scholarly journals Health Disparities Research With the National Institute on Aging (NIA)

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 363-363
Author(s):  
Cerise Elliott ◽  
Patricia Jones ◽  
Patricia Jones

Abstract The National Institute on Aging has taken special efforts to support research endeavors that explore ways to address health disparities. For example, the NIA Health Disparities Research Framework was developed in 2015 to provide a visualization of priority areas in Aging Research. The Framework can help researchers assess advances and potential opportunities for stimulating and supporting rigorous methods to address health disparities in Aging Research among the phases of research. The goal of this symposium is to highlight the different resources and research opportunities that NIA offers to support aging researchers, centers, and institutions for health disparities-related research or programs. Dr. Ron Kohanski will present a concept piece on how laboratory animals might be leveraged to mimic the impact of early life disparities on aging over the life-course, based on research in the hallmarks of aging support by NIA’s Extramural Division of Aging Biology. Dr. Damali Martin will identify the different resources focused on health disparities related research within the Division of Neuroscience. Dr. Lyndon Joseph will discuss the different health disparities research opportunities that are available from the Division of Geriatrics and Clinical Geriatrics. Dr. Frank Bandiera will highlight the different resources and research opportunities that are available to address health disparities within the Division of Behavior and Social Research. These presentations, taken together, will provide important information that bolsters knowledge of resources and research opportunities to address health disparities over the lifecourse and in late life.

2020 ◽  
Author(s):  
Antonio Pedro Ramos ◽  
Robert Weiss ◽  
Simeon Nietcher ◽  
Leiwen Gao

Background: Various studies suggest that corruption affects public health systems across the world. However, the extant literature lacks causal evidence about whether anti-corruption interventions can improve health outcomes. We examine the impact of randomized anti-corruption audits on early-life mortality in Brazil. Methods: The Brazilian government conducted audits in 1,949 randomly selected municipalities between 2003 and 2015. To identify the causal effect of anti-corruption audits on early-life mortality, we analyse data on health outcomes from individual- level vital statistics (DATASUS) collected by Brazil government before and after the random audits. Data on the audit intervention are from the Controladoria-Geral da Uniao, the government agency responsible for the anti-corruption audits. Outcomes are neonatal mortality, infant mortality, child mortality, preterm births, and prenatal visits. Analyses examine aggregate effects for each outcome, as well as effects by race, cause of death, and years since the intervention. Results: Anti-corruption audits significantly decreased early-life mortality in Brazil. Expressed in relative terms, audits reduced neonatal mortality by 6.7% (95% CI -8.3%, -5.0%), reduced infant mortality by 7.3% (-8.6%, -5.9%), and reduced child mortality by 7.3% (-8.5%, -6.0%). This reduction in early mortality was higher for nonwhite Brazilians, who face significant health disparities. Effects are greater when we look at deaths from preventable causes, and show temporal persistence with large effects even a decade after audits. In addition, analyses show that the intervention led to a 12.1% (-13.4%, -10.6%) reduction in women receiving no prenatal care, as well as a 7.4% (-9.4%, -5.5%) reduction in preterm births; these effects are likewise higher for nonwhites and are persistent over time. All effects are robust to various alternative specifications. Interpretation: Governments have the potential to improve health outcomes through anti-corruption interventions. Such interventions can reduce early-life mortality and mitigate health disparities. The impact of anti-corruption audits should be investigated in other countries, and further research should further explore the mechanisms by which combating corruption affects the health sector.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Courtney S Thomas Tobin ◽  
Myles D Moody

Abstract To evaluate the impact of early life racial discrimination (ELRD) on mental health among Black adults. Data were from the Nashville Stress and Health Study (n=618). OLS regression models examined the relationship between ELRD and adult psychological distress; logistic regression estimated the probability of past-year major depressive disorder (MDD). We also assessed whether ELRD moderated the relationship between adult discrimination and mental health. Childhood (b=1.07, SE=0.51, p=0.04) and adolescent ELRD (b=1.32, SE=0.42, p=0.002) were associated with adult distress. Individuals who experienced childhood ERLD had 88% lower odds of adult MDD than individuals with no ELRD. Significant interaction analyses showed that ELRD was generally protective against adult discrimination. While ELRD importantly shapes distress and MDD among Black adults, patterns vary by outcome. Results indicate that adult distress and MDD develop through cumulative adversity processes that are further influenced by sensitive periods in the life course.


