A Social Demography of Racial Health Disparities

描述（由申请人提供）：健康差距是一个棘手的，但不是美国分层制度的必然特征。首当其冲遭受贫困、边缘化劳动力、歧视、工资差距和隔离的亚人口群体也首当其冲受到健康状况不佳的影响（Williams and Collins 1995）。美国人生活的这一方面导致人们越来越关注健康差距；事实上，健康人2010 （HP2010）为我们的国民健康提出了两个崇高的目标。2010年人类健康计划的第一个目标是提高健康生活的质量，延长健康生活的年限，这一目标取得了许多进展，但在实现第二个目标——消除健康差距方面取得的进展微不足道（2000年人口与健康服务部）。实现这一目标的主要障碍之一肯定是我们不了解哪些社会过程产生了健康差异，以及这些差异如何在发病率和死亡率不断下降的情况下持续存在。很明显，遗传学并没有提供一个完整的答案来解决持续差异的问题（LaVeist 1994, Cooper 1986, Frank 2007）。因此，有必要对可能的社会、经济和结构解释进行调查，以便更好地了解现代健康差距的起源和原因。关于健康差异，最令人不安的发现之一是在健康、死亡率和发病率方面持续存在的种族差距。这一建议代表了一种系统的、雄心勃勃的尝试，旨在理解和解释这些模式是如何随着时间的推移而持续和波动的。通过结合人口学、公共卫生和社会学理论和方法，我们建议严格检查种族健康差异的动态模式，特别关注“黑人/白人”健康差距，同时估计年龄、时期和队列对健康趋势的影响。具体来说，这个研究项目将采用一种雄心勃勃的人口统计学方法来研究健康差异，方法是观察年龄、时期和群体效应，以及它们如何随时间变化而产生健康差异和健康差异的变化。这种方法可以证明是对当前方法的一个重要补充，这些方法只关注调查对象的个人层面的影响。

DESCRIPTION (provided by the applicant): Health disparities are an intractable, but not inevitable feature of the American stratification system. Sub-population groups that bear the brunt of poverty, marginalized labor, discrimination, wage gaps, and segregation---also bear the brunt of poor health (Williams and Collins 1995). This facet of American life has led to an increased focus on health disparities; in fact, Healthy People 2010 (HP2010) has put forth two lofty goals for the health of our nation. While many gains have been made for HP2010's first goal, to increase quality and years of healthy life---negligible gains have been made to meet the second goal---to eliminate health disparities (DHHS 2000). One of the primary impediments for reaching this goal is most certainly our lack of understanding of which social processes generate health disparities and how these disparities persist amidst declining morbidity and mortality rates. It is clear that genetics does not offer a complete answer to the question of persistent disparities (LaVeist 1994, Cooper 1986, Frank 2007). Consequently, investigations into possible social, economic, and structural explanations are necessary in order to better understand the origin and cause of modern health disparities. One of the most disconcerting finding with regards to health disparities is the persistent racial gap in health, mortality, and morbidity. This proposal represents a systematic and ambitious attempt to both understand and explain how these patterns have both persisted and fluctuated over time. By combining demographic, public health, and sociological theory and methods we propose to critically examine the dynamic patterns of racial health disparities, focusing specifically on the "Black/White" health gap, by simultaneously estimating the contribution of age, period, and cohort effects on health trends over time. Specifically, this research project will take an ambitious demographic approach to health disparities by looking at age, period, and cohort effects and how they change temporally to produce health disparities and changes in health disparities over time. This approach could prove to be a major addition to current approaches that simply focus on individual-level effects of survey respondents.