Environmental Changes and Health Outcomes across 25 Years: Four US Cities

描述(由申请人提供)：虽然观察性研究表明肥胖相关的社会环境因素与肥胖和心脏代谢风险因素之间存在联系，但很少有研究涉及将社会环境与心脏代谢风险联系起来的具体因素和途径。缺乏研究的主要原因是：1)缺乏与心脏代谢风险生物标志物有关的高质量的饮食、活动、随时间测量的身高和体重的数据；2)缺乏与食物和活动相关的环境特征的引入、更新和关闭的细粒度纵向数据；3)缺乏复杂的统计模型来检验这个依赖时间的复杂系统的每一部分，说明食物、活动和交通设施的建立和扩展过程，以及个人有选择地迁移到这些设施附近的可能性。这项为期25年的青年冠状动脉纵向风险发展研究(CARDIA)提供了四个基准城市：伯明翰、芝加哥、明尼阿波利斯和奥克兰的CARDIA的广泛年龄范围、高质量的纵向、生物、行为和人体测量和生物标记物数据、地理多样性以及不同的变化模式和速度。研究团队开发了一种独特的方法，使用追溯和当代来源来创建关于以下项目的介绍、翻新和关闭的时间和地点的数据：1)食物资源(例如，餐馆、食品购物)；2)娱乐设施(例如，步道、公园)；以及3)伯明翰、芝加哥、明尼阿波利斯和奥克兰的交通基础设施(例如，轻轨、自行车停车场、自行车道)，在25年的时间里。此外，我们开发了复杂的统计模型，考虑到有目的(而不是随机)相关资源在社会环境中的放置，以及个人有选择地迁移到此类资源附近的能力。研究目标包括：1)开发和验证新的细粒措施，以捕捉引入、翻新和关闭，这些措施反映了以下方面的变化：a)公园、步道和其他娱乐场所；b)食物环境；c)将在25年内与CARDIA受访者的地理位置同时联系的交通基础设施；2)使用这一独特的数据来源，估计在过去25年里，关键食品和活动设施以及交通基础设施的引入、翻新和关闭对四个现场城市的饮食和活动行为、体重和心脏代谢风险的影响，同时考虑到食物和活动设施的内生放置和选择性迁移。我们将特别关注个人水平的种族、收入和教育群体的比较，以检查环境因素如何导致从年轻到成年的饮食、肥胖和心脏代谢风险方面的种族和SES不平等。拟议的研究将改善目前对社会环境(特别是更广泛的社会、经济和环境背景)影响健康结果的机制的理解。 与公共健康相关：美国正经历着肥胖和心脏代谢疾病的沉重负担，但很少有研究探讨社会环境与心脏代谢风险之间的具体因素和途径。这项拟议研究的目的是提高对社会环境影响肥胖和心脏代谢风险的机制的理解，确定社会环境中哪些因素特别有影响，并提出分析方法来理解这些复杂的途径。最终，拟议的研究将为宏观层面的社会环境政策提供信息，以减轻早中年疾病风险的早期发展。

DESCRIPTION (provided by applicant): While observational research suggests an association between obesity-related social environment factors with obesity and cardiometabolic risk factors, very little research has addressed the specific factors and pathways linking the social environment to cardiometabolic risk. The primary reasons for this lack of research are: 1) lack of high quality data on diet, activity, measured height and weight over time linked to cardiometabolic risk biomarkers; 2) lack of fine-grain longitudinal data on the introduction, renovation, and closure of food- and activity-related environmental features; and 3) lack of complex statistical models examining each piece of the time-dependent, complex system, accounting for the process by which food, activity, and transportation facilities are established and expanded and the potential for individuals to selectively migrate to locate near such facilities. The 25-year, longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study provides a wide age range, high quality longitudinal, biological, behavioral and anthropometry and biomarker data of CARDIA, geographic diversity, and different patterns and pace of change across the four baseline cities: Birmingham, Chicago, Minneapolis and Oakland. The research team has developed a unique method to use retrospective and contemporary sources to create data on the timing and placement of introductions, renovations, and closures of: 1) food resources (e.g., restaurants, food shopping); 2) recreation facilities (e.g., trails, parks); and 3) transportation infrastructure (e.g., light rail, bike parking, bike paths) in Birmingham, Chicago, Minneapolis, and Oakland over a 25-year period. Furthermore, we have developed sophisticated statistical models that account for purposeful (as opposed to random) placement of relevant resources in the social environment as well as individuals' ability to selectively migrate to locate near such resources. Study objectives include: 1) Develop and validate new fine-grain measures to capture introductions, renovations, and closures representing changes in: a) parks, trails, and other recreational sites; b) food environments; and c) transportation infrastructure that will be contemporaneously linked to CARDIA respondents' geographic locations over 25 years; and 2) Using this unique data source, estimate the effects of introductions, renovations, and closures of key food and activity facilities and transportation infrastructure on diet and activity behaviors, body weight and cardiometabolic risk in the four field cities over 25 years, while accounting for the endogenous placement of food and activity facilities and selective migration. We will specifically focus on comparisons across individual-level race, income, and education groups to examine how environmental factors contribute to race and SES inequalities in diet, obesity, and cardiometabolic risk from young- to mid-adulthood. The proposed research will improve current understanding of the mechanisms through which social environments (specifically broader societal, economic, and environmental contexts) influence health outcomes. PUBLIC HEALTH RELEVANCE: The US is experiencing substantial burden in obesity and cardiometabolic disease, yet very little research has addressed the specific factors and pathways linking the social environment to cardiometabolic risk. The objective of the proposed research is to improve understanding of mechanisms through which social environments influence obesity and cardiometabolic risk, determine which factors in the social environment are particularly influential, and to advance analytic methods to understand these complex pathways. Ultimately the proposed research will inform macro-level social environment policies to mitigate early development of disease risk in the early to middle adult years.