2021 ◽  
Author(s):  
G. David Batty ◽  
Mika Kivimäki ◽  
Philipp Frank

SummaryBackgroundRemoval from family of origin to placement in state care is a highly challenging and increasingly prevalent childhood experience. The purpose of this report was to synthesise published and unpublished prospective evidence on adult mortality in people with a history of state care in early life.MethodsFor this systematic review and meta-analysis, we searched PubMed and Embase from their inception to May 31st 2021, extracting standard estimates of association and variance from qualifying studies. We augmented these findings with analyses of unpublished individual-participant data from the 1958 and 1970 Birth Cohort Studies (total N = 21,936). Study-specific estimates were aggregated using random-effect meta-analysis. The Cochrane Risk of Bias Tool was used to assess study quality. This review is PROSPERO-registered (CRD42021254665).FindingsWe identified 209 potentially eligible published articles, of which 11 prospective cohort studies from the UK, Sweden, Finland, the USA, and Canada met the inclusion criteria (2 unpublished). In 2,273,998 individuals (10 studies), relative to those without a care history in childhood, those who were exposed had 2.5 times the risk of total mortality in adulthood (summary rate ratio; 95% confidence interval: 2.58; 1.96 to 3.39), study-specific estimates varying between 1.53 and 5.77 (I2=92%). Despite some attenuation, this association held following adjustment for other measures of early life adversity; extended into middle- and older-age; was stronger in higher quality studies; and was of equal magnitude according to sex and geographical region. There was a suggestion of sensitive periods of exposure to care, whereby individuals who entered public care for the first time in adolescence (3.54; 2.00 to 6.29) experienced greater rates of total mortality than those doing so earlier in the life course (1.69; 1.35 to 2.12). In five studies capturing 1,524,761 individuals (5 studies), children in care had more than three times the risk of competed suicide in adulthood (3.37; 2.64 to 4.30) with study-specific estimates ranging between 2.42 and 5.85 (I2=68%). The magnitude of this relationship was weaker after adjustment for multiple covariates; in men versus women; and in lower quality studies.InterpretationThe excess rates of total and suicide mortality in children exposed to state care suggest child protection systems and social policy following care graduation are insufficient to mitigate the effects of the adverse experiences of care itself and the social disadvantage that preceded it.FundingNone.Research in contextEvidence before this studyExposure to state care during childhood has emerging links with an array of unfavourable social, psychological, and behavioural characteristics in early adulthood. We searched PubMed and Embase from their inception to May 31st 2021 for studies examining whether care is also related to elevated rates of adult mortality. While we identified a series of relevant studies, there was no synthesis of this evidence. Few studies utilised a prospective design such that the assessment of care was made in childhood, so avoiding biases of distant retrospective recall. There was also a lack of clarity regarding: the role of confounding factors; the influence of the timing of care entry on mortality; whether the impact of care extended into middle-age and beyond; and, as has been hypothesised, if men with a care history have a greater vulnerability than women.Added value of this studyWe conducted a systematic review to synthesis evidence on adult mortality risk in children placed in state care. Drawing also on unpublished resources to complement the findings of published studies, a total of 10 studies consistently showed that exposure to state care in childhood was associated with more than a doubling in the risk of total mortality. This association, while attenuated, held following statistical adjustment for other early life risk factors, including other adversities; extended into later adulthood such that it did not exclusively occur immediately following graduation from care; was stronger in better designed studies; and was of equal magnitude in men and women. There was also a suggestion of sensitive periods of exposure to care, whereby individuals who entered public care for the first time in adolescence experienced greater rates of total mortality in adulthood than those doing so earlier in the life course. The magnitude of the association between childhood care and adult risk of completed suicide (5 studies) were somewhat higher than for total mortality. This relationship was not completely explained by control for other early life risk factors; and the magnitude was somewhat weaker in lower quality studies, and in men versus women. There were too few studies to explore the impact of care on other causes of mortality.Implications of all the available evidenceIn recent years there has been a secular rise in the prevalence of children in state care in western societies. This excess mortality risk in this group did not appear to be attributable to other measures of adversity, suggesting that, in the countries studied, child protection systems and social policy following care graduation are insufficient to mitigate the effects of the adverse experiences of care itself and the unfavourable events that preceded it.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 580-581
Author(s):  
Roland Thorpe ◽  
Carl Hill

