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

描述(申请人提供)：美国黑人的预期寿命明显短于白人，男性之间的差异比女性更大。心血管疾病(CVD)是造成这种差异的最大因素。健康方面的地理差异在程度和影响上类似于种族差异。越来越多的人认识到，心血管疾病和认知障碍存在共同的风险因素。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在确诊或死亡时的社会经济地位(SES)或居住地。然而，越来越多的证据表明，在较早的生命周期中，暴露在其中起到了重要作用。然而，生命周期暴露的作用很难研究，因为移民模式掩盖了地理暴露与长期健康结果之间的联系。这项研究的总体目的是确定影响血管和认知健康差异的儿童和家庭SES因素(CH-SES)。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，REAGES(中风的地理和种族差异的原因)研究是一项基于全国人群的队列研究。2003年至2007年，招募了30,239名年龄在45岁或以上的参与者，其中45%为男性，42%为黑人。数据是通过电话采访、家庭体检和自填式问卷相结合的方式收集的。参与者目前正在接受心血管事件和认知评估的跟踪。我们的方法建立在特殊资源的基础上，特别是关于详细的住宅历史数据。这项研究建议从三个来源获得有关社会保障和社会保障因素的数据：1)通过邮寄问卷从队列中收集新的数据；2)将现有的儿童居住地数据与关于家庭和社区层面社会保障状况的公共人口普查数据联系起来；以及3)将现有的儿童居住地数据与县/学区一级公立学校的历史学校质量记录联系起来。这些关于CH-SES的数据将与队列的人口学和临床特征的详细数据联系起来，并被视为心血管疾病和后续行动中认知功能下降的预测因子。

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.