Public housing was developed to provide stable housing for low-income families. It has since become synonymous with concentrated poverty. Programs to reduce poverty have focused on dismantling public housing to be replaced, if at all, by mixed income design alternatives. Studies have shown that low-income residents living in public housing have deleterious health outcomes. It is not clear, however, how public housing residents fare on a number of cardiovascular health indicators compared to those with an alternate low-income housing arrangement. Mechanistic models that incorporate housing with neighborhood access to resources and individual behaviors are poorly defined and understood. However, examining individual- and neighborhood- level data in synergistic ways can provide an important contribution to existing health campaigns to address cardiovascular disease in low-income populations. The current proposal uses a novel geocoding approach to analyze primary care electronic clinical record data in relation to housing and neighborhood level data from various sources in order to track health outcomes. This analysis approach focuses on individual level data within the context of the patient's housing and neighborhood environment. This K 01 award is designed to provide the foundation both conceptual and technical for Dr. Chambers to develop a career trajectory that combines prior experience in social and built environmental determinants of health with new knowledge in socio-ecologic models, graphical science, multi-level statistical modeling, and research informatics. The long-term goal is to develop clinical and public health partnerships that will use multi- source data, including housing and neighborhood environment, to the develop interventions that target vulnerable patient populations.

Public Health Relevance

Among urban, low-income patients, it is not clear how public housing residents fare on a number of cardiovascular health indicators compared to those with an alternate low-income housing arrangement. The current proposal will provide the socio-ecologic, content, and analytic training to develop and test theoretic models. These models will integrate multi-source data to evaluate how blood pressure, BMI, and lifestyle behaviors are influenced by access to material (i.e. supermarkets, parks) and social (i.e. safety, deprivation) resources in the neighborhoods where patients live.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZHL1)
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Nelson, Cheryl R
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Albert Einstein College of Medicine, Inc
United States
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Chambers, Earle C; Bafna, Sonit; Machry, Herminia (2018) The Association Between Apartment Layout and Depressive Symptomology among Hispanic/Latino Residents in Low-Income Housing: the AHOME Study. J Urban Health 95:51-60
Camacho-Rivera, Marlene; Rosenbaum, Emily; Yama, Cecile et al. (2017) Low-Income Housing Rental Assistance, Perceptions of Neighborhood Food Environment, and Dietary Patterns among Latino Adults: the AHOME Study. J Racial Ethn Health Disparities 4:346-353
Chambers, Earle C; Rehm, Colin D; Correra, Jordan et al. (2017) Factors in Placement and Enrollment of Primary Care Patients in YMCA's Diabetes Prevention Program, Bronx, New York, 2010-2015. Prev Chronic Dis 14:E28
Heo, Moonseong; Meissner, Paul; Litwin, Alain H et al. (2017) Preference option randomized design (PORD) for comparative effectiveness research: Statistical power for testing comparative effect, preference effect, selection effect, intent-to-treat effect, and overall effect. Stat Methods Med Res :962280217734584
Chambers, Earle C; Pichardo, Margaret S; Rosenbaum, Emily (2016) Sleep and the Housing and Neighborhood Environment of Urban Latino Adults Living in Low-Income Housing: The AHOME Study. Behav Sleep Med 14:169-84
Chambers, Earle C; Fuster, Damaris; Suglia, Shakira F et al. (2015) Depressive Symptomology and Hostile Affect among Latinos Using Housing Rental Assistance: the AHOME Study. J Urban Health 92:611-21
Merchant, Gina; Buelna, Christina; CastaƱeda, Sheila F et al. (2015) Accelerometer-measured sedentary time among Hispanic adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med Rep 2:845-53
Chambers, Earle C; Wong, Barbara C; Riley, Rachael W et al. (2015) Combining clinical and population-level data to understand the health of neighborhoods. Am J Public Health 105:510-2
Chambers, Earle C; Wylie-Rosett, Judith; Blank, Arthur E et al. (2015) Increasing Referrals to a YMCA-Based Diabetes Prevention Program: Effects of Electronic Referral System Modification and Provider Education in Federally Qualified Health Centers. Prev Chronic Dis 12:E189
Llabre, Maria M; Arguelles, William; Schneiderman, Neil et al. (2015) Do all components of the metabolic syndrome cluster together in U.S. Hispanics/Latinos? Results from the Hispanic Community Health study/Study of Latinos. Ann Epidemiol 25:480-5