SOCIAL DETERMINANTS OF ADULT, AGING AND ELDERLY HEALTH

我们建议研究健康的社会决定因素，特别是收入、消费、教育、种族和健康之间的关系。我们的首要主题是试图理清社会和医学决定因素对健康的相对贡献，我们在六个具体的研究问题中探索这一主题。(1)为什么在非洲裔美国人占人口比例较大的地方，美国的死亡率会更高？一方面是种族主义和贫困，另一方面是提供医疗服务，两者的相对作用是什么？(2)自我报告的健康状况随着年龄的增长而恶化的方式如何取决于工作、收入和性别？体力劳动是衰老速度的主要决定因素吗？(3)健康的梯度是由医学技术进步决定的吗？特别是，当特定疾病的技术进步特别迅速时，梯度是否会扩大？(4)年轻人的梯度如何增长，老年的梯度如何减小？社会因素在多大程度上 当历史被充分控制时重要吗？(5)健康如何随家庭内的商品分配而变化？(6)年龄相关死亡率的下降一方面与(差异很大的)国家增长和不平等模式有关，另一方面与医疗保健技术进步的或多或少的国际统一变化有什么关系？国家健康相关行为模式的作用是什么？这些问题中的每一个都被这样一个事实联系在一起，即存在相互竞争的答案，其中一些主要是“社会”的，一些主要是“医学”的。每一个项目本身也是一个重要的研究项目。

We propose to examine the social determinants of health, particularly the relationship between income, consumption, education, race, and health. Our overarching theme is the attempt to disentangle the relative contributions to health of social versus medical determinants, and we explore this theme within six specific research questions. (1) Why are mortality rates in the US higher in places where African Americans are a larger share of the population? What are the relative roles of racism and poverty on the one hand, and provision of medical services on the other? (2) How does the way that self-reported health status deteriorates with age depend on work, income, and gender? Is manual work a primary determinant of the speed of aging? (3) Is the gradient in health determined by technical progress in medicine? In particular, does the gradient widen when there is particularly rapid technical progress for a specific disease? (4) How does the gradient grow in youth and diminish in old-age? How much do social factors matter when history is adequately controlled? (5) How does health vary with the allocation of goods within the household? (6) How do declines in age-specific mortality relate to (widely varying) national patterns of growth and inequality on the one hand, and to more or less internationally uniform changes in technical progress in medical care on the other? What is the role of national patterns of health-related-behaviors? Each of these questions is tied together by the fact that there are competing answers, some of which are largely "social" and some of which are largely "medical." Each is also an important research project in its own right.