Trends in ethnic and socioeconomic differentials in diet quality in American chil

描述（由申请人提供）：来自少数民族和低社会经济家庭的美国儿童健康状况不佳和死亡率较高。最近的数据表明，这些种族和社会经济差异在美国儿童的健康结果中持续存在或扩大。例如，在过去的三十年里，美国儿童的伤害和自然原因死亡率总体上有所下降。然而，来自少数民族和社会经济地位较低家庭的儿童下降幅度较小，导致社会经济差距扩大。对美国儿童肥胖、糖尿病前期和高血压患病率等风险因素的趋势分析也表明，社会经济和种族差异也存在类似的持续性或增加。包括饮食在内的不良健康风险行为是许多因素之一，如获得医疗保健，环境暴露，邻里环境，收入限制和歧视，这些因素可能导致美国儿童健康的种族和社会经济差异。饮食可能是健康方面的种族和社会经济差异的媒介这一假设似乎是合理的，因为饮食是许多慢性病的公认风险因素。然而，令人惊讶的是，很少有人知道的独立协会的种族和社会经济地位的措施-家庭收入，教育和职业-与饮食属性在一个多变量框架内，在美国儿童。此外，没有关于饮食和社会经济地位之间的联系如何随着时间的推移在美国儿童中发生变化的公开信息。评估由于种族和社会经济群体成员资格导致的饮食差异的时间趋势可能有助于我们了解饮食是否可能是美国儿童健康差异持续或增加的原因。因此，本申请的总体目标是在美国儿童和青少年中检查：1）种族/民族和社会经济地位（家庭收入，教育和职业）与报告的饮食属性和饮食摄入量的客观生物标志物的独立关联，以及2）1971年至2006年种族/民族和社会经济地位与饮食质量关联的趋势。我们将使用1971 - 1974年、1976-1980年、1982-1984年（西班牙裔HANES）、1988-1994年和2001-2006年进行的全国健康和营养调查（NHANES）中2-19岁奥尔兹（n= 39，607）的全国代表性数据来解决这些问题。公共卫生相关性：饮食因素在改善健康结果方面的重要性突出表现在以下事实：饮食因素易于干预，饮食是普遍消费的，即使是很小的相对风险也可能产生相当大的公共健康影响。因此，对饮食质量方面的种族和社会经济差异的时间趋势进行评估，将有助于确定在缩小健康结果方面的种族和社会经济差距方面取得的绝对和相对进展，这是国家健康促进议程的一个既定目标。因此，这项研究的结果将有助于评估过去在这些高危人群中促进理想行为改变的努力的有效性，并设计新的策略，以针对与种族和社会经济地位相关的饮食属性。

DESCRIPTION (provided by applicant): American children from ethnic minority and low socioeconomic families have higher rates of poor health and higher mortality rates. Recent data suggest persistence or widening of these ethnic and socioeconomic differentials in health outcomes of US children. For example, over the past three decades, overall, injury, and natural-cause mortality in childhood in the US declined. However, children from minority and lower socioeconomic position families experienced a smaller decline, resulting in a widening of the socioeconomic gap. The trends analysis for risk factors such as prevalence of obesity, prediabetes, and high blood pressure in US children also suggest similar persistence or increase of socioeconomic and ethnic disparities. Adverse health risk behaviors that include diet are among the many factors such as access to health care, environmental exposures, neighborhood contexts, income constraints, and discrimination that may contribute to ethnic and socioeconomic disparities in the health of US children. The hypothesis that diet may be a mediator of ethnic and socioeconomic disparities in health appears reasonable given that diet is an acknowledged risk factor for a number of chronic diseases. However, surprisingly little is known about the independent associations of ethnicity and measures of socioeconomic position-- family income, education, and occupation--with dietary attributes within a multivariate framework in US children. Also, there is no published information on how the association of diet and socioeconomic position may be changing over time in US children. Assessment of time trends in dietary disparities due to ethnic and socioeconomic group membership may help us to understand whether diet may be a contributor to persistence or increase of health disparities among US children. Therefore, the overall objectives of this application are to examine in US children and adolescents: 1) the independent associations of race/ethnicity and measures of socioeconomic position (family income, education, and occupation) with attributes of reported diets and objective biomarkers of dietary intake, and 2) the trends in the association of race/ethnicity and socioeconomic position with diet quality from 1971 to 2006. We will use nationally representative data for 2-19 year olds (n= 39,607) from the National Health and Nutrition Examination Surveys (NHANES) conducted in1971-74, 1976-1980, 1982-1984 (Hispanic HANES), 1988-1994, an 2001-2006, to address these issues. PUBLIC HEALTH RELEVANCE: The importance of dietary factors in improving health outcomes is underscored by the fact that dietary factors are amenable to intervention, and diet is universally consumed and even a small relative risk may have a considerable public health impact. Assessment of time trends in ethnic and socio- economic differentials in diet quality will therefore help in determining the absolute as well as relative progress in closing the ethnic and socioeconomic gaps in health outcomes that is a stated goal of the national health promotion agenda. The results of this study will thus help in evaluating the effectiveness of past efforts to promote desirable behavior changes in these high risk populations, and design of newer strategies to target dietary attributes associated with ethnicity and socioeconomic position.