Cardiovascular disease is the leading cause of death in the US, and a significant source of racial and socioeconomic disparities in morbidity among aging populations. Chronic inflammation is thought to underlie the pathogenesis of atherosclerosis and the development of cardiovascular disease. There are racial and socioeconomic disparities in biomarkers of cardiovascular inflammation that increase across middle and older age, particularly among women. These disparities are not completely explained by traditional risk factors at the individual level, including behavioral risk factors. Area-level socioeconomic status may influence the incidence of cardiovascular disease by promoting inflammation. The candidate seeks training to investigate the role of metropolitan area and neighborhood level social factors in the pathogenesis of cardiovascular inflammation among aging populations. The proposed research has a novel focus on geographic social determinants of pre-disease risk markers of inflammation. The candidate is trained in Internal Medicine (MD) and Social Epidemiology (SD). The candidate brings experience evaluating social exposures at the individual level among middle-aged and elder adults. Over five years, the candidate will acquire training in (1) physiology and regulation of cardiovascular inflammatory pathways, (2) analytic techniques to integrate geographic data on social factors with biologic data in epidemiologic research, and (3) leadership in interdisciplinary research in diverse and aging populations. This training provides preparation for the candidate's long-term career goal to investigate area-level socioeconomic factors that contribute to pre-disease cardiovascular risk factors in diverse and aging populations. The proposed training program will be mentored by Dr. Lisa Berkman (primary mentor. Social Epidemiologist, social influences on aging, interdisciplinary epidemiology research) and Dr. Paul Ridker (Cardiologist, cardiovascular inflammation in atherosclerosis, cardiac event risk prediction among women). A team of advisors will (1) provide training in geographic analysis, and (2) support working with the two study populations. The proposed research will be conducted in the (1) Women's Health Study (WHS) and the (2) Jackson Heart Study (JHS). Publications stemming from these investigations will enhance scientific understandings of geographic variation in cardiovascular disease risks among middle-aged and elder populations.

Public Health Relevance

Investigators who are trained to investigate connections between social factors and biomarkers of disease risk are needed to guide social and behavioral interventions to reduce the incidence and severity of cardiovascular disease in diverse and aging populations. Connecting geographic level socioeconomic status to biomarkers of inflammation is a new contribution to population-based prevention approaches to CVD risk reduction among elders.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Clinical Investigator Award (CIA) (K08)
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National Institute on Aging Initial Review Group (NIA)
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Nielsen, Lisbeth
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Brigham and Women's Hospital
United States
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Ommerborn, Mark J; Blackshear, Chad T; Hickson, DeMarc A et al. (2016) Ideal Cardiovascular Health and Incident Cardiovascular Events: The Jackson Heart Study. Am J Prev Med 51:502-6
Clark, Cheryl R; Ommerborn, Mark J; A Coull, Brent et al. (2016) Income Inequities and Medicaid Expansion are Related to Racial and Ethnic Disparities in Delayed or Forgone Care Due to Cost. Med Care 54:555-61
Djoussé, Luc; Petrone, Andrew B; Blackshear, Chad et al. (2015) Prevalence and changes over time of ideal cardiovascular health metrics among African-Americans: the Jackson Heart Study. Prev Med 74:111-6
Clark, Cheryl R; Soukup, Jane; Riden, Heather et al. (2014) Preventive care for low-income women in massachusetts post-health reform. J Womens Health (Larchmt) 23:493-8
Pham, Do Quyen; Ommerborn, Mark J; Hickson, DeMarc A et al. (2014) Neighborhood safety and adipose tissue distribution in African Americans: the Jackson Heart Study. PLoS One 9:e105251
Clark, Cheryl R; Ommerborn, Mark J; Coull, Brent A et al. (2013) State Medicaid eligibility and care delayed because of cost. N Engl J Med 368:1263-5
Clark, Cheryl R; Ommerborn, Mark J; Hickson, DeMarc A et al. (2013) Neighborhood disadvantage, neighborhood safety and cardiometabolic risk factors in African Americans: biosocial associations in the Jackson Heart study. PLoS One 8:e63254
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Clark, Cheryl R; Ridker, Paul M; Ommerborn, Mark J et al. (2012) Cardiovascular inflammation in healthy women: multilevel associations with state-level prosperity, productivity and income inequality. BMC Public Health 12:211
Clark, Cheryl R; Coull, Brent; Berkman, Lisa F et al. (2011) Geographic variation in cardiovascular inflammation among healthy women in the Women's Health Study. PLoS One 6:e27468