Network on Life Course Health Dynamics and Disparities in 21st Century America

描述(由申请人提供)：这项提案寻求正式创建一个研究网络，以了解美国如何以及为什么在人口健康的主要指标上越来越落后于几乎所有相对发达/富裕的国家，甚至一些发展中国家，尽管美国在医疗保健和保险方面的支出远远超过任何国家。目前各国之间数据可比性的限制使得对这些问题的比较分析变得困难，拟议的网络和其他科学家将努力缓解这些限制。然而，了解我们的部分人口如何以及为什么表现出健康状况不佳和/或恶化，对于理解美国人在医疗保健和保险支出迅速增长的情况下健康状况的矛盾下降是至关重要的。因此，该网络将把最初的工作重点放在处理现有的许多数据来源上，以了解：1)相对于其他国家的美国男性和女性，自1980年以来，美国女性的健康状况是如何恶化的，以及为什么会恶化；2)健康方面的社会经济差距，特别是教育方面的社会经济差距，如何以及为什么在过去30年里持续存在甚至扩大；以及3)种族-民族健康差距是如何存在和为什么存在的，同时近几十年来也在以某些方式缓解。这项工作稍后将引导该网络：1)系统地预测过去、现在、特别是未来美国人口健康和健康差距的趋势及其对医疗保健和保险支出的影响；以及2)进行比较研究，以了解与其他相对发达/富裕的国家相比，哪些因素是导致美国人口健康恶化的最重要因素。该网络将汇集来自三个机构的多学科研究小组，这三个机构在研究人口健康和健康差距的社会和生物医学决定因素方面一直处于领先地位：大学。密歇根大学、南加州大学/加州大学洛杉矶分校和加州大学。德克萨斯州的奥斯汀分校。来自其他机构的关键科学家将加入网络和/或进行互动 并通过年度会议和/或持续的工作组与之合作。我们寻求产生和传播新的科学分析和发现，并促进能够改进这些分析的方法和数据的开发。

DESCRIPTION (provided by applicant): This proposal seeks to formally create a research network to understand how and why the United States is increasingly falling behind virtually all comparably developed/wealthy nations, and even some developing countries, on major indicators of population health, despite the U.S. spending far more than any nation on health care and insurance. Limitations in data comparability across nations currently make comparative analysis of these issues difficult, and the proposed network and other scientists will be working to alleviate these limitations. However, understanding how and why portions of our population exhibit poor and/or worsening health is crucial to understanding America's paradoxical decline in health despite burgeoning spending for health care and insurance. Thus, the network will focus initial efforts on working across many existing sources of data to understand: 1) how and why the health of American women has been worsening since 1980 relative to both American men and women in other countries; 2) how and why socioeconomic disparities in health, especially by education, have persisted and even increased over the past three decades; and 3) how and why racial-ethnic disparities in health exist and persist, while also alleviating in some ways in recent decades. This work will later lead the network to: 1) systematic projection of past, present and especially future trends in U.S. population health and health disparities and the implications for expenditures on health care and insurance; and 2) comparative research to understand what factors have been most important in the worsening of America's population health relative to other comparably developed/wealthy nations. The network will bring together multidisciplinary teams of investigators from three institutions that have been leaders in research on social and biomedical determinants of population health and health disparities: Univ. of Michigan, Univ of Southern California/UCLA, and the Univ. of Texas at Austin. Key scientists from other institutions will be added to the network and/or will interact and collaborate with it via annual meetings and/or ongoing working groups. We seek to generate and disseminate new scientific analyses and findings, and to facilitate development of methods and data that can improve these analyses.