AWARDS | Innovation Grant
Land-Use, Walkability, the Food Environment in Baltimore City and the Association with Modifiable Risk Factors for Cardiovascular Disease (2007)
Sarah Stark Casagrande, MHS Student, Department of Epidemiology, JHSPH
Over the past several decades, the prevalence of obesity among adults in the U.S. has risen dramatically from roughly 15% in 1978 to 33% in 2004. Additionally, more than half of U.S. adults do not meet physical activity recommendations. To combat physical inactivity and the high prevalence of obesity in the U.S., researchers have previously focused on individual-level factors to influence behavior. With the recognition that intensive individual-level approaches are generally poor for sustained behavior change, it is necessary to understand and identify modifiable environmental factors that impact behavioral risk factors and physical conditions that increase cardiovascular disease risk. In this study, we propose to (1) characterize land-use, walkability, and the food environment in Baltimore City neighborhoods, (2) independently evaluate neighborhood land-use and walkability and the association with (a) physical activity, (b) obesity, and (c) diabetes, and (3) evaluate the food environment and the association with (a) dietary intake, (b) obesity, and (c) diabetes. We plan to use participant and objective neighborhood data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study, which boasts a powerful study design, to achieve our research aims. First, the HANDLS study consists of African American and white adults of low and high socioeconomic status living in designated Baltimore City neighborhoods. Thus, the design of the study will enable us to investigate differences in cardiovascular risk factors between African American and white adults living in the same city but in neighborhoods of varying socioeconomic status. Second, the comprehensive study measures are implemented in three stages: an in-home interview, a physical examination conducted in mobile research vehicles, and a comprehensive neighborhood assessment. To build on neighborhood data collected in the parent study, the Pedestrian Environmental Data Scan will be implemented to evaluate walking for transportation and physical activity. Multi-level regression models, adjusted for individual-level variables, will be used to determine associations between environmental factors and health outcomes; all analyses will be stratified by race and socioeconomic status. Results from this study will inform policy-makers and promote urban development for healthy, sustainable living. 
Results Research in progress
See Other Related Projects Food Quality Positive Deviants among low income urban African Americans: Identification and evaluation of their role in dietary knowledge diffusion (2007)
Mohan Kumar, Ph.D., MPH student, Department of International Health, JHSPH Type and Cost of Foods Sold in Baltimore Neighborhoods: Impact on Dietary Intake and Cardiovascular Risk (2005)
Manuel Franco, MD, Doctoral candidate, Department of Epidemiology, JHSPH Development, Implementation and Evaluation of an Intervention for Korean Food Stores in Baltimore City to Improve Availability of Healthy Foods for Lower-Income African Americans (2005)
Hee-Jung Song, MS, Doctoral candidate, Department of International Health, JHSPH Increasing Food Security for the Inner-City Population in Baltimore: Formative Research for Food Store-Based Environmental Interventions (2002)
Joel Gittelsohn, PhD, Associate Professor, Division of Human Nutrition, Department of International Health
|
