State and county level income inequality and infant mortality risk: The moderating role of race and socioeconomic status

州和县级收入不平等和婴儿死亡风险：种族和社会经济地位的调节作用

基本信息

批准号：
8994651
负责人：
Daniel Martin Cook
金额：
$ 43.91万
依托单位：
UNIVERSITY OF NEVADA RENO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-27 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8994651
关键词：
Address African American Age American Indian and Alaska Native Area Birth Caucasians Censuses Cessation of life Characteristics Country County Data Developed Countries Ecological Bias Economic Conditions Economics Education Effectiveness Environment Epidemiology Expenditure Geographic state Government Health Health Professional Health system Hispanics Income Individual Inequality Infant Infant Health Infant Mortality Investigation Knowledge Lead Life Life Expectancy Life Style Link Literature Live Birth Maternal Health Measures Mediator of activation protein Methodology Modeling Morbidity - disease rate Mothers Native Americans Newborn Infant Not Hispanic or Latino Outcome Personal Satisfaction Play Policies Policy Maker Population Population Group Prenatal care Public Health Puerto Rican Race Research Research Design Risk Role Social Conditions Social Environment Socioeconomic Status Source Statistical Methods Target Populations Techniques Testing United States Woman Work caucasian American contextual factors experience improved infant death low socioeconomic status mortality novel programs public health relevance segregation social social capital social health determinants socioeconomics

项目摘要

DESCRIPTION (provided by applicant): The purpose of this R15 application is to study the impact of contextual income inequality, at the US state and county level, on the risk for infant birth mortality. Since infants from African-American and low socioeconomic (SES) groups are more likely to die before their first birthday, we will evaluate whether the mechanisms involved differ across racial and SES groups. The infant mortality rate (IMR) is an estimate of the number of infant deaths for every 1,000 live births. One of the most important and powerful measures of life expectancy in a population is infant mortality. It is a reflection of the economic and social conditions on the health of mothers and newborns, the social environment, individual lifestyles as well as the characteristics and effectiveness of health systems. In 2011, around 24,000 infants died in the United States, resulting in an IMR of 6.1 deaths occurring before the first birthday per 1,000 live births. This rate is high in comparison to other OECD countries. IMR are higher among Blacks, Hispanics, and Native Americans, in comparison to White Americans. Also, IMR are higher among low socioeconomic groups than among moderate and high socioeconomic groups. On top of individual characteristics, the social determinants of health framework posit that the conditions in which people are born, grow, live, work, and age, play an important role in health and well-being. Therefore, contextual exposures, as well as individual level factors need to be addressed. For example, income inequality, or the distribution of wealth in an area such as a US state or county, can play a role in infant mortality. Since most of the studies that investigate the role of income inequality on infant mortality have utilized the ecological study design, results might be biased. Furthermore, contextual income inequality might have a differential impact on infant mortality across racial and socioeconomic groups. Income inequality might have a more detrimental effect on African-Americans and might explain why the IMR is higher among this population group in comparison to White Americans. We propose the following specific aims: 1) To examine the causal association between contextual income inequality and risk for infant mortality; 2) To identify the mechanisms that link contextual income inequality and risk for infant mortality; 3) to test for differential effects of contextual income inequality on risk for infant mortality across racial and SES groups. To achieve these aims, we will conduct novel statistical methods using birth-mortality linked data. We anticipate that findings from this project will improve our understanding of the causes of and mechanisms leading to infant mortality. The proposed study will generate knowledge that is valuable and will inform policy makers and public health professionals to develop and implement policies and programs aimed at lowering the risk for infant mortality, especially among those at greatest risk such as those from African-American or low SES backgrounds.

描述（由应用程序提供）：该R15应用的目的是研究美国州和县一级上下文收入不平等的影响，对婴儿出生死亡的风险。由于来自非裔美国人和低社会经济（SES）群体的婴儿在第一个生日之前更有可能死亡，因此我们将评估种族和SES群体中涉及的机制是否不同。婴儿死亡率（IMR）是对每1000名活产婴儿死亡人数的估计。婴儿死亡率是人群中预期寿命的最重要措施之一。这反映了对母亲和新生儿健康，社会环境，个人生活方式以及卫生系统的特征和有效性的经济和社会状况的反映。 2011年，大约有24,000名婴儿在美国死亡，导致IMR在每1000例活生生的第一个生日之前发生6.1例死亡。与其他经合组织国家相比，此速度很高。与白人美国人相比，黑人，西班牙裔和美洲原住民的IMR更高。同样，在低社会经济群体中，IMR比现代和高社会经济群体中的IMR高。除个人特征外，健康框架的社会决定者认为，人们的出生，成长，生活，工作和年龄的状况在健康和福祉中起着重要作用。因此，需要解决上下文暴露以及个人级别因素。例如，收入不平等或在美国州或县等地区的财富分配可以在婴儿死亡率中发挥作用。由于研究收入不平等对婴儿死亡率的作用的大多数研究都利用了生态研究设计，因此结果可能会偏见。此外，上下文收入不平等可能对跨种族和社会经济群体的婴儿死亡率产生不同的影响。收入不平等可能会对非洲裔美国人产生更有害的影响，并且可以解释为什么与白人美国人相比，该人群中的IMR更高。我们提出以下具体目的：1）检查背景不平等与婴儿死亡风险之间的因果关系； 2）确定链接上下文的机制收入不平等和婴儿死亡率的风险； 3）测试背景不平等对跨种族和SES组婴儿死亡风险的差异影响。为了实现这些目标，我们将使用链接的数据进行新的统计方法。我们预计该项目的发现将提高我们对导致婴儿死亡率的原因和机制的理解。拟议的研究将产生有价值的知识，并将告知政策制定者和公共卫生专业人员制定和实施旨在降低婴儿死亡率风险的政策和计划，尤其是在具有最大风险的人中，例如来自非裔美国人或低SES背景的风险。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

State-level income inequality and mortality among infants born in the United States 2007-2010: A Cohort Study.

2007-2010 年美国出生婴儿的州级收入不平等和死亡率：队列研究。

DOI：
10.1186/s12889-019-7651-y
发表时间：
2019
期刊：
BMC public health
影响因子：
4.5
作者：
Pabayo,Roman;Cook,DanielM;Harling,Guy;Gunawan,Anastasia;Rosenquist,NatalieA;Muennig,Peter
通讯作者：
Muennig,Peter

State- and county-level income inequality and infant mortality in the USA in 2010: a cohort study.

2010 年美国州和县级收入不平等和婴儿死亡率：一项队列研究。