Impact of Structural Racism on Racial Disparities in Cognitive Impairment

结构性种族主义对认知障碍种族差异的影响

基本信息

批准号：
10572864
负责人：
Talha Ali
金额：
$ 11.71万
依托单位：
TUFTS UNIVERSITY MEDFORD
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-01 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10572864
关键词：
3-Dimensional Accounting Address Adopted Adverse effects Affect Age Age Years Aging Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Area Belief Black American Black Populations Black race Buffers Cause of Death Censuses Chronic Clinical Trials Cognitive County Data Dementia Diagnosis Disease Management Disparity Economics Education Educational Status Elderly Environment Environmental Risk Factor Equity Exposure to Frequencies Future Goals Health Health Care Visit Health Services Research Health and Retirement Study Healthcare Home Home Care Services Hospitalization Housing Hypertension Impaired cognition Impairment Incidence Individual Institution Intervention Length of Stay Life Cycle Stages Link Measures Medicaid Medicare claim Mentors Methods Modeling Modification Neurobiology Obesity Observational Study Outcome Ownership Pathogenesis Pensions Persons Policies Policy Analysis Policy Maker Population Research Public Health Schools Quality of life Race Reduce health disparities Research Research Priority Resources Risk Risk Factors Skilled Nursing Facilities Social Justice Social Network Social support Source Statistical Data Interpretation Stress Structural Racism System Training United States Work black/white disparity cardiovascular health caucasian American cognitive function dementia care dementia risk design experience foster care functional decline functional disability health assessment health care availability health care service utilization health disparity health inequalities improved insight interest lifestyle factors negative affect neuropsychiatric symptom physical conditioning pollutant prevent protective factors psychosocial racial disparity racism resilience socioeconomic disparity statistics stressor toxicant

3-Dimensional Accounting Address Adopted Adverse effects Affect Age Age Years Aging Alzheimer&apos s Disease Alzheimer&apos s disease related dementia American Area Belief Black American Black Populations Black race Buffers Cause of Death Censuses Chronic Clinical Trials Cognitive County Data Dementia Diagnosis Disease Management Disparity Economics Education Educational Status Elderly Environment Environmental Risk Factor Equity Exposure to Frequencies Future Goals Health Health Care Visit Health Services Research Health and Retirement Study Healthcare Home Home Care Services Hospitalization Housing Hypertension Impaired cognition Impairment Incidence Individual Institution Intervention Length of Stay Life Cycle Stages Link Measures Medicaid Medicare claim Mentors Methods Modeling Modification Neurobiology Obesity Observational Study Outcome Ownership Pathogenesis Pensions Persons Policies Policy Analysis Policy Maker Population Research Public Health Schools Quality of life Race Reduce health disparities Research Research Priority Resources Risk Risk Factors Skilled Nursing Facilities Social Justice Social Network Social support Source Statistical Data Interpretation Stress Structural Racism System Training United States Work black/white disparity cardiovascular health caucasian American cognitive function dementia care dementia risk design experience foster care functional decline functional disability health assessment health care availability health care service utilization health disparity health inequalities improved insight interest lifestyle factors negative affect neuropsychiatric symptom physical conditioning pollutant prevent protective factors psychosocial racial disparity racism resilience socioeconomic disparity statistics stressor toxicant

