A Social Demography of Racial Health Disparities

描述(由申请人提供)：健康差距是美国分层制度的一个棘手但不是必然的特征。首当其冲地承受贫困、边缘化劳动、歧视、工资差距和隔离的亚人口群体也首当其冲地承受着糟糕的健康状况(Williams和Collins，1995)。美国人生活的这一方面导致了对健康差距的日益关注；事实上，2010年健康人(HP2010)为我们国家的健康提出了两个崇高的目标。虽然惠普2010年的S第一个目标--提高质量和健康生活年数-在实现第二个目标-消除健康差距方面取得了微不足道的进展-但取得了许多进展(卫生部2000年)。实现这一目标的主要障碍之一当然是我们缺乏对哪些社会进程造成健康差距以及在发病率和死亡率下降的情况下这些差距如何持续的认识。显然，遗传学并不能完全解决持续不平等的问题(LaVeist，1994，Coper，1986，Frank，2007)。因此，为了更好地了解现代健康差距的起源和原因，有必要对可能的社会、经济和结构解释进行调查。关于健康差距，最令人不安的发现之一是在健康、死亡率和发病率方面持续存在的种族差距。这一提议代表了一种系统和雄心勃勃的尝试，旨在理解和解释这些模式是如何随着时间的推移而持续和波动的。通过结合人口学、公共卫生和社会学的理论和方法，我们建议批判性地检查种族健康差距的动态模式，特别是关注“黑人/白人”健康差距，同时估计年龄、时期和队列效应对随着时间推移的健康趋势的贡献。具体地说，这项研究项目将对健康差距采取雄心勃勃的人口统计学方法，通过观察年龄、时期和队列的影响以及它们如何在时间上发生变化来产生健康差距和随着时间的推移健康差距的变化。这一方法可能被证明是对目前的方法的重大补充，这些方法仅仅侧重于调查受访者的个人影响。

DESCRIPTION (provided by the applicant): Health disparities are an intractable, but not inevitable feature of the American stratification system. Sub-population groups that bear the brunt of poverty, marginalized labor, discrimination, wage gaps, and segregation---also bear the brunt of poor health (Williams and Collins 1995). This facet of American life has led to an increased focus on health disparities; in fact, Healthy People 2010 (HP2010) has put forth two lofty goals for the health of our nation. While many gains have been made for HP2010's first goal, to increase quality and years of healthy life---negligible gains have been made to meet the second goal---to eliminate health disparities (DHHS 2000). One of the primary impediments for reaching this goal is most certainly our lack of understanding of which social processes generate health disparities and how these disparities persist amidst declining morbidity and mortality rates. It is clear that genetics does not offer a complete answer to the question of persistent disparities (LaVeist 1994, Cooper 1986, Frank 2007). Consequently, investigations into possible social, economic, and structural explanations are necessary in order to better understand the origin and cause of modern health disparities. One of the most disconcerting finding with regards to health disparities is the persistent racial gap in health, mortality, and morbidity. This proposal represents a systematic and ambitious attempt to both understand and explain how these patterns have both persisted and fluctuated over time. By combining demographic, public health, and sociological theory and methods we propose to critically examine the dynamic patterns of racial health disparities, focusing specifically on the "Black/White" health gap, by simultaneously estimating the contribution of age, period, and cohort effects on health trends over time. Specifically, this research project will take an ambitious demographic approach to health disparities by looking at age, period, and cohort effects and how they change temporally to produce health disparities and changes in health disparities over time. This approach could prove to be a major addition to current approaches that simply focus on individual-level effects of survey respondents.