Understanding the role of structural racism and intergenerational wealth on obesity outcome

了解结构性种族主义和代际财富对肥胖结果的作用

• 批准号: 10458274
• 负责人: Shanise Erika Owens
• 金额: $ 4.04万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10458274
• 关键词: Accounting; Address; Adult; Aptitude; Area; Back; Black American; Black race; Body mass index; Cardiovascular Diseases; Categories; Characteristics; Chronic; Chronic Disease; Cohort Effect; Data Set; Degenerative polyarthritis; Depressed mood; Development; Diabetes Mellitus; Discrimination; Economic Policy; Environment; Family; Federal Government; Future Generations; Generations; Geography; Goals; Health; Health Policy; Healthcare; Healthcare Systems; Home; Household; Hypertension; Income; Individual; Inequality; Institutional Racism; Intervention; Kidney Diseases; Knowledge; Lead; Life Cycle Stages; Link; Literature; Longevity; Malignant Neoplasms; Mediating; Mediation; Mentorship; Natural experiment; Nature; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Outcome; Pathway interactions; Plant Roots; Play; Policies; Policy Maker; Process; Property; Public Health; Quasi-experiment; Race; Research; Research Personnel; Risk; Risk Factors; Role; Socioeconomic Status; Specific qualifier value; Stroke; Structural Racism; Testing; Training; United States; Woman; base; caucasian American; cost; deprivation; econometrics; economic determinant; ethnic minority; experience; health data; health disparity; high risk; intergenerational; middle age; minority communities; mortality; obesity risk; obesogenic; panel study of income dynamics; prevent; preventable death; racial disparity; racial health disparity; racial minority; racism; segregation; skills; social; social determinants; social health determinants; trend

PROJECT SUMMARY/ABSTRACT Obesity is a preventable cause of early mortality and poses a significant cost burden to public health and health care systems. Obesity increases risk for several chronic conditions including kidney disease, hypertension, diabetes, cardiovascular disease, osteoarthritis, stroke, and preventable cancers. Disparities in obesity by racialized groups are marked, yet only a small body of literature has interrogated the role of structural racism in the creation of obesity disparities. This research aims to determine the plausible causal role that one form of structural racism—“redlining”, or the process of categorizing neighborhoods into race-based credit risk levels instigating discriminatory mortgage lending practices–plays in creating wealth inequality and obesity disparities over the life course. Using the geographical nature of Home Owners’ Loan Corporation (HOLC) racialized mortgage credit risk categories (e.g., redlined areas) provides an opportunity for a good natural experiment to evaluate the plausible causal impacts of the manifestation of neighborhood-level structural racism and its long-term consequences. Our specific aims are: 1) To identify the impact of neighborhood-level structural racism and intergenerational wealth accumulation; 2) To test the effect of structural racism on obesity over multiple generations; and 3) To test the mediating role of intergenerational wealth on the causal relationship between structural racism and obesity outcomes in adults. Our overarching hypothesis is that federally supported racialized “redlining” policies effectively prohibited Black Americans from building wealth in their homes, leading to decades of divestment in predominately Black neighborhoods and contributing to the development of obesogenic environments, and ultimately obesity risk over the life course. We leverage the longitudinal nature of the Panel Study for Income Dynamics (PSID) to implement a life course approach for assessing generational wealth inequality and obesity disparities and use a quasi-experimental design which circumvents the use of random assignment of the exposure variable. Aims 1 and 2 will use the actual boundaries of the “redlined” neighborhoods to conduct a geographical regression discontinuity (GRD) which addresses endogeneity of neighborhood characteristics by specifying a spatial or geographical boundary split with a marked threshold. Aim 3 will investigate the indirect effects of each generation of wealth accumulation on neighborhood-level structural racism and body mass index (BMI) outcomes. Results will contribute to understanding why health disparities exist for racialized minority communities by identifying how specific pathways operate through structural racism to create racialized inequities in obesity outcomes. Implications from this research will help identify consequences of structural racism and can help to lead to full accounting of the impacts, as well as identify corrective economic and health policy interventions that address inequalities in wealth and obesity disparities in middle-aged adults.

项目概要/摘要 肥胖是导致早期死亡的一个可预防的原因，并对公共卫生和健康造成巨大的成本负担。 肥胖会增加多种慢性疾病的风险，包括肾脏疾病、 高血压、糖尿病、心血管疾病、骨关节炎、中风和可预防癌症的差异。 种族群体的肥胖现象很明显，但只有一小部分文献质疑了肥胖的作用 这项研究旨在确定结构性种族主义在造成肥胖差异中的合理因果作用。 结构性种族主义的一种形式——“红线”，或者将社区划分为基于种族的过程 信用风险水平引发歧视性抵押贷款做法——造成财富不平等和 利用房主贷款公司的地理性质来衡量生命周期中的肥胖差异。 （HOLC）种族化抵押贷款信用风险类别（例如红线区域）提供了良好的机会 评估邻里层面表现的合理因果影响的自然实验 我们的具体目标是： 1) 确定结构性种族主义的影响。 邻里层面的结构性种族主义和代际财富积累；2）检验效果 结构性种族主义对多代肥胖的影响；3) 检验代际的中介作用 财富关于结构性种族主义与成人肥胖结果之间的因果关系。 假设是联邦政府支持的种族化“红线”政策有效地禁止了美国黑人 在他们的家中积累财富，导致以黑人为主的社区几十年来的撤资和 促进肥胖环境的发展，最终导致生命过程中的肥胖风险。 我们利用收入动态面板研究 (PSID) 的纵向性质来实施生命历程 评估代际财富不平等和肥胖差异的方法，并使用准实验方法 规避暴露变量随机分配的设计将使用 “红线”社区的实际边界进行地理回归不连续性（GRD） 它通过指定空间或地理边界来解决邻里特征的内生性 目标 3 将调查每一代财富的间接影响。 社区层面的结构性种族主义和体重指数（BMI）结果的积累。 通过确定如何实现种族化少数群体社区的健康差异，有助于理解为什么存在健康差异 通过结构性种族主义的特定途径，造成肥胖结果中的种族不平等。 这项研究的意义将有助于识别结构性种族主义的后果，并有助于导致全面的 核算影响，并确定纠正性经济和卫生政策干预措施，以解决 中年人的财富不平等和肥胖差异。