Mid-Life Health Inequalities in the Rural South: Risk and Resilience

南方农村的中年健康不平等：风险和复原力

基本信息

批准号：
10583808
负责人：
Kathleen A Cagney
金额：
$ 65.79万
依托单位：
UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
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：
2023-09-15 至 2028-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10583808
关键词：
Adult Affect African American African American population Age Aging Alcohol abuse American Indians Appalachian Region Area Attention Attitude Behavioral Black Populations Black race Blood Blood Pressure Cardiometabolic Disease Cause of Death Censuses Characteristics Cherokee Indian Cognition Collaborations Collection Communities Consent County Coupled Data Data Collection Data Set Data Sources Databases Diabetes Mellitus Disease Disparity Ecological momentary assessment Economics Education Educational workshop Emotional Employment Equation Ethnic Origin Ethnic Population FAIR principles Frequencies Funding Gender Geography Goals Health Health Status Healthcare Height Home Hypertension Income Individual Knowledge Life Life Expectancy Measurement Measures Memory Mental Depression Methods Modeling Monitor Moods Movement National Archive National Longitudinal Survey of Adolescent to Adult Health Native Americans Neurocognitive North Carolina Not Hispanic or Latino Obesity Outcome Overdose Participant Persons Pharmaceutical Preparations Politics Populations at Risk Premature Mortality Prevention Process Protocols documentation Public Policy Race Religion Research Resources Risk Risk Behaviors Risk Factors Role Rural Rural Appalachia Rural Health Sampling Science Policy Scoring Method Smoking Social Environment Social Functioning Social isolation Social support Spirituality Spottings Statistical Methods Statistical Models Suicide Surveys Testing Time Unemployment United States National Institutes of Health Urban Population Walking Weight Work addiction adverse childhood events base body system computerized data harmonization ethnic difference executive function health assessment health determinants health disparity populations health inequalities improved middle age mortality multilevel analysis optimism premature pulmonary function racial difference racial population recruit regional difference resilience resilience factor rural America rural area rural counties social social situation socioeconomics trend

项目摘要

Abstract This application builds on the Great Smoky Mountains Study (GSMS) and leverages its recently funded extension, Great Smoky Mountains Study of Rural Aging (GSMS-RA) to improve our understanding of the determinants of health inequalities in rural America. This new study, the Mid-Life Health Inequalities in the Rural South: Risk and Resilience, augments data being collected (and already funded) for two GSMS-RA samples in western North Carolina, one of Native Americans and the other of non-Hispanic Whites, that are in their early 40s and currently reside in rural regions of Appalachia, with two new samples from the northeastern part of the State, one of African Americans and the other of non-African Americans, ages of 30 and 55, that will be recruited from rural Census tracts of the “Black Belt” region of the state. The Black Belt samples will be recruited, consented and surveyed using the same 120-minute in-home assessment utilized in the GSMS-RA to collect demographic and socioeconomic and attitudinal information, neurocognitive tasks (IQ, memory, attention, and executive function), and biomeasure collection (i.e., height, weight, waist, blood pressure, pulmonary function, bloodspots) (Aim 1). The Black Belt sample will also participate in the same 6-month Ecological Momentary Assessment (EMA) every other week (13 times total), using protocols to measure within-person day- to-day or week-to-week fluctuations in one's financial and social situations and/or mood, as these measurements may affect individuals' risk/resilience related to mid-life health outcomes, and track geospatial movement using GPS monitoring to assess activity space (Aim 2). For each of these 2 rural regions (Appalachia and Black Belt), we will assemble contextual data from several existing data bases to construct measures of the health, economic and social contexts of the localities in which participants in our 4 samples reside. The data from Aims 1 and 2 for these 4-sample/2 region samples will be used to analyze the causal linkages between person-specific and contextual measures of risk and resilience factors for those health conditions (e.g., suicide, alcohol abuse, cardiometabolic diseases) most associated with mid-life mortality (Aim 3). Multiple statistical methods, including fixed effect, structural equation and multilevel models as well as instrumental variables methods will be used to identify these causal linkages and their racial/ethnic and region differences. A distinctive feature of this analysis will be to employ the within-person data collected under the EMA protocol to examine the role of instability of socio-emotional, economic and social support as a unique contributor to those health conditions that result in midlife mortality. Finally, this project will harmonize measures collected in this rural-based study with measures in existing health/aging studies, disseminate the data collected through the National Archive of Computerized Data on Aging and conduct interdisciplinary user workshops on these data to facilitate urban/rural national comparisons of the study of health inequalities at midlife (Aim 4).

抽象的该应用程序建立在大烟山研究 (GSMS) 的基础上，并利用其最近资助的大烟山农村老龄化研究 (GSMS-RA) 的扩展，以提高我们对农村老龄化问题的了解这项新研究是美国农村地区中年健康不平等的决定因素。南方农村：风险和弹性，增强了为两个 GMS-RA 收集的数据（并已获得资助）北卡罗来纳州西部的样本，其中一个是美洲原住民，另一个是非西班牙裔白人，他们 40 岁出头，目前居住在阿巴拉契亚农村地区，其中两个新样本来自东北部该州的一部分，一名非裔美国人和另一名非裔美国人，年龄在 30 岁和 55 岁之间，从该州“黑带”地区的农村人口普查区招募黑带样本。使用 GSMS-RA 中使用的相同 120 分钟家庭评估进行招募、同意和调查，收集人口统计、社会经济和态度信息、神经认知任务（智商、记忆力、注意力、和执行功能），以及生物测量收集（即身高、体重、腰围、血压、肺功能）功能、血点）（目标 1）。黑带样本也将参加同样的 6 个月生态。每隔一周进行一次瞬时评估 (EMA)（总共 13 次），使用协议来衡量人内一天的情况- 一个人的财务和社交状况和/或情绪的每日或每周波动，因为这些测量可能会影响个人与中年健康结果相关的风险/弹性，并使用跟踪地理空间运动 GPS 监测以评估活动空间（目标 2）。对于这 2 个农村地区（阿巴拉契亚和黑带），我们将从几个现有数据库中收集背景数据，以构建健康、经济等方面的衡量标准目标 1 和 2 的数据。对于这些 4 个样本/2 个区域样本，将用于分析特定人群与特定人群之间的因果关系针对这些健康状况（例如自杀、酗酒、心脏代谢疾病）与中年死亡率最相关（目标 3）。将使用固定效应、结构方程和多水平模型以及工具变量方法确定这些因果联系及其种族/民族和地区差异是本分析的一个显着特征。将利用根据 EMA 协议收集的个人数据来检查不稳定因素的作用社会情感、经济和社会支持是导致健康状况的独特因素最后，该项目将协调这项基于农村的研究中收集的措施。在现有的健康/老龄化研究中，传播通过国家计算机档案馆收集的数据老龄化数据并就这些数据举办跨学科用户研讨会，以促进城乡国家中年健康不平等研究的比较（目标 4）。