Ethnic minorities tend to face more stressors than the majority population and to have excess risk of many health problems. These disparities are strikingly evident for Puerto Ricans living on the mainland, especially for older Puerto Ricans who face psychosocial stressors related to drastically changed social and physical environments. The limited research on Puerto Ricans has provided evidence of much poorer physical health and greater disability', including cardiovascular risk, compared to other Hispanic groups. The effects of psychosocial factors on heart health risk are not well understood for older Puerto Ricans, as research has primarily focused on other Latinos and has been mainly cross-sectional. Theoretically, it is important to understand the mechanisms of mediating factors and the longitudinal causal pathways through which psychosocial factors influence cardiovascular risk. It is therefore critical to identify and explore the interactions between personal, social and environmental factors which contribute to cardiovascular risk for Puerto Ricans. The longterm goal of this work is to contribute to understanding psychological, social and environmental contexts of cardiovascular risk of older Puerto Ricans. The objective of this proposal is to examine in our study population how stressors, personal resources, social networks, and perceptions and characteristics ofthe built environment relate to cardiovascular risk indicators over time. We approach the analysis of these factors using a multi-level approach and drawing on the large scale cohort longitudinal data set with 1350 participants and three points in time.
The aims ofthe projects are 1) to assess associations between depressive symptomatology, psychosocial stress and CVD risk over a period of 5 years;2) to assess the characteristics of social networks and their effects on cardiovascular risk, and 3) to assess the characteristics ofthe local environment and its impact on heart health and cardiovascular risk. This project is innovative in its integration of analj/sis at the individual, social and environmental levels which should yield a richer data set and a more thorough analysis. The work vrill contribute significantiy to gaining a fuller view ofthe context of psychosocial stress and how it influences the cardiovascular health of older Puerto Ricans. We add an interdisciplinaty social science perspective to grounding and contextualizing findings from our proposed work but also those ofthe other projects in this program. Results will allow the development of more effective strategies and programs to reduce health disparities in this high risk population.

Public Health Relevance

This project will contribute significantly to gaining a holistic view ofthe built environinent, social networks, personal resources and how they influence cardiovascular risk and health disparities for adult Puerto Ricans. Results will allow the development of more effective strategies and programs to reduce cardiovascular health disparities in this high risk population. From such an analysis, conclusions can also be useful for other highrisk populations.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Specialized Center (P50)
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Special Emphasis Panel (ZCA1-SRLB-3)
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University of Massachusetts Lowell
United States
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