Individuals live within a series of hierarchical environments, and these environments are associated with health and behaviors over and beyond individual level influences such as socioeconomic status or race. In many cases, these macro-level environmental influences that affect health have been measured by investigators by using geographic information systems, in order to contextualize individuals'home and work environments. This growing area of research has lead public health researchers towards environmental level interventions to address cardiovascular health. However, because contextual studies have been primarily cross-sectional, and physical activity is often assessed without evaluating diet and vise-versa, there remain many knowledge gaps regarding the best avenues for interventions. Furthermore, how the direction for interventions may vary by age and other population demographics remain unknown. The purpose of this project is to assess the local food and physical activity environments simultaneously on the health and behaviors of urban Seniors in Brooklyn NY. Because Seniors may be more reliant on a local area for good and services and at higher risk for cardiovascular disease outcomes, our aim is to focus on individuals 65 years or older. We plan to study the intersection between the built environment and Seniors'health and behaviors in order to provide empirical evidence to direct public health interventions. Methods: We will conduct a prospective cohort study of 1,655 Seniors recruited from five areas of Brooklyn who will be seen two years after the baseline visit. The study will consist of environmental assessment of food;physical activity and transportation resources as well interviews with Seniors to gain information about attitudes, perceptions and cultural variation around nutrition, physical activity and health. We will also monitor diet, physical activity and cardiovascular disease risk factors. We will measure the influence of changes and utilization of the food and physical activity environment on individuals'behaviors and health outcomes as well as the contribution of other environmental (physical and social) and individual-level (i.e. income) factors. Conclusions: The study will provide empirical evidence of Seniors'interactions in their built environments and effect on health behaviors and health outcome.
This prospective evaluation of the effect of the built environment on cardiovascular health and health behaviors of Seniors is intended to develop evidence-based knowledge to inform public health interventions. This proposal aims to evaluate the relationships between individuals, physical and social environments and dietary/physical activity decisions and behaviors that effect cardiovascular disease risk.
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