1 -Understanding Recent Trends in Mortality and Morbidity

1 -了解死亡率和发病率的最新趋势

• 批准号: 10224048
• 负责人: ANNE CASE
• 金额: $ 16.31万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-02-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224048
• 关键词: Acquired Immunodeficiency Syndrome; Activities of Daily Living; Age; Age-Years; Alcoholic Liver Diseases; American; Automobile Driving; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Child; Cirrhosis; Clinical; Community Surveys; Country; County; Data; Data Set; Data Sources; Databases; Deltastab; Deterioration; Documentation; Economics; Education; Elderly; Employment; Ethnic Origin; Ethnic group; Face; Foundations; Generations; Geographic Distribution; Geographic Locations; Geography; Goals; Growth; Health; Health trends; Heavy Drinking; Hispanics; Income; Inequality; International; Life Expectancy; Link; Location; Manuals; Marital Status; Measures; Mental Depression; Mental Health; Morbidity - disease rate; Mortality Decline; Not Hispanic or Latino; Occupational; Occupations; Opioid; Outcome; Pain; Patient Self-Report; Pattern; Pharmaceutical Preparations; Play; Poverty; Prescription drug overdose; Race; Records; Reporting; Research; Rest; Role; Structure; Suicide; Surveys; Testing; Time; Unemployment; Vital Statistics; Woman; Work; age group; aged; aging population; alcohol poisoning; burden of illness; caucasian American; chronic pain; cohort; college; conditioning; economic evaluation; expectation; experience; falls; high school; human mortality; improved; insight; liver function; men; middle age; mortality; opioid mortality; opioid use; physical conditioning; population health; programs; public health relevance; sex; socioeconomics; statistics; trend

PROJECT SUMMARY/ABSTRACT Project 1 – Understanding Recent Trends in Mortality and Morbidity The goal of this project is to understand the deterioration in health among middle-aged American men and women, especially among white non-Hispanics – only recently brought to light. After three decades of decline, all-cause mortality rates for white non-Hispanics aged 45–54 have been on the rise since 1998. The increase has been driven by drug and alcohol poisonings, suicides, and cirrhosis and alcoholic liver disease. If white non-Hispanic mortality rates had continued to decline at 1.8 percent a year after 1998 – the average rate of decline for whites in the previous two decades – about 500,000 deaths would have been avoided through 2013, a number comparable to cumulative AIDS deaths in the U.S. There has been no corresponding change in the rate of mortality decline for non-Hispanic blacks or for Hispanics. In the same age group, morbidity among white non-Hispanics has increased for a range of measures, including self-reported physical and mental health, chronic pain, ability to conduct activities of daily living, including work, self-reports of heavy drinking, and clinically measured liver function. In contrast to the midlife group, mortality and morbidity have continued to improve for those aged 65 and above. The project will drill down into these overall statistics, disaggregating by location, by age, by sex, by occupational and educational groups, and by race and ethnicity, as well as by making comparisons with other wealthy countries. It will also attempt to understand the causes behind the decline in midlife health. There are two broad Specific Aims: (1) to build a public use database for the U.S. and for other rich countries that will be rich enough to document, for the U.S., the geographical distribution of midlife deaths and to link mortality and morbidity patterns, across space and time, to patterns of income, poverty, inequality, employment, unemployment, education and occupation and, internationally, to study the differences and similarities in mortality and morbidity patterns between the U.S. and other rich countries; and (2) to use the spatial and temporal ordering of those data to consider a range of hypotheses and possible determining factors, including (i) diminishing economic opportunity, especially for those with only a high school degree or less education, (ii) increases in pain and morbidity, before and after the marked increase in opioid availability, (iii) changes in occupational structure on reports of pain and other morbidity, and (iv) education itself, in conditioning mortality and morbidity independent of occupation and income. We will test whether hypotheses on economic prosperity, pain and other morbidity, increased availability of opioids, occupation, and education help to explain the differences between the US and other rich countries, and differences between racial and ethnic groups within the U.S.

项目摘要/摘要 项目1 - 了解死亡率和发病率的最新趋势 该项目的目的是了解中年美国男性健康的定义以及 妇女，尤其是在白人非西班牙裔中的妇女 - 直到最近才曝光。经过三十年的衰落， 自1998年以来，白人非西班牙裔美国人的全因死亡率一直在上升。 由毒品和酒精中毒，自杀，肝硬化和酒精肝病驱动。如果白色 非西班牙裔死亡率持续下降，1998年后每年1.8％ - 平均率 在过去的二十年中，白人的下降 - 将避免死亡约500,000人 2013年，与美国累积艾滋病死亡相当的数字没有相应的变化 在非西班牙裔黑人或西班牙裔的死亡率下降速度下。在同一年龄段，发病率 在白人非西班牙裔中，在一系列测量中有所增加，包括自我报告的身体和 心理健康，慢性疼痛，进行日常生活活动的能力，包括工作，重度自我报告 饮酒和临床测量的肝功能。与中年群体相反，死亡率和发病率具有 65岁及以上的人继续改善。 该项目将深入研究这些总体统计数据，按地点，年龄，性别，性别，通过 占领和教育团体，以及通过种族和种族以及与其他人进行比较 富裕国家。它还将试图了解中年健康下降背后的原因。有 两个广泛的具体目标：（1）为美国和其他富裕国家建立公共使用数据库 足以记录美国中年死亡的地理分布，并将死亡率和联系 跨时时间和时间的发病率模式，收入，贫困，不平等，就业， 失业，教育和职业，以及国际上，以研究 美国和其他富裕国家之间的死亡率和发病率模式； （2）使用空间和 临时订购这些数据，以考虑一系列假设和可能的决定因素，包括 （i）减少经济机会，特别是对于只有高中学位或更少教育的人，（ii） 疼痛和发病率的增加，阿片类药物可用性的明显增加之前和之后，（iii）变化 在疼痛和其他发病率的报告中占据结构，以及（iv）教育本身，以调节死亡率 和发病率与发生和收入无关。我们将测试是否关于经济的假设 繁荣，痛苦和其他发病率，增加阿片类药物，占领和教育的可用性有助于解释 美国与其他富裕国家之间的差异以及种族和种族之间的差异 美国境内