BIODEMOGRAPHY OF HEALTH, SOCIAL FACTORS & LIFE CHALLENGE

人口统计过程、社会环境和生活挑战与功能状态和疾病密切相关。社会环境，包括在社会等级中的地位以及社会网络和支助系统内的联系，影响对挑战的暴露，并调节其影响。这项生物人口调查有两个主要目标。首先，我们建议阐述生活挑战和健康之间的关系，探索社会环境如何影响这种关系。具体地说，我们将：1)确定与健康保护和恶化最密切相关的挑战，并最好地区分这些挑战；2)研究社会联系、支持网络、工具性援助和情感支持以及社会活动对健康的成本和好处。我们将确定对维持心理和身体功能以及调节挑战对健康结果的影响最重要的组成部分；以及3)在考虑到生活事件的时间和严重性的情况下，探索累积优势和累积逆境对健康的影响。其次，我们建议探索如何通过结合健康和压力的生物标记物来增强我们对生活挑战、社会环境和健康之间关系的理解。我们将：1)调查压力和慢性病的生物标记物与生活事件报告的关系；2)检查生物标记物与医生检查数据和自我报告的健康状况之间的关联，并基于死亡证明和家庭登记数据探索它们与生存的联系；3)探索生物标记物可以在多大程度上解释社会环境、挑战和健康之间的关系。我们将使用来自对老年人的纵向研究的异常丰富的、基于人口的数据。这些数据自1989年以来定期收集，包括关于卫生以及社会、经济和人口特征的详细的回顾和当前状况信息。我们建议从1000名参与者中收集健康和生活挑战的生物标记物，基于体检以及血液和尿液样本的分析。我们的分析策略使用了两个多变量程序：1)广义线性模型(特别是有限因变量的模型)；2)隶属度模型。我们使用这两种技术将利用它们的互补优势来回答我们的研究问题。

Demographic processes, the social environment, and life challenge are intimately interlocked with functional status and illness. The social environment, encompassing position in social hierarchy as well as linkages within social networks and support systems, affects exposure to challenge and mediates its effects. This biodemographic investigation has two primary goals. First, we propose to elaborate the relationship between life challenge and health, exploring how the social environment affects that relationship. Specifically we will: 1) Identify challenges that are most strongly associated with, and discriminate best between, the preservation and deterioration of health; 2) Examine both the costs and benefits to health of social connection, support networks, instrumental assistance and emotional support, and social activity. We will identify the components that are most important for the maintenance of mental and physical functioning and for mediating the effects of challenge on health outcomes; and 3) Explore the effects of cumulative advantage and cumulative adversity on health taking into account both timing and severity of life events. Second, we propose to explore how our understanding of the relationships among life challenge, the social environment, and health can be enhanced by incorporating biological markers of health and stress. We will: 1) Investigate the extent to which biological markers of stress and chronic illness are related to reports of life events; 2) Examine the associations between the biological markers and data from physicians' examinations and self-reported health status, and explore their links to survival based on data from death certificates and the household registry; and 3) Explore the extent to which the biological markers can explicate the relations among the social environment, challenge, and health. We will use unusually rich, population-based data from a longitudinal study of the elderly. These data have been collected periodically since 1989 and comprise detailed retrospective and current status information on health and on social, economic, and demographic characteristics. We propose to collect biological markers of health and of life challenge from a subset of 1000 of the participants based on physical exams, and assays of blood and urine specimens. Our analytical strategy uses two multivariate procedures: 1) generalized linear models (especially those for limited dependent variables); and 2) grade of membership models. Our use of both techniques will exploit their complementary strengths for answering our research questions.