Childhood SES Factors: Impact on age-related cognitive and vascular health

描述（由申请人提供）：美国黑人的预期寿命明显短于白人，男性之间的差异大于女性。心血管疾病（CVD）是造成这种差异的最大原因。健康方面的地域差异在程度和影响上与种族差异相似。越来越多的人认识到心血管疾病和认知障碍有共同的风险因素。许多试图解释这些种族和地理健康差异的研究都集中在参与者的社会经济地位（SES）或诊断或死亡时的居住地。然而，越来越多的证据表明，在生命过程的早期阶段，照射具有重要作用。然而，很难研究生命过程暴露的作用，因为移徙模式掩盖了地理暴露与长期健康结果之间的联系。本研究的总体目的是确定儿童和家庭SES因素（CH-SES），形状差异血管和认知健康。REGARDS（中风地理和种族差异的原因）研究旨在确定中风发病率、死亡率和认知能力下降的种族和地理差异的原因，是一项基于全国人群的队列研究。从2003年到2007年，REGARDS招募了30,239名年龄在45岁或45岁以上的参与者，其中45%是男性，42%是黑人。数据收集采用电话访谈，在家里的身体检查，和自我管理的问卷调查相结合。目前正在对参与者进行CVD事件和认知评估。我们的方法建立在REGARDS的特殊资源，特别是详细的住宅历史数据。本研究建议从三个来源获得有关CH-SES因素的数据：1）通过邮件问卷从队列中收集的新数据; 2）将有关儿童居住的现有REGARDS数据与有关家庭和社区级别SES条件的公共人口普查数据联系起来; 3）将有关儿童居住的现有REGARDS数据与有关县/学区级别学校质量的历史公立学校记录联系起来。这些关于CH-SES的数据将与队列的人口统计学和临床特征的详细数据相关联，并作为随访期间CVD和认知下降的预测因子进行检查。

DESCRIPTION (provided by applicant): U.S. blacks have a life expectancy that is significantly shorter than whites, with a larger difference between men than women. Cardiovascular diseases (CVD) are the single largest contributor to this disparity. Geographic disparities in health are similar to racial disparities in magnitude and effect. There is growing recognition that there are shared risk factors for CVD and cognitive impairment. Much of the research attempting to explain these racial and geographic disparities in health has focused on the participant's socioeconomic status (SES) or place of residence at the time of diagnosis or death. Increasing evidence, however, points to an important role of exposures during earlier lifecourse periods. The role of lifecourse exposures is difficult to study, however, because migration patterns obscure the links between geographic exposures and long- term health outcomes. The general aim of this study is to identify childhood and family SES factors (CH-SES) that shape disparities in vascular and cognitive health. Designed to determine the causes of racial and geographic differences in stroke incidence, mortality and cognitive decline, the REGARDS (REasons for Geographic And Racial Differences in Stroke) study is a national population-based cohort study. REGARDS recruited 30,239 participants aged 45 or older, from 2003-2007, 45% men, 42% blacks. Data were collected using a combination of telephone interview, in-home physical exam, and self-administered questionnaire. Participants are currently being followed for CVD events and cognitive assessments. Our approach builds on the exceptional resources in REGARDS, in particular, the detailed residential history data. This study proposes to obtain data on CH-SES factors from three sources: 1) new data collected from the cohort via a mail-questionnaire; 2) linking existing REGARDS data on childhood residence to public Census data on family and community level SES conditions; and 3) linking existing REGARDS data on childhood residence to historic public school records on school quality at the county/school district level. These data on CH-SES will be linked to the detailed data on demographic and clinical characteristics of the cohort and examined as predictors of CVD and cognitive decline over follow-up.