My goal for the K01 award is to establish myself as an independent cardiovascular researcher with expertise in spatial statistics and disease mapping methods and an integral member of multidisciplinary research teams devoted to addressing cardiovascular disparities. Attaining these objectives will require focused didactic training and research guidance. Training The proposed career development and training plan consists of four distinct components: (1) career guidance and mentoring in methodological development and collaborative cardiovascular research through on-site and off-site mentoring by cardiovascular and social epidemiologists as well as spatial statisticians and GIS specialists; (2) structured coursework designed at establishing a basic foundation in cardiovascular and social epidemiology and advanced training in spatial methods in collaboration with geographic information systems; (3) leading innovative research utilizing the gained training; and (4) contributing in the exchange of ideas in statistics and epidemiology through conference and workshop attendance. These proposed training activities will allow me to become well grounded in cardiovascular epidemiology and cardiovascular disease disparities. These activities will also focus on deepening my understanding of CVD, enabling me to reasonably assess the spatial heterogeneity in its associated risk factors within and between blacks and whites. Research The proposed work will explore the extent to which environmental factors and cardiovascular health (CVH) vary over space at a small-area local scale and at a regional scale with a focus on spatial variation in CVH among blacks and whites and spatial variation in black-white disparities in CVH. By combining a novel health indicator, the CVH index, with novel spatial methods, this proposed work will better characterize the geographic heterogeneity in CVH for blacks and whites and for black-white disparities. Our novel statistical methods will be applied to two very rich and unique cohorts, the Multi-Ethnic Study of Atherosclerosis (MESA) cohort and the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The larger goal of this work is to define these differences in a way that provides evidence for targeted interventions to improve the built environment. Additionally, our findings will help support informed health policies to improve the cardiovascular health of both blacks and whites.
Cardiovascular disease (CVD) is a significant public health problem. Finding ways to impact CVD is essential to better public health and to inform policy makers regarding the effect of various policies on cardiovascular risk. Our proposed methods will explore the impact of both individual and environmental risk factors for CVD, across two geographically, diverse NIH funded cohorts. The knowledge to be gained will focus on assessing the spatial heterogeneity of CVD risk factors within and between blacks and whites, and will inform the future development and implementation of policies.