A Lifecourse Approach to Emerging Health Disparities in a US Birth Cohort

描述（由申请人提供）：拟议的研究提供了新的数据，以承担在生命过程中出现的种族和社会经济健康差异。我们研究了社会经济地位（SES）、认知能力和健康本身这三个因素的交叉和相互影响。现有的研究充分表明，社会经济地位的指标可以预测健康结果，健康影响社会经济成就，认知能力可以预测教育成就和健康。但是社会经济地位、认知能力和健康之间的这种联系是如何在整个生命过程中出现的呢？种族歧视在影响这些因素造成种族差异方面起了什么作用？这些因素在整个生命过程中动态相互作用的理论被认为可以解释种族和社会经济差异在一般健康、肥胖、呼吸功能和抑郁方面的出现。一个基于加州的队列，儿童健康与发展研究-青少年样本（CHDS-A） （n=2020），出生于1959-1966年，提供了新的数据来评估这一理论。从出生前到15-17岁，在多个时间点收集了黑人和白人后代及其家庭的详细信息。样本中包括了足够数量的来自高和低社会经济地位家庭的黑人和白人后代。已经收集的数据包括儿童期和青春期对SES、认知能力和选定健康领域的评估。该项目将增加42-49岁的评估。对累积数据的分析将阐明保健差距的基本来源之间的关系，并为制定旨在减少这种不平等的政策和干预措施提供信息。公共卫生相关性：社会经济地位和种族的健康差异是需要解决的主要公共卫生问题。这项研究将提供来自双种族出生队列的新数据，该队列已被集中跟踪到青春期，现在已进入中年。对拟议研究中收集的关键数据的分析将创造一个不同寻常的机会，以了解健康差异在生命历程中何时以及为何出现，并为确定干预措施的内容和时机提供进一步指导，以改善观察到的差异。

DESCRIPTION (provided by applicant): The proposed research brings novel data to bear on the emergence of racial and socioeconomic disparities in health over the life course. We examine the intersection and mutual influence of three factors-socioeconomic status (SES), cognitive ability, and health itself. Extant research has demonstrated amply that indicators of SES predict health outcomes, that health affects socioeconomic attainment, and that cognitive ability predicts both educational attainment and health. But how do such associations between SES, cognitive ability, and health arise over the life course? And what role does racial discrimination play in influencing each of these factors to create disparities by race? A theory of dynamic interplay of these factors across the life course is posited to explain the emergence of racial and socioeconomic disparities in general health, obesity, respiratory function, and depression. A California-based cohort, the Child Health and Development Study-Adolescent Sample (CHDS-A) (n=2020), born 1959-1966, provides the novel data to evaluate this theory. Detailed information was collected at multiple time points from before birth until age 15-17 years for black and white offspring and their families. Sufficient numbers of black and white offspring from both high and low SES families were included in the sample. The data already collected include assessments during childhood and adolescence of SES, cognitive ability, and the selected domains of health. This project will add assessments at age 42-49 years. Analysis of the accumulated data will elucidate the relationships among fundamental sources of health disparities and inform the construction of policies and interventions designed to reduce such inequalities. PUBLIC HEALTH RELEVANCE: Health disparities by socioeconomic status and race represent major public health issues in need of resolution. This study will provide novel data from a bi-racial birth cohort that has been intensively followed through adolescence and is now in middle-age adulthood. The analysis of key data collected in the proposed study will create an unusual opportunity to understand when and why health disparities emerge over the life course, and further guidance for shaping the content and timing of interventions to ameliorate observed disparities.