Associations of Neighborhood Green Space and Social Disadvantage with Stress-Sensitive Inflammatory Biomarkers

项目摘要/摘要 心血管疾病(CVD)是影响美国41%人口的主要公共卫生问题 并在2016年花费了5550亿美元的医疗支出和生产力损失。干预的预防战略 健康的社会决定因素，如邻里环境特征，是一种方法 减轻心血管疾病日益加重的负担。社区绿地，包括公园、休闲区和 植被是可改变的，重要的邻里因素与较低的心血管疾病风险和 更好的生理结果。绿地可以通过物理方式缓解压力，从而预防心血管疾病 活动、放松和积极的社交互动，减少个人在紧张的社交环境中的暴露。 邻里社会劣势，以邻里心理社会危害性为衡量标准 组织混乱、安全、身体紊乱和经济匮乏，可能会引发压力反应，可能 经常暴露会导致下丘脑-垂体-肾上腺皮质(HPA)轴功能障碍。心理社会 危险与心血管疾病风险增加和更高水平的应激敏感促炎性疾病有关 生物标志物。社区绿地对健康的好处表明，它可能是一种潜在的弹性 考虑到邻里社会的不利因素。拟议的横断面研究将审查协会 邻里绿地、邻里社会劣势、应激敏感促炎 624名城市居民、中老年人样本中的生物标志物。这项研究是次要数据 巴尔的摩记忆研究的分析，一项队列研究，调查了认知能力下降的决定因素 来自65个毗邻城市社区的1140名年龄在50岁至70岁之间的巴尔的摩市居民(R01 AG19604， 派：B.施瓦茨)。研究数据将与来自美国的植被覆盖的卫星地图配对 地质局测量绿地。拟议研究的具体目的是测试：(1) 邻里绿地与应激敏感的促炎生物标志物的关系； 邻里社会劣势与应激敏感的促炎生物标志物之间的关系；以及 (3)邻里绿地是否改变了邻里社会劣势与 压力敏感的促炎生物标志物。这些发现可能有助于阐明社区绿化的作用 空间作为一个可修改的社区复原力因素，可以作为社区一级干预的目标 降低心血管疾病风险。这项拟议的研究与国家心肺和血液研究所的优先事项一致 调查造成人群健康差异的因素，并了解 环境暴露和社会决定因素调节生物系统，促进复原力。这个 建议的培训计划是专注于了解社会和文化的研究计划的基础 心血管健康的环境贡献者和开发技能以创建有针对性的干预措施 倡导心脏健康的生活方式。

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is a major public health concern that affected 41% of the United States population and cost $555 billion in medical spending and lost productivity in 2016. Prevention strategies that intervene on social determinants of health, such as neighborhood environmental characteristics, are one approach to decreasing the growing burden of CVD. Neighborhood green spaces, including parks, recreational areas, and vegetation, are modifiable and important neighborhood factors have been associated with lower CVD risk and better physiologic outcomes. Green spaces may protect against CVD by mitigating stress through physical activity, relaxation, and positive social interactions that reduce individuals’ exposure to stressful social conditions. Neighborhood social disadvantage, measured as neighborhood psychosocial hazards comprised of social disorganization, safety, physical disorder, and economic deprivation, likely provokes a stress response that may lead to hypothalamic–pituitary–adrenocortical (HPA) axis dysfunction with regular exposure. Psychosocial hazards have been associated with increased CVD risk and higher levels of stress sensitive pro-inflammatory biomarkers. The health benefits of neighborhood green space suggest it may serve as a potential resilience factor against neighborhood social disadvantage. The proposed cross-sectional study will examine associations among neighborhood green space, neighborhood social disadvantage, and stress sensitive pro-inflammatory biomarkers in a sample of 624 urban-dwelling, middle-aged and older adults. This study is a secondary data analysis of the Baltimore Memory Study, a cohort study that investigated determinants of cognitive decline in 1,140 Baltimore City residents ages 50 to 70-year-old from 65 contiguous city neighborhoods (R01 AG19604, PI: B. Schwartz). Study data will be paired with satellite maps of vegetated land cover from the United States Geological Service to measure green space. The specific aims of the proposed study are to test: (1) the association between neighborhood green space and stress sensitive pro-inflammatory biomarkers; (2) the association between neighborhood social disadvantage and stress sensitive pro-inflammatory biomarkers; and (3) whether neighborhood green space modifies the association between neighborhood social disadvantage and stress sensitive pro-inflammatory biomarkers. These findings may help clarify the role of neighborhood green spaces as a modifiable neighborhood resilience factor that can be targeted for community-level interventions to reduce CVD risk. This proposed study aligns with the National Heart, Lung, and Blood Institute’s priorities to investigate factors that account for differences in health among populations and to understand how environmental exposures and social determinants modulate biological systems and promote resilience. The proposed training plan is foundational to a program of research focused on understanding social and environmental contributors to cardiovascular health and developing skills to create targeted interventions that promote heart-healthy lifestyles.