There has been much recent interest in how features of residential environments (the built environment as well as social features of neighborhoods) affect the prevalence and development of cardiovascular disease and its risk factors, including obesity, diabetes, and hypertension. Identifying modifiable features of neighborhoods that contribute to cardiovascular risk would have important implications for the development of interventions and strategies to prevent cardiovascular disease and reduce social inequalities and race/ethnic differences in cardiovascular risk. Although randomized trials and/or evaluation of quasi experiments or natural experiments will ultimately be needed to determine the effectiveness of specific neighborhood-level interventions, rigorous observational work is still needed to determine what the most promising areas for intervention may be. However, very few observational studies have the type of detailed neighborhood and individual- level data necessary for this work. This competing renewal proposal builds on prior work conducted under R01 HL071759. As part of the prior funding cycle we created a unique and rich dataset with a multiplicity of rigorous objective and survey-based measures of residential environments linked to the Multi-Ethnic Study of Atherosclerosis (MESA), a state-of-the art, longitudinal, population-based, multi-site and multi-ethnic epidemiologic study of cardiovascular disease. In this renewal we propose to enhance and update the neighborhood-level environmental measures to allow for methodologically rigorous longitudinal analyses that build on key findings of cross-sectional analyses conducted as part of the prior cycle.
The Specific Aims of the project are: (1) To examine associations of specific neighborhood characteristics (including measures of access to healthy foods, walkability and urban design, access to recreational resources, and neighborhood stressors) with changes in diet, physical activity, and body weight over time;(2) To examine associations of neighborhood characteristics with incident diabetes and hypertension as well as with changes over time in continuous measures of insulin resistance and blood pressure (3) To examine associations of neighborhood characteristics with incident fatal and non fatal cardiovascular events;and (4)To investigate the contribution of neighborhood environments to race/ethnic and socioeconomic differences in longitudinal changes in risk factors and incident disease. In addition, the creation and maintenance of a rich data set on environmental features for MESA participants over time will generate a unique resource to be used in gene-environment interaction studies as MESA genotyping proceeds.

Public Health Relevance

If features of neighborhoods are shown to be important in the development of cardiovascular disease and its risk factors, strategies to prevent cardiovascular disease may need to focus on environments as well as individuals. Identifying the specific neighborhood features that are most important is key to the development and future testing of these interventions.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Cardiovascular and Sleep Epidemiology (CASE)
Program Officer
Reis, Jared P
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Michigan Ann Arbor
Public Health & Prev Medicine
Schools of Public Health
Ann Arbor
United States
Zip Code
Kershaw, Kiarri N; Osypuk, Theresa L; Do, D Phuong et al. (2015) Neighborhood-level racial/ethnic residential segregation and incident cardiovascular disease: the multi-ethnic study of atherosclerosis. Circulation 131:141-8
Hirsch, Jana A; Diez Roux, Ana V; Moore, Kari A et al. (2014) Change in walking and body mass index following residential relocation: the multi-ethnic study of atherosclerosis. Am J Public Health 104:e49-56
Remigio-Baker, Rosemay A; Diez Roux, Ana V; Szklo, Moyses et al. (2014) Physical environment may modify the association between depressive symptoms and change in waist circumference: the multi-ethnic study of atherosclerosis. Psychosomatics 55:144-54
Ranchod, Yamini K; Diez Roux, Ana V; Evenson, Kelly R et al. (2014) Longitudinal associations between neighborhood recreational facilities and change in recreational physical activity in the multi-ethnic study of atherosclerosis, 2000-2007. Am J Epidemiol 179:335-43
Zahuranec, Darin B; Lisabeth, Lynda D; Sánchez, Brisa N et al. (2014) Intracerebral hemorrhage mortality is not changing despite declining incidence. Neurology 82:2180-6
Unger, Erin; Diez-Roux, Ana V; Lloyd-Jones, Donald M et al. (2014) Association of neighborhood characteristics with cardiovascular health in the multi-ethnic study of atherosclerosis. Circ Cardiovasc Qual Outcomes 7:524-31
Hirsch, Jana A; Moore, Kari A; Clarke, Philippa J et al. (2014) Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis. Am J Epidemiol 180:799-809
Needham, Belinda L; Carroll, Judith E; Diez Roux, Ana V et al. (2014) Neighborhood characteristics and leukocyte telomere length: the Multi-Ethnic Study of Atherosclerosis. Health Place 28:167-72
Yang, Yong; Diez-Roux, Ana; Evenson, Kelly R et al. (2014) Examining the impact of the walking school bus with an agent-based model. Am J Public Health 104:1196-203
Hirsch, Jana A; Moore, Kari A; Barrientos-Gutierrez, Tonatiuh et al. (2014) Built environment change and change in BMI and waist circumference: Multi-ethnic Study of Atherosclerosis. Obesity (Silver Spring) 22:2450-7

Showing the most recent 10 out of 54 publications