Green space and cognitive health: the role of structural racism in environmental and health disparities.

绿色空间和认知健康：结构性种族主义在环境和健康差异中的作用。

• 批准号: 10689756
• 负责人: Jaime Madrigano
• 金额: $ 78.67万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689756
• 关键词: Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Area; Behavior; Black American; Black Populations; Black race; Caregivers; Characteristics; Cities; Clinical; Cognition; Cognitive; Cognitive aging; Color; Communities; Dementia; Diabetes Mellitus; Discrimination; Disease; Disparity; Economics; Educational Status; Elderly; Elements; Emotional Stress; Epidemiology; Ethnic Origin; Ethnic Population; Exposure disparity; Exposure to; Family Caregiver; Green space; Health; Health and Retirement Study; Heart Diseases; Hispanic Populations; Impaired cognition; Impairment; Individual; Inequity; Intention; Intervention; Link; Literature; Longitudinal Studies; Malignant Neoplasms; Measures; Mediating; Mediator; Mental Health; Moods; Nature; Neighborhoods; Not Hispanic or Latino; Pattern; Persons; Physical activity; Plants; Policies; Population; Prevalence; Prevention; Process; Public Health; Race; Racial Segregation; Regulation; Research; Resources; Risk; Risk Factors; Role; Sampling; Socioeconomic Status; Structural Racism; Syndrome; Trees; Work; care giving burden; caucasian American; cognitive function; cognitive impairment no dementia; contextual factors; dementia risk; design; disorder prevention; environmental disparity; environmental justice; experience; health disparity; health equity; improved; inequitable distribution; migration; modifiable risk; neighborhood disadvantage; physical inactivity; prevent; psychosocial stressors; racial disparity; racial population; residential segregation; restoration; social engagement; stress reduction; stressor

PROJECT SUMMARY In 2020, an estimated 5.8 million Americans had Alzheimer’s disease (AD), the most common cause of dementia, and this number is expected to reach 13.8 million by 2050. Alzheimer’s Disease and related dementias (ADRD) take an enormous toll on individuals affected, as well as their caregivers. Because disease- modifying therapies have proved largely ineffective, a priority is placed on finding ways to prevent this debilitating disease. This is particularly important for Black Americans who have a greater risk for poor cognitive aging compared to non-Hispanic White Americans, whether measured as clinical dementia or lower cognitive function in late life. Because neighborhood design factors can be modified at the population level through policy and regulation, they are an attractive area for intervention. Green space is one neighborhood design element that may be associated with cognitive function because exposure to it may reduce stress, improve mood, promote physical activity, and provide opportunities for social engagement, all of which have been associated with better cognitive health. Communities of color are more likely to live in neighborhoods with lower green space than white communities and structural racism, through past discriminatory policies leading to residential segregation, has been implicated in this inequitable distribution of green space. Recognition of these inequities has led to recent efforts to increase the amount and quality of green space in historically disadvantaged communities through park improvement projects, street tree plantings, and vacant lot restoration. While these initiatives may have the intention of combatting decades of disinvestment rooted in structural racism, they may, instead, end up reinforcing segregation by race and/or socioeconomic status because of gentrification, a process by which under-resourced neighborhoods are developed and experience in-migration of affluent newcomers. Therefore, it is unclear if green space improvements are harmful or beneficial to communities of color, particularly in neighborhoods that are undergoing revitalization. In the proposed work, we will (1) assess the cross-sectional and longitudinal association between changes in green space and cognitive function, cognitive decline, and dementia over a 20-year period in the (a) overall population and (b) by race/ethnicity; (2) estimate the association between structural racism (as measured by historical redlining spatial patterns) and cognitive function, cognitive decline, and dementia; and determine if this association is mediated by green space exposure; (3) determine if (a) the association between green space and cognitive function, cognitive decline, and dementia is moderated by gentrification; and (b) there is an independent association between gentrification and psychosocial stressors, mental health, and perceived neighborhood characteristics; and (4) partner with a national network of local environmental justice-oriented organizations to explore barriers and facilitators to green space improvements and mitigation for displacement due to gentrification. This work has the potential to provide guidance to improve cognitive health equity.

项目概要 2020 年，估计有 580 万美国人患有阿尔茨海默病 (AD)，这是导致老年痴呆症的最常见原因 痴呆症，预计到 2050 年这一数字将达到 1380 万。阿尔茨海默病及相关疾病 痴呆症（ADRD）对受影响的个人及其护理人员造成巨大损失，因为这种疾病- 事实证明，修改疗法基本上无效，优先考虑的是寻找预防这种情况的方法 这对于贫困风险更大的美国黑人来说尤其重要。 与非西班牙裔美国白人相比的认知老化，衡量是否为临床痴呆或更低 因为社区设计因素可以在人口水平上进行修改。 通过政策和监管，它们是一个有吸引力的干预领域。 可能与认知功能相关的设计元素，因为接触它可以减轻压力， 改善情绪、促进身体活动并提供社交参与的机会，所有这些都具有 有色人种社区更有可能居住在具有更好的认知健康的社区。 绿地面积低于白人社区，并且过去的歧视性政策导致结构性种族主义 居住隔离，与这种对绿色空间的不公平分配有关。 这些不平等导致了最近历史上增加绿地数量和质量的努力 通过公园改善项目、行道树种植和空地建设弱势社区 虽然这些举措可能旨在打击数十年来根深蒂固的投资减少。 结构性种族主义，相反，它们最终可能会加强种族和/或社会经济地位的隔离 由于中产阶级化，这是资源贫乏社区发展和经历的过程 因此，尚不清楚绿色空间的改善是否有害。 有色人种社区受益，特别是正在经历复兴的社区。 在拟议的工作中，我们将（1）评估绿色变化之间的横截面和纵向关联 (a) 20 年来的空间和认知功能、认知衰退和痴呆 人口和（b）按种族/民族；（2）估计结构性种族主义之间的关联（通过衡量） 历史红线空间模式）和认知功能、认知能力下降和痴呆； 这种关联是由绿色空间暴露介导的；(3) 确定 (a) 绿色空间之间是否存在关联； 空间和认知功能、认知能力下降和痴呆症受到中产阶级化的影响；(b) 中产阶级化与社会压力、心理健康和感知之间的独立心理联系 邻里特征；(4) 与地方环境正义导向的全国网络合作 组织探索绿地改善和减少流离失所的障碍和促进因素 由于中产阶级化，这项工作有可能为改善认知健康公平提供指导。