EXPLORING TRENDS IN US HEALTH INEQUITIES IN CONTEXT: NHES TO NHANES, 1959-2006

探索美国健康不平等的趋势：NHES 到 NHANES，1959-2006

• 批准号: 8043418
• 负责人: NANCY KRIEGER
• 金额: $ 24.23万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8043418
• 关键词: Address; Adult; African American; Behavioral Sciences; Blood Pressure; Cardiovascular system; Case Study; Child; Child Development; Child health care; Cholesterol; Civil Rights; Code; Complex; Crows; Data; Databases; Decayed, Missing, and Filled Teeth; Dental; Development; Economics; Education; Ethnic Origin; Gender; Grant; Health; Health Status; Healthy People 2010; Height; Hypertension; Income; Individual; Institutes; Institution; Knowledge; Laws; Life; Link; Low income; Manuscripts; Measures; Methods; National Health and Nutrition Examination Survey; Obesity; Outcome; Overweight; Pattern; Periodontal Diseases; Policies; Population; Population Attributable Risks; Premature Mortality; Preparation; Preventive Intervention; Public Health; Public Policy; Publishing; Race; Relative (related person); Research; Research Project Grants; Serum; Shapes; Socioeconomic Status; Surveys; Testing; Text; Time; Triglycerides; United States National Center for Health Statistics; United States National Institutes of Health; Weight; base; blood lead; falls; health disparity; improved; interest; mortality; novel; policy implication; population health; programs; racial and ethnic; racial and ethnic disparities; racial discrimination; response; social inequality; socioeconomics; trend

DESCRIPTION (provided by applicant): OUR PROPOSED EXPLORATORY STUDY, PREPARED IN RESPONSE TO PA-10-069, FOCUSES ON A SIGNIFICANT PROBLEM: INADEQUATE DATA ON LONG-TERM TRENDS IN US SOCIOECONOMIC AND RACIAL/ETHNIC INEQUITIES IN MEASURED HEALTH STATUS. WE THEREFORE SEEK TO DETERMINE THE FEASIBILITY OF CREATING AND ANALYZING A NOVEL MULTILEVEL US NATIONAL DATABASE THAT COMBINES: (A) INDIVIDUAL-LEVEL HEALTH DATA, (B) NOVEL MEASURES OF SOCIOECONOMIC POSITION (SEP) THAT CAN BE MEANINGFULLY COMPARED OVER TIME, AND (C) NOVEL CONTEXTUAL DATA ON "JIM CROW" LAWS (I.E., LAWS THAT PERMITTED RACIAL DISCRIMINATION ABOLISHED BY THE 1964 US CIVIL RIGHTS ACT). THESE DATA ARE KEY FOR ADDRESSING a new debate WITH CRITICAL PUBLIC HEALTH AND POLICY IMPLICATIONS: as overall population health improves, do the absolute and relative magnitudes of socioeconomic disparities increase, stay the same, or decrease? - and, in the US, do these patterns vary by race/ethnicity and gender? WERE RESULTS TO SHOW ALL 3 PATTERNS ARE POSSIBLE, THEY WOULD REFUTE HYPOTHESES, BASED ON POST-1980 DATA, THAT INEQUITIES NECESSARILY WIDEN. [TEXT DELETED] Our specific aims thus are: (a) Aim 1: Create a US national health outcomes database spanning 1959- 2006 using data from the US National Health Examination Survey (NHES; Cycle I: 1959-1962; Cycle II: 1963- 1965; Cycle III: 1966-1970) and the subsequent US National Health and Nutrition Examination Surveys (NHANES I: 1971-1975; NHANES II: 1976-1980; NHANES III: 1988-1994; and NHANES 1999-2000; 2001- 2002; 2003-2004; 2005-2006), AND VIA THE NATIONAL CENTER FOR HEALTH STATISTICS (NCHS) RESEARCH DATA CENTER (RDC), LINK THESE DATA TO: (1) DETAILED INDIVIDUAL-LEVEL INCOME AND EDUCATION DATA, AND (2) DATA ON STATE'S PRE-1964 JIM CROW STATUS; (b) Aim 2: Explore developing socioeconomic measures that can meaningfully be compared over time; (c) Aim 3: Explore quantifying temporal patterns in the magnitude of socioeconomic inequities in health, using the measures developed for Aim 2, to test the hypothesis that socioeconomic inequities in health decreased between 1960 and 1980 (especially among black Americans) and then stagnated or widened thereafter; (d) Aim 4: [TEXT DELETED] Test the hypothesis that the sharpest reductions in pre-1980 and the largest rises in post-1980: (a) socio-economic inequities in health (especially among black Americans), and (b) black/white inequities (especially in lower income strata), occurred among residents of Jim Crow states; and (e) Aim 5: Disseminate results by publishing scientific manuscripts and use the results to inform preparation of an R01 to conduct the first multilevel contextual analysis of long-term temporal patterns (1959-present) in the magnitude of US HEALTH INEQUITIES. ADDRESSING THESE AIMS HAS THE POTENTIAL TO CHANGE SIGNIFICANTLY CONCEPTS, METHODS, AND PREVENTIVE INTERVENTIONS REGARDING US SOCIOECONOMIC AND RACIAL/ETHNIC DISPARITIES IN HEALTH, WHOSE ELIMINATION IS a key objective of Healthy People 2010. PUBLIC HEALTH RELEVANCE: Our objective is to explore novel multilevel approaches to developing the methods and database that would enable addressing a new debate about whether, as overall population health improves, the absolute and relative magnitude of socioeconomic disparities increase, stay the same, or decrease? In accord with the purpose of an exploratory grant (R21), the intent is to set the basis for a subsequent application (R01) that would permit generating the full-fledged database suitable for rigorously testing, with appropriate methods, the hypotheses of interest. Knowledge produced by the proposed study HAS THE POTENTIAL TO CHANGE SIGNIFICANTLY CONCEPTS, METHODS, AND PREVENTIVE INTERVENTIONS REGARDING US SOCIOECONOMIC AND RACIAL/ETHNIC DISPARITIES IN HEALTH, WHOSE ELIMINATION IS A KEY OBJECTIVE OF Healthy People 2010.

