Geographic Trends And Disparities In Psychosocial Wellbeing, Health Behaviors, And Mortality In Midlife

社会心理健康、健康行为和中年死亡率的地理趋势和差异

基本信息

批准号：
10712146
负责人：
Shannon M Monnat
金额：
$ 29.98万
依托单位：
SYRACUSE UNIVERSITY
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：
2023-08-01 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10712146
关键词：
Academy Address Adult Affect Age Alcohols Appalachian Region Area Automobile Driving Bachelor&apos s Degree Behavioral Black race Bundling COVID-19 pandemic Cardiometabolic Disease Cardiovascular Diseases Cause of Death Cessation of life Cities Code Communities Consumption County Data Data Set Diabetes Mellitus Dimensions Disparity Documentation Drug usage Economic Conditions Economics Education Educational workshop Employment Ethnic Origin Ethnic Population Etiology Family Female Food Funding Geographic Locations Geography Health behavior Hispanic Hypertension Income Individual Instruction Intervention Knowledge Life Life Expectancy Link Measures Mental Health Methods Michigan Midwestern United States National Institute of Drug Abuse Not Hispanic or Latino Occupations Overdose Pathway interactions Pattern Personal Satisfaction Pharmaceutical Preparations Policies Population Predictive Factor Process Race Reporting Research Resources Risk Risk Factors Shapes Suicide Surveys System Universities Vital Statistics Work age group alcohol poisoning college data enclave data resource demographics experience fast food food consumption geographic disparity health disparity innovation large datasets local economy male metropolitan middle age mortality mortality disparity novel strategies psychosocial psychosocial wellbeing racial population response rural area satisfaction sex social social determinants trend virtual web page

项目摘要

The rise in U.S. midlife mortality in recent decades has been substantial, ending the increase in life expectancy around 2010 and triggering its decline after 2014. The trend has been exacerbated by the COVID-19 pandemic. One of the most telling features of the rise is its geographic pattern. It has been pronounced in Midwestern and Southern states and in rural areas and small cities. Explaining these growing geographic disparities is a necessary step toward identifying the etiologies of rising midlife mortality overall. The overarching objective of this project is to assess how state policy contexts and county economic contexts collectively predict growing geographic disparities in 1) all-cause midlife mortality, 2) major trend-driving causes of death for midlife mortality: suicide, drug overdose, alcohol-induced causes, and cardiometabolic diseases, and 3) psychosocial and health behavior risk factors for those causes of death The project answers key unresolved questions about the growing geographic disparities in midlife mortality that have been major obstacles to understanding them. One question regards the collective influence of state and local contexts. Studies tend to focus on state or local contexts, providing an incomplete explanation. We advance this work by examining state and local contexts concomitantly, which is critical because they may affect mortality via independent and synergistic processes. A second question concerns the influence of states’ policy “contexts”. States have enacted highly correlated, or “bundled”, policies which necessitates new approaches for understanding their influence on mortality. We advance this work by using innovative methods to develop annual scores for interpretable policy bundles. A third question concerns the degree to which state and local contexts collectively predict individual-level psychosocial wellbeing and health behaviors—i.e., the proximate determinants of the four major causes of death behind rising midlife mortality. Deindustrialization, declines in good jobs, and concomitant disruptions to families and communities in some places may have harmed the psychosocial wellbeing of midlife adults, particularly those without a 4-year college degree, leading to consumption of drugs, alcohol, and unhealthy food. We advance this work by examining how state and local contexts collectively predict psychosocial and health behavior risk factors for the four major causes of death. The project will accomplish its objective through three Specific Aims. Aim 1 identifies how state policy and county economic contexts collectively predict county-level mortality (from all causes and the four specific causes) from 1990-2025 for all midlife adults and by age, sex, race-ethnicity, education, and metro status. Aim 2 identifies how state policy and county economic contexts collectively predict individual-level psychosocial and health behavior risk factors from 2021-2025, and examines hypothesized pathways, among all midlife adults and by age, sex, race/ethnicity, education, and metro status. Aim 3 merges the 100+ annual state and county measures into multiple geocoded surveys available via the UM’s Virtual Data Enclave. We will also disseminate the data, documentation, and code via ICPSR and offer workshops on these resources.

近几十年来美国中年死亡率大幅上升，结束了预期寿命的增长 2010 年左右开始下降，2014 年之后开始下降。COVID-19 大流行加剧了这一趋势。崛起最显着的特征之一是其地理格局，这一趋势在中西部和西部地区尤为明显。南部各州以及农村地区和小城市的地理差异是如何解释的。确定中年死亡率总体上升的病因的必要步骤。该项目旨在评估国家政策背景和县经济背景如何共同预测增长 1) 全因中年死亡率，2) 中年死亡率主要趋势驱动原因的地理差异：自杀、药物过量、酒精引起的原因和心脏代谢疾病，以及 3) 心理社会和健康这些死亡原因的行为风险因素该项目回答了有关日益增长的未解决的关键问题中年死亡率的地理差异一直是理解这一问题的主要障碍。考虑州和地方背景的集体影响。我们通过同时检查州和地方背景来推进这项工作，这很重要，因为它们可能通过独立和协同过程影响死亡率。关注各国政策“背景”的影响。各国制定了高度相关或“捆绑”的政策。这需要新的方法来了解它们对死亡率的影响，我们通过以下方式推进这项工作。使用创新方法为可解释的政策组合制定年度分数。州和地方环境共同预测个人心理社会健康的程度健康行为——即中年上升的四大死因的直接决定因素死亡率、好工作的减少以及随之而来的对家庭和社区的破坏。有些地方可能损害了中年成年人的社会心理健康，特别是那些没有四年教育的人大学学位，导致药物、酒精和不健康食品的消费，我们通过以下方式推进这项工作。研究州和地方环境如何共同预测社会和健康行为风险因素该项目将通过确定的三个具体目标 1 来实现其目标。国家政策和县经济环境如何共同预测县级死亡率（各种原因和死亡率）四个具体原因），从 1990 年到 2025 年，针对所有中年成年人，按年龄、性别、种族、教育程度和目标 2 确定国家政策和县经济背景如何共同预测个人层面。 2021 年至 2025 年的心理社会和健康行为风险因素，并检查停滞的途径，其中 Aim 3 按年龄、性别、种族/民族、教育程度和地铁状况合并了 100 多个中年成年人。我们将通过 UM 的虚拟数据飞地将州和县的措施纳入多个地理编码调查中。还通过 ICPSR 传播数据、文档和代码，并举办有关这些资源的研讨会。