Collaborative Research: Factors Affecting Ethnic Differences in Adult Mortality

这是一项关于成人死亡率的种族差异的研究。它将采用人口统计学、概念和方法论的方法来实现关于特定原因死亡率和多原因死亡率的三个主要研究目标。首先，它将开发一个比迄今提出的更全面的模型，将风险因素与种族死亡率差异联系起来。其次，这项工作将扩大死亡率研究中常见的种族类别的范围。第三，它将使用一个独特的数据库，将详细的人口统计、社会经济、家庭结构、健康和行为因素与种族群体的死亡率联系起来。该项目的具体目标是：(1)汇编和调整一个完整的、预期的数据库，以便在分析按死因分列的成人死亡率的种族差异时，能够同时检查人口和社会经济背景因素、家庭结构、健康行为和健康史因素。(2)扩大死亡率研究中通常发现的种族类别的范围，将墨西哥人、土著、非洲人、亚洲人和高加索美国人包括在内。(3)揭示为什么某些种族群体，特别是非裔美国人，死于循环系统疾病的风险相对较高。(4)揭示为什么非裔美国人的癌症死亡率高得不成比例。(5)说明为什么高加索裔美国人的呼吸系统疾病死亡率高得不成比例。(6)解释为什么墨西哥裔、土著和非洲裔美国人表现出相对较高的糖尿病死亡率。(7)说明为什么墨西哥裔、土著和非裔美国人死于社会病态的比例相对较高。(8)扩大死因分析范围，包括基本死因和多种死因。(9)考虑到按性别和年龄组划分的族裔死亡模式的差异。(10)使用连续时间危险率模型，该模型允许按族裔群体对死亡风险进行多变量检查。美国长期以来存在的死亡率种族差异是一个令人担忧和具有挑战性的问题。虽然不同群体之间的死亡率差异一直有更好的记录，特别是非洲人和高加索美国人之间的差异，但对差异的解释一直很薄弱，特别是在比较众多种族群体的时候。例如，人们对墨西哥裔美国人的死亡率知之甚少，以至于他们的有利死亡率经常被称为“流行病学悖论”。对于亚裔美国人和土著美国人表现出的不同死因模式，人们更是知之甚少。因此，这项研究的主要目的是使用一个将人口统计、社会经济、家庭结构、行为和健康史因素与潜在和多原因死亡率差异联系起来的模型来解释特定原因死亡率的种族差异。一个更全面和更具体的模型将更容易确定社会项目、公共政策、医疗和未来研究可能产生最有益影响的关键领域。

This is a study of ethnic differences in adult mortality. It will employ demographic conceptual and methodological approaches to accomplish three main research goals both for cause-specific and multiple-cause mortality. First, it will develop a more comprehensive model relating risk factors to ethnic mortality differentials than has heretofore been presented. Second, the work will broaden the range of ethnic categories typically found in mortality studies. Third, it will employ a unique data base that links detailed demographic, socioeconomic, family structure, health, and behavioral factors to mortality of ethnic groups. The specific aims of the project are to: (1) Assemble and adapt an integral, prospective database that will permit simultaneous examination of demographic and socioeconomic background factors, family structure, health behaviors, and health history factors in an analysis of ethnic variations in adult mortality by cause of death. (2) Broaden the range of ethnic categories typically found in mortality studies to include Mexican, Native, African, Asian, and Caucasian Americans. (3) Uncover why some ethnic groups, notably African Americans, experience relatively high mortality risk from circulatory diseases. (4) Reveal why African Americans suffer disproportionately high rates of cancer mortality. (5) Show why respiratory disease mortality is disproportionately high among Caucasian Americans. (6) Illuminate why Mexican, Native, and African Americans exhibit relatively high rates of diabetes mortality. (7) Illustrate why Mexican, Native, and African Americans die at relatively high rates from social pathologies. (8) Extend the cause of death analysis to include both underlying and multiple causes of death. (9) Account for variations in ethnic mortality patterns by sex and age groupings. (10) Use continuous-time hazard rate models, which allow a multivariate examination of the risk of death by ethnic group. The ethnic differences in mortality that have so long persisted i n the U.S. represent a troubling and challenging question. While mortality differences between groups are continually better-documented, particularly between African and Caucasian Americans, the explanation of differences has been weak, particularly when numerous ethnic groups are compared. For example, so little is known about Mexican American mortality that their favorable mortality rates are often termed an "epidemiological paradox." Even less is known about the differing cause patterns of death exhibited by Asian and Native Americans. Thus, the principal purpose of this research is to explain ethnic differences in cause-specific mortality, using a model that relates demographic, socioeconomic, family structure, behavioral, and health history factors to both underlying and multiple cause mortality differentials. A more comprehensive and more specific model will make it easier to identify key areas where social programs, public policy, medical treatment, and future research can have the most beneficial effects.