The Loved Ones Left Behind: Examining the Health Implications of Racial Inequities in Mortality

留下的亲人：审视种族死亡率不平等对健康的影响

• 批准号: 10650251
• 负责人: Angela R Dixon
• 金额: $ 13.21万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-19 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10650251
• 关键词: Achievement; Adoption; Adult; Age; Bereavement; Black Populations; COVID-19; COVID-19 mortality; COVID-19 stress; Cessation of life; Child; Communities; Complex; Data; Demography; Disparity; Equation; Exposure disparity; Exposure to; Extended Family; Family; Family Leave; Family health status; Family member; Feedback; Generations; Health; Health Insurance; Health Status; High Prevalence; Household; Household and Family; Individual; Inequality; Inequity; Insurance Coverage; Intervention; Interview; Kinship Networks; Knowledge; Latin America; Left; Life Cycle Stages; Life Expectancy; Link; Literature; Mediating; Mental Health; Mentors; Methodology; Methods; Michigan; Modeling; Nuclear Family; Outcome; Pathway Analysis; Pathway interactions; Play; Policies; Population; Prevalence; Psychosocial Stress; Race; Research; Research Personnel; Resources; Rest; Risk; Role; Running; Shapes; Siblings; Social Network; Societies; Socioeconomic Factors; Socioeconomic Status; Sociology; Source; Stressful Event; Structure; Survival Analysis; Survivors; System; Time; Training; Universities; Work; biopsychosocial; black/white disparity; design; economic outcome; evidence base; experience; grandparent; health inequalities; improved; innovation; intergenerational; loved ones; low socioeconomic status; member; mortality; mortality risk; novel; panel study of income dynamics; perceived discrimination; physical conditioning; premature; psychological distress; racial disparity; racial health disparity; racism; social; social epidemiology; social health determinants; social structure; socioeconomic disparity; socioeconomics; theories; tool

PROJECT SUMMARY Blacks are more likely than whites to experience the deaths of multiple family members and experience them at earlier ages. Between 1970-2004, an estimated 2.7 million excess black deaths occurred because of blacks’ elevated mortality rates. Further, the estimated 600,000 COVID-19 deaths in the US as of July 2021 have directly impacted the lives of more than 5.3 million individuals in nuclear families according to a bereavement multiplier, with blacks facing twice the risk of death from COVID-19 as whites. Although experiencing death within a family or network powerfully shapes survivors’ health, we know little about how network death contributes to health inequities. The objective of the proposed study is to quantify black–white disparities in familial and household exposure to deaths and their relationship to disparities in psychological distress and all- cause mortality. My specific aims are to: 1) quantify the prevalence of and racial disparities in network mortality by lifecourse stage and socioeconomic status (SES) for blacks and whites, exploring differences before and during COVID-19; 2) identify key perceived mechanisms through which exposure to death may impact the SES–health feedback loop throughout the lifecourse and intergenerationally for blacks and whites using semi- structured interviews, exploring differences before and during COVID-19; and 3a) estimate the contribution of exposure to premature and cumulative deaths to black–white inequalities in psychological distress, before and during COVID-19, and to all-cause mortality; and 3b) determine the extent to which SES mediates the relationship of network mortality with psychological distress and all-cause mortality for blacks and whites. To do this, I will analyze data from the Panel Study of Income Dynamics (PSID) and conduct semi-structured interviews with black and white adults in Atlanta, GA. This project is innovative in its focus on examining racial disparities in death from broader social network ties including extended kin and household members as well as how network deaths can initiate a cascade of SES consequences that contribute to adverse health for survivors. This K01 project will enhance my prior sociological training in race, racism, socioeconomic inequality, and demography with additional training in: 1) social epidemiology, with a focus on racial health inequities; 2) network analysis, survival analysis, and structural equation modeling; 3) qualitative and mixed methods; and 4) use of PSID data. My access to excellent resources and mentoring at Emory University is supplemented with affiliations at Harvard University and the University of Michigan. Study findings will provide an evidence base for efforts to reform bereavement and family leave policies that do not account for the collateral health effects of individuals embedded in networks beyond the traditional nuclear family. The K01 will facilitate my transition to a scientific leader advancing policy-relevant research examining the degree to which racial health inequalities reverberate across social networks and generations to (re)produce health inequities.

项目摘要 黑人比白人更有可能体验多个家庭成员的死亡并体验他们 在早期。在1970 - 2004年之间，由于黑人的身份，估计有270万超过黑人死亡。 死亡率升高。此外，截至2021年7月，美国估计有600,000名Covid-19死亡 根据丧亲，直接影响了核家庭中超过530万个人的生活 乘数，黑人面临两倍的死亡风险，即白人死亡。虽然经历了死亡 在家庭或网络中，有力地塑造了生存的健康状况，我们对网络死亡的了解一无所知 有助于健康不平等。拟议的研究的目的是量化黑白分布 家庭和家庭接触死亡及其与心理困扰和无处不在的差异的关系 导致死亡率。我的具体目的是：1）量化网络死亡率中的种族分布和种族分布 通过生命的阶段和黑人和白人的社会经济地位（SES），探索之前和探索差异 在Covid-19期间； 2）确定接触死亡可能影响的关键感知机制 SES - 健康反馈循环在整个生命程度中，并使用半代表黑人和白人。 结构化的访谈，探索Covid-19之前和期间的差异；和3a）估计 暴露于心理困扰，前后的黑白不平等的过早和累积死亡 在Covid-19期间，以及全因死亡率；和3b）确定SES介导的程度 网络死亡率与黑人和白人的心理困扰和全因死亡率的关系。到 这样做，我将分析收入动态小组研究（PSID）的数据并进行半结构 佐治亚州亚特兰大的黑白成年人的采访。该项目专注于检查种族具有创新性 与更广泛的社交网络联系的死亡差异，包括扩展的亲戚和家庭成员以及 网络死亡如何启动一系列SES后果，导致不利的健康 幸存者。这个K01项目将增强我以前在种族，种族主义，社会经济上的社会学培训 不平等和人口统计学以及其他培训：1）社会流行病学，重点是种族健康 不平等； 2）网络分析，生存分析和结构方程建模； 3）定性和混合 方法; 4）使用PSID数据。我在埃默里大学获得出色的资源和心理的机会是 补充哈佛大学和密歇根大学的会员。研究结果将提供 努力改革丧亲和家庭的证据基础，不考虑 传统核心家庭以外的网络中嵌入的个体的抵押健康影响。 K01会 促进我向科学领导者的过渡，促进与政策相关的研究，以研究以下程度 种族健康不平等在社交网络和几代人之间回荡，以产生健康不平等。