Trends in ethnic and socioeconomic differentials in diet quality in American chil

美国儿童饮食质量的种族和社会经济差异趋势

• 批准号: 7572166
• 负责人: ASHIMA K KANT
• 金额: $ 15.5万
• 依托单位: QUEENS COLLEGE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-22 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7572166
• 关键词: 19 year old; Address; Adolescent; American; Ascorbic Acid; Biological Markers; Biomarker of Dietary Intake; Carotenoids; Child; Childhood; Chronic Disease; Data; Diet; Dietary Factors; Discrimination; Economics; Education; Educational Background; Effectiveness; Environmental Exposure; Ethnic Origin; Family; Folate; Glycosylated Hemoglobin; Goals; Health; Health Promotion; Health Services Accessibility; High Density Lipoprotein Cholesterol; Hispanics; Household Heads; Hypertension; Income; Injury; Intake; Intervention; Knowledge; Lipids; Low-Density Lipoproteins; Malignant Neoplasms; Measures; Mediator of activation protein; Micronutrients; Minority; National Health and Nutrition Examination Survey; Neighborhoods; Obesity; Occupations; Outcome; Population; Prediabetes syndrome; Prevalence; Public Health; Publishing; Race; Relative (related person); Relative Risks; Reporting; Research; Risk Behaviors; Risk Factors; Serum; Socioeconomic Status; Surveys; Testing; Time; Vitamin D; Vitamin E; behavior change; design; ethnic minority population; experience; health disparity; high risk; improved; low socioeconomic status; mortality; public health relevance; socioeconomics; trend

DESCRIPTION (provided by applicant): American children from ethnic minority and low socioeconomic families have higher rates of poor health and higher mortality rates. Recent data suggest persistence or widening of these ethnic and socioeconomic differentials in health outcomes of US children. For example, over the past three decades, overall, injury, and natural-cause mortality in childhood in the US declined. However, children from minority and lower socioeconomic position families experienced a smaller decline, resulting in a widening of the socioeconomic gap. The trends analysis for risk factors such as prevalence of obesity, prediabetes, and high blood pressure in US children also suggest similar persistence or increase of socioeconomic and ethnic disparities. Adverse health risk behaviors that include diet are among the many factors such as access to health care, environmental exposures, neighborhood contexts, income constraints, and discrimination that may contribute to ethnic and socioeconomic disparities in the health of US children. The hypothesis that diet may be a mediator of ethnic and socioeconomic disparities in health appears reasonable given that diet is an acknowledged risk factor for a number of chronic diseases. However, surprisingly little is known about the independent associations of ethnicity and measures of socioeconomic position-- family income, education, and occupation--with dietary attributes within a multivariate framework in US children. Also, there is no published information on how the association of diet and socioeconomic position may be changing over time in US children. Assessment of time trends in dietary disparities due to ethnic and socioeconomic group membership may help us to understand whether diet may be a contributor to persistence or increase of health disparities among US children. Therefore, the overall objectives of this application are to examine in US children and adolescents: 1) the independent associations of race/ethnicity and measures of socioeconomic position (family income, education, and occupation) with attributes of reported diets and objective biomarkers of dietary intake, and 2) the trends in the association of race/ethnicity and socioeconomic position with diet quality from 1971 to 2006. We will use nationally representative data for 2-19 year olds (n= 39,607) from the National Health and Nutrition Examination Surveys (NHANES) conducted in1971-74, 1976-1980, 1982-1984 (Hispanic HANES), 1988-1994, an 2001-2006, to address these issues. PUBLIC HEALTH RELEVANCE: The importance of dietary factors in improving health outcomes is underscored by the fact that dietary factors are amenable to intervention, and diet is universally consumed and even a small relative risk may have a considerable public health impact. Assessment of time trends in ethnic and socio- economic differentials in diet quality will therefore help in determining the absolute as well as relative progress in closing the ethnic and socioeconomic gaps in health outcomes that is a stated goal of the national health promotion agenda. The results of this study will thus help in evaluating the effectiveness of past efforts to promote desirable behavior changes in these high risk populations, and design of newer strategies to target dietary attributes associated with ethnicity and socioeconomic position.

描述（由申请人提供）：来自少数族裔和低社会经济家庭的美国儿童健康状况不佳的比例较高，死亡率也较高。最近的数据表明，美国儿童健康结果中的这些种族和社会经济差异持续存在或扩大。例如，在过去三十年中，美国儿童期的伤害和自然原因死亡率总体上有所下降。然而，少数民族和社会经济地位较低家庭的儿童下降幅度较小，导致社会经济差距扩大。对美国儿童肥胖、糖尿病前期和高血压等危险因素的趋势分析也表明，社会经济和种族差异也存在类似的持续存在或增加。包括饮食在内的不良健康风险行为是可能导致美国儿童健康方面的种族和社会经济差异的众多因素之一，例如获得医疗保健的机会、环境暴露、邻里环境、收入限制和歧视。鉴于饮食是许多慢性疾病公认的危险因素，饮食可能是种族和社会经济健康差异的中介因素的假设似乎是合理的。然而，令人惊讶的是，我们对美国儿童多元框架内的种族和社会经济地位衡量标准（家庭收入、教育和职业）与饮食属性之间的独立关联知之甚少。此外，目前还没有关于美国儿童饮食与社会经济地位之间的关系如何随时间变化的公开信息。评估由于种族和社会经济群体成员身份而导致的饮食差异的时间趋势可能有助于我们了解饮食是否可能是美国儿童健康差异持续或扩大的一个因素。因此，本申请的总体目标是检查美国儿童和青少年：1）种族/民族和社会经济地位衡量标准（家庭收入、教育和职业）与报告饮食属性和饮食客观生物标志物的独立关联摄入量，以及 2) 1971 年至 2006 年种族/族裔和社会经济地位与饮食质量之间关系的趋势。我们将使用 2-19 岁儿童的全国代表性数据（n= 39,607）来自1971-74年、1976-1980年、1982-1984年（西班牙裔HANES）、1988-1994年和2001-2006年进行的国家健康和营养检查调查（NHANES），以解决这些问题。公共卫生相关性：饮食因素易于干预，饮食被普遍消费，即使很小的相对风险也可能对公共卫生产生相当大的影响，这一事实强调了饮食因素在改善健康结果方面的重要性。因此，评估饮食质量的种族和社会经济差异的时间趋势将有助于确定缩小健康结果方面的种族和社会经济差距的绝对和相对进展，这是国家健康促进议程的既定目标。因此，这项研究的结果将有助于评估过去为促进这些高风险人群的理想行为改变而做出的努力的有效性，并设计新的策略来针对与种族和社会经济地位相关的饮食属性。