Abstract There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. First, Nguyen and colleagues examine 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in using data from the National Survey of American Life. Discrimination was positively associated with being subjectively isolated from friends only and family only. This relationship varied by age. Discrimination did not predict objective isolation. Second, Brown examines evidence of the black-white paradox in anxiety and depressive symptoms among older adults using data from 6,019 adults ages 52+ from the 2006 HRS. After adjusting for socioeconomic factors, everyday discrimination, chronic conditions, and chronic stress, there are no black-white differences in anxiety and depressive symptoms. Third, Cobb and colleagues investigate the joint consequences of multiple dimensions of perceived discrimination on mortality risk using mortality data from the 2006-2016 HRS. The authors report the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.


Author(s):  
Cara L Green ◽  
Davis A Englund ◽  
Srijit Das ◽  
Mariana M Herrerias ◽  
Matthew J Yousefzadeh ◽  
...  

Abstract While the average human lifespan continues to increase, there is little evidence that this is leading to a contemporaneous increase in “healthy years” experienced by our aging population. Consequently, many scientists focus their research on understanding the process of aging and trialing interventions that can promote healthspan. The 2021 Midwest Aging Consortium (MAC) consensus statement is to develop and further the understanding of aging and age-related disease using the wealth of expertise across universities in the Midwestern United States. This report summarizes the cutting-edge research covered in a virtual symposium held by a consortium of researchers in the Midwestern United States, spanning such topics as senescence biomarkers, serotonin induced DNA protection, immune system development, multi-system impacts of aging, neural decline following severe infection, the unique transcriptional impact of CR of different fat depots, the pivotal role of fasting in calorie restriction, the impact of peroxisome dysfunction, and the influence of early life trauma on health. The symposium speakers presented data from studies conducted in a variety of common laboratory animals as well as less-common species, including C. elegans, Drosophila, mice, rhesus macaques, elephants and humans. The consensus of the symposium speakers is that this consortium highlights the strength of aging research in the Midwestern United States as well as the benefits of a collaborative and diverse approach to geroscience.


2021 ◽  
pp. 089826432098818
Author(s):  
Courtney S. Thomas Tobin ◽  
Myles D. Moody

Objectives: To evaluate the impact of early life racial discrimination (ELRD) on mental health among Black adults. Methods: Data were from the Nashville Stress and Health Study ( n = 618). Ordinary least squares regression models examined the relationship between ELRD and adult psychological distress; logistic regression estimated the probability of past-year major depressive disorder (MDD). We also assessed whether ELRD moderated the relationship between adult discrimination and mental health. Results: Childhood (b = 1.07, SE = .51, p = .04) and adolescent ELRD (b = 1.32, SE = .42, p = .002) were associated with adult distress. Individuals who experienced childhood ERLD had 88% lower odds of adult MDD than individuals with no ELRD. Significant interactions showed that childhood and adolescent ELRD was protective against adult discrimination. Discussion: While ELRD importantly shapes distress and MDD among Black adults, patterns vary by outcome. Results indicate that adult distress and MDD develop through cumulative adversity processes that are further influenced by sensitive periods in the life course.


