Assessing Biological Pathways: Linking Neighborhoods to Cardiovascular Mortality

评估生物途径：将社区与心血管死亡率联系起来

• 批准号: 8077313
• 负责人: Chloe E. Bird
• 金额: $ 26.92万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8077313
• 关键词: Address; Adult; Area; Biological; Biological Markers; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Censuses; Centers for Population Health; Cessation of life; Characteristics; Cholesterol; Conscious; Data; Discipline; Environment; Environmental Risk Factor; Gender; Glycosylated Hemoglobin; Goals; Health; Health Status; Health behavior; Housing; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Light; Link; Literature; Mediating; National Health and Nutrition Examination Survey; Neighborhoods; Outcome; Pathway interactions; Physical environment; Policies; Population; Population Density; Predisposition; Public Health; Public Policy; Reporting; Research; Research Personnel; Risk Factors; Role; Sampling; Seminal; Sex Characteristics; Skin; Social Environment; Socioeconomic Status; Source; Staging; Stress; United States; Waist-Hip Ratio; Woman; Women' s Health; Work; base; cardiovascular disorder risk; cardiovascular risk factor; factor A; follow-up; health disparity; improved; indexing; interest; land use; men; mortality; neighborhood association; population health; public health relevance; social; theories

DESCRIPTION (provided by applicant): A growing number of studies report gender differences in how the neighborhood environment impacts individual health behaviors, health status, and/or mortality. Although research in this domain has made great strides, researchers are still in the early stages of identifying the biological pathways through which neighborhood characteristics actually "get under the skin," and the Institute of Medicine's (IOM) call for gender- based analyses has not been fulfilled. More specifically, research to date has lacked the necessary combination of data on individual-level sociodemographic, health behavior and biological markers, objective neighborhood data, and follow-up data on individual mortality. Also, there is a dearth of work systematically assessing gender differences in the association of neighborhood factors and cardiovascular disease (CVD) mortality in the United States. We propose to address this gap in the literature by assessing biological pathways between key aspects of the residential environment and CVD mortality in a national sample of adults. The specific aims of this proposed research are to: 1. Assess the relationship between selected characteristics of the neighborhood environment (i.e., neighborhood socioeconomic status (NSES), population density, and residential stability) and acquired biological risk factors for CVD and examine whether these relationships differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. 2. Assess the relationship between acquired biological risk factors for CVD and subsequent CVD mortality, and examine whether they differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. 3. Assess the role of acquired biological risk factors for CVD as mediating pathways between the selected characteristics of the neighborhood environment and CVD mortality, and examine how their role may differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. The proposed project will draw on integrated data from five major sources: (1) Third National Health and Nutrition Examination Survey (NHANES III), (2) the NHANES 1999-2004; (3) United States Census; (4) RAND Center for Population Health and Health Disparities (CPHHD) Data Core; and (5) National Death Index (NDI). Biomarkers are available through the NHANES data, including both traditional and more recently identified predictors of CVD risk and mortality. Taken together, these data provide a unique opportunity to assess key pathways between neighborhood context and men's and women's CVD risk and subsequent mortality. PUBLIC HEALTH RELEVANCE: The proposed research focuses on aspects of the social and physical environment of neighborhoods interventions in the area of building, housing, and land-use policy could address. This work will shed light on how related public policy efforts and public health interventions, particularly in the area of cardiovascular health, could-in the long term-improve health behaviors, cardiovascular risk factors, and survival, as well as reduce health disparities. The proposed gender-based analysis can also help inform efforts to improve population health for both men and women without inadvertently increasing health disparities.

越来越多的研究报告了社区环境如何影响个人健康行为，健康状况和/或死亡率的性别差异。虽然这一领域的研究已经取得了很大的进展，但研究人员仍然处于确定邻里特征实际上“进入皮肤下”的生物途径的早期阶段，医学研究所（IOM）呼吁进行基于性别的分析尚未实现。更具体地说，迄今为止的研究缺乏必要的个人层面的社会人口，健康行为和生物标志物，客观的邻里数据，以及个人死亡率的后续数据的数据组合。此外，在美国，缺乏系统地评估邻里因素与心血管疾病（CVD）死亡率相关性的性别差异的工作。我们建议通过评估全国成年人样本中居住环境和CVD死亡率关键方面之间的生物途径来解决文献中的这一差距。本研究的具体目的是：1。评估邻近环境的选定特征之间的关系（即，社区社会经济地位（NSES）、人口密度和居住稳定性）和获得性CVD生物风险因素，并检查这些关系是否因性别而异，控制关键的个人水平的健康行为和社会人口学特征。2.评估CVD的获得性生物学风险因素与随后的CVD死亡率之间的关系，并检查它们是否因性别而异，控制关键的个人水平的健康行为和社会人口学特征。3.评估获得性CVD生物风险因素作为邻里环境和CVD死亡率的选定特征之间的中介途径的作用，并检查其作用如何因性别而异，控制关键的个人水平的健康行为和社会人口特征。拟议的项目将利用五个主要来源的综合数据：（1）第三次全国健康和营养检查调查（NHANES III）;（2）1999-2004年全国健康和营养检查调查;（3）美国人口普查;（4）兰德人口健康和健康差异中心数据核心;（5）全国死亡指数。通过NHANES数据可以获得生物标志物，包括传统的和最近确定的CVD风险和死亡率的预测因子。总之，这些数据提供了一个独特的机会，以评估邻里环境和男性和女性的心血管疾病风险和随后的死亡率之间的关键途径。 公共卫生相关性：拟议的研究重点是社区的社会和物理环境方面的干预措施，在建筑，住房和土地使用政策领域可以解决。这项工作将阐明如何相关的公共政策的努力和公共卫生干预措施，特别是在心血管健康领域，可以在长期改善健康行为，心血管危险因素和生存，以及减少健康差距。拟议的基于性别的分析还有助于为改善男女人口健康的努力提供信息，而不会无意中增加健康差距。