This project will capitalize on, extend, and enhance the Chicago Community Adult Health Study (CCAHS), (P50 HD 38986) which is designed to become a major prospective multi-level study of the impact of individual and social environmental factors on health, their role in understanding socioeconomic and racial- ethnic disparities in health, and the biological and behavioral pathways that are involved. This project has completed a major survey of a probability sample of 3105 adults age 18+ in the city of Chicago, with a response rate of 72 percent and including physical measurements of height, weight, waist, hip length, and blood pressure. In addition, saliva and/or a blood sample have been collected for 661 people (60 percent of respondents in a subsample of 80 of the 343 neighborhood clusters (NCs) covering the entire city of Chicago, developed and characterized by the Project on Human Development in Chicago Neighborhoods (PHDCN) (http://phdcn.harvard.edu/), from which the CCAHS sample is drawn. In addition to utilizing existing and collecting new archival data on these areas, the CCAHS carried out Systematic Social Observations of 1664 blocks containing sampled households for the study. Thus, the current application seeks to utilize all these data to extend and enhance the CCAHS as follows: 1) to estimate via state of the art multi-level analysis the role in health and health disparities of the immediate social contexts or """"""""neighborhoods"""""""" in which people live; 2) to estimate how a wide range of aspects of immediate residential contexts and broader social contexts (assessed by multiple methods and measures and considered both singly and in interaction with each other and individual and household factors) affect health and health disparities and help to understand or flesh out the role of social context in health; 3) to estimate via innovative new methods the role in health and health disparities of the broader social contexts which surround more immediate residential contexts; and 4) to begin to convert the existing cross-sectional study into a longitudinal and prospective study via respondent tracking and mortality follow-up, which will allow initial prospective analyses of the predictive association with mortality of individual, household, and contextual psychosocial risk factors for health assessed in the CCAHS, as well as laying the foundation for a second wave of data collection in 2008-9, which will be funded by a subsequent competing renewal application, and allow for prospective analyses with respect to the full range of health outcomes in CCAHS. This study will importantly advance the understanding of socioeconomic and racial/ethnic disparities in health - a major priority of the Public Health Service and National Institutes of Health for the new millennium. ? ? ? ?
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