Measuring Health Effects of the Great Recession

衡量大衰退对健康的影响

• 批准号: 8783064
• 负责人: Teresa E SEEMAN
• 金额: $ 25.89万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8783064
• 关键词: Acceleration; Adult; Affect; African American; Age; American; Area; Atherosclerosis; Behavior; Behavioral; Biological; Biological Assay; Biological Markers; Biology; Blood Glucose; Blood Pressure; Blood specimen; Blushing; Body mass index; Cardiovascular system; Clinical; Clinical Markers; Code; Data; Disease; Disease Pathway; Economic Conditions; Economics; Education; Employment; Environment; Ethnic Origin; Event; Exercise; Exposure to; Foreclosure; Foundations; Future; Gender; Genes; Genetic; Glucose; Goals; Health; Heavy Drinking; Heterogeneity; Home environment; Hospitalization; Housing; Individual; Investigation; Link; Lipids; Literature; Location; Marketing; Measures; Mental Depression; Morbidity - disease rate; Natural experiment; Nature; Neighborhoods; Obesity; Outcome; Patient Self-Report; Peripheral; Physiological; Physiological Processes; Physiology; Population; Pulse Pressure; Race; Relative (related person); Research; Respondent; Risk; Risk Factors; Risk Marker; Running; Sampling; Serum; Shock; Skin; Smoking; Socioeconomic Status; Stress; Subgroup; Time; Unemployment; Variant; Waist-Hip Ratio; Weight; Work; blood lipid; clinical risk; design; experience; falls; gene environment interaction; indexing; insight; male; mortality; physical conditioning; population health; premature; public health relevance; sex; trend; young adult

DESCRIPTION (provided by applicant): Despite long-standing evidence of strong gradients of increasingly better health from the lowest to the highest levels of socioeconomic status (SES), the causal nature of SES-health relationships has not been clearly established, and mechanisms underlying the relationships are not well understood. Beginning in 2008, the "Great Recession" was a major, and largely unanticipated, economic shock that impacted the vast majority of Americans and its impact on health has the potential to provide scientific evidence on the causal impact of SES on health. Assuming the timing and magnitude of the recession was largely unanticipated, the Great Recession can be treated as an exogenous economic shock that offers enhanced opportunities to establish the extent to which there are causal effects of SES on health. This R21 will empirically evaluate whether uniquely rich longitudinal, objective biological data (reflecting physiological processes linked to major morbidity and mortality) measured for the same 4,655 individuals before and after the Recession can be used to establish health effects of the Recession. These data from the Multi-Ethnic Study of Atherosclerosis (MESA) will be linked with time-varying area- and age-sex-race-education-specific measures of the local labor and housing markets (with over 200 zip-codes for housing markets and at least 200 location-specific demographic subgroups for labor markets). Four waves of MESA data were collected before Fall 2008 (onset of the Recession) with a 5th exam between July 2010 and December 2011. In contrast to the self-report health data used in much prior work on health effects of economic downturns, MESA offers the unique strength of standardized, objective assessments of major physiological markers of health, including systolic blood pressure, pulse pressure, blood glucose, serum lipids, body mass index and waist-hip ratio. Combining these rich health data with economic status measured on the same individuals before and after the onset of the Great Recession, and with local area- and demographic-specific exposures to the recession provides unparalleled opportunities to evaluate the effects of economic stress on objectively assessed and important health markers. The research will describe how these health markers change over time and how they change as exposure to area- and demographic-specific economic stress varies. This R21 is designed to provide initial evidence to establish feasibility and power for a larger, more comprehensive investigation (R01) of the impact of the Great Recession on biology (including new biomarkers assayed from stored blood samples), behaviors (e.g., exercise, smoking, heavy drinking), subclinical disease (e.g., carotid and peripheral atherosclerosis), overt disease (e.g., cardiovascular events, hospitalizations), and total mortality. Moreover, extensive MESA genetics data will also allow exploration of possible gene-by-environment (Recession) interaction effects in future work.

描述（由申请人提供）：尽管长期以来证明了从最低到最高水平的社会经济地位（SES）越来越好的梯度的证据，但SES健康关系的因果性质尚未得到明确建立，并且基于关系的机制尚未得到充分理解。从2008年开始，“大萧条”是一项重大，并且在很大程度上是意外的经济冲击，影响了绝大多数美国人及其对健康的影响，有可能提供有关SES对健康的因果影响的科学证据。假设经济衰退的时机和规模在很大程度上是故意的，那么大萧条可以视为一种外在的经济冲击，提供了增强的机会，以确定SES对健康的因果关系的程度。该R21将凭经验评估对经济衰退之前和之后对相同4,655个人测量的独特纵向，客观生物学数据（反映与主要发病率和死亡率相关的生理过程）是否可以用于建立经济衰退的健康影响。这些数据来自动脉粥样硬化的多民族研究（MESA）将与当地劳动力和住房市场的时变面积和年龄性别和年龄性别 - 婚姻特定的特定指标有关（有200多个用于房屋市场的邮政编码以及至少200个用于营业市​​场的位置特异性范围内的范围特异性范围。 Four waves of MESA data were collected before Fall 2008 (onset of the Recession) with a 5th exam between July 2010 and December 2011. In contrast to the self-report health data used in much prior work on health effects of economic downturns, MESA offers the unique strength of standardized, objective assessments of major physiological markers of health, including systolic blood pressure, pulse pressure, blood glucose, serum lipids, body mass index and waist-hip ratio.将这些丰富的健康数据与大萧条开始前后在同一个人中的经济状况相结合，并在特定于人口统计学的经济衰退中，为经济衰退提供了无与伦比的机会，可以评估经济压力对客观评估和重要健康标志物的影响。该研究将描述这些健康标志物如何随着时间的流逝而变化，以及它们如何随着面积和人口特定的经济压力而变化。该R21旨在提供初始证据，以确立对大衰退对生物学的影响（包括根据储存的血液样本测定的新生物标志物）的影响（例如，锻炼，吸烟，饮酒），果皮和疾病（例如，果皮和外围疾病）的行为（例如，锻炼，吸烟，饮酒）的影响（例如，锻炼，吸烟，饮酒）（例如，锻炼，吸烟，饮酒）住院）和总死亡率。此外，广泛的MESA遗传学数据还将允许探索未来工作中可能的基因 - 环境（衰退）相互作用的影响。