Educational Trajectories & Health: when People finish School and how it matters

项目概要（摘要） 教育是一个公认的对健康具有重要影响的社会因素。教育程度 与各种条件和行为的死亡率和发病率相关。我们对 将教育与健康联系起来。2016年1月，NIH发布了《教育与健康：新的 前沿”（PAR 16-080），以进一步深入探讨这一主题。 我们提出了一种混合方法来解决我们的总体目标-调查不同的教育轨迹是否以及如何影响健康，以及这种关联如何因性别，种族/民族，家庭和学校情况而异。教育轨迹是指人们如何随着时间的推移获得他们的教育地位，如高中或大学毕业。我们将首先分析1979年和1997年全国青年纵向研究（NLSY）的数据。 然后，基于这些发现，我们将在美国三个不同的人群中进行半结构化访谈，以探索定量观察到的关联的可能机制。最后，我们将去一个额外的 第二个数据集，中风的地理和种族差异的原因（REGARDS），这将使我们能够 探讨定性确定的某些机制的可能作用。我们混合的具体目标 研究方法：1）采用理论驱动和序列分析（数据驱动）技术，确定 1979年和1997年的NLSY组最常见的教育轨迹是什么。例子包括： 直接通过或“不间断”; B）高中辍学;和c）“中断高中，”其中 学生们离开了，但后来又回来拿高中文凭或GED。类似的例子有 可能的大学学位，与高中毕业的额外的例子，去工作，或 失业，然后去上大学; 2）调查教育轨迹如何与体重相关 指数与肥胖、慢性病、抑郁症和死亡率之间的关系。2a）两性之间的关系如何不同， 种族/民族和家庭特征（如母亲的教育程度、不良的童年经历 (in 2b）这些关系如何因学校特点（如辍学率、经济状况）而不同 学校政策和学校的社会环境（例如同一群体中的人的教育水平）。 社区）？学校特点包括学校的种族/民族构成、学校的辍学率， 和/或入学学生的经济构成。社会环境包括人们的教育水平 3）基于目标#2的结果，使用密集的半结构化一对一 对具有不同人口特征的人（即男性和女性; 白色，非洲裔美国人等）和教育轨迹在不同的地理区域，以调查潜在的 将教育轨迹与健康联系起来的机制，例如家庭动态、居住流动性、获得 金融和社会资本，4）根据目标#3的结果，调查已确定的机制， NLSY 79、NLSY 97和卒中地理和种族差异的原因（REGARDS）研究。

PROJECT SUMMARY (ABSTRACT) Education is a recognized social factor with important implications for health. Educational attainment is associated with mortality and morbidity for a variety of conditions and behaviors. We know less about the mechanisms that connect education to health. In January 2016, NIH released, “Education and Health: New Frontiers” (PAR 16-080) to delve further into this topic. We propose a mixed methods approach to address our overall aim – to investigate if and how different education trajectories affect health and how this association may differ by sex, race/ethnicity, and family and school circumstances. Educational trajectories refer to how people attain their education status, such as high school or college graduate, over time. We will first analyze the 1979 and 1997 waves of data of the National Longitudinal Study of Youth (NLSY). Then, based upon these findings, we will conduct semi-structured interviews in three diverse populations across the US to explore possible mechanisms for the associations observed quantitatively. Finally, we will go to an additional secondary dataset, Reasons for Geographic and Racial Differences in Stroke (REGARDS) that will allow us to explore the possible roles of some of the mechanisms identified qualitatively. The Specific Aims for our mixed methods study are: 1) Using both theory-driven and sequence analysis (data-driven) techniques, determine what the most common education trajectories are for the NLSY 1979 and 1997 cohorts. Examples include: a) straight through or “uninterrupted”; b) dropped out of high school; and c) “interrupted high school,” where students left but returned subsequently to get a high school diploma or a GED. Comparable examples are possible for a college degree, with the additional example of graduated from high school, went to work or unemployed, then went to college; 2)Investigate how educational trajectories are associated with body mass index and obesity, chronic conditions, depression, and mortality. 2a) How do the relationships differ by sex, race/ethnicity, and family characteristics (e.g. maternal education attainment, adverse childhood experiences (in the 1979 cohort)); 2b) How do the relationships differ by school characteristics (e.g. dropout rate, economic composition), school policies, and schooling social milieu (e.g. education level of people in the same community) ? School characteristics include racial/ethnic composition of the school, dropout rate of the school, and/or economic composition of students attending the school. Social milieu includes education level of people in the same community; 3) Based on the results of Aim #2, use intensive semi-structured one-one-one interviews of qualitative methods of people with different demographic characteristics (i.e. men and women; White, African American etc) and educational trajectories in different geographic areas to investigate potential mechanisms linking education trajectories to health, e.g. family dynamics, residential mobility, access to financial and social capital, 4) Based on results from Aim #3, investigate the identified mechanisms with the NLSY79, NLSY97, and Reasons for Geographic and Racial Differences in Stroke (REGARDS) studies.