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）：尽管长期存在的证据表明，从社会经济地位（SES）最低水平到最高水平，健康水平不断提高，但 SES 与健康关系的因果关系尚未明确确立，其背后的机制尚未明确。这些关系还没有被很好地理解。从 2008 年开始，“大衰退”是一场重大且很大程度上出乎意料的经济冲击，影响了绝大多数美国人，其对健康的影响有可能为 SES 对健康的因果影响提供科学证据。假设经济衰退的时间和规模基本上是出乎意料的，那么大衰退可以被视为一种外生经济冲击，它提供了更多的机会来确定社会经济地位对健康的因果影响程度。该 R21 将根据经验评估在经济衰退之前和之后对 4,655 名个体测量的独特丰富的纵向、客观生物数据（反映与主要发病率和死亡率相关的生理过程）是否可用于确定经济衰退对健康的影响。来自动脉粥样硬化多种族研究 (MESA) 的这些数据将与当地劳动力和住房市场（包括住房市场的 200 多个邮政编码）随时间变化的地区和年龄、性别、种族、教育具体措施联系起来以及劳动力市场至少 200 个特定地点的人口亚组）。在 2008 年秋季（经济衰退开始）之前收集了四波 MESA 数据，并在 2010 年 7 月至 2011 年 12 月之间进行了第五次检查。与之前关于经济衰退对健康影响的研究中使用的自我报告健康数据相比，MESA 提供了对主要健康生理指标（包括收缩压、脉压、血糖、血脂、体重指数和腰臀比）进行标准化、客观评估的独特优势。将这些丰富的健康数据与大衰退爆发前后对同一个人测量的经济状况相结合，并结合当地地区和人口特定的衰退风险，为评估经济压力对客观评估和预测的影响提供了无与伦比的机会。重要的健康标志。该研究将描述这些健康指标如何随时间变化，以及它们如何随着地区和人口特定经济压力的变化而变化。该 R21 旨在提供初步证据，以确定大衰退对生物学（包括从储存的血液样本中测定的新生物标记物）、行为（例如运动、吸烟）影响的更大规模、更全面的调查 (R01) 的可行性和效力。 、酗酒）、亚临床疾病（例如颈动脉和外周动脉粥样硬化）、明显疾病（例如心血管事件、住院治疗）和总死亡率。此外，广泛的 MESA 遗传学数据还将允许在未来的工作中探索可能的基因与环境（经济衰退）相互作用的影响。