Communities Designed to Support Cardiovascular Health for Older Adults

旨在支持老年人心血管健康的社区

• 批准号: 8985562
• 负责人: Gina Schellenbaum Lovasi
• 金额: $ 62.48万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8985562
• 关键词: Accounting; Acute; Address; Adult; Affect; African American; Age; Aging; Area; Attention; Attenuated; Behavior; Big Data; Businesses; Cardiovascular Diseases; Cardiovascular system; Caring; Censuses; Characteristics; Chronic; Cities; Clinical; Cohort Studies; Communities; Crime; Data; Destinations; Dietary intake; Disadvantaged; Disease Outcome; Disease-Free Survival; Elderly; Enrollment; Environment; Etiology; Event; Female; Fishes; Food; Geographic Locations; Geographic state; Goals; Grooming; Health; Health Food; Health Services Accessibility; Health behavior change; Health care facility; Healthcare; Heart; Home environment; Hospitals; Incentives; Incidence; Independent Living; Individual; Interdisciplinary Study; Investigation; Knowledge; Life; Link; Location; Longitudinal Studies; Marketing; Medical; Myocardial Infarction; Neighborhoods; Nuts; Onset of illness; Participant; Pattern; Pharmacy facility; Physical activity; Play; Policies; Population; Population Characteristics; Population Density; Population Heterogeneity; Questionnaires; Race; Reasons for Geographic And Racial Differences in Stroke; Recommendation; Recording of previous events; Relative (related person); Research; Research Infrastructure; Resource Allocation; Resources; Restaurants; Risk; Role; Safety; Science; Series; Services; Shapes; Site; Socioeconomic Status; Source; Spatial Distribution; Stroke; Subgroup; Supermarket; Taxes; Time; Transportation; Urbanization; Walking; Work; aging population; base; cardiovascular disorder prevention; cardiovascular health; cohort; density; design; disorder prevention; experience; fast food; food marketing; fruits and vegetables; geographic difference; health disparity; healthy lifestyle; innovation; land use; population based; population health; prevent; prospective; public health relevance; racial difference; racial disparity; social; tertiary prevention; trend

 DESCRIPTION (provided by applicant): Business establishments have the potential to shape individual behaviors including dietary intake, physical activity patterns, and management of chronic medical conditions, all with relevance to risk of myocardial infarction and related cardiovascular disease (CVD) outcomes. Policy strategies targeting local businesses may play an important role in CVD prevention, extending years of healthy life, and facilitating independent living. We propose to bring together commercially available "big data" and detailed population-based cohort data to examine the role of local business environments in CVD and racial disparities in CVD as they emerged across decades. Longitudinal studies of local environments have been strongly recommended as a direction for future research to advance our understanding of causal neighborhood effects on health. The local density of businesses with potential relevance to CVD has changed over time, and such temporal fluctuations vary across regions, cities and neighborhoods. These differences can be used to investigate how residentially stable older adults are affected by their local context. Meanwhile, older adults who relocate to a new home address may respond to their new context by changing health behaviors, offering another window into causation. However, careful attention is needed to acute health changes that precipitate relocation, and which local environment features predict aging in place despite new health or functional limitations. In the proposed project, we will link longitudinal data to investigate how neighborhood change and residential relocation shape cardiovascular health and health disparities. We will use a census of national businesses, the National Establishment Time Series (NETS). NETS data for all 52.4 million US business establishments includes annual point-level geocodes and business characteristics for the years 1990-2012, offering an unprecedented opportunity to characterize changing business environments nationally at multiple spatial scales. Geographic context data (from NETS as well as longitudinal population, safety, and transportation data) will be linked to individual data from two ongoing cohort studies: the Cardiovascular Health Study (CHS) and the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. CHS is a well-characterized population- based study of 5,888 older adults (100% age 65+ at baseline, 58% female, 16% African American). A majority of the CHS participants enrolled 1990-1993 from four US sites, with oversampling of African Americans, have been followed prospectively for the remainder of their lives, allowing in-depth characterization of neighborhood environments experienced by older adults in their final decades. REGARDS is also a prospective population-based cohort study with oversampling of African Americans, allowing for examination of racial disparities. However, the 30,239 REGARDS participants (49% age 65+ at baseline, 55% female, 42% African American) were enrolled more recently (2003-2007) and from a broader geographic region (48 contiguous US states, oversampling Stroke Belt residents). For these two cohorts with complementary strengths, cardiovascular events have been ascertained and longitudinal address data collected. This project brings together unparalleled data resources, builds on a track record of policy-relevant work with large geographic data resources, and leverages comprehensive cardiovascular cohort data.

 描述（由申请人提供）：商业机构有可能塑造个人行为，包括饮食摄入，身体活动模式和慢性疾病的管理，所有这些都与心肌梗死和相关心血管疾病（CVD）结局的风险相关。针对当地企业的政策战略可能在预防心血管疾病、延长健康寿命和促进独立生活方面发挥重要作用。我们建议将商业上可用的“大数据”和详细的基于人群的队列数据结合起来，以研究当地商业环境在CVD中的作用以及数十年来出现的CVD种族差异。强烈建议对当地环境进行纵向研究，作为未来研究的一个方向，以促进我们对因果关系的邻居对健康的影响的理解。与CVD潜在相关的企业的当地密度随着时间的推移而发生变化，这种时间波动在不同地区，城市和社区之间存在差异。这些差异可以用来调查如何居住稳定的老年人受到当地环境的影响。与此同时，搬迁到新家庭地址的老年人可能会通过改变健康行为来应对他们的新环境，这为因果关系提供了另一个窗口。然而，需要仔细注意的急性健康变化，沉淀搬迁，当地环境特征预测老化的地方，尽管新的健康或功能限制。在拟议的项目中，我们将链接纵向数据，以调查邻里变化和居民搬迁如何塑造心血管健康和健康差异。我们将使用全国企业普查，即全国企业时间序列（NETS）。美国所有5240万商业机构的NETS数据包括1990-2012年的年度点级地理编码和业务特征，为在多个空间尺度上描述全国不断变化的商业环境提供了前所未有的机会。地理背景数据（来自NETS以及纵向人口、安全和交通数据）将与来自 两项正在进行的队列研究：心血管健康研究（CHS）和卒中地理和种族差异原因研究（REGARDS）。CHS是一项对5，888名老年人（基线时100%年龄为65岁以上，58%为女性，16%为非洲裔美国人）进行了充分表征的基于人群的研究。大多数CHS参与者于1990-1993年从四个美国研究中心招募， 非裔美国人的过度采样，已经被前瞻性地跟踪了他们的余生，允许深入描述老年人在最后几十年所经历的邻里环境。REGARDS也是一项前瞻性的基于人群的队列研究，对非裔美国人进行过采样，以检查种族差异。然而，30，239名REGARDS参与者（49%基线时年龄65岁以上，55%女性，42%非裔美国人）是最近（2003-2007年）招募的，来自更广泛的地理区域（美国48个相邻州，过度抽样中风带居民）。对于这两个具有互补优势的队列，已确定心血管事件并收集了纵向地址数据。该项目汇集了无与伦比的数据资源，建立在政策相关工作的跟踪记录与大型地理数据资源的基础上，并利用全面的心血管队列数据。