Socio-Spatial Determinants of Health (SSDH)

National Institute On Minority Health And Health Disparities

Investigators

Linked publications, trials & patents

Abstract

In FY23, we set up the Socio-Spatial Determinants of Health (SSDH) laboratory focusing on neighborhood social environment and cardiovascular disease (CVD) risk factors and outcomes from a geospatial perspective. Two postdoctoral fellows and one postbac fellow joined the SSDH lab. We continued to collaborate with intramural and extramural researchers to publish manuscripts on geospatial determinants of health disparities in minority populations. These efforts and accomplishments are described in detail below. Objective 1. In FY23, after setting up a new laboratory ready to perform high-quality research, it is important to seek and hire postdoctoral (postdoc) and postbaccalaureate (postbac) fellows who conduct neighborhood research with a special emphasis on CVD risk factors and outcomes. During fall 2022 and spring 2023, we hired two postdoc fellows and one postbac fellow. Research interests of these postdoc fellows include physical activity, mental health, and neighborhood contexts from a life-course perspective. Postbac fellows research interests include neighborhoods and mental health and personality among understudied populations, such as US older adults. Objective 2. The goal of Objective 2 is to better elucidate the mechanisms by which adverse neighborhood social environmental factors, as measured by using geospatial technologies, impact biomarkers of stressors. Pursuant to this goal in collaboration with the Social Determinants of Obesity and Cardiovascular Health Laboratory, the main aim of this study is to test the hypothesis that women residing with exposure to adverse residential neighborhood contexts are associated with higher stress biomarkers (amygdala activity, vascular function, immune system activation), and to test the hypothesis that the association is moderated by objectively measured PA using an accelerometer. This study has started recruiting healthy women living in low (n=30) and high (n=30) socio-economic status areas in Washington, D.C. among a total of 60 Black and White adult women. In collaboration with the Social Determinants of Obesity and Cardiovascular Health Lab, we further plan to address the current limitations in neighborhood research. Neighborhood social contexts and their links to CVD risk factors are expected to be interconnected and part of a multifaceted system. However, traditional statistical techniques do not incorporate feedback loops into the linkages among biomarkers, individuals, and the environment. In addition, such methods have rarely provided new insights into the effectiveness of environmental intervention in a community before allocating scarce resources. To address these shortcomings, building upon established collaborations, we are developing a protocol that performs a detailed match to compare immune cell biomarkers among individuals residing in different socioeconomic status neighborhoods in Washington DC. Second, we are developing an agent-based model (ABM) to determine the dynamic linkages between neighborhood crime, perceived safety, immune system activation, and CVD risk. Third, we will use the ABM to assess the cost-effectiveness of potential multifaceted environmental interventions targeting crime or safety as environmental barriers to behavior change. Combining temporally dense, complex "big data" in a systems model could accelerate the development and implementation of multilevel interventions to manage crime and perceived safety as stressors, increase physical activity, reduce obesity, and subsequently, reduce CVD risk. Objective 3. The goal of Objective 3 is to investigate how neighborhood physical and social environments are associated with CVD risk factors and outcomes. To achieve this goal, we sought potential collaborative research projects with intramural and extramural researchers who utilize large cohort studies, such as the Jackson Heart Study (JHS), Multi-Ethnic Study of Atherosclerosis (MESA), and UK Biobank. First, we investigated the mediating role of physical activity on the associations between neighborhood social environments and the severity of metabolic syndromes stratified by gender. We found women perceiving greater neighborhood violence and problems had a higher severity of the metabolic syndrome, mediated by low levels of physical activity. Similarly, men perceiving greater neighborhood violence and problems had a higher severity of the metabolic syndrome, mediated by low levels of physical activity. Second, we investigated to examine longitudinal associations between perceived neighborhood characteristics and type 2 diabetes (T2D) among MESA participants. We found that those perceiving medium-to-low favorable neighborhoods compared to highly favorable neighborhoods had a greater risk of developing T2D. Third, we tested the role of the neighborhood deprivation index on CVD outcomes in the UK Biobank cohort. We demonstrated that those residing in the most deprived neighborhoods (compared to the least deprived neighborhoods) had a greater risk of CVD incidence and mortality. These studies highlighted the importance of interventions to promote better neighborhoods (i.e., lower deprivation) and increase physical activity in conjunction with community efforts to reduce neighborhood issues. Objective 4. The goal of Objective 4 is to understand how COVID-19-related outcomes (vaccine rates and therapeutics) are geographically clustered and how these clusters vary based on sociodemographic and societal factors, such as the social vulnerability index across U.S. counties. We found that some significant socio-demographic characteristics such as neighborhood-level racial composition, poverty level, etc. are less likely to be fully vaccinated. The results might be beneficial for public health practitioners and policymakers in reducing disparities in vaccine rates by racial and economic barriers across the U.S. As a next step, we plan to perform additional analyses to address geographic disparities in COVID-19 therapeutics, which could inform allocating limited resources effectively across the U.S. Objective 5. The goal of Objective 5 is to investigate how adverse neighborhood characteristics are temporally and geospatially associated with mental health and substance use disorder treatment facilities and address disparities in access to those care. As a next step, we plan to link the US county-level neighborhood physical and social environment measures to those facilities and examine the impact of neighborhood measures on access to the facilities across US counties.