Neighborhood Socioeconomic Environments and Pathways to Coronary Heart Disease

描述（由申请人提供）：候选人的主要兴趣是调查社区社会经济（SES）环境，行为和心理社会风险因素与心血管疾病（CVD）之间的关系。指导阶段将包括地理信息系统（GIS）和复杂的多层建模课程，以及独立阶段项目之前的数据链接。独立阶段将建立候选人的独立性，同时促进GIS和多层次建模的技能发展。来自哈佛护士健康研究的近9万名女性的数据，一个完善的队列，以及来自全国健康访谈调查的约26.2万名男性和31.4万名女性的全国代表性数据，将使用多层次离散时间生存分析模型来估计社区SES与非致命性和致命性冠心病（CHD）风险之间的关系，并测试行为和社会心理介质的存在。此外，将使用地理信息系统方法来评估其中一些中介是否可能由特定的社区服务和便利设施决定。通过提供有关冠心病的社区决定因素和途径的知识库，该项目的努力可能最终通过干预措施转化为更有效地减少美国人的心血管疾病负担。该奖项应使候选人能够在研究心血管疾病的邻近决定因素方面取得成功。

DESCRIPTION (provided by applicant): The candidate has a primary interest in investigating the associations between neighborhood socioeconomic (SES) environments, behavioral and psychosocial risk factors, and cardiovascular disease (CVD). The mentored phase will include coursework in Geographic Information Systems (GIS) and complex multilevel modeling, as well as data linkages prior to the independent phase project. The independent phase will establish the candidate's independence while enabling skill development in GIS and multilevel modeling. Data on nearly 90,000 women from the Harvard-based Nurses' Health Study, a well-established cohort, and nationally-representative data on approximately 262,000 men and 314,000 women from the National Health Interview Survey, will be analyzed using multilevel discrete-time survival analysis models to estimate the relations between neighborhood SES and risks of non-fatal and fatal coronary heart disease (CHD), and to test for the presence of behavioral and psychosocial mediators. Furthermore, GIS methods will be used to assess whether some of these mediators may be determined by particular neighborhood services and amenities. By contributing to the knowledge base on the neighborhood determinants of and pathways to CHD, the project's efforts may ultimately translate through interventions into more effective reductions in CVD burden among Americans. This award should enable the candidate to pursue a successful career in the study of the neighborhood determinants of CVD.