评估S在个人层面上的社会支持， 医疗补助的扩大，在结构层面上，改变了结构性种族主义的不利影响。与一致 NIA的研究重点，这项工作的发现将为未来的多层次干预和政策提供信息 减少认知障碍的健康差距(RFA：PA-15-349)。此外，这两种技术的结合 研究将作为候选人长期目标的跳板，使该领域超越 评估和解决认知障碍的结构性风险因素的风险因素。 C L F