Environmental Changes and Health Outcomes across 25 Years: Four US Cities

摘要 虽然观察性研究表明，肥胖相关的社会环境因素与 肥胖和心脏代谢危险因素，很少有研究涉及具体因素和途径 将社会环境与心脏代谢风险联系起来。缺乏研究的主要原因是：1）缺乏 关于饮食、活动、测量的身高和体重随时间推移与心脏代谢风险相关的高质量数据 生物标志物; 2）缺乏关于引进，翻新和关闭食物的细粒纵向数据-以及 与活动有关的环境特征; 3）缺乏复杂的统计模型来检查每一个 时间依赖的，复杂的系统，占食物，活动和运输的过程， 设施的建立和扩大，以及个人有选择地迁移到附近地区的可能性。 这样的设施。25年的年轻人冠状动脉风险发展纵向研究（CARDIA） 提供广泛的年龄范围，高质量的纵向，生物，行为和人体测量和生物标志物 CARDIA数据、地理多样性以及四个基线之间的不同模式和变化速度 伯明翰、芝加哥、明尼阿波利斯和奥克兰。研究小组开发了一种独特的方法， 使用回顾性和当代来源来创建关于引入时间和位置的数据， 翻新和关闭：1）食物资源（例如，餐馆、食品购物）; 2）娱乐设施 (e.g.,小径、公园）;以及3）交通基础设施（例如，轻轨，自行车停车场，自行车道）在伯明翰， 芝加哥，明尼阿波利斯，奥克兰在25年内。此外，我们还开发了先进的 统计模型，用于说明相关资源有目的（而不是随机）放置在 社会环境以及个人有选择地迁移到这些资源附近的能力。研究 目标包括：1）开发和验证新的细粒度措施，以捕获引进，更新， 代表以下变化的封闭：a）公园、小径和其他娱乐场所; B）食品环境;以及 c）交通基础设施将同时与CARDIA受访者的地理位置相联系 地点超过25年;和2）使用这个独特的数据源，估计引进的影响， 翻修和关闭关键的饮食和活动设施以及饮食和活动方面的交通基础设施 行为，体重和心脏代谢风险在四个外地城市超过25年，而占 食物和活动设施的本地安置以及选择性移徙。我们将特别关注 在个人层面的种族，收入和教育群体之间进行比较，以研究环境因素如何影响 从青年到中年，在饮食、肥胖和心脏代谢风险方面造成种族和社会经济地位的不平等。 拟议的研究将改善目前对社会影响机制的理解。 环境（特别是更广泛的社会、经济和环境背景）影响健康结果。

ABSTRACT While observational research suggests an association between obesity-related social environment factors with obesity and cardiometabolic risk factors, very little research has addressed the specific factors and pathways linking the social environment to cardiometabolic risk. The primary reasons for this lack of research are: 1) lack of high quality data on diet, activity, measured height and weight over time linked to cardiometabolic risk biomarkers; 2) lack of fine-grain longitudinal data on the introduction, renovation, and closure of food- and activity-related environmental features; and 3) lack of complex statistical models examining each piece of the time-dependent, complex system, accounting for the process by which food, activity, and transportation facilities are established and expanded and the potential for individuals to selectively migrate to locate near such facilities. The 25-year, longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study provides a wide age range, high quality longitudinal, biological, behavioral and anthropometry and biomarker data of CARDIA, geographic diversity, and different patterns and pace of change across the four baseline cities: Birmingham, Chicago, Minneapolis and Oakland. The research team has developed a unique method to use retrospective and contemporary sources to create data on the timing and placement of introductions, renovations, and closures of: 1) food resources (e.g., restaurants, food shopping); 2) recreation facilities (e.g., trails, parks); and 3) transportation infrastructure (e.g., light rail, bike parking, bike paths) in Birmingham, Chicago, Minneapolis, and Oakland over a 25-year period. Furthermore, we have developed sophisticated statistical models that account for purposeful (as opposed to random) placement of relevant resources in the social environment as well as individuals' ability to selectively migrate to locate near such resources. Study objectives include: 1) Develop and validate new fine-grain measures to capture introductions, renovations, and closures representing changes in: a) parks, trails, and other recreational sites; b) food environments; and c) transportation infrastructure that will be contemporaneously linked to CARDIA respondents' geographic locations over 25 years; and 2) Using this unique data source, estimate the effects of introductions, renovations, and closures of key food and activity facilities and transportation infrastructure on diet and activity behaviors, body weight and cardiometabolic risk in the four field cities over 25 years, while accounting for the endogenous placement of food and activity facilities and selective migration. We will specifically focus on comparisons across individual-level race, income, and education groups to examine how environmental factors contribute to race and SES inequalities in diet, obesity, and cardiometabolic risk from young- to mid-adulthood. The proposed research will improve current understanding of the mechanisms through which social environments (specifically broader societal, economic, and environmental contexts) influence health outcomes.