Communities Designed to Support Cardiovascular Health for Older Adults

旨在支持老年人心血管健康的社区

• 批准号: 9131608
• 负责人: Gina Schellenbaum Lovasi
• 金额: $ 58.17万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9131608
• 关键词: Accounting; Acute; Address; Adult; Affect; African American; Age; Aging; Area; Attention; Attenuated; Behavior; Big Data; Businesses; Cardiac health; Cardiovascular Diseases; Cardiovascular system; Caring; Censuses; Characteristics; Chronic; Cities; Clinical; Cohort Studies; Communities; Crime; Data; Destinations; Dietary intake; Disease Outcome; Disease-Free Survival; Elderly; Enrollment; Environment; Etiology; Event; Female; Fishes; Food; Geographic Locations; Geographic state; Goals; Grooming; Health; Health Food; Health Services Accessibility; Health behavior change; Health care facility; Healthcare; Home environment; Hospitals; Incentives; Incidence; Independent Living; Individual; Interdisciplinary Study; Investigation; Knowledge; Life; Link; Location; Longitudinal Studies; Marketing; Medical; Myocardial Infarction; Neighborhoods; Nuts; Onset of illness; Participant; Pattern; Pharmacy facility; Physical activity; Play; Policies; Population; Population Characteristics; Population Density; Population Heterogeneity; Questionnaires; Race; Reasons for Geographic And Racial Differences in Stroke; Recommendation; Recording of previous events; Research; Research Infrastructure; Resource Allocation; Resources; Restaurants; Risk; Role; Safety; Science; Series; Services; Shapes; Site; Socioeconomic Status; Source; Spatial Distribution; Stroke; Subgroup; Supermarket; Taxes; Time; Transportation; Urbanization; Walking; Work; aging population; base; cardiovascular disorder prevention; cardiovascular health; cohort; density; design; disadvantaged population; disorder prevention; experience; fast food; food marketing; fruits and vegetables; geographic difference; health disparity; healthy lifestyle; innovation; land use; population based; population health; prevent; prospective; racial difference; racial disparity; racial diversity; social; survival prediction; tertiary prevention; trend

 DESCRIPTION (provided by applicant): Business establishments have the potential to shape individual behaviors including dietary intake, physical activity patterns, and management of chronic medical conditions, all with relevance to risk of myocardial infarction and related cardiovascular disease (CVD) outcomes. Policy strategies targeting local businesses may play an important role in CVD prevention, extending years of healthy life, and facilitating independent living. We propose to bring together commercially available "big data" and detailed population-based cohort data to examine the role of local business environments in CVD and racial disparities in CVD as they emerged across decades. Longitudinal studies of local environments have been strongly recommended as a direction for future research to advance our understanding of causal neighborhood effects on health. The local density of businesses with potential relevance to CVD has changed over time, and such temporal fluctuations vary across regions, cities and neighborhoods. These differences can be used to investigate how residentially stable older adults are affected by their local context. Meanwhile, older adults who relocate to a new home address may respond to their new context by changing health behaviors, offering another window into causation. However, careful attention is needed to acute health changes that precipitate relocation, and which local environment features predict aging in place despite new health or functional limitations. In the proposed project, we will link longitudinal data to investigate how neighborhood change and residential relocation shape cardiovascular health and health disparities. We will use a census of national businesses, the National Establishment Time Series (NETS). NETS data for all 52.4 million US business establishments includes annual point-level geocodes and business characteristics for the years 1990-2012, offering an unprecedented opportunity to characterize changing business environments nationally at multiple spatial scales. Geographic context data (from NETS as well as longitudinal population, safety, and transportation data) will be linked to individual data from two ongoing cohort studies: the Cardiovascular Health Study (CHS) and the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. CHS is a well-characterized population- based study of 5,888 older adults (100% age 65+ at baseline, 58% female, 16% African American). A majority of the CHS participants enrolled 1990-1993 from four US sites, with oversampling of African Americans, have been followed prospectively for the remainder of their lives, allowing in-depth characterization of neighborhood environments experienced by older adults in their final decades. REGARDS is also a prospective population-based cohort study with oversampling of African Americans, allowing for examination of racial disparities. However, the 30,239 REGARDS participants (49% age 65+ at baseline, 55% female, 42% African American) were enrolled more recently (2003-2007) and from a broader geographic region (48 contiguous US states, oversampling Stroke Belt residents). For these two cohorts with complementary strengths, cardiovascular events have been ascertained and longitudinal address data collected. This project brings together unparalleled data resources, builds on a track record of policy-relevant work with large geographic data resources, and leverages comprehensive cardiovascular cohort data.

 描述（由适用提供）：商业机构有可能塑造个人行为，包括饮食摄入，体育锻炼模式和慢性病治疗的管理，所有这些都与心肌梗死的风险和相关心血管疾病（CVD）结局有关。针对本地企业的政策策略可能在预防CVD，延长数年的健康生活和支持独立生活中发挥重要作用。我们建议将市售的“大数据”和详细的基于人群的队列数据汇总在一起，以研究当地商业环境在CVD和种族分布中的作用，而在CVD中，它们在数十年中出现。强烈建议对当地环境进行纵向研究，以促进未来研究的方向，以促进我们对因果关系对健康的影响的理解。随着时间的推移，与CVD潜在相关性的局部企业密度随着时间的流逝而发生了变化，并且这种暂时的波动在各个地区，城市和社区之间有所不同。这些差异可用于调查居民如何稳定的老年人受其当地情况影响。意思是，搬迁到新家庭住址的老年人可能会通过改变健康行为来应对他们的新环境，从而为原因提供另一个窗口。但是，需要仔细注意急性健康变化，这些变化是宝贵的搬迁，以及哪些当地环境特征可以预测目的地的新健康或功能限制。在拟议的项目中，我们将将纵向数据链接起来，以调查邻里变化和居民的搬迁形状心血管健康和健康分布如何。我们将使用国家企业的人口普查，国家机构时间序列（NETS）。所有5240万个美国业务机构的NETS数据包括1990 - 2012年的年度点级地理编码和业务特征，提供了前所未有的机会，以在多个空间尺度上在全国范围内表征不断变化的商业环境。地理环境数据（来自网络以及纵向人口，安全和运输数据）将与个人数据相关 两项正在进行的队列研究：心血管健康研究（CHS）以及中风（有关）研究的地理和种族差异的原因。 CHS是一项针对5,888名老年人（基线时65岁以上的100％年龄，58％女性，16％的非裔美国人）的基于人群的良好研究。大多数CHS参与者从美国四个网站招收了1990 - 1993年， 非洲裔美国人的过度采样可能在其余生中可能被遵循，从而可以深入地表征老年人在最后几十年中经历的邻里环境。在非洲裔美国人的过度采样，允许检查种族分布的情况下，这也是一项基于人群的前瞻性研究研究。然而，最近有30,239个参与者（基线时49％以上，女性为55％，42％的非裔美国人）被录入（2003-2007），并从一个更广泛的地理区域（48个连续的美国州，过度采样中风的居民）。对于具有完全优势的这两个队列，已经确定了心血管事件并收集了纵向地址数据。该项目汇集了无与伦比的数据资源，建立在与大量地理数据资源有关的与政策相关的工作记录的基础上，并利用全面的心血管群体数据。