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（调查员提供）：健康的社会差异是一个主要未解决的公共卫生问题；它们会影响包括老年人在内的整个生命周期中的许多健康成果。通过在中欧和东欧（CEE）和前苏联（FSU）的研究中补充西方国家的研究，我们可以通过补充西方国家的研究来增强我们对衰老人口健康的社会差异的理解，利用共产主义堕落后该地区的独特社会和健康状况。 CVD的死亡率和发病率和中年及以上年龄较大的其他慢性疾病在CEE/FSU中比西方高得多，并且可用的数据表明，对于与老年人（例如残疾，身体功能下降，身体功能下降和认知障碍）的其他结果也是如此。扩大对衰老人群健康状况的社会差异的研究将由于西方数据中存在的社会经济因素之间的相互关系而破坏混淆（因为CEE/FSU中社会经济指标之间的关联较弱）；可以使用社会转型期间CEE/FSU发生的社会状况和健康状况的巨大时间变化，可以解决内生性的问题；与西方研究（例如美国卫生与退休研究（HRS）和英国衰老纵向研究（ELSA））的比较。该应用的目的是建立在CEE/FSU中的CVD研究的基础上，并通过重复测量健康，功能，社会地位，经济学和社会心理因素进行纵向研究。拟议的研究的具体目的是：（1）调查CVD和国家之间与宏观经济因素之间的相关健康结果的差异； （2）研究国家内的社会差异，以确定对健康最重要的社会经济地位的维度； （3）检查将社会经济地位与健康联系起来的行为，心理和生物学机制； （4）调查健康状况不佳是否与人口老龄化的社会经济地位下降有关（内生性）。现有的研究基于俄罗斯，波兰和捷克共和国，包括基线调查和死亡率随访。关于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正在45-69岁的男性和女性的随机样本上收集。提议进行新的数据收集浪潮（Wave II）并添加立陶宛（作为波罗的海国家的一个例子）。研究工具将与HRS和ELSA中使用的工具相同，专注于功能和残疾，认知，生活质量，社会经济地位，经济学和社会心理因素。新研究的预期总规模是28,000名受试者。分析将检查基线和基线II之间的横截面结果，健康变化以及基线和波浪之间的功能以及自基线以来的CVD和死亡率的发生率。