Centers

Proposal Abstract – Caroline McKay, Peter Muennig, Bruce Link, NIH

Disparities in access to social goods, such as education or income, have a dramatic effect on health disparities later in life. However, remarkably little is known about how social and psychological risk factors for health explain the relationship between socio-economic status (SES) and health through the life course. Moreover, paradoxical findings, such as high levels of health among foreign-born and native-born Hispanic sub-groups with low SES, have gotten in the way of fully understanding the effects of SES on health. Social variables, such as social capital, and psychological variables, such as emotions, beliefs, and perceptions, offer a potential explanation for these paradoxical findings. But research to address these gaps in understanding has been hampered by the absence of an ongoing nationally-representative, prospective dataset that contains robust measures in social and psychological domains. We propose to address this gap in a rapid and highly cost-effective way by prospectively linking the 1980-2002 General Social Survey (GSS), a multiple year, cross-sectional survey that is rich in health and sociological variables, to National Death Index (NDI) data through 2008. Our objective is to use this dataset to move social epidemiologic studies of health disparities beyond identification and description to a deeper understanding of underlying mechanisms, paving the way for highly targeted policies to address “health gaps” between groups.

To accomplish this, we will:

1. generate a large, nationally representative dataset that is prospectively linked to mortality data, and is novel both in its comprehensiveness and in the depth of its measurement of social and psychological factors,
2. use this dataset to begin to address some of the most vexing questions surrounding the social and psychological aspects of health disparities,
3. convene a group of leading interdisciplinary experts to develop a research plan for addressing other important social questions in this area, and
4. promote the widespread use of this dataset upon its release to the public.

We propose that the creation of this data set will allow ourselves and others to answer critical questions concerning the social causation of disparities in mortality between various demographically defined groups that were heretofore unanswerable due to lack of data. Understanding the causes of these disparities, in turn, will help identify social policies that address such inequalities, moving us closer to the ongoing Department of Health and Human Services’ objective of reducing and eventually eliminating health disparities.