Built Environment & Hispanic Elders' health

描述（由申请人提供）：拟议的研究建立在一个跨学科研究项目的基础上，旨在调查建筑环境在西班牙裔美国人健康风险和保护中的作用。建筑环境是用一个理论推导的编码系统来测量的。该应用程序利用了小哈瓦那东部现有的273名西班牙裔老人，其中230人仍然存在。本研究探讨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，并探讨了邻里社会行为和社会支持的轨迹在这种关系中的潜在中介作用。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个月的随访评估；增加了身体功能的轨迹；提出了一种新的建筑环境分析单元——“有效建筑环境”暴露；并研究不断变化的建筑环境的影响。在目标社区中大量地块的重建是一个自然实验，允许评估建筑环境变化对社会过程、行为和物理结果的影响。如果建筑环境的外生变化会影响社会进程和老年人的结果，这将为建筑环境是老年人健康风险和保护的重要因素这一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元的争论，本研究调查了可供选择的分析单元的优势。分析将在结构方程建模框架中估计潜在增长曲线。时变建筑环境变化对健康结果的影响将使用潜在生长曲线框架中的时变协变量和自回归模型进行估计。

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.