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

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，到 70 岁时，65% 的人会出现某种程度的认知障碍。损伤、阿尔茨海默氏病和相关痴呆症是死亡的主要原因，影响着 580 万美国人。美国黑人被诊断出患有此病的可能性是美国白人的两倍在患有认知障碍的老年人中，黑人与白人相比。认知功能更差，功能障碍更严重，神经精神症状更严重，防止表明可能的种族差异。预防检查健康差异，使用索赔数据评估医疗保健利用率和政策分析，这些差异的根源将有助于深入了解所提出的 K01 的目标是培训候选人。建立在她之前的工作重点关注老年人的人际动态和社交网络作为危险因素对于功能衰退。实践，机会候选人拟议的研究重点是结构性种族主义——更大的政策体系，以及通过创造资源和资源获取机会的差异而加剧种族不平等的机构 – 作为认知障碍种族差异的根本原因。将 (1) 将美国人口普查、医疗保险索赔以及健康与退休研究的数据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) 制定了解如何利用基于人群的研究为健康和非健康政策提供信息老年人部门；公平，是广泛的域设计在穿过种族主义利用率和，这解决方案训练个人层面 (3) 完成痴呆症神经生物学、社会正义和健康方面的工作卫生服务研究方法和政策建模方法。候选人的主要导师 Danya Keene 博士拥有绝佳的培训环境。住房政策和实践领域的结构性种族主义如何与其他方面相互交叉的专业知识希瑟·阿洛尔博士（共同导师）是这方面的专家。和统计分析 o 针对老年人的观察性研究和临床试验，特别感兴趣 Belinda Needham 博士（共同导师）是健康差异方面的专家。拟议的项目将研究结构的三个维度之间的关联。认知障碍（包括痴呆）的风险以及这些结果的种族差异；在有认知障碍的个体中；并评估个人层面的社会支持是否医疗补助的扩张在结构层面上改变了结构性种族主义的不利影响。 NIA 的研究重点，这项工作的结果将为未来的多层次干预措施和政策提供信息减少认知障碍的健康差异（RFA：PA-15-349）。研究将作为候选人实现该领域超越的长期目标的跳板评估和解决认知障碍的结构层面风险因素的风险因素。 c 我 f