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 认知的 估计的 据估计，到 70 岁时，65% 的人会出现某种程度的认知障碍。之内 损伤、阿尔茨海默氏病和相关痴呆症是死亡的主要原因，影响着 580 万美国人。美国黑人被诊断出患有此病的可能性是美国白人的两倍 认知障碍。在患有认知障碍的老年人中，黑人与白人相比，个体 认知功能更差，功能障碍更严重，神经精神症状更严重， 表明种族差异是可以预防的。理解 预防 检查健康差异，使用索赔数据评估医疗保健利用率和政策分析， 这些差异的根源将有助于深入了解 并延缓认知障碍。拟议 K01 的目标是培训候选人 建立在 她之前的工作重点关注老年人的人际动态和社交网络作为危险因素 对于功能衰退。 实践， 机会 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， 以及通过创造资源和资源获取机会的差异而加剧种族不平等的机构 – 作为认知障碍种族差异的根本原因。通过这个K01， 将 (1) 将美国人口普查、医疗保险索赔以及健康与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方面的健康差异； (2) 开发一个 了解如何利用基于人群的研究为健康和非健康政策提供信息 老年人部门； 公平， 是 广泛的 域 设计 在 穿过 种族主义 利用率 和， 这 解决方案 训练 个人层面 (3) 完成痴呆症神经生物学、社会正义和健康方面的工作 卫生服务研究方法和政策建模方法。耶鲁大学公共卫生学院 进行这种培训的非凡环境。候选人的主要导师 Danya Keene 博士 住房政策和实践领域的结构性种族主义如何与其他方面交叉的专业知识 结构性种族主义造成健康不平等。 Heather Allore 博士（共同导师）是该领域的专家 和统计分析 o 针对老年人的观察性研究和临床试验，特别感兴趣 痴呆症背景下的种族差异。 Belinda Needham 博士（联合导师）是健康差异方面的专家 生命历程。拟议的项目将研究结构的三个维度之间的关联 认知障碍（包括痴呆）的风险以及这些结果的种族差异；卫生保健 有认知障碍的个体；并评估个人层面的社会支持是否 医疗补助的扩张在结构层面上改变了结构性种族主义的不利影响。符合 NIA 的研究重点，这项工作的结果将为未来的多层次干预措施和政策提供信息 减少认知障碍方面的健康差异（RFA：PA-15-349）。进一步地，组合 研究将作为候选人实现该领域超越的长期目标的跳板 评估和解决认知障碍的结构层面风险因素的风险因素。 c 我 f