Cardiovascular outcomes related to nutrition policies among socioeconomically disadvantaged populations

项目概要/摘要 候选人：Eric J. Brandt，医学博士，MHS，是一位健康服务研究员、预防心脏病学家和脂质学家。 他因心血管疾病 (CVD) 损失的个人故事和临床经验激发了他的研究 CVD 结果、营养政策和健康公平的交叉点。他的目标是成为一个独立的人 影响政策变化的临床医生调查员和领先的心血管健康服务研究人员 减少弱势群体心血管疾病方面的健康差距。 研究背景：不良饮食是美国 CVD 过早死亡的主要原因 种族和社会经济弱势群体的饮食质量较低，心血管疾病负担较高。 补充营养援助计划 (SNAP) 旨在公平地改善营养安全和 不成比例地为少数族裔个人服务。 SNAP 减少了粮食不安全，但现有的 关于 SNAP 参与者的饮食质量、SNAP 参与者如何处理竞争性营养以及 医疗需求，以及 SNAP 参与是否影响健康结果和医疗服务的使用。的 本提案中的项目旨在填补健康问题社会决定因素交叉点的关键知识空白 (SDOH)、少数族裔健康差异、医疗保健和心血管疾病结果。 具体目标： 1) 定义具有 CVD 或 CVD 风险因素的 SNAP 参与者的饮食模式，并 将这些与 CVD 死亡率相关联； 2) 确定患有 CVD 的 SNAP 参与者如何导航 营养、医疗保健和健康结果； 3) 评估 SNAP 参与如何推动使用 医疗保健以及心血管疾病事件如何影响食品购买。 研究计划：为了实现这些目标，布兰特博士将研究以下人群的饮食模式和 CVD 死亡率： 国家健康和营养检查调查中的 SNAP 参与者；收集定性数据进行评估 不同心血管疾病患者的食物与健康之间的相互作用；并使用链接的 SNAP 注册， 医疗补助索赔和杂货数据用于研究 SNAP 参与者与医疗护理的互动。所有项目都将 评估解释不同种族不同结果的潜在 SDOH。 职业发展计划：Brandt 博士将以 SDOH 课程或研讨会的先前培训为基础， 政策、营养流行病学、因果推理分析以及定性和混合方法。通过强 指导、科学会议、早期职业教师工作组、手稿出版和 R01 研讨会 他将过渡到独立并成为领先的心血管健康服务研究员。 环境：布兰特博士得到了他的部门和部门的全力支持。他将利用理想 密歇根大学的培训环境，包括强有力的协作指导和获得 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.