Social inequalities have been linked to health disparities at the individual and the population levels and are associated with income inequalities, not simply with absolute income. There is clear evidence of a strong association between socioeconomic status (SES), economic development, and cardiovascular disease (CVD), the largest contributor to all-cause mortality in the U.S. The pathways linking these social and economic inequalities to health are not yet well understood. The Social and Physical Environments and Health Disparities Project is a community-based, participatory research partnership of the University of Michigan School of Public Health, community-based organizations, and healthcare institutions in Detroit.
The specific aims of the proposed project are to 1) estimate the relationship between racial and ethnic group status, SES, and mental and physical health in a stratified, multistage probability sample (n = 1000) of an adult population in Detroit, Michigan, and estimate the relationship between racial or ethnic group status, SES, and specific biomarkers for cardiovascular risk factors in a subset of this sample (n = 200); 2) examine the relationships between neighborhood sociodemographic context (e.g., concentrated poverty), selected aspects of the physical environment (exposure to PM 10 and PM 2.5 airborne particulate matter), and selected aspects of the social environment (e.g., acute life events); 3) investigate independent and cumulative effects of exposure to psychosocial stressors on biological risk markers for CVD (e.g., total serum cholesterol and LDL); 4) document the strength of the association between airborne particulate matter and selected proximate risk and protective factors (e.g., elevated plasma homocysteine, F2 isoprostane) for CVD; 5) investigate potential mediating and moderating effects of behavioral and psychosocial responses to stressors (e.g., smoking), and micronutrient intake (e.g., intake of folic acid, B-6, and B-12) on the relationships between selected aspects of the physical and social environments and biological markers for CVD, and self-reported CVD and depression; and 6) create a Community Outreach and Education Program to disseminate and translate knowledge gained from the study to inform new and established intervention and policy efforts in Detroit.
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