Assessing Biological Pathways: Linking Neighborhoods to Cardiovascular Mortality

评估生物途径：将社区与心血管死亡率联系起来

• 批准号: 7789350
• 负责人: Chloe E. Bird
• 金额: $ 24.06万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7789350
• 关键词: Address; Adult; Area; Biological; Biological Markers; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Censuses; Centers for Population Health; Cessation of life; Characteristics; Cholesterol; Conscious; Data; Discipline; Environment; Environmental Risk Factor; Gender; Glycosylated Hemoglobin; Goals; Health; Health Status; Health behavior; Housing; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Light; Link; Literature; Mediating; National Health and Nutrition Examination Survey; Neighborhoods; Outcome; Pathway interactions; Physical environment; Policies; Population Density; Predisposition; Public Health; Public Policy; Reporting; Research; Research Personnel; Risk Factors; Role; Sampling; Seminal; Sex Characteristics; Skin; Socioeconomic Status; Source; Staging; Stress; United States; Waist-Hip Ratio; Woman; Women' s Health; Work; base; cardiovascular disorder risk; cardiovascular risk factor; factor A; follow-up; health disparity; improved; indexing; interest; land use; men; mortality; neighborhood association; population health; public health relevance; social; theories; Address; Adult; Area; Biological; Biological Markers; Biological Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Censuses; Centers for Population Health; Cessation of life; Characteristics; Cholesterol; Conscious; Data; Discipline; Environment; Environmental Risk Factor; Gender; Glycosylated Hemoglobin; Goals; Health; Health Status; Health behavior; Housing; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Light; Link; Literature; Mediating; National Health and Nutrition Examination Survey; Neighborhoods; Outcome; Pathway interactions; Physical environment; Policies; Population Density; Predisposition; Public Health; Public Policy; Reporting; Research; Research Personnel; Risk Factors; Role; Sampling; Seminal; Sex Characteristics; Skin; Socioeconomic Status; Source; Staging; Stress; United States; Waist-Hip Ratio; Woman; Women' s Health; Work; base; cardiovascular disorder risk; cardiovascular risk factor; factor A; follow-up; health disparity; improved; indexing; interest; land use; men; mortality; neighborhood association; population health; public health relevance; social; theories

DESCRIPTION (provided by applicant): A growing number of studies report gender differences in how the neighborhood environment impacts individual health behaviors, health status, and/or mortality. Although research in this domain has made great strides, researchers are still in the early stages of identifying the biological pathways through which neighborhood characteristics actually "get under the skin," and the Institute of Medicine's (IOM) call for gender- based analyses has not been fulfilled. More specifically, research to date has lacked the necessary combination of data on individual-level sociodemographic, health behavior and biological markers, objective neighborhood data, and follow-up data on individual mortality. Also, there is a dearth of work systematically assessing gender differences in the association of neighborhood factors and cardiovascular disease (CVD) mortality in the United States. We propose to address this gap in the literature by assessing biological pathways between key aspects of the residential environment and CVD mortality in a national sample of adults. The specific aims of this proposed research are to: 1. Assess the relationship between selected characteristics of the neighborhood environment (i.e., neighborhood socioeconomic status (NSES), population density, and residential stability) and acquired biological risk factors for CVD and examine whether these relationships differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. 2. Assess the relationship between acquired biological risk factors for CVD and subsequent CVD mortality, and examine whether they differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. 3. Assess the role of acquired biological risk factors for CVD as mediating pathways between the selected characteristics of the neighborhood environment and CVD mortality, and examine how their role may differ by gender, controlling for key individual-level health behavior and sociodemographic characteristics. The proposed project will draw on integrated data from five major sources: (1) Third National Health and Nutrition Examination Survey (NHANES III), (2) the NHANES 1999-2004; (3) United States Census; (4) RAND Center for Population Health and Health Disparities (CPHHD) Data Core; and (5) National Death Index (NDI). Biomarkers are available through the NHANES data, including both traditional and more recently identified predictors of CVD risk and mortality. Taken together, these data provide a unique opportunity to assess key pathways between neighborhood context and men's and women's CVD risk and subsequent mortality. PUBLIC HEALTH RELEVANCE: The proposed research focuses on aspects of the social and physical environment of neighborhoods interventions in the area of building, housing, and land-use policy could address. This work will shed light on how related public policy efforts and public health interventions, particularly in the area of cardiovascular health, could-in the long term-improve health behaviors, cardiovascular risk factors, and survival, as well as reduce health disparities. The proposed gender-based analysis can also help inform efforts to improve population health for both men and women without inadvertently increasing health disparities.

描述（由申请人提供）：越来越多的研究报告了社区环境如何影响个人健康行为，健康状况和/或死亡率的性别差异。尽管该领域的研究取得了长足的进步，但研究人员仍处于识别邻里特征实际“在皮肤下”的生物学途径的早期阶段，而医学研究所（IOM）呼吁进行基于性别的分析。更具体地说，迄今为止的研究缺乏有关个人级别社会人口统计学，健康行为和生物学标记，客观邻里数据以及有关个体死亡率的后续数据的必要数据组合。此外，在美国，有系统地评估社区因素与心血管疾病（CVD）死亡率的性别差异的缺乏。我们建议通过评估居民环境的关键方面与CVD死亡率之间的生物学途径来解决文献中的这一差距。这项拟议研究的具体目的是：1。评估邻里环境的选定特征（即邻里社会经济地位（NSES），人口密度和住宅稳定性）以及获得CVD的生物学风险因素并检查这些关系是否因性别而差异，控制关键的个人水平的个人水平的健康行为和社会化学人类学特征是否有所不同。 2。评估CVD获得的生物学风险因素与随后的CVD死亡率之间的关系，并检查它们是否因性别而差异，控制关键的个人水平健康行为和社会人口统计学特征。 3。评估CVD获得的生物学风险因素的作用，作为邻里环境和CVD死亡率之间的介导途径，并研究其作用可能因性别而差异，从而控制关键的个人级别的健康行为和社会人口统计学特征。拟议的项目将利用来自五个主要来源的综合数据：（1）第三个国家健康和营养检查调查（NHANES III），（2）NHANES 1999-2004； （3）美国人口普查； （4）兰德人口健康与健康差异中心（CPHHD）数据核心； （5）国家死亡指数（NDI）。可以通过NHANES数据获得生物标志物，包括传统和最近确定的CVD风险和死亡率的预测指标。综上所述，这些数据提供了一个独特的机会，可以评估邻里环境与男女CVD风险以及随后的死亡率之间的关键途径。 公共卫生相关性：拟议的研究重点介绍了建筑物，住房和土地使用政策领域中社区干预措施的社会和物理环境的各个方面。这项工作将阐明相关的公共政策努力和公共卫生干预措施，尤其是在心血管健康领域，可能会陷入长期生存的健康行为，心血管危险因素和生存以及减少健康差异。拟议的基于性别的分析还可以帮助为改善男性和女性的人口健康而努力，而不会无意地增加健康差异。