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Principal Investigator: Angela R Dixon
Organization: EMORY UNIVERSITY
Fiscal Year: 2024
Award: $132,057
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY
Blacks are more likely than whites to experience the deaths of multiple family members and experience them
at earlier ages. Between 1970-2004, an estimated 2.7 million excess black deaths occurred because of blacks’
elevated mortality rates. Further, the estimated 600,000 COVID-19 deaths in the US as of July 2021 have
directly impacted the lives of more than 5.3 million individuals in nuclear families according to a bereavement
multiplier, with blacks facing twice the risk of death from COVID-19 as whites. Although experiencing death
within a family or network powerfully shapes survivors’ health, we know little about how network death
contributes to health inequities. The objective of the proposed study is to quantify black–white disparities in
familial and household exposure to deaths and their relationship to disparities in psychological distress and all-
cause mortality. My specific aims are to: 1) quantify the prevalence of and racial disparities in network mortality
by lifecourse stage and socioeconomic status (SES) for blacks and whites, exploring differences before and
during COVID-19; 2) identify key perceived mechanisms through which exposure to death may impact the
SES–health feedback loop throughout the lifecourse and intergenerationally for blacks and whites using semi-
structured interviews, exploring differences before and during COVID-19; and 3a) estimate the contribution of
exposure to premature and cumulative deaths to black–white inequalities in psychological distress, before and
during COVID-19, and to all-cause mortality; and 3b) determine the extent to which SES mediates the
relationship of network mortality with psychological distress and all-cause mortality for blacks and whites. To
do this, I will analyze data from the Panel Study of Income Dynamics (PSID) and conduct semi-structured
interviews with black and white adults in Atlanta, GA. This project is innovative in its focus on examining racial
disparities in death from broader social network ties including extended kin and household members as well as
how network deaths can initiate a cascade of SES consequences that contribute to adverse health for
survivors. This K01 project will enhance my prior sociological training in race, racism, socioeconomic
inequality, and demography with additional training in: 1) social epidemiology, with a focus on racial health
inequities; 2) network analysis, survival analysis, and structural equation modeling; 3) qualitative and mixed
methods; and 4) use of PSID data. My access to excellent resources and mentoring at Emory University is
supplemented with affiliations at Harvard University and the University of Michigan. Study findings will provide
an evidence base for efforts to reform bereavement and family leave policies that do not account for the
collateral health effects of individuals embedded in networks beyond the traditional nuclear family. The K01 will
facilitate my transition to a scientific leader advancing policy-relevant research examining the degree to which
racial health inequalities reverberate across social networks and generations to (re)produce health inequities.
Terms: <0-11 years old><21+ years old><Achievement><Achievement Attainment><Adoption><Adult><Adult Human><Age><Bereavement><Black Populations><Black group><Black individual><Black people><Blacks><COVID-19><COVID-19 associated death><COVID-19 associated fatality><COVID-19 associated mortality><COVID-19 associated stress><COVID-19 death><COVID-19 fatality><COVID-19 induced death><COVID-19 induced fatality><COVID-19 induced mortality><COVID-19 induced stress><COVID-19 mortality><COVID-19 related death><COVID-19 related fatality><COVID-19 related mortality><COVID-19 related stress><COVID-19 stress><COVID19 associated death><COVID19 associated fatality><COVID19 associated mortality><COVID19 death><COVID19 fatality><COVID19 induced death><COVID19 induced fatality><COVID19 induced mortality><COVID19 mortality><COVID19 related death><COVID19 related fatality><COVID19 related mortality><CV-19><Cessation of life><Child><Child Youth><Children (0-21)><Communities><Complex><Coronavirus Infectious Disease 2019><Data><Death><Death Rate><Demography><Disparities><Disparity><Equation><Exposure disparity><Exposure to><Extended Family><Family><Family Health><Family Leave><Family health status><Family member><Feedback><Generations><Health><Health Inequity><Health Insurance><Health Status><High Prevalence><Household><Household and Family><Individual><Inequalities in Health><Inequality><Inequities in Health><Inequity><Insurance Coverage><Insurance Status><Intervention><Intervention