Social Determinants of Cardiovascular Health and Mortality among Older Adults with Hearing Loss

项目摘要 听力损失是美国成年人中最常见的疾病之一。目前，超过3000万美国人 成年人经历某种形式的听力损失，预计到2020年，这一数字将增加到5940万人。 2060.随着这一数字的增加，专注于听力损失患者健康结果的研究将成为- 越来越重要。现有的研究表明，与听力损失患者相比，听力损失患者的健康状况较差。 听力同伴。目前的文献表明，美国听力损失的成年人更有可能处于中等或较差的水平。 健康，在过去一个月里身体和精神健康状况不佳的天数明显增加，并报告严重的心理问题， 与那些听力几乎没有问题的人相比，患有听力损失的美国成年人也有显著的 健康知识水平低于听力正常的同龄人，这可能会影响健康结果，因为缺乏可获得的健康信息， 与医疗服务提供者沟通不畅。许多成年人在老年时首次经历听力损失， 健康状况开始出现在生命的这个阶段。事实上，大约三分之一的65岁以上的人 74人有听力损失，75岁以上的人中有近一半有听力困难。因此，听力损失成为 在老年人中更常见，需要更多的研究来确定这种健康差异 人口和了解导致这种差距的因素，如卫生知识。使用国家代表性数据 从美国老年人的样本中，拟议的F31项目将通过以下研究目标来满足这一需求：1） 描述关键社会人口学因素在自我评估和身体评估听力损失方面的不公平性; 2）调查风险 按性别/性别交叉亚组划分的听力损失与心血管结局之间关系的差异- der和种族/民族;和3）检查健康素养在听力损失和听力损失之间关系的中介作用。 心血管结局。这项研究将包括使用调查，物理测量和双向数据分析的二次数据分析。 来自美国健康和退休研究的标记数据，这是一项基于人口的纵向小组研究， 调查51岁及以上的成年人。建议的培训计划和指导团队在这个NIH露丝L。基施斯坦钠 国家研究服务奖将支持这个项目的成功完成，并将提供宝贵的知识 以及在衰老和听力损失领域建立独立研究人员职业生涯所需的技能。如听力下降 在老年人中变得越来越普遍，像拟议中的项目这样的研究将是基础性的。 在建立导致老年人心血管结局较差和死亡率较高的因果途径方面， 听力损失，这将是帮助预防，检测，诊断和治疗残疾成年人疾病的关键， 关系的

PROJECT SUMMARY Hearing loss is one of the most common conditions among adults in the US. Currently, more than 30 million American adults experience some form of hearing loss and this number is expected to increase to 59.4 million people in the US by 2060. As this number increases, research focusing on health outcomes for individuals with hearing loss will become in- creasingly important. Existing research shows that those with hearing loss have poorer health outcomes compared to their hearing peers. The current literature shows that adults in the US with hearing loss were more likely to be in fair or poor health, have significantly more days of poor physical and mental health in the past month, and report serious psychologi- cal distress compared to those with little to no trouble hearing. American adults with hearing loss also had significantly lower health literacy than their hearing peers, which may affect health outcomes due to a lack of accessible health infor- mation and poor communication with health providers. Many adults first experience hearing loss in older ages as more health conditions begin to arise during this stage of life. In fact, approximately one in three people between the ages of 65 and 74 have hearing loss and nearly half of those older than 75 have difficulty hearing. Therefore, as hearing loss becomes a more common occurrence among aging adults, more research is needed to identify health disparities experienced by this population and understand factors that lead to such disparities, such as health literacy. Using nationally representative data from a US sample of older adults, the proposed F31 project will address this need with the following research aims: 1) Describe inequities in self-rated and physically assessed hearing loss by key sociodemographic factors; 2) Investigate risk differences in the relationship between hearing loss and cardiovascular outcomes by intersectional subgroups of sex/gen- der and race/ethnicity; and 3) Examine the mediating effect of health literacy in the relationship between hearing loss and cardiovascular outcomes. This research will consist of secondary data analysis using survey, physical measure, and bi- omarker data from the US Health and Retirement Study, a population-based longitudinal panel study that interviews and surveys adults aged 51 and older. The proposed training plan and mentoring team in this NIH Ruth L. Kirschstein Na- tional Research Service Award will support the successful completion of this project and will provide valuable knowledge and skills needed to establish a career as an independent researcher in the areas of aging and hearing loss. As hearing loss becomes a more common occurrence among aging individuals, research such as the proposed project will be foundational in establishing the causal pathways that lead to poorer cardiovascular outcomes and higher mortality among older adults with hearing loss, which will be key in helping to prevent, detect, diagnose, and treat diseases among adults with disabili- ties.