Area-level Socio-economic Conditions and Individual-level Health and Mortality: Exploring Place-Based Mechanisms and Individual-level Psychosocial Processes

地区层面的社会经济条件和个人层面的健康和死亡率：探索基于地方的机制和个人层面的心理社会过程

• 批准号: 10583024
• 负责人: David Stuart Curtis
• 金额: $ 56.62万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583024
• 关键词: Address; Adult; Affect; Age; Air; Alcohols; Area; Attention; Birth Certificates; Black race; Cardiovascular Diseases; Cessation of life; Communities; Complex; Country; County; Data; Data Set; Death Records; Development; Diabetes Mellitus; Disadvantaged; Economic Conditions; Enrollment; Environment; Equation; Family; Floods; Health; Health Status; Health behavior; Individual; Intervention; Investigation; Knowledge; Licensing; Life Expectancy; Link; Literature; Longitudinal Studies; Measures; Mediating; Medical; Mental Health; Methods; Modeling; Morbidity - disease rate; Outcome; Overdose; Pathway interactions; Persons; Pharmaceutical Preparations; Physical activity; Population Database; Premature Mortality; Process; Records; Research; Resources; Risk; Role; Sampling; Socioeconomic Status; Statistical Methods; Suicide; Surveys; Survival Analysis; System; Testing; Time; Unemployment; United States; Utah; aged; aging population; built environment; cardiometabolism; college; design; follow-up; geographic difference; health disparity; improved; innovation; insight; middle age; mortality; mortality disparity; novel; obesogenic; overdose death; prescription opioid; prevent; prospective; psychosocial; social; social capital; social norm; social organization; socioeconomics; substance misuse; synthetic opioid; trend; urban area; walkability

PROJECT SUMMARY More than 1 million drug overdose deaths have occurred in the US since 1999, while progress in reducing mortality from cardiovascular disease and diabetes has stalled since 2010. This evidence of rising morbidity and mortality in midlife has drawn attention to health risks among the working-age population. Increasing geographic variation in premature mortality, most pronounced during early to mid-adulthood, highlights the role of place. Research is needed that systematically identifies how place-based features contribute to the US midlife health and mortality crisis. Drawing from socio-ecological perspectives of health, the present study will test a comprehensive conceptual framework to examine the direct, indirect, and moderating effects within the place and health relationship. We will use two unique datasets that allow us to address limitations that have stymied past efforts. First, the Midlife in the United States study (MIDUS) enrolled 7,108 adults in the contiguous US aged 25 to 74 in 1995-1996 and surveyed them again in 2004-2006 and in 2013-2014, adding a sample of 592 Black adults in 2004-2006 who were surveyed again in 2016-2017. Second, the Utah Population Database (UPDB) includes data from a variety of state vital and administrative records for over 12 million individuals over 100 years, linked by family and containing geocoded residential addresses. From the UPDB, we will create a sample of 1.6 million adults aged 25 to 74 residing in a four-county urban area in 2000, for whom mortality is tracked until 2020 with 142,330 deaths recorded. Both datasets enable place-based longitudinal health research. In examining the health outcomes of substance misuse, mental health, cardiometabolic health, and mortality, we will: identify the prospective effects of area-level socioeconomic conditions on individual-level health and mortality outcomes (Aim 1); and document the prospective effects of place-based built, social, and natural environments on individual-level health and mortality outcomes (Aim 2). Attention will be given to how environmental features moderate and mediate prospective effects of area-level socioeconomic conditions, and to the individual-level mediating processes. We will use innovative methods to measure a range of place-based features and improve estimation using rigorous statistical methods (e.g., multi-level structural equation modeling, spatial analysis, and advanced survival analysis). Through this comprehensive investigation, we will document how place-based factors drive midlife health and mortality disparities and provide valuable insights into the complex and dynamic relationships within systems of people and places. This holistic research effort will produce novel evidence to support the development of effective place-based interventions.

项目摘要 自1999年以来，美国已发生超过100万例药物过量死亡，而减少药物过量的进展 自2010年以来，心血管疾病和糖尿病的死亡率一直停滞不前。发病率上升的证据 中年死亡率的上升引起了人们对工作年龄人口健康风险的关注。增加 过早死亡的地理差异，在成年早期到中期最为明显，突出了 的地方。需要进行研究，系统地确定基于地点的特征如何对美国做出贡献 中年健康和死亡危机从健康的社会生态角度出发，本研究将 测试一个全面的概念框架，以检查直接，间接和调节作用， 位置与健康的关系。我们将使用两个独特的数据集，使我们能够解决限制， 阻碍了过去的努力。首先，美国中年研究（MIDUS）招募了7,108名成年人， 1995-1996年，25至74岁的美国连续人口，并在2004-2006年和2013-2014年再次对他们进行调查， 2004-2006年的592名黑人成年人样本，他们在2016-2017年再次接受调查。第二，犹他州 人口数据库（Population Database）包括12年以上的各种州人口动态和行政记录的数据。 100万个人，由家庭联系在一起，并包含地理编码的居住地址。从 2000年，我们将在四个县的城市地区建立一个160万年龄在25岁至74岁之间的成年人的样本， 对这些人的死亡率进行跟踪，直到2020年，记录了142，330例死亡。这两个数据集都支持基于地点的 纵向健康研究。 在检查药物滥用、心理健康、心脏代谢健康和死亡率的健康结果时， 我们将：确定地区一级社会经济条件对个人一级健康的预期影响， 死亡率结果（目标1）;并记录基于地点的建筑、社会和自然 环境对个人健康和死亡率结果的影响（目标2）。将注意如何 环境特征对区域一级社会经济条件的预期影响具有中度和中度影响， 到个人层面的调解过程。我们将使用创新的方法来衡量一系列基于地点的 特征并使用严格的统计方法改进估计（例如，多层结构方程 建模、空间分析和高级生存分析）。通过这次全面调查，我们将 记录基于地点的因素如何推动中年健康和死亡率的差异，并提供有价值的见解 人与地之间复杂而动态的关系。这种全面的研究努力 将产生新的证据，以支持制定有效的基于地点的干预措施。