Diversity Supplement to the Transitions from Impaired Respiratory Health to Lung Disease

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PROJECT SUMMARY/ABSTRACT The goal of this diversity supplement is to facilitate Dr. Daniel Meza's development as an independent physician- scientist and a leader in respiratory epidemiology, with a focus on the primary prevention and interception of chronic obstructive pulmonary disease. This diversity supplement for a post-doctoral award in support of Dr. Meza will aid his career development as a physician-investigator focused on understanding the impact of social environments on future lung health and disease. This will allow the candidate to develop the necessary skills and leverage study findings for the submission of a National Institutes of Health (NIH) career development (K) award prior to completing the supplement. This work exploring novel risk factors for impaired respiratory health is aligned with the parent grant and its central hypotheses. The candidate and his mentors have designed a specific training plan that builds upon his background in internal medicine, pulmonary medicine, and clinical investigation and aims toward launching his career as an independent investigator. This plan includes developing additional skills during the award period through (1) coursework designed to expand his knowledge and training in clinical research techniques, (2) interaction with a multidisciplinary team of sponsors and collaborators, including those in pulmonary and epidemiology, and (3) a supervised research project with national funding. The overall scientific objective of this project is to identify neighborhood factors that impair respiratory health through two primary specific aims: (1) determine whether neighborhood factors (green space, walkability index, and exposure to crime/violence) in young adulthood are associated with respiratory symptoms and decline in lung function over 20-25 years of follow-up and (2) To determine whether neighborhood factors in young adulthood are associated with greater risk of emphysema and lung injury later in life. This will be the first study to obtain and analyze neighborhood factors in the Coronary Artery Disease Risk in Young Adults (CARDIA) cohort. The CARDIA cohort has multiple strengths, including the original enrollment of young adults aged 18-30, 51% of participants identifying as Black or African-American, and having 35 years of follow-up data. It is essential to identify risk factors for decline of lung health and development of chronic lung abnormalities. We plan to expand on our prior work, which examined neighborhood deprivation, to now investigate specific neighborhood factors and their association with developing respiratory symptoms, decline in FEV1, and development of lung disease. Our proposal advances the goal of NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases by looking at neighborhood factors as a novel trigger that in the future can be analyzed to intercept future chronic lung disease.