Mechanisms Underlying Racial/Ethnic Disparities in Mental Disorders

精神障碍中种族/民族差异的潜在机制

• 批准号: 9172760
• 负责人: MARGARITA ALEGRIA
• 金额: $ 55.33万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9172760
• 关键词: Mechanisms; Underlying; Racial; Ethnic; Disparities

 DESCRIPTION (provided by applicant): As part of the Affordable Health Care Act, the Department of Health and Human Services (HHS) must develop and evaluate an action plan to reduce racial/ethnic health disparities, including increased preventive care and investments in community health teams that can benefit minority communities. But for such a plan to be effective, thoughtful targeting is needed. The proposed research has the potential to build a solid research foundation for developing interventions to achieve mental health equity that could be implemented as part of the HHS agenda to reduce disparities. Nearly 40% of the US population develops a mental disorder in their lifetime, with racial/ethnic minority groups at particularly high risk of severe-persistent mental disorders and untreated mental illness. But fundamental questions remain unanswered given that few studies investigate the mechanisms that underlie these disparities. The research proposed here aims to attend to this knowledge gap by examining four sets of mechanisms hypothesized to play important roles in causing racial/ethnic disparities in mental disorders: (1) low socio-economic status (SES); 2) childhood adversities (e.g., maltreatment, family violence); (3) disadvantaged role constellations (e.g., early child-bearing, divorce); and (4) disadvantaged neighborhood context (e.g., residential segregation, concentrated disadvantage). We propose to study four mechanisms by carrying out secondary analysis of community epidemiological data across five surveys that provide unparalleled information about the lifetime onset of a wide range of these lifetime disorders, and disparities in the persistence and severity of these disorders once they occur. We also examine barriers to mental health care since untreated mental illness has devastating effect on minority communities. But because empirical findings typically do not bridge the distance between the people who produce the information and the people who could use the information, our last aim identifies how best to frame and use our research results as actionable targets for Intervention and/or policy change. We will work with community, consumer, and policy groups to generate recommendations for prevention, service, and policy interventions aimed at reducing racial/ethnic disparities in mental health outcomes and services.

 描述（由申请人提供）：作为负担得起的医疗保健法的一部分，卫生和人类服务部（HHS）必须制定和评估一项行动计划，以减少种族/民族的健康差距，包括增加预防性护理和对社区卫生团队的投资，可以使少数民族社区受益。但要使这样一个计划有效，就需要有深思熟虑的目标。拟议的研究有可能建立一个坚实的研究基础，制定干预措施，以实现心理健康的公平，可以作为HHS议程的一部分，以减少差距。近40%的美国人口在其一生中发展为精神障碍，少数种族/族裔群体患严重持续性精神障碍和未经治疗的精神疾病的风险特别高。但由于很少有研究调查这些差异背后的机制，根本问题仍然没有答案。这里提出的研究旨在通过检查四组假设在造成精神障碍的种族/民族差异方面发挥重要作用的机制来解决这一知识差距：（1）低社会经济地位（SES）; 2）童年逆境（例如，虐待，家庭暴力）;（3）弱势角色群（例如，早育、离婚）;以及（4）不利的邻里环境（例如，居住隔离，集中的不利条件）。我们建议通过对五项调查中的社区流行病学数据进行二次分析来研究四种机制，这些调查提供了关于这些终身疾病的广泛的终身发病的无与伦比的信息，以及这些疾病一旦发生的持久性和严重程度的差异。我们还研究了精神卫生保健的障碍，因为未经治疗的精神疾病对少数民族社区具有破坏性影响。但是，由于实证研究结果通常不能弥合产生信息的人与可能使用信息的人之间的距离，我们的最后一个目标是确定如何最好地构建和使用我们的研究结果作为干预和/或政策变化的可操作目标。我们将与社区，消费者和政策团体合作，为预防，服务和政策干预提出建议，旨在减少心理健康结果和服务中的种族/民族差异。