Inequality and Disability among Older Adults: Paths to Differential Trajectories

这个项目将检查人口，健康，社会经济，行为，心理，支持，结构， 以及预测黑人和白人残疾和死亡率差异的背景因素 在美国最弱势的种族群体(黑人)中按性别划分的独特因果路径 各州。该项目从四个方面扩展了对晚年黑人/白人残疾差异的研究：(1) 将使用多种类型的高级定量轨迹分析来检查不同轨迹 以及对残疾时间与随时间积累的时间的影响进行区分并重新估计模型 使用独特的方法处理选择性死亡；(2)流行病学的理论贡献， 女权主义者和其他文献将被用来探索种族之间和种族内部的性别差异； (3)除个体因素外，环境变量在致残途径中的作用 以及黑人和白人的死亡率；(4)黑人/白人预期寿命20年的趋势 将使用贝叶斯方法进行生命表估计，允许直接包括协方差 从而实现对独立效应的假设的直接测试。我的培训和工作经验 为我提供了人口老龄化和社会学的实质性和方法论知识基础 问题。K99将使我能够扩大这个基础，使我对多学科有更好的理解 消除按种族和性别划分的健康差距的框架和办法，并参加正规培训 在贝叶斯统计和多水平建模中，用于测试上下文影响。Roo阶段将 作为年轻的教职员工，请允许我在我的指导下完成我的研究计划 导师和顾问，并提交一份关于残疾和死亡率方面的种族差异的R01提案 生命历程。尽管美国老年人的健康状况总体上有所改善，但种族/种族健康 差距继续扩大。消除健康差距，包括残疾差异，是一个主要关注点。 国家老龄问题研究所的主要使命是促进2010年健康人的健康和延长活跃的寿命。 了解导致残疾差异的因果路径将为研究和政策提供信息 解决这些目标。

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) mutiple 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 reestimate 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 covarites 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 proposal 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.