Inequality and Disability among Older Adults: Paths to Differential Trajectories

描述（由申请人提供）：该项目将研究人口统计学，健康，社会经济，行为，心理，支持，结构和背景因素预测残疾和死亡率差异的黑人和白人除了独特的因果途径，性别之间的最弱势种族群体（黑人）在美国。本项目从四个方面扩展了对黑人/白色人晚年残疾差异的研究：（1）多种类型的高级定量轨迹分析将用于检查差异轨迹，并解开对残疾时间与随时间积累的影响，并使用独特的方法重新估计模型来处理选择性死亡;（2）从流行病学，女权主义和其他文献的理论贡献将被用来探讨跨种族和种族内的性别差异;（3）除了个体水平因素外，背景变量在导致黑人和白人残疾和死亡的因果途径中的作用也将得到检验;（4）将使用贝叶斯寿命表估计方法检查黑人/白色人的20年活跃预期寿命趋势，该方法允许直接纳入协变量，从而能够直接检验独立效应的假设。我的培训和工作经验为我提供了老龄人口学和社会学问题的实质性和方法学知识基础。K99将使我能够扩展这个基础，包括更好地理解多学科框架和方法，以种族和性别的健康差异，并参加贝叶斯统计和多层次建模的正式培训，以测试背景效应。ROO阶段将使我有所需的时间，作为年轻的教师，在我的导师和顾问的指导下完成我的研究计划，并提交R 01申请，说明生命过程中残疾和死亡率的种族差异。虽然美国老年人的健康状况总体上有所改善，但种族/民族健康差距继续扩大。消除健康方面的差异，包括残疾方面的差异，是2010年“健康人”的一个主要重点，延长积极生活是国家老龄问题研究所的首要使命。了解导致残疾差异的因果途径将为实现这些目标的研究和政策提供信息。

DESCRIPTION (provided by applicant): This project will examine demographic, health, socioeconomic, behavioral, psychological, support, structural, and contextual factors predicting disability and mortality differentials for blacks and whites in addition to the unique causal pathways by gender among the most disadvantaged racial group (blacks) in the United States. This project extends the study of black/white disability differentials in later life in four ways: (1) multiple types of advanced quantitative trajectory analyses will be used to examine differential trajectories and disentangle effects on the timing of disability versus accumulation over time and re-estimate models using unique approaches to handle selective mortality; (2) theoretical contributions from epidemiologic, feminist, and other literatures will be drawn on to explore differentials across race and within race by gender; (3) the role of contextual variables in addition to individual-level factors in the causal pathways to disability and mortality for blacks and whites will be examined; (4) 20-year trends in black/ white active life expectancy will be examined using Bayesian methods for life table estimation that allow the direct inclusion of covariates and thus enable direct tests of hypotheses for independent effects. My training and work experiences have provided me a substantive and methodological knowledge base in demography of aging and sociological issues. A K99 would allow me to expand this base to include a greater understanding of multidisciplinary frameworks and approaches to health disparities by race and gender and to participate in formalized training in Bayesian statistics and multilevel modeling for the testing of contextual effects. The ROO phase would allow me the time needed, as young faculty, to complete my research plan under the guidance of my mentors and consultants, and submit an R01 application on racial disparities in disability and mortality over the life course. Although the health of older Americans has been improving on the whole, racial/ethinic health disparities continue to grow. Eliminating health disparities, including differentials in disability, is a major focus of Healthy People 2010 and extending active life is primary to the mission of the National Institute on Aging. Understanding the causal pathways leading to disability differentials would inform research and policy addressing these goals.