Built Environment & Hispanic Elders' Health

描述(由申请人提供)：这项拟议的研究建立在一个跨学科研究计划的基础上，旨在调查随着时间的推移，建筑环境在拉美裔美国人健康风险和保护中的作用。建筑环境使用理论推导的编码系统进行测量。这一应用程序利用了小哈瓦那东部现有的273名拉美裔长老的人口队列，其中230人仍在继续。这项研究考察了建筑环境对老年人身体功能、认知功能和心理困扰轨迹的影响，并调查了邻里社会行为和社会支持作为这种关系的潜在中介的轨迹。这项研究从四个方面扩展了正在进行的研究：增加了48个月和60个月的跟踪评估；增加了身体功能的轨迹；为建筑环境提出了一个新的分析单位--“有效建筑环境”暴露；以及检查了建筑环境变化的影响。在目标社区重建大量地块是一项自然的实验，它允许评估建成环境的变化对社会过程以及行为和身体结果的影响。如果建筑环境的外在变化影响社会进程和老年人的结果，这将为建筑环境是风险和保护老年人健康的重要因素的假设提供额外的支持。为了解决关于正确的建筑环境分析单位的争论，这项研究调查了替代分析单位的优势。分析将在结构方程建模框架中估计潜在增长曲线。将使用潜在增长曲线框架中的时变协变量和自回归模型来估计时变建成环境变化对健康结果的影响。

DESCRIPTION (provided by applicant): The proposed study builds on a transdisciplinary program of research to investigate the role of the built environment in risk and protection of Hispanics' health over time. Built environment is measured using a theoretically-derived coding system. This application capitalizes on an existing population-based cohort of 273 Hispanic elders in East Little Havana, 230 of who remain. The proposed research examines the impact of the built environment on elders' trajectories of physical functioning, cognitive functioning, and psychological distress, and investigates trajectories of neighborhood social behaviors and social support as potential mediators in this relationship. This study extends ongoing research in four ways: adds 48- and 60-month follow up assessments; adds a trajectory of physical functioning; proposes a novel unit of analysis for the built environment, "effective built environment" exposure; and examines the impact of a changing built environment. The rebuilding of a large number of lots in the target neighborhood is a natural experiment that permits the assessment of the impact of changes in the built environment on social processes, and behavioral and physical outcomes. Should exogenous changes in the built environment impact social processes and elders' outcomes, this would provide additional support for the hypothesis that the built environment is an important factor in risk and protection of elders' health. To address the debate about the correct built environment unit of analysis, the study investigates the strengths of alternative units of analysis. Analysis will estimate latent growth curves in a structural equation modeling framework. The impact of time-varying built environment changes on health outcomes will be estimated using both time-varying covariates in the latent growth curve framework and autoregressive models.