Strategies><Interview><Investigators><Kinship Networks><Knowledge><Latin America><Left><Level of Health><Life Cycle><Life Cycle Stages><Life Expectancy><Link><Literature><Mediating><Mental Health><Mental Hygiene><Mentors><Methodology><Methods><Michigan><Modeling><Network Analysis><Nuclear Family><Outcome><Pathway Analysis><Pathway interactions><Play><Policies><Population><Prevalence><Psychological Health><Psychosocial Stress><Race><Races><Research><Research Personnel><Research Resources><Researchers><Resources><Rest><Risk><Role><Running><SARS-CoV-2 associated death><SARS-CoV-2 associated fatality><SARS-CoV-2 associated mortality><SARS-CoV-2 death><SARS-CoV-2 fatality><SARS-CoV-2 induced death><SARS-CoV-2 induced fatality><SARS-CoV-2 induced mortality><SARS-CoV-2 mortality><SARS-CoV-2 related death><SARS-CoV-2 related fatality><SARS-CoV-2 related mortality><SES disparity><Shapes><Siblings><Social Network><Societies><Socio-economic status><Socioeconomic Factors><Socioeconomic Status><Sociology><Source><Stressful Event><Structure><Survival Analyses><Survival Analysis><Survivors><System><Time><Training><Universities><Work><adulthood><ages><biopsychosocial><black/white disparity><coronavirus disease 2019><coronavirus disease 2019 associated death><coronavirus disease 2019 associated fatality><coronavirus disease 2019 associated mortality><coronavirus disease 2019 death><coronavirus disease 2019 fatality><coronavirus disease 2019 induced death><coronavirus disease 2019 induced fatality><coronavirus disease 2019 induced mortality><coronavirus disease 2019 mortality><coronavirus disease 2019 related death><coronavirus disease 2019 related fatality><coronavirus disease 2019 related mortality><coronavirus disease-19><coronavirus disease-19 mortality><coronavirus infectious disease-19><death due to COVID-19><death due to COVID19><death due to SARS-CoV-2><death due to coronavirus disease 2019><death due to severe acute respiratory syndrome coronavirus 2><death in COVID><death in COVID-19><death in SARS-CoV-2><death in coronavirus disease><death in coronavirus disease 2019><death in severe acute respiratory syndrome coronavirus 2><death risk><design><designing><disparities in race><disparity due to race><economic outcome><evidence base><experience><experienced discrimination><fatality due to COVID-19><fatality due to COVID19><fatality due to SARS-CoV-2><fatality due to coronavirus disease 2019><fatality due to severe acute respiratory syndrome coronavirus 2><grandparent><health inequalities><health insurance plan><health level><improved><inequality due to race><inequity due to race><innovate><innovation><innovative><intergenerational><interventional strategy><kids><life course><loved ones><low SES><low socio-economic position><low socio-economic status><low socioeconomic position><low socioeconomic status><member><mortality><mortality due to COVID-19><mortality due to COVID19><mortality due to SARS-CoV-2><mortality due to coronavirus disease 2019><mortality due to severe acute respiratory syndrome coronavirus 2><mortality rate><mortality ratio><mortality risk><novel><panel study of income dynamics><pathway><perceived discrimination><perception of discrimination><physical conditioning><physical health><premature><prematurity><psychological distress><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial><racial background><racial disparities in health><racial disparity><racial health disparity><racial inequality><racial inequity><racial origin><racially unequal><racism><self-reported discrimination><severe acute respiratory syndrome coronavirus 2 associated death><severe acute respiratory syndrome coronavirus 2 associated fatality><severe acute respiratory syndrome coronavirus 2 associated mortality><severe acute respiratory syndrome coronavirus 2 death><severe acute respiratory syndrome coronavirus 2 fatality><severe acute respiratory syndrome coronavirus 2 induced death><severe acute respiratory syndrome coronavirus 2 induced fatality><severe acute respiratory syndrome coronavirus 2 induced mortality><severe acute respiratory syndrome coronavirus 2 mortality><severe acute respiratory syndrome coronavirus 2 related death><severe acute respiratory syndrome coronavirus 2 related fatality><severe acute respiratory syndrome coronavirus 2 related mortality><social><social epidemiology><social health determinants><social role><social structural><social structure><socio-economic><socio-economic disparity><socio-economic factors><socio-economic inequality><socio-economic inequity><socio-economic position><socio-economically><socio-structural><socioeconomic disparity><socioeconomic inequality><socioeconomic inequity><socioeconomic position><socioeconomically><socioeconomics><sociostructural><stress due to COVID-19><stressful experience><stressful life event><stressful life experience><theories><tool><youngster>