2020 ◽  
Vol 32 (S1) ◽  
pp. 1-2

Personal Narratives of AgeingPersonal Narratives of Ageing: This paper presents personal narratives reflecting on the ageing process, and growing older in the UK.This presentation reflects on self-written narratives from 170 respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first-person description of past, present, future or imaginary experiences of later life. This presentation will focus on the findings with reference to mental and physical and impacts, both real and anticipated to the ageing experience. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma.The data should be utilised to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.The Health Impact of Financial Fraud: ‘Scams’The Health Impact of financial fraud: This presentation will offer new and alternative insights into fraud and the health effects on older people, using data from the mass observation directive. The term utilised for such crimes in the UK is ‘Scam’.The paper reports data captured from a Mass Observation Project “Directive” focusing on ‘scams’ (see the UK definition of ‘scam’ below) and the impact on individuals. One hundred and forty-four ‘Observers’ responded to the ‘Directive’. Narratives indicate that victimisation to a scam may have negative impacts on individuals’ mental wellbeing, self-esteem, and relationships with others. Furthermore, data analysis identified that fear of victimisation can also affect individuals, resulting in worry, anxiety, and maladaptive coping strategies.Offering further understanding of the health impacts of ‘scams’ highlights the necessity to legitimise the issue as a public health concern.A scam is interpreted to be: a misleading or deceptive business practice where you receive an unsolicited or uninvited contact (for example by email, letter, phone or ad) and false promises are made to con you out of money (Office of Fair Trading 2006).Perceptions of DementiaPerceptions of Dementia: This paper (Exploring public perceptions and understanding of dementia: Analysing narratives from the Mass Observation Project, (Olsen et al 2019) presents a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public’s knowledge and understanding about dementia.This paper considers narratives of 143 respondents (“Observers”) to a Mass Observation Project Directive exploring individuals’ perceptions of dementia. Perceptions of dementia held by “Observers” with experience of dementia and those without differed sharply. “Observers” with experience of dementia offered insight into living with, and caring for, a person with dementia; including the impact this had on their lives and personal relationships. Whereas, “Observers” with no direct experience of dementia focused more on common disease symptoms, such as memory loss and reflected idealised views of care. “Observers” often feared being diagnosed with dementia themselves. This suggests education to facilitate care planning and ameliorate fears held by the public is required.Previously, perceptions of dementia have been captured utilising traditional research methods and samples drawn mainly from professionals. This new approach identifies public understanding of dementia, highlighting areas concern, and supplements the existing UKOlsen, V., Taylor, L., Whitely, K., Ellerton, A., Kingston, P. & Bailey, J. Exploring public perceptions and understanding of dementia: Analysing narratives from the Mass Observation Project. Dementia: The International Journal of Social Research and Practice.https://doi.org/10.1177/1471301219861468.End of life careThis paper considers narratives from two Mass Observation Directives exploring individuals’ perceptions of dementia (n=143) and personal narratives of ageing (n=170). ‘End of Life Care’ has, in a UK context, focused on care and support for individuals in the last months or years of their life. Care planning and management of this stage in the life course usually incorporates symptom management and emotional support for the individual, the family and carers. Whilst patient choice, involvement and co-production of the care plan is widely advocated to promote a dignified death, responses to the mass observation directives also reflect the need to revisit the options for individuals with a diagnosis of dementia and other life limiting illness. There was, in particular, a renewed call to return to the ‘euthanasia’ debate and to encourage discussion and end of life decisions to be undertaken earlier in the life course, prior to any diagnosis of a life limiting illness. As people’s attitudes and behaviours towards end of life care planning change, it is imperative to ascertain current perspectives to inform and guide future direction of social policy and services.


2014 ◽  
Vol 17 (3) ◽  
pp. 421-426 ◽  
Author(s):  
B. Tokarz-Deptuła ◽  
P. Niedźwiedzka-Rystwej ◽  
B. Hukowska-Szematowicz ◽  
M. Adamiak ◽  
A. Trzeciak-Ryczek ◽  
...  

Abstract In Poland, rabbit is a highly valued animal, due to dietetic and flavour values of its meat, but above all, rabbits tend to be commonly used laboratory animals. The aim of the study was developing standards for counts of B-cells with CD19+ receptor, T-cells with CD5+ receptor, and their subpopulations, namely T-cells with CD4+, CD8+ and CD25+ receptor in the peripheral blood of mixed-breed Polish rabbits with addition of blood of meet breeds, including the assessment of the impact of four seasons of the year and animal sex on the values of the immunological parameters determined. The results showed that the counts of B- and T-cells and their subpopulations in peripheral blood remain within the following ranges: for CD19+ B-cells: 1.05 - 3.05%, for CD5+ T-cells: 34.00 - 43.07%, CD4+ T-cells: 23.52 - 33.23%, CD8+ T-cells: 12.55 - 17.30%, whereas for CD25+ T-cells: 0.72 - 2.81%. As it comes to the season of the year, it was observed that it principally affects the values of CD25+ T-cells, while in the case of rabbit sex, more changes were found in females.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.


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