Neighborhood Change: Impact on Sleep and Obesity-Related Health Disparities

社区变化：对睡眠和肥胖相关健康差异的影响

• 批准号: 8817924
• 负责人: Tamara Dubowitz
• 金额: $ 86.91万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-15 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8817924
• 关键词: Adult; Affect; African American; Behavior; Businesses; Cardiovascular Diseases; Characteristics; Classification; Cohort Studies; Communities; Control Groups; Crime; Data; Diet; Disadvantaged; Economics; Employee Strikes; Esthetics; Funding; Goals; Health; Health behavior; Healthy People 2020; Home environment; Individual; Intervention; Investments; Life; Link; Literature; Longitudinal Studies; Low income; Measurable; Measures; Mediating; Mediator of activation protein; Minority; Modeling; Monitor; Morbidity - disease rate; Natural experiment; Neighborhoods; Obesity; Obstructive Sleep Apnea; Outcome; Pathway interactions; Patient Self-Report; Perception; Physical activity; Play; Policies; Population; Populations at Risk; Process; Public Housing; Relative (related person); Research; Research Design; Research Infrastructure; Risk; Role; Safety; Services; Sleep; Sleep Disorders; Sleep disturbances; Social Environment; Solid; Staging; Strategic Planning; Stress; Supermarket; Testing; Time; United States National Institutes of Health; actigraphy; base; built environment; cohesion; cohort; experience; group intervention; health disparity; high risk; improved; mortality; neighborhood safety; novel; policy implication; public health relevance; racial disparity; screening; social; socioeconomic disparity; socioeconomics

DESCRIPTION (provided by applicant): Individuals living in socioeconomically disadvantaged neighborhoods have disproportionately high rates of obesity and obesity-related morbidity, including increased risk for physical role limitations and cardiovascular diseases (CVD). Studies of potential mechanisms linking neighborhood disadvantage with health outcomes have primarily focused on daytime health behaviors, including diet or physical activity. However, sleep is a critical health behavior that is associated with neighborhood disadvantage, and may play a causal role in explaining the links between neighborhood disadvantage and health. However, the extant research on neighborhood disadvantage and sleep is based exclusively on cross-sectional data, using self-reports of sleep and neighborhood characteristics. Building on the existing research infrastructure developed by our team's previously funded, ongoing studies, we have a unique and important opportunity to study whether changes in the built and social environment, stimulated by substantial economic investment improves sleep, and in turn, reduces obesity-related health disparities. The study cohort includes a randomly selected cohort of 1100 low- income, African American adults, from two urban neighborhoods, one of which is undergoing a dramatic revitalization over the next 5 years (i.e., the intervention neighborhood), and the other (the sociodemographically-matched control neighborhood) is not undergoing any such changes. We will add longitudinal assessments of sleep using actigraphy, self-reports, and in a subsample of 300, objective, in-home monitoring of obstructive sleep apnea, to provide a rich characterization of sleep profiles before, during, and, after neighborhood changes. Evidence gained from this study would have substantial scientific and policy implications for identifying novel individual-level and neighborhood level factors that contribute to striking and pervasive racial and socioeconomic disparities in health.

描述（由申请人提供）：生活在社会经济弱势社区的个人肥胖和肥胖相关的发病率不成比例地高，包括身体角色限制和心血管疾病（CVD）的风险增加。对邻里劣势与健康结果之间联系的潜在机制的研究主要集中在白天的健康行为，包括饮食或体育活动。然而，睡眠是一个关键的健康行为，与邻里劣势，并可能在解释邻里劣势和健康之间的联系发挥因果作用。然而，现有的研究邻里劣势和睡眠是完全基于横截面数据，使用自我报告的睡眠和邻里特征。在我们团队先前资助的正在进行的研究开发的现有研究基础设施的基础上，我们有一个独特而重要的机会来研究建筑和社会环境的变化，由大量的经济投资刺激改善睡眠，从而减少与肥胖相关的健康差距。该研究队列包括随机选择的1100名低收入非洲裔美国成年人的队列，他们来自两个城市社区，其中一个社区在未来5年内正在经历戏剧性的复兴（即，干预邻域），而另一个（社会人口统计学匹配的控制邻域）不经历任何这样的变化。我们将使用体动记录仪、自我报告和300个阻塞性睡眠呼吸暂停客观家庭监测子样本增加睡眠纵向评估，以提供邻居改变之前、期间和之后睡眠概况的丰富表征。从这项研究中获得的证据将具有重大的科学和政策意义，以确定新的个人层面和社区层面的因素，有助于显着和普遍的种族和社会经济差异的健康。