Neighborhoods, Women and Coronary Heart Disease: A Prospective Study

描述（由申请人提供）：虽然研究表明，一个人的生活影响一个人的冠心病（CHD）的风险，科学家们才刚刚开始探索的途径，通过社区“进入皮肤下。“最近的研究表明，建筑环境会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，影响冠心病发展和临床表现的因素在女性和男性中有很大差异，研究表明，邻里社会和建筑环境也对男性和女性产生不同的影响。该项目的总体目标是研究社区因素对妇女冠心病发展的影响。我们的目标是确定可以通过城市规划或公共政策修改的建筑环境的各个方面，并与健康效益相关。该项目将通过调查社会和建筑环境，并通过研究行为因素，社会关系和心理健康是否介导环境特征与女性CHD发展之间的联系，扩大现有的研究。我们三年计划的具体目标是：1。在控制了基线社会人口学和生物学指标的冠心病风险后，评估社区的建筑和社会特征是否能预测冠心病的发生。2.评估建筑和社会环境的各个方面是否与已知与女性CHD相关的个人健康行为、社会支持和心理健康相关。3.确定环境特征与CHD之间的通路是否由个体健康行为、社会支持和/或心理健康介导。为了实现这些目标，该项目汇集了两种独特的资源：来自妇女健康倡议（WHI）的观察性研究（OS）和临床试验（CT）组的个人水平数据，这是一项前瞻性研究，纳入了161，809名年龄在50至79岁的女性，并进行了地理编码，人口普查-由兰德人口健康与健康中心获得的研究对象居住的社会人口统计学和建筑环境的区域水平背景数据来自人口普查和其他来源的差异（CPHHD）数据核心。

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.