Area-level Socio-economic Conditions and Individual-level Health and Mortality: Exploring Place-Based Mechanisms and Individual-level Psychosocial Processes

地区层面的社会经济条件和个人层面的健康和死亡率：探索基于地方的机制和个人层面的心理社会过程

• 批准号: 10583024
• 负责人: David Stuart Curtis
• 金额: $ 56.62万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583024
• 关键词: Address; Adult; Affect; Age; Air; Alcohols; Area; Attention; Birth Certificates; Black race; Cardiovascular Diseases; Cessation of life; Communities; Complex; Country; County; Data; Data Set; Death Records; Development; Diabetes Mellitus; Disadvantaged; Economic Conditions; Enrollment; Environment; Equation; Family; Floods; Health; Health Status; Health behavior; Individual; Intervention; Investigation; Knowledge; Licensing; Life Expectancy; Link; Literature; Longitudinal Studies; Measures; Mediating; Medical; Mental Health; Methods; Modeling; Morbidity - disease rate; Outcome; Overdose; Pathway interactions; Persons; Pharmaceutical Preparations; Physical activity; Population Database; Premature Mortality; Process; Records; Research; Resources; Risk; Role; Sampling; Socioeconomic Status; Statistical Methods; Suicide; Surveys; Survival Analysis; System; Testing; Time; Unemployment; United States; Utah; aged; aging population; built environment; cardiometabolism; college; design; follow-up; geographic difference; health disparity; improved; innovation; insight; middle age; mortality; mortality disparity; novel; obesogenic; overdose death; prescription opioid; prevent; prospective; psychosocial; social; social capital; social norm; social organization; socioeconomics; substance misuse; synthetic opioid; trend; urban area; walkability

PROJECT SUMMARY More than 1 million drug overdose deaths have occurred in the US since 1999, while progress in reducing mortality from cardiovascular disease and diabetes has stalled since 2010. This evidence of rising morbidity and mortality in midlife has drawn attention to health risks among the working-age population. Increasing geographic variation in premature mortality, most pronounced during early to mid-adulthood, highlights the role of place. Research is needed that systematically identifies how place-based features contribute to the US midlife health and mortality crisis. Drawing from socio-ecological perspectives of health, the present study will test a comprehensive conceptual framework to examine the direct, indirect, and moderating effects within the place and health relationship. We will use two unique datasets that allow us to address limitations that have stymied past efforts. First, the Midlife in the United States study (MIDUS) enrolled 7,108 adults in the contiguous US aged 25 to 74 in 1995-1996 and surveyed them again in 2004-2006 and in 2013-2014, adding a sample of 592 Black adults in 2004-2006 who were surveyed again in 2016-2017. Second, the Utah Population Database (UPDB) includes data from a variety of state vital and administrative records for over 12 million individuals over 100 years, linked by family and containing geocoded residential addresses. From the UPDB, we will create a sample of 1.6 million adults aged 25 to 74 residing in a four-county urban area in 2000, for whom mortality is tracked until 2020 with 142,330 deaths recorded. Both datasets enable place-based longitudinal health research. In examining the health outcomes of substance misuse, mental health, cardiometabolic health, and mortality, we will: identify the prospective effects of area-level socioeconomic conditions on individual-level health and mortality outcomes (Aim 1); and document the prospective effects of place-based built, social, and natural environments on individual-level health and mortality outcomes (Aim 2). Attention will be given to how environmental features moderate and mediate prospective effects of area-level socioeconomic conditions, and to the individual-level mediating processes. We will use innovative methods to measure a range of place-based features and improve estimation using rigorous statistical methods (e.g., multi-level structural equation modeling, spatial analysis, and advanced survival analysis). Through this comprehensive investigation, we will document how place-based factors drive midlife health and mortality disparities and provide valuable insights into the complex and dynamic relationships within systems of people and places. This holistic research effort will produce novel evidence to support the development of effective place-based interventions.

项目概要 自 1999 年以来，美国已发生超过 100 万人因药物过量死亡，而在减少药物过量方面取得了进展 自 2010 年以来，心血管疾病和糖尿病导致的死亡率已趋于停滞。这一发病率上升的证据 中年死亡率引起人们对劳动年龄人口健康风险的关注。增加 过早死亡率的地理差异，在成年早期到中期最为明显，凸显了过早死亡率的作用 的地方。需要进行研究来系统地确定基于地点的特征如何对美国做出贡献 中年健康和死亡危机。本研究从健康的社会生态学角度出发， 测试一个全面的概念框架来检查直接、间接和调节效应 地点与健康的关系。我们将使用两个独特的数据集，使我们能够解决现有的限制 阻碍了过去的努力。首先，美国中年研究 (MIDUS) 招募了 7,108 名成年人参加 1995-1996 年对美国本土 25 至 74 岁人群进行了调查，并于 2004-2006 年和 2013-2014 年再次对他们进行了调查，补充道 2004 年至 2006 年期间对 592 名黑人成年人进行了抽样调查，并于 2016 年至 2017 年再次接受了调查。二、犹他州 人口数据库 (UPDB) 包含来自超过 12 个国家的各种重要和行政记录的数据 超过 100 年的数百万人，通过家庭联系在一起，并包含地理编码的居住地址。从 UPDB，我们将在 2000 年创建一个居住在四个县市区的 160 万 25 至 74 岁成年人的样本， 到 2020 年为止，对这些人的死亡率进行了追踪，记录死亡人数为 142,330 人。两个数据集都支持基于地点的 纵向健康研究。 在检查药物滥用、心理健康、心脏代谢健康和死亡率的健康结果时， 我们将： 确定地区级社会经济条件对个人健康的预期影响； 死亡率结果（目标 1）；并记录基于地点的建筑、社会和自然的预期影响 环境对个人健康和死亡率结果的影响（目标 2）。将关注如何 环境特征调节和调节地区社会经济条件的预期影响，以及 到个人层面的调解过程。我们将使用创新方法来衡量一系列基于地点的 特征并使用严格的统计方法（例如，多层结构方程）改进估计 建模、空间分析和高级生存分析）。通过这次全面的调查，我们将 记录地域因素如何影响中年健康和死亡率差异，并提供有价值的见解 深入了解人和地方系统内复杂且动态的关系。这项全面的研究工作 将产生新的证据来支持制定有效的基于地点的干预措施。