There has been much recent interest in how features of residential environments (the built environment as well as social features of neighborhoods) affect the prevalence and development of cardiovascular disease and its risk factors, including obesity, diabetes, and hypertension. Identifying modifiable features of neighborhoods that contribute to cardiovascular risk would have important implications for the development of interventions and strategies to prevent cardiovascular disease and reduce social inequalities and race/ethnic differences in cardiovascular risk. Although randomized trials and/or evaluation of quasi experiments or natural experiments will ultimately be needed to determine the effectiveness of specific neighborhood-level interventions, rigorous observational work is still needed to determine what the most promising areas for intervention may be. However, very few observational studies have the type of detailed neighborhood and individual- level data necessary for this work. This competing renewal proposal builds on prior work conducted under R01 HL071759. As part of the prior funding cycle we created a unique and rich dataset with a multiplicity of rigorous objective and survey-based measures of residential environments linked to the Multi-Ethnic Study of Atherosclerosis (MESA), a state-of-the art, longitudinal, population-based, multi-site and multi-ethnic epidemiologic study of cardiovascular disease. In this renewal we propose to enhance and update the neighborhood-level environmental measures to allow for methodologically rigorous longitudinal analyses that build on key findings of cross-sectional analyses conducted as part of the prior cycle.
The Specific Aims of the project are: (1) To examine associations of specific neighborhood characteristics (including measures of access to healthy foods, walkability and urban design, access to recreational resources, and neighborhood stressors) with changes in diet, physical activity, and body weight over time;(2) To examine associations of neighborhood characteristics with incident diabetes and hypertension as well as with changes over time in continuous measures of insulin resistance and blood pressure (3) To examine associations of neighborhood characteristics with incident fatal and non fatal cardiovascular events;and (4)To investigate the contribution of neighborhood environments to race/ethnic and socioeconomic differences in longitudinal changes in risk factors and incident disease. In addition, the creation and maintenance of a rich data set on environmental features for MESA participants over time will generate a unique resource to be used in gene-environment interaction studies as MESA genotyping proceeds.

Public Health Relevance

If features of neighborhoods are shown to be important in the development of cardiovascular disease and its risk factors, strategies to prevent cardiovascular disease may need to focus on environments as well as individuals. Identifying the specific neighborhood features that are most important is key to the development and future testing of these interventions.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL071759-09
Application #
8471156
Study Section
Cardiovascular and Sleep Epidemiology (CASE)
Program Officer
Reis, Jared P
Project Start
2003-06-02
Project End
2014-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
9
Fiscal Year
2013
Total Cost
$592,445
Indirect Cost
$160,286
Name
University of Michigan Ann Arbor
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Hussein, Mustafa; Diez Roux, Ana V; Mujahid, Mahasin S et al. (2018) Unequal Exposure or Unequal Vulnerability? Contributions of Neighborhood Conditions and Cardiovascular Risk Factors to Socioeconomic Inequality in Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 187:1424-1437
Kern, David M; Auchincloss, Amy H; Stehr, Mark F et al. (2018) Neighborhood price of healthier food relative to unhealthy food and its association with type 2 diabetes and insulin resistance: The multi-ethnic study of atherosclerosis. Prev Med 106:122-129
Crawford, Natalie D; Moore, Kari; Christine, Paul J et al. (2018) Examining the Role of Neighborhood-Level Foreclosure in Smoking and Alcohol Use Among Older Adults in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 187:1863-1870
Johnson, Dayna A; Hirsch, Jana A; Moore, Kari A et al. (2018) Associations Between the Built Environment and Objective Measures of Sleep: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 187:941-950
Mayne, Stephanie L; Moore, Kari A; Powell-Wiley, Tiffany M et al. (2018) Longitudinal Associations of Neighborhood Crime and Perceived Safety With Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 31:1024-1032
Jones, Sydney A; Li, Quefeng; Aiello, Allison E et al. (2018) Physical Activity, Sedentary Behavior, and Retirement: The Multi-Ethnic Study of Atherosclerosis. Am J Prev Med 54:786-794
Christine, Paul J; Moore, Kari; Crawford, Natalie D et al. (2017) Exposure to Neighborhood Foreclosures and Changes in Cardiometabolic Health: Results From MESA. Am J Epidemiol 185:106-114
Kern, David M; Auchincloss, Amy H; Stehr, Mark F et al. (2017) Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis. Int J Environ Res Public Health 14:
Barrientos-Gutierrez, Tonatiuh; Moore, Kari A B; Auchincloss, Amy H et al. (2017) Neighborhood Physical Environment and Changes in Body Mass Index: Results From the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 186:1237-1245
Gebreab, Samson Y; Hickson, DeMarc A; Sims, Mario et al. (2017) Neighborhood social and physical environments and type 2 diabetes mellitus in African Americans: The Jackson Heart Study. Health Place 43:128-137

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