Neighborhoods, Women and Coronary Heart Disease: A Prospective Study

社区、妇女和冠心病：一项前瞻性研究

• 批准号: 7617952
• 负责人: Chloe E. Bird
• 金额: $ 79.09万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7617952
• 关键词: Address; Affect; Age; Age of Onset; Behavioral; Biological; Cardiac; Cardiovascular system; Cause of Death; Censuses; Centers for Population Health; Cessation of life; Characteristics; Clinical; Clinical Trials; Coronary heart disease; Coupled; Data; Development; Disease Outcome; Elderly woman; Environment; Environmental Risk Factor; Epidemiology; Event; Exercise; Gender; Genetic; Health; Health Benefit; Health Status; Health behavior; Incidence; Income; Individual; Intervention; Libraries; Life; Link; Literature; Measurement; Measures; Mediating; Modeling; Monitor; Neighborhoods; Observational Study; Outcome; Pathway interactions; Pattern; Policies; Pollution; Poverty; Prospective Studies; Public Policy; Research; Resources; Risk; Risk Factors; Scientist; Skin; Social Characteristics; Social Environment; Social support; Source; Study Subject; Testing; United States; Upper arm; Well in self; Woman; Women' s Health; behavioral health; cardiovascular disorder risk; cohort; contextual factors; depression; design; health disparity; heart disease risk; improved; innovation; men; middle age; social; suburb

DESCRIPTION (provided by applicant): Although research suggests that where one lives affects one's risk of coronary heart disease (CHD), scientists have only begun to explore the pathways through which neighborhoods "get under the skin." Recent studies demonstrate that the built environment affects individual health and health behaviors, but have not examined the relationship between the built environment and cardiovascular health risk or subsequent cardiac events. Moreover, factors influencing the development and clinical manifestations of CHD differ substantially in women and men, and studies suggest that neighborhood social and built environments also affect men and women differently. The overarching objective of the proposed project is to examine the impact of neighborhood factors on women's development of CHD. We aim to identify aspects of the built environment that can be modified through urban planning or public policy and are associated with health benefits. The project will expand on existing research by investigating both the social and built environment and by examining whether behavioral factors, social relationships, and psychological well-being mediate the links between environmental characteristics and CHD development among women. The specific aims of our 3-year project are: 1. To assess whether built and social characteristics of neighborhoods predict the development of CHD after controlling for baseline sociodemographic and biological measures of CHD risk. 2. To evaluate whether aspects of the built and social environment are associated with individual health behaviors, social support, and psychological well-being that are known to be related to CHD in women. 3. To determine whether pathways between environmental characteristics and CHD are mediated by individual health behaviors, social support, and/or psychological well-being. To address these aims this project brings together two unique resources: individual-level data from the Observational Study (OS) and Clinical Trial (CT) arms of the Women's Health Initiative (WHI), a prospective study of 161,809 women ages 50 to 79 at entry, and geocoded, census-tract level contextual data on the sociodemographic and built environment where study subjects reside derived by the RAND Center for Population Health and Health Disparities (CPHHD) data core from the Census and other sources.

描述（由申请人提供）：尽管研究表明一个人居住的地方会影响一个人患冠心病（CHD）的风险，但科学家们才刚刚开始探索社区“深入人心”的途径。最近的研究表明，建筑环境影响个人健康和健康行为，但尚未研究建筑环境与心血管健康风险或随后的心脏事件之间的关系。此外，影响先心病发展和临床表现的因素在女性和男性中存在很大差异，研究表明邻里社会和建筑环境对男性和女性的影响也不同。拟议项目的总体目标是研究社区因素对妇女患先心病的影响。我们的目标是确定建筑环境中可以通过城市规划或公共政策进行修改且与健康益处相关的方面。该项目将通过调查社会和建筑环境以及检查行为因素、社会关系和心理健康是否介导环境特征与女性先心病发展之间的联系来扩展现有研究。我们为期 3 年的项目的具体目标是： 1. 在控制 CHD 风险的基线社会人口统计学和生物学测量后，评估社区的建筑和社会特征是否可以预测 CHD 的发展。 2. 评估建筑和社会环境的各个方面是否与已知与女性先心病相关的个人健康行为、社会支持和心理健康有关。 3. 确定环境特征与冠心病之间的通路是否由个人健康行为、社会支持和/或心理健康介导。为了实现这些目标，该项目汇集了两个独特的资源：来自妇女健康倡议 (WHI) 的观察研究 (OS) 和临床试验 (CT) 部门的个人级数据、一项针对 161,809 名 50 至 79 岁女性的前瞻性研究，以及由兰德人口健康和健康差异中心得出的关于研究对象所在的社会人口统计和建筑环境的地理编码、人口普查区级背景数据。 (CPHHD) 来自人口普查和其他来源的核心数据。

项目成果

Use of alternative time scales in Cox proportional hazard models: implications for time-varying environmental exposures.

• DOI: 10.1002/sim.5347
• 发表时间: 2012-11-30
• 期刊: STATISTICS IN MEDICINE
• 影响因子: 2
• 作者: Griffin, Beth Ann;Anderson, Garnet L.;Shih, Regina A.;Whitsel, Eric A.
• 通讯作者: Whitsel, Eric A.