The Effects of Structural Racism on Present-Day Disparities in Environmental and Social Burdens and Cardiovascular Health.

College Of Environmental Sci & Forestry, Syracuse NY

Investigators

Abstract

Prior research indicates that non-Hispanic Black, Hispanic, South Asian, and low-income populations in resource-limited neighborhoods face increased cardiovascular disease (CVD) risk, exacerbated by exposure to industrial air pollution and heat. While community-level social deprivation and environmental exposures often co-occur, these factors have not yet been studied together in the context of redlining. This K01 application seeks to leverage New York State's (NYS) all-payer data—a comprehensive statewide hospital database—to disentangle the effects of combined environmental and social burdens on CVDs associated with neighborhood redlining. The project will integrate a statewide hospital-based electronic health record (EHR) system with neighborhood-level public data and primary data from questionnaires, air samplers, blood pressure measurements, and geographic information systems (GIS). EHR data offers cost-effective access to longitudinal health information on different populations, ideal for studying varying environmental exposures. The project requires significant expertise to optimize EHR data, supplement it with primary data, perform air dispersion modeling, analyze land surface temperatures, and conduct comprehensive causal analyses. The K01 is designed to enhance the candidate's research experience through coursework, observerships, and training in (1) advanced statistical methods, (2) real-time primary data collection, (3) co-exposure analysis, and (4) implementation science. These skills are essential for studying CVDs over time, implementing interventions, and informing policy. Aim 1 links neighborhood-level social and environmental data with diagnosis codes to extract CVD outcomes from EHR data, applying machine learning to identify potential risk and susceptibility indicators. Aim 2 evaluates the independent and combined effects of industrial air emissions and heat islands on CVDs, using high-resolution data and causal inference to assess subgroup variations. Aim 3 pilots the collection of primary data on social stressors, behavioral factors, and risks while evaluating home-based interventions—such as air filters and self-monitoring of blood pressure—to improve air quality, temperature, and hypertension among adults in Syracuse, NY. Dr. Lee aims to become an independent investigator, focusing on identifying potential moderators and mediators of cumulative environmental and social exposures that impact cardiovascular outcomes. She will leverage her mentors' expertise in environmental epidemiology, community-engaged research, biostatistics, air-temperature modeling, and cardiovascular health to develop a comprehensive training and research program. Building on her experience in chronic diseases, environmental epidemiology, air dispersion modeling, and GIS, she will design community-engaged interventions aiming to improve clinical outcomes among populations susceptible to CVD. This award provides training, protected time, and mentorship to support her transition to an independent research career examining CVD in communities with differing environmental and social neighborhood contexts.