Understanding the role of structural racism and intergenerational wealth on obesity outcome

了解结构性种族主义和代际财富对肥胖结果的作用

• 批准号: 10640092
• 负责人: Shanise Erika Owens
• 金额: $ 4.11万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10640092
• 关键词: Accounting; Address; Adult; Aptitude; Area; Back; Black American; Black race; Body mass index; Cardiovascular Diseases; Categories; Characteristics; Chronic; Chronic Disease; Data Set; Degenerative polyarthritis; Depressed mood; Development; Diabetes Mellitus; Discrimination; Disparity; Economic Policy; Environment; Family; Federal Government; Future Generations; Generations; Geography; Goals; Health; Health Policy; Healthcare Systems; Home; Household; Hypertension; Income; Individual; Inequality; Inequity; Institutionalization; Intervention; Kidney Diseases; Knowledge; Life Cycle Stages; Link; Literature; Longevity; Malignant Neoplasms; Mediating; Mediation; Mentorship; Natural experiment; Nature; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Outcome; Pathway interactions; Play; Policies; Policy Maker; Process; Property; Public Health; Quasi-experiment; Race; Randomized; Research; Research Personnel; Risk; Risk Factors; Role; Socioeconomic Status; Specific qualifier value; Stroke; Structural Racism; Testing; Training; United States; Woman; caucasian American; cost; deprivation; econometrics; economic determinant; ethnic minority; experience; health data; health disparity; high risk; intergenerational; middle age; minority communities; mortality; obesity risk; obesogenic; panel study of income dynamics; prevent; preventable death; racial disparity; racial health disparity; racial minority; racial population; racism; segregation; skills; social; social determinants; social health determinants; trend

PROJECT SUMMARY/ABSTRACT Obesity is a preventable cause of early mortality and poses a significant cost burden to public health and health care systems. Obesity increases risk for several chronic conditions including kidney disease, hypertension, diabetes, cardiovascular disease, osteoarthritis, stroke, and preventable cancers. Disparities in obesity by racialized groups are marked, yet only a small body of literature has interrogated the role of structural racism in the creation of obesity disparities. This research aims to determine the plausible causal role that one form of structural racism—“redlining”, or the process of categorizing neighborhoods into race-based credit risk levels instigating discriminatory mortgage lending practices–plays in creating wealth inequality and obesity disparities over the life course. Using the geographical nature of Home Owners’ Loan Corporation (HOLC) racialized mortgage credit risk categories (e.g., redlined areas) provides an opportunity for a good natural experiment to evaluate the plausible causal impacts of the manifestation of neighborhood-level structural racism and its long-term consequences. Our specific aims are: 1) To identify the impact of neighborhood-level structural racism and intergenerational wealth accumulation; 2) To test the effect of structural racism on obesity over multiple generations; and 3) To test the mediating role of intergenerational wealth on the causal relationship between structural racism and obesity outcomes in adults. Our overarching hypothesis is that federally supported racialized “redlining” policies effectively prohibited Black Americans from building wealth in their homes, leading to decades of divestment in predominately Black neighborhoods and contributing to the development of obesogenic environments, and ultimately obesity risk over the life course. We leverage the longitudinal nature of the Panel Study for Income Dynamics (PSID) to implement a life course approach for assessing generational wealth inequality and obesity disparities and use a quasi-experimental design which circumvents the use of random assignment of the exposure variable. Aims 1 and 2 will use the actual boundaries of the “redlined” neighborhoods to conduct a geographical regression discontinuity (GRD) which addresses endogeneity of neighborhood characteristics by specifying a spatial or geographical boundary split with a marked threshold. Aim 3 will investigate the indirect effects of each generation of wealth accumulation on neighborhood-level structural racism and body mass index (BMI) outcomes. Results will contribute to understanding why health disparities exist for racialized minority communities by identifying how specific pathways operate through structural racism to create racialized inequities in obesity outcomes. Implications from this research will help identify consequences of structural racism and can help to lead to full accounting of the impacts, as well as identify corrective economic and health policy interventions that address inequalities in wealth and obesity disparities in middle-aged adults.

项目摘要/摘要 肥胖是早期死亡率的可预防原因，并为公共卫生造成了巨大的成本 卫生保健系统。肥胖会增加几种慢性病的风险，包括肾脏疾病， 高血压，糖尿病，心血管疾病，骨关节炎，中风和可预防的癌症。差异 种族化群体的肥胖是标记的，但只有一小部分文学质疑 肥胖差异的建立种族主义。这项研究旨在确定合理的因果作用 结构性种族主义的一种形式 - “红线”，或将邻里分类为基于种族的过程 信贷风险水平煽动歧视性抵押贷款惯例 - 播放财富不平等和 生命过程中的肥胖差异。使用房主贷款公司的地理性质 （HOLC）种族化抵押信贷风险类别（例如，红线区域）为善良提供了机会 自然实验，以评估邻里级别表现的合理因果影响 结构性种族主义及其长期后果。我们的具体目的是：1）确定 邻里水平的结构性种族主义和代际财富积累； 2）测试效果 几代人观察的结构种族主义； 3）测试代际的中介作用 成人结构性种族主义与肥胖结果之间因果关系的财富。我们的总体 假设是，联邦政府支持的种族化“红线”政策有效地禁止黑人美国人 在他们的家中建立财富，导致数十年的剥离，主要是黑人社区和 为肥胖环境的发展做出贡献，并最终在生活过程中肥胖风险。 我们利用小组研究的纵向性质进行收入动态（PSID）来实施生活课程 评估世代财富不平等和肥胖分布并使用准实验的方法 设计的设计可以规定使用曝光变量的随机分配。目标1和2将使用 “红线”社区的实际边界，以进行地理回归不连续性（GRD） 通过指定空间或地理边界来解决邻里特征的内生性 用明显的阈值分开。 AIM 3将调查每一代财富的间接影响 积累了邻里水平的结构种族主义和体重指数（BMI）的结果。结果将 有助于理解为什么要确定如何为种族化的少数民族社区存在健康分配 特定的途径通过结构性种族主义运作，在肥胖结果中造成种族不平等。 这项研究的含义将有助于确定结构性种族主义的后果，并有助于充分 对影响的核算，并确定纠正措施的经济和健康政策干预措施 中年成年人财富和肥胖分布的不平等。