Cardiovascular outcomes related to nutrition policies among socioeconomically disadvantaged populations

项目摘要/摘要 候选人：埃里克·J·勃兰特，医学博士，麻省理工学院医学博士，卫生服务研究员、预防心脏病专家和血脂专家。 他的心血管疾病(CVD)损失的个人故事和临床经验促使他在 心血管疾病结果、营养政策和健康公平的交集。他的目标是成为一名独立人士 临床医生研究员和领先的心血管健康服务研究员，影响政策变化 减少弱势人群在心血管疾病方面的健康差距。 研究背景：在美国种族中，不良饮食是导致心血管疾病过早死亡的主要原因 族裔和社会经济弱势群体的饮食质量较低，心血管疾病负担较重。 补充营养援助计划(SNAP)寻求公平地改善营养安全和 不成比例地服务于少数族裔个人。然而，Snap减少了现有的粮食不安全 关于SNAP参与者的饮食质量、SNAP参与者如何处理竞争的营养和 医疗需求，以及SNAP的参与是否影响健康结果和医疗服务的使用。这个 本提案中的项目寻求填补健康的社会决定因素交叉点的关键知识空白 (SDOH)、少数群体健康差距、医疗保健和心血管疾病结局。 具体目标：1)确定有心血管疾病或心血管疾病危险因素的SNAP参与者的饮食模式，并 将这些与心血管疾病死亡率相关联；2)确定SNAP参与者和心血管疾病患者如何在 营养、医疗保健和健康结果；以及3)评估SNAP的参与如何推动 医疗保健以及心血管事件如何影响食品购买。 研究计划：为了实现这些目标，勃兰特博士将研究饮食模式和心血管疾病死亡率 国家健康和营养检查调查的Snap参与者；收集定性数据以评估 在不同的心血管疾病患者中食物和健康之间的相互作用；以及使用关联的SNAP登记， 医疗补助申请和杂货数据，以研究SNAP参与者与医疗保健的互动。所有项目都将 评估潜在的SDOH，解释不同种族的不同结果。 职业发展计划：勃兰特博士将以之前的培训为基础，开设SDOH课程或研讨会， 政策、营养流行病学、因果推断分析以及定性和混合方法。历久弥坚 导师指导、科学会议、早期教师工作组、手稿出版和R01研讨会 他将过渡到独立，并成为一名领先的心血管健康服务研究员。 环境：勃兰特博士得到了他所在部门和部门的全力支持。他将利用这一理想 密歇根大学的培训环境，包括强大的协作指导和获得 广泛的课程、研讨会和专业发展资源。

PROJECT SUMMARY/ABSTRACT CANDIDATE: Eric J. Brandt, MD, MHS is a health services researcher, preventive cardiologist, and lipidologist. His personal story of loss from cardiovascular disease (CVD) and clinical experience motivates his research at the intersection of CVD outcomes, nutrition policy, and health equity. His goal is to become an independent clinician investigator and leading cardiovascular health services researcher who influences policy changes to reduce health disparities in CVD among disadvantaged populations. RESEARCH CONTEXT: Poor diet is the leading contributor to premature death from CVD in the U.S. Racial, ethnic, and socioeconomically disadvantaged groups have lower-quality diets and a higher burden of CVD. The Supplemental Nutrition Assistance Program (SNAP) seeks to equitably improve nutrition security and disproportionately serves racial-ethnic minority individuals. SNAP decreases food insecurity, however, existing data are unclear about SNAP participants’ diet quality, how SNAP participants handle competing nutrition and medical needs, and if SNAP participation influences health outcomes and use of medical services. The projects in this proposal seek to fill critical knowledge gaps at the intersection of social determinants of health (SDOH), minority health disparities, medical care, and CVD outcomes. SPECIFIC AIMS: 1) To define dietary patterns among SNAP participants with CVD or CVD risk factors and to correlate these with CVD mortality; 2) To identify how SNAP participants with CVD navigate the intersection of nutrition, medical care, and health outcomes; and 3) To assess how SNAP participation drives the use of medical care and how CVD events impact food purchases. RESEARCH PLAN: To accomplish these aims, Dr. Brandt will study dietary patterns and CVD mortality of SNAP participants in the National Health and Nutrition Examination Survey; collect qualitative data to assess the interplay between food and health among diverse individuals with CVD; and use linked SNAP enrollment, Medicaid claims, and grocery data to study SNAP participant interactions with medical care. All projects will assess underlying SDOH that explain differential outcomes across race-ethnicity. CAREER DEVELOPMENT PLAN: Dr. Brandt will build upon prior training with courses or workshops in SDOH, policy, nutritional epidemiology, causal inference analytics, and qualitative and mixed methods. Through strong mentorship, scientific meetings, early-career faculty workgroups, manuscript publication, and R01 workshops he will transition to independence and emerge as a leading cardiovascular health services researcher. ENVIRONMENT: Dr. Brandt has full support from his Department and Division. He will leverage the ideal training environment at the University of Michigan, including strong, collaborative mentorship and access to a vast range of courses, workshops, and professional development resources.