Health disparities and aging in societies in transition

转型社会中的健康差距和老龄化

• 批准号: 6754917
• 负责人: Michael G Marmot
• 金额: $ 45.41万
• 依托单位: UNIVERSITY COLLEGE LONDON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-15 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6754917
• 关键词: Commonwealth of Independent States; Europe; Poland; aging; behavioral /social science research tag; cardiovascular disorder epidemiology; clinical research; culture; functional ability; health disparity; health surveys; human middle age (35-64); human mortality; human old age (65+); human subject; longitudinal human study; psychological aspect of aging; psychological tests; quality of life; questionnaires; social class; social psychology; socioeconomics

DESCRIPTION (provided by investigator): Social disparities in health are a major unsolved public health problem; they affect many health outcomes throughout the lifespan, including the elderly. Our understanding of social disparities of health in aging populations can be enhanced by complementing studies in western countries by studies in Central and Eastern Europe (CEE) and the former Soviet Union (FSU), taking advantage of the unique set of social and health conditions in the region after the fall of communism. Mortality and morbidity from CVD and other chronic diseases at middle and older ages are much higher in CEE/FSU than in the West, and available data suggest that this is also true for other outcomes pertinent to older ages, such as disability, decline in physical functioning and cognitive impairment. Extending research on social disparities in the health of aging populations into CEE/FSU will break confounding due to inter-correlation between socioeconomic factors present in western data (as associations between socioeconomic indicators are weak in CEE/FSU); the questions of endogeneity can be addressed, using the dramatic temporal changes in social conditions and health status that have taken place in CEE/FSU during the societal transformation; and comparisons with western studies, such as the US Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA), will be conducted. The objective of the application is to build on an existing study of CVD in CEE/FSU and to establish a longitudinal study of aging with repeated measurements of health, functioning, social position, economics and psychosocial factors. The specific aims of the proposed study are: (1) to investigate disparities in CVD and aging related health outcomes between countries and their relation with macro-economic factors; (2) to study social disparities within countries in order to identify the dimension(s) of socioeconomic position that are most important for health; (3) to examine behavioral, psychosocial and biological mechanisms linking socioeconomic position and health; and (4) to investigate whether poor health is associated with decline in socioeconomic status in aging populations (endogeneity). The existing study is based in Russia, Poland and the Czech Republic, and consists of a baseline survey and mortality follow up. Baseline data on socioeconomic and psychosocial factors, nutrition, alcohol and biological samples are being collected on random samples of men and women 45-69 years old. It is proposed to conduct a new wave of data collection (Wave II) and to add Lithuania (as an example of a Baltic country). As far as possible, the study instruments will be identical to those used in HRS and ELSA, focusing on functioning and disability, cognition, quality of life, socioeconomic position, economics, and psychosocial factors. The expected total size of the new study is 28,000 subjects. Analyses will examine cross-sectional outcomes, changes in health and functioning between the baseline and Wave II, and incidence of CVD and mortality since the baseline.

描述（由研究者提供）：健康方面的社会差异是一个尚未解决的重大公共卫生问题；它们影响整个生命周期的许多健康结果，包括老年人。我们可以通过中欧和东欧 (CEE) 和前苏联 (FSU) 的研究来补充西方国家的研究，并利用该国独特的社会和健康条件，来加深对老龄化人口健康方面的社会差异的理解。共产主义垮台后的地区。中老年心血管疾病和其他慢性疾病的死亡率和发病率在中欧和东欧/前苏联远高于西方，现有数据表明，与老年相关的其他结果也是如此，例如残疾、体能下降。功能和认知障碍。将老龄人口健康方面的社会差异研究扩展到中东欧/前苏联，将打破西方数据中社会经济因素之间相互关联造成的混淆（因为中欧和东欧/前苏联社会经济指标之间的关联较弱）；可以利用中东欧/前苏联在社会转型期间社会条件和健康状况发生的巨大时间变化来解决内生性问题；并将与美国健康与退休研究（HRS）和英国老龄化纵向研究（ELSA）等西方研究进行比较。该应用程序的目的是建立在中欧东欧/佛罗里达州立大学现有的 CVD 研究的基础上，通过重复测量健康、功能、社会地位、经济和社会心理因素来建立衰老的纵向研究。本研究的具体目的是：（1）调查各国之间CVD和老龄化相关健康结果的差异及其与宏观经济因素的关系； (2) 研究各国内部的社会差异，以确定对健康最重要的社会经济地位维度； (3) 检查将社会经济地位与健康联系起来的行为、社会心理和生物机制； (4) 调查健康状况不佳是否与老龄化人口社会经济地位下降有关（内生性）。现有的研究以俄罗斯、波兰和捷克共和国为基础，包括基线调查和死亡率随访。正在从 45-69 岁男性和女性的随机样本中收集有关社会经济和社会心理因素、营养、酒精和生物样本的基线数据。建议进行新一轮数据收集（第二波）并添加立陶宛（作为波罗的海国家的示例）。研究工具将尽可能与 HRS 和 ELSA 中使用的工具相同，重点关注功能和残疾、认知、生活质量、社会经济地位、经济学和社会心理因素。新研究的预计总规模为 28,000 名受试者。分析将检查横断面结果、基线和第二波之间健康和功能的变化，以及自基线以来心血管疾病的发生率和死亡率。