The HANDLS study is a prospective, epidemiologic, longitudinal study of a baseline representative sample of African Americans and whites between 30-64 years old recruited as a fixed cohort of participants by household screenings from an area probability sample of twelve census segments in Baltimore City. The HANDLS design is an area probability sample of Baltimore based on the 2000 Census. Using this methodology, working with survey statisticians we chose 12 neighborhoods to meet race by SES by age distribution because they were likely to yield representative distributions of Baltimore City with sufficient individuals to fill the sampling design based. Within the 12 neighborhoods, housing units are selected with a known non-zero chance of selection. The addresses are screened for individuals who meet the age-gender-race-poverty sample size, and those were chosen to be included in the sample using a probability sampling method. From these probabilities we can compute weights to adjust for unequal probabilities of selection. These weights will be needed to compute estimates that combine subjects across any of the age-gender-race-poverty group. The poverty status delimiter is 125% poverty based on 125% of the 2004 Health and Human Services Poverty Guidelines. ? The initial examination and recruitment phase will take approximately 4 years to complete. The study data is being collected in two parts. The first part consists of an in-home interview that includes questionnaires about the participants health status, health service utilization, psychosocial factors, nutrition, neighborhood characteristics, and demographics. The second part is collected on the medical research vehicles and includes medical history and physical examination, dietary recall, cognitive evaluation, psychophysiology assessments including heart rate variability, arterial thickness, carotid ultrasonography, assessments of muscle strength and bone density, and laboratory measurements (blood chemistries, hematology, biomarkers of oxidative stress and biomaterials for genetic studies). Ultimately, the baseline HANDLS sample will consist of approximately 4,000 community-dwelling African American and white adults aged 30-64. Using our mobile medical research vehicles, we visit each census tract for 4 months and we will re-visit every census tract in a 3.5-year cycle. ? ? Thus far HANDLS has recruited 3182 participants in the South Baltimore, Reservoir Hill, Cherry Hill, Govans, Forest Park, Highlandtown, Morrell Park, Curtis Bay, Park Heights, Frankford, South Hilton and Penrose neighborhoods of Baltimore. This is approximately 80% of the planned total cohort, specifically 3,182 participants: 1,977 African Americans (62%) and 1,205 whites (38%).Approximately 45% of the cohort reported a household income below the 125% poverty status delimiter. Of those below the 125% poverty delimiter, 31% were white and 69% African American. Of those above the 125% poverty delimiter, 44% were white and 56% African American. The mean age of the sample was 47.9 years. There were no significant age differences associated with sex or race. Participants below the 125% poverty delimiter were slightly younger than those above the delimiter.? ? Covariates: Other variables include nutrition, environment and neighborhood effects, genetic make-up, family history, activity level, access to health care, and prevalent medical, dental, psychiatric conditions, oxidative stress, and DNA repair capacity which may modulate the effects of SES and race on cardiovascular, musculoskeletal, cognitive, and autonomic functioning.
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