UNDERSTANDING NEIGHBORHOOD IMPACTS OF HEALTH

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Neighborhoods impact a host of health outcomes, including infant mortality, the development of asthma and heart disease and life expectancy, independent of personal characteristics. The pathways through which neighborhoods 'get under the skin', are only partly understood. This center will study neighborhood influences on health, focusing on those characteristics of neighborhoods that are potentially amenable to change through changes in public policy. The Center has the following goals: 1) To conduct research to explain how neighborhoods contribute to health throughout the life cycle, including through biological pathways and health behaviors 2) To develop a rich data resource that can be used to advance the understanding of how neighborhoods influence health, and the biological pathways through which such influences work. 3) To develop robust community-based participatory research (CBPR) partnerships within each of the 3 cities in which RAND is located, involving both community-based organizations and academic institutions. 4) To develop and foster a community of interdisciplinary researchers (including social and basic scientists) focused on the social determinants of health, specifically the role of neighborhoods in health. 5) To contribute to improving public policies that can improve population health through a set of policy recommendations that are developed from the results of the Center's research. The Center, which places a high priority on community-based participatory research, will be composed of 4 projects, 2 pilots, and 2 cores. Projects span 3 levels of analysis: biological, social/environmental, and behavioral/psychological. Project 1 will examine the impact of a large natural experiment involving the development and renovation of recreational facilities on physical activity and other health outcomes. Project 2 will study neighborhood factors that impact the functional and cognitive aspects of the disabling process in the elderly. Project 3 examines the relationships between neighborhoods and biological markers of allostatic load. Project 4 studies the impact of the built environment on mental health. Pilot 1 examines the impact of neighborhoods on oxidative stress and preterm birth. Pilot 2 examines gene-environment interactions in prostate cancer. An administrative core will support the entire project. A data and methods core provides data and computing support, and serves as a focus for intellectual activity around measurement and statistical issues.