Built environments on stroke risk and stroke disparities in a national sample
Investigators: Natalie Colabianchi, Michael R. Elliott, Daniel G. Brown, Philippa J. Clarke
Funding: National Institute of Neurological Disorders and Stroke, 2016-2020 (1 R01 NS 092706 01 A1)
Stroke is a leading cause of death and a top cause of serious long-term disability. Research has established a number of individual-level factors that partially explain stroke risk, but these factors account for only about half of the racial disparities in stroke. Recently, built and social environments (BSEs) have been identified as important factors in studying cardiovascular disease. However, to date no research has examined the effect of BSEs on stroke risk, or on the large racial and geographic disparities in stroke rates nationally. This study addresses these gaps by examining the effects of BSEs on incident stroke risk and on racial and geographic disparities in stroke. The analytic data set includes data from the REGARDS Study, a national study of stroke risk factors in a large national sample of adults over age 45, and data obtained on a broad range of BSE characteristics in REGARDS respondent residential areas. The BSE data are obtained from a number of sources including secondary commercial and administrative sources, participant self-reports, and primary audits using the Street View feature in Google Earth, and they are spatially linked to respondent data. Identifying the BSE characteristics that are predictive of incident stroke and BSEs that contribute to racial and geographic disparities will help inform future modifications of environments to improve population health.