Socioeconomic Status, Mortality, and Morbidity in Older Americans

其他项目信息-项目摘要/摘要 美国老年人的社会经济地位、死亡率和发病率 现在有充分的证据表明，在过去的几年里，其他富裕国家经历的中年死亡率下降 在过去的20年里，美国白人非拉美裔(WHH)一直被绕过。对于从25岁到29岁到50岁的所有五岁年龄组- 54,2015年卫生保健机构的死亡率高于1999年，但非西班牙裔黑人和 西班牙裔。这种进展的停滞和逆转在很大程度上是由非白人死亡人数增加推动的 没有四年大学学位的西班牙裔美国人。死于药物过量、自杀和酒精相关的肝脏 疾病(“绝望死亡”)在此期间上升，而防治心脏病的进展停滞不前。什么不是 这些不同趋势的原因是众所周知的。使用关于死亡率、发病率、劳动力市场的数据 条件、信用评分和社会关系，我们提议的研究将分析为什么这些令人震惊的趋势 在早期死亡和阿片类药物使用已经发生。我们将探索多种因果解释，通灵 通过教育、就业机会、不平等、健康行为和医疗保健。你的角色是什么 教育在不断上升的“绝望之死”中扮演了什么角色？在质量和可获得性方面恶化到什么程度 低技能工作会在一生中累积影响死亡率和发病率吗？这个项目的成功是否 受过高等教育的人是以受教育程度较低的人为代价的吗？差距在多大程度上 强调健康行为和保健，如阿片类药物处方和心血管疾病治疗 条件呢？这些不同的潜在因果路径并不是相互排斥的，而是建立了它们的 重要性对于制定有意义的干预措施至关重要，无论是在教育、劳动力市场、医疗保健、 社会支持或其他政策。最后，我们将考虑不利的死亡率和发病率 在中年明显的模式，可能会延续到更年长的年龄，或者恢复到更有利的模式 目前由老年人经历的。

OTHER PROJECT INFORMATION – Project Summary/Abstract Socioeconomic Status, Mortality, and Morbidity in Older Americans It is now well documented that the midlife mortality declines experienced in other wealthy countries over the last 20 years have bypassed US white non-Hispanics (WNHs). For all five-year age groups from 25-29 to 50- 54, mortality rates for WNHs were higher in 2015 than in 1999, but lower for black non-Hispanics and Hispanics. This stalling and reversal of progress is largely driven by the increasing deaths of white non- Hispanics without a four-year college degree. Deaths from drug overdose, suicide, and alcohol-related liver disease (“deaths of despair”) rose over this period, while progress against heart disease stalled. What is not well understood is the causes of these differential trends. Using data on mortality, morbidity, labor market conditions, credit scores, and social connection, our proposed research will analyze why these alarming trends in early mortality and opioid use have occurred. We will explore multiple causal explanations, channeling through education, employment opportunities, inequality, health behaviors, and health care. What role does education play in rising “deaths of despair”? To what degree does deterioration in the quality and availability of low-skilled jobs cumulatively impact mortality and morbidity over the life course? Does the success of the highly educated come at the expense of those with less education? To what degree are disparities accentuated by health behaviors and health care, such as opioid prescribing and treatment of cardiovascular conditions? These various potential causal pathways are not mutually exclusive, but establishing their importance is critical to developing meaningful interventions, whether in education, labor markets, health care, social supports, or other policies. And finally, we will consider whether the adverse mortality and morbidity patterns evident in midlife, are likely to carry forward into older ages, or to revert to the more favorable patterns currently experienced by the elderly.