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项目摘要

It cognitive estimated is estimated that 65% of individuals experience some level of cognitive impairment by 70 years of age. Within impairment, Alzheimer's disease and related dementias are a leading cause of death, affecting an 5.8 million Americans.Black Americans are twice as likely as White Americans to be diagnosed with cognitive impairment. And among older adults with cognitive impairment, Black, compared to White, individuals have worse cognitive function, greater functional disability, and more severe neuropsychiatric symptoms, indicating preventable racial disparities. Understanding preventing examining health disparities, using claims data to assess healthcare utilization, and policy analysis, sources of these disparities will provide great insight into and delaying cognitive impairment. The goal of the proposed K01 is to train the candidate in to build on her prior work, which has focused on interpersonal dynamics and social networks of older adults as risk factors for functional decline. practices, opportunities candidate The proposed research focuses on structural racism – the larger system of policies, and institutions that reinforces racial inequality by creating differential access to resources and – as a fundamental cause of racial disparities in cognitive impairment. Through this K01, t he will (1) link data from the US Census, Medicare claims, and the Health and Retirement Study, to examine how structural racism leads to health disparities in cognitive impairment and dementia; (2) develop an understanding of how population-based research can be leveraged to inform policies in health and non-health sectors for older adults; equity, is extensive domains design in across racism utilization and, the solutions training individual-level and (3) complete oursework in neurobiology of dementia, social justice and health methods in health services research, and policy modeling approaches. The Yale School of Public Health a phenomenal environment to pursue this training. The candidate's primary mentor, Dr. Danya Keene, has expertise in how structural racism in the domain of housing policies and practices, intersects with other of structura racism to create health inequalities. Dr. Heather Allore (co-mentor) is an expert in the and statistical analysis o observational studies and clinical trials for older adults, with a special interest racial disparities in the context of dementia. Dr. Belinda Needham (co-mentor) is an expert in health disparities the life course. The proposed project will examine the association between three dimensions of structural and risk of cognitive impairment, including dementia, and racial disparities in these outcomes; health care among individuals with cognitive impairment; and assess whether s ocial support, at the individual level, Medicaid expansion, at the structural-level, modify the adverse effects of structural racism. Consistent with research priorities of NIA, findings f rom this work will inform future multi-level interventions and policy to reduce health disparities in cognitive impairment (RFA: PA-15-349). Further, the combination of and research will serve as a spring board for the candidate's long-term goal to move the field beyond risk factors to evaluate and address structural-level risk factors for cognitive impairment. c l f

它认知的估计的据估计，有65％的人在70岁之前就经历了一定程度的认知障碍。之内损害，阿尔茨海默氏病和相关痴呆症是死亡的主要原因，影响了 580万美国人。美国人被诊断出患有白人的美国人的可能性是认知障碍。在认知障碍的老年人中，黑色，与白人相比具有较差的认知功能，更大的功能残疾和更严重的神经精神症状，表示可预防的种族分布。理解预防检查健康分布，使用索赔数据来评估医疗保健利用和政策分析，这些分布的来源将为您提供深入的了解并延迟认知障碍。提议的K01的目标是培训候选人建立她的先前工作是针对人际动态和老年人的社交网络作为风险因素用于功能下降。实践，机会候选人拟议的研究重点是结构性种族主义 - 更大的政策制度，以及通过创建对资源和资源的差异访问和 - 作为认知障碍中种族差异的根本原因。通过这个K01，他（1）将美国人口普查的数据，医疗保险索赔和健康和退休研究链接到研究结构性种族主义如何导致认知障碍和痴呆症的健康差异；（2）开发了解如何利用基于人群的研究来为健康和非健康政策提供信息老年人的部门；公平，是广泛的域设计在过度种族主义利用率和，这解决方案训练个人级别（3）完成我们在痴呆，社会正义和健康神经生物学方面的工作卫生服务研究和政策建模方法的方法。耶鲁公共卫生学院进行这项培训的惊人环境。候选人的主要导师Danya Keene博士有关于住房政策和实践领域的结构种族主义如何与其他人相交的专业知识结构种族主义以造成健康不平等。希瑟·阿洛雷（Heather Allore）博士（院）是和统计分析o具有特殊兴趣的老年人的观察研究和临床试验种族差异在痴呆症的背景下。贝琳达·尼德姆（Belinda Needham）博士（Co-Indor）是健康差异的专家生活过程。拟议的项目将检查结构的三个维度之间的关联以及认知障碍的风险，包括痴呆症以及这些结果中的种族差异；卫生保健在认知障碍的人中；并评估是否在个人层面上的ECO支持，在结构层面上，医疗补助扩张改变了结构种族主义的不利影响。与 NIA的研究优先事项，这项工作将为未来的多层次干预和政策提供信息减少认知障碍的健康差异（RFA：PA-15-349）。此外，结合了研究将成为候选人的长期目标的弹簧董事评估和解决认知障碍的结构级别风险因素的风险因素。 c l f