Contribution of Longitudinal Neighborhood Determinants to Cognitive Health and Dementia Disparities within a Multi-Ethnic Cohort

项目摘要 灾害在所有社会系统中造成广泛的破坏。随着气候变化， 灾害的强度在增加。现有的研究表明， 老年人口的增长。此外，这些灾害影响的可能异质性， 个人和社区层面的特征可能会加剧健康方面的种族和社会经济差异 这一人群中的结果，如认知能力下降。这就需要确定具体的 影响与灾害影响相关的认知结果差的风险的特征。邻里提供 有机会通过建立社区抗灾能力来解决差距问题。获得支持 邻里环境，包括人们聚集在一起互动建立联系的地方， 是应对灾难所必需的。通过了解社区的变化， 我们可以改善灾害应对政策和计划，以支持那些创造积极影响的机构。 健康影响和减少认知健康方面的差异。 这个为期一年的项目将增加目前资助的R 01，以确定防止灾害相关的因素 老年人的认知障碍。我们将整合来自Spatial的灾害风险量化数据， 美国灾害事件和损失数据库（SHELDUS）和社区一级的复原力， 调查和地理信息系统数据，包括个人风险因素和健康结果 从梅萨和REGARDS队列中。衡量和描述与气候相关的灾难和社区 在20年的恢复能力，我们将计算灾害影响的指标（月，严重程度）和访问指标 to diverse多样化neighborhood邻里institutions机构（density密度，diversity多样性）.这些数据将与6，814个梅萨相关联 参与者和30，107名REGARDS参与者（目标1）。使用两个队列的纵向健康数据，我们将 估计与灾害有关的认知障碍的程度和社区复原力因素， 定量地减轻风险（目标2和3）。我们将利用队列的地理和种族/民族多样性， 了解个人和社区在灾害影响和与灾害有关的认知障碍方面的差异。 这些研究结果将导致改进的复原力措施，为建立抗灾能力的干预措施提供信息 和恢复，并最终防止健康差距。

PROJECT SUMMARY Disasters create widespread disruption across all societal systems. With climate change, the number and intensity of disasters is increasing. Existing research supports a disproportionate impact of disasters among the growing population of older adults. Furthermore, likely heterogeneity in these disaster impacts by individual- and community-level characteristics may exacerbate racial and socioeconomic disparities in health outcomes among this population, such as cognitive decline. This necessitates identification of specific characteristics that influence risk for poor cognitive outcomes related to disaster impact. Neighborhoods offer the opportunity to address disparities by building up community resilience to disaster. Access to supportive neighborhood environments, including places where people come together to interact to build connections, are necessary for coping with disasters. By understanding community changes that mitigate cognitive disparities, we can improve disaster response policies and programs to support institutions that create positive health effects and reduce disparities in cognitive health. This 1-year project will augment a currently funded R01 to identify factors that prevent disaster-related cognitive impairment among older adults. We will integrate quantitative data on disaster exposure from Spatial Hazard Events and Losses Database for the United States (SHELDUS) and community-level resilience from surveys and geographic information systems (GIS) data with individual-level risk factors and health outcomes from the MESA and REGARDS cohorts. To measure and describe climate-related disaster and community resilience over 20 years, we will compute metrics of disaster impact (months, severity) and indicators of access to diverse neighborhood institutions (density, diversity). These data will be linked to the 6,814 MESA participants and 30,107 REGARDS participants (Aim 1). Using longitudinal health data in both cohorts, we will estimate the magnitude of disaster-related cognitive impairment and the community-resilience factors that quantitatively mitigate risk (Aims 2 & 3). We will use the geographic and racial/ethnic diversity of the cohorts to understand individual- and community-disparities in disaster impact and disaster-related cognitive impairment. These findings will result in refined measures of resilience to inform interventions that build disaster resistance and recovery, and ultimately prevent health disparities.