Neighborhoods and CVD Risk in a Multiethnic Cohort

描述（由申请人提供）：最近的流行病学研究发现，即使在控制了个人收入，教育和职业的措施之后，生活在社会经济上处于不利地位的社区与冠心病的患病率和发病率增加有关。尽管这表明社区的特征可能与心血管风险有关，但关于观察到的关联是否反映了因果过程，仍然存在重要问题。两个重要的未解决的问题是选择因素在产生这些关联中的作用，以及需要确定相关的社区的具体特征。这项流行病学研究的总体目的是调查在多种族队列中邻里特征是否与疾病风险相关。该项目利用公开的和新收集的与多种族动脉粥样硬化研究（梅萨）相关的邻里数据，将：（1）检查邻里社会经济特征与亚临床动脉粥样硬化的患病率和进展之间的关系;（2）检查邻里社会经济特征与特定个体水平因素之间的关系，这些因素可能介导邻里疾病风险的差异;（3）制定针对社区环境具体特点的措施（4）确定这些特定的社区特征是否可以解释社会经济弱势社区和社会经济弱势社区之间心血管风险的差异;以及（5）检查邻居特征是否有助于心血管风险的种族/民族差异。邻里属性的措施将根据2000年人口普查数据，地区居民的调查，并使用地理信息系统的方法，以连接数据的区域资源的梅萨邻里。将亚临床疾病作为结果的检查避免了与根据其健康状况选择人员进入社区有关的问题。该项目将使用两种创新方法（住宅调查和生态计量技术以及基于地理信息系统的方法）来制定具体社区属性的直接措施，以测试它们与疾病风险的关系。确认社区的特定特征与疾病有因果关系，将对预防产生重要影响。

DESCRIPTION (provided by applicant): Recent epidemiologic studies have found that living in socioeconomically disadvantaged neighborhoods is associated with increased prevalence and incidence of coronary heart disease, even after controlling for measures of personal income, education, and occupation. Although this suggests that features of neighborhoods may be relevant to cardiovascular risk, important questions remain regarding whether the associations observed reflect causal processes. Two important unresolved issues are the role of selection factors in generating these associations and the need to identify the specific characteristics of neighborhoods that are relevant. The general aim of this epidemiologic study is to investigate if neighborhood characteristics are related to disease risk in a multiethnic cohort. Using publicly available and newly collected neighborhood data linked to the Multi-Ethnic Study of Atherosclerosis (MESA) the project will: (1) examine the relationship between neighborhood socioeconomic characteristics and the prevalence and progression of subclinical atherosclerosis; (2) examine associations of neighborhood socioeconomic characteristics with specific individual-level factors which may mediate neighborhood differences in disease risk; (3) develop measures of specific characteristics of neighborhood environments (such as measures of resource availability, neighborhood social cohesion and neighborhood stress) and examine their relation to selected individual-level risk factors; (4) determine if these specific neighborhood characteristics explain differences in cardiovascular risk between socioeconomically advantaged and socioeconomically disadvantaged neighborhoods; and (5) examine if neighborhood characteristics contribute to race/ethnic differences in cardiovascular risk. Measures of neighborhood attributes will be based on Year 2000 Census data, surveys of area residents, and the use of GIS methods to link data on area resources to MESA neighborhoods. The examination of subclinical disease as outcomes avoids problems related to selection of persons into neighborhoods based on their health status. The project will use two innovative approaches (residential surveys and ecometric techniques and GIS-based methods) to develop direct measures of specific neighborhood attributes in order to test their relationship to disease risk. Confirming that specific features of neighborhoods are causally related to disease would have important implications for prevention.