Cardiovascular Health Effects of the Great Recession

大衰退对心血管健康的影响

• 批准号: 10388405
• 负责人: Arun S Karlamangla
• 金额: $ 62.52万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10388405
• 关键词: Acceleration; Address; Aging; American; Antihypertensive Agents; Area; Behavioral; Biological; Biological Markers; Biological Testing; Biology; Blood Glucose; Blood Pressure; Body mass index; C-reactive protein; Cardiovascular Diseases; Clinical; Code; Communities; Data; Data Files; Deposition; Diabetes Mellitus; Dimensions; Dose; Economic Conditions; Economic Recession; Economics; Event; Exposure to; Fasting; Foreclosure; Foundations; Funding; Future; Glucose; Health; Health Insurance; Health behavior; Hip region structure; Home; Housing; Income; Individual; Insurance Coverage; Investigation; LDL Cholesterol Lipoproteins; Link; Measurement; Measures; Mediating; Mental Depression; Methods; Modeling; Morbidity - disease rate; Multi-Ethnic Study of Atherosclerosis; Myocardial Infarction; Outcome; Pathway interactions; Pharmaceutical Preparations; Plasma; Policies; Population; Public Health; Recovery; Research; Research Project Grants; Risk; Risk Factors; Serum; Severities; Shock; Social Security; Social support; Source; Stress; Stroke; Subgroup; System; Testing; Time; Variant; Work; adjudicate; age related; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; economic impact; experience; innovation; insight; mortality; negative affect; physical conditioning; population health; pre-clinical; response; time use; trend

PROJECT SUMMARY/ABSTRACT Few Americans were untouched by the Great Recession (GR). Though one might expect major economic downturns such as this to negatively affect physical health, the evidence is, in fact, mixed. This project will integrate biologically-informed empirical methods with uniquely rich longitudinal data at the individual and local market level to test hypotheses about the effects of economic stress from the GR on cardiovascular disease (CVD) risk factors and events. Six waves of CVD risk factors and validated CVD events from the Multi-Ethnic Study of Atherosclerosis (MESA) collected before and after the GR will be linked with detailed time-varying area- and demographic-specific measures of local labor and housing market conditions. The first four waves of MESA, collected between mid-2000 and mid-2007, before the onset of the GR in 2008, will be used to estimate individual-specific aging trajectories. The fifth wave, collected in 2010 through 2012 immediately post GR, and the sixth wave, collected in 2016 and 2017, will be used to investigate both short and longer-term effects of the Recession beyond the expected age-related changes that we allow to differ for each individual. Specific aims of this project are to: (1) test hypotheses about effects of exposures to different sources of economic stress on six major biological risk factors for CVD, controlling for individual-specific trajectories of biology, exploiting plausibly exogenous variation in the severity of the GR and post-recession recovery to isolate causal effects. This includes, for example, comparing effects of changes in housing market conditions on those who owned homes pre-Recession vs. those who did not. (2) test biologically informed hypotheses about the timing and persistence of these effects across systems; (3) test whether GR effects on biological risk factors are reflected in increased rates of CVD events – a hard clinical outcome; (4) test whether potential pathway variables: health behaviors, health insurance, medication use (anti-hypertensives, diabetes medications, and statins), depression, and social support changed with the economic stresses of the GR; and (5) measure CRP levels in stored plasma from MESA for this research and for future use by the entire research community. Integrating insights from biology and economics, this project will provide new, credible evidence on the causal effects of economic conditions on health by leveraging unique strengths of MESA to test biologically informed hypotheses regarding differential impacts of the GR on different biomarkers over time, using innovative models that control for individual-specific aging trends in biology, while exploiting variation in economic stress across population sub-groups from differential exposures to the unanticipated changes in local housing and labor markets. Empirical estimates from this work of the magnitude of health impacts of varying levels of economic stress will provide a comprehensive and credible body of evidence on the causal impacts of economic upheavals on health outcomes in the U.S. population.

项目总结/摘要 很少有美国人没有受到大衰退（GR）的影响。尽管人们可能会预计， 事实上，这种衰退对身体健康产生负面影响的证据是混合的。该项目将 将生物学经验方法与个人和当地独特丰富的纵向数据相结合， 市场水平，以检验有关GR经济压力对心血管疾病影响的假设 (CVD)风险因素和事件。来自多种族人群的六波CVD危险因素和经验证的CVD事件 在GR之前和之后收集的动脉粥样硬化研究（梅萨）将与详细的随时间变化的 对当地劳动力和住房市场状况的区域和人口统计具体措施。前四波 在2008年全球变暖开始之前，2000年中期至2007年中期收集的梅萨将用于估计 个体特定的衰老轨迹。第五波，收集于2010年至2012年，紧接GR之后， 2016年和2017年收集的第六波数据将用于调查气候变化的短期和长期影响。 衰退超出了预期的年龄相关的变化，我们允许每个人都有所不同。具体目标 本研究的主要目的是：（1）检验关于不同经济压力源暴露效应的假设 心血管疾病的六个主要生物风险因素，控制个体特定的生物学轨迹， GR的严重程度和衰退后复苏的合理外生变化，以隔离因果效应。 例如，这包括比较住房市场条件变化对那些拥有住房的人的影响。 经济衰退前的家庭与那些没有的家庭。(2)测试生物学上关于时间的假设， 这些影响在系统中的持续性;（3）测试GR对生物风险因素的影响是否反映在 心血管事件的发生率增加-一个硬的临床结果;（4）测试是否潜在的途径变量：健康 行为，健康保险，药物使用（抗高血压药，糖尿病药物和他汀类药物）， 抑郁症和社会支持随着GR的经济压力而变化;（5）测量 从梅萨储存的血浆用于这项研究，并供整个研究界未来使用。整合 从生物学和经济学的见解，该项目将提供新的，可靠的证据的因果关系， 经济条件对健康的影响，利用梅萨的独特优势， 关于GR随时间推移对不同生物标志物的不同影响的假设，使用创新模型 控制生物学中个体特定的衰老趋势，同时利用经济压力的变化， 人口亚组从差异暴露于当地住房和劳动力的意外变化 市场的根据这项工作对不同经济水平的健康影响程度的经验估计， 压力将提供一个全面和可信的证据机构的因果影响的经济 对美国人口健康状况的影响。