描述（由申请人提供）：我们提出的探索性研究是针对PA-10-069的响应，重点是一个重大问题：关于美国社会经济和种族/种族/种族不平等的长期趋势数据不足。因此，我们试图确定创建和分析结合：（a）个人级健康数据，（b）社会经济地位（SEP）的新颖衡量的新型多级美国国家数据库的可行性，可以随着时间的推移有意义地进行比较，（c）“吉姆·克劳”法律上的新颖上下文数据（jim crow'法律（即允许种族歧视的法律），该法律允许了1964年的行为。这些数据是解决具有关键公共卫生和政策影响的新辩论的关键：随着总体人口健康的改善，社会经济差异的绝对和相对幅度是否增加，保持不变或减少？ - 在美国，这些模式会因种族/种族和性别而异？如果结果表明所有3种模式都是可能的，他们将根据1980年后的数据来反驳任何不平等的假设。 [TEXT DELETED] Our specific aims thus are: (a) Aim 1: Create a US national health outcomes database spanning 1959- 2006 using data from the US National Health Examination Survey (NHES; Cycle I: 1959-1962; Cycle II: 1963- 1965; Cycle III: 1966-1970) and the subsequent US National Health and Nutrition Examination Surveys (NHANES I: 1971-1975; NHANES II: 1986年，NHANES III：1988-194; （b）目标2：探索正在制定随着时间的时间进行有意义比较的社会经济措施； （c）目标3：使用针对AIM 2开发的措施，探索量化健康不平等的时间模式，以检验以下假设：健康中的社会经济不平等在1960年至1980年之间（尤其是在黑人美国人中），然后在此后停滞或扩大或扩大。 （d）目的4：[删除文本]检验了以下假设：1980年前的最大减少和1980年后的最大升高：（a）健康中的社会经济不平等（尤其是黑人美国人），以及（b）黑人/白人不平等现象（尤其是较低的收入阶层）（尤其是在较低的收入阶层），发生了吉姆·尤姆（Jim jim Crow Crow Crow Crow）的居民； （e）目标5：通过发表科学手稿来传播结果，并利用结果为R01的准备提供了准备，以对美国健康不平等的大小进行长期时间模式（1959-至今）进行首次多层次上下文分析。解决这些目标的潜力有可能改变有关美国社会经济和种族/种族/种族差异的重大概念，方法和预防干预措施，他们的消除是健康人的关键目标。 公共卫生相关性：我们的目标是探索开发方法和数据库的新型多层次方法，这些方法和数据库可以解决有关随着整体人口健康是否改善，社会经济差异的绝对和相对幅度是否增加，保持相同或减少的新辩论？根据探索性赠款（R21）的目的，目的是为后续申请（R01）设定基础，该申请将允许生成适用于严格测试的完整数据库，并采用适当的方法，即利益的假设。拟议研究产生的知识有可能改变有关美国社会经济和种族/种族差异的重大概念，方法和预防性干预措施，其消除是健康人的关键目标。