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The Assessment of Cardiovascular Disease Risk in Relation to the Built Environment and Race

Brown, Vanisha L. (2010) The Assessment of Cardiovascular Disease Risk in Relation to the Built Environment and Race. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Cardiovascular disease (CVD) is a critical public health challenge, and the leading cause of death for both genders in the United States and worldwide. Much research has focused on addressing the health burden associated with CVD, and has identified a number of modifiable risk factors (i.e., lipid abnormalities, hypertension, obesity, the metabolic syndrome, diabetes, and physical inactivity).One issue affecting CVD risk factors may be the built environment, which includes all things that are developed and altered by man. The built environment may impact health, yet, the underlying mechanisms by which it influences health remains unknown. The purpose of this study was to examine the association between the built environment and CVD risk, the degree to which these associations are influenced by race, and the extent to which assessments of the environment differ by the method applied.Significant inverse relationships were found between the built environment and BMI, obesity, diabetes mellitus, hypertension, and physical inactivity. Physical activity was found to partially mediate the relationship between the built environment and BMI. In Whites, significant inverse relationships were found between the built environment and BMI, obesity, and physical inactivity. Again, physical activity was found to mediate the relationship between the built environment and BMI. No significant relationships were found between the built environment and measures of CVD risk in Blacks. Environmental assessments revealed fair agreement between ratings from participants and independent evaluators, although agreement was better for more objective items. Agreement was also higher for racially mixed neighborhoods. Measurement of objective attributes revealed a significant difference in the mean distance between neighborhood ratings for participants and independent evaluators for the presence of sidewalks; and among participants, there was a significant difference in the mean distance to trees.Information from this study is of considerable public health significance, as it emphasizes the need to consider race in future interventions and modifications to the built environment, and highlights some of the measurement issues surrounding the built environment. By investigating relationships between the built environment and other measures of CVD risk, additional insights on adequate and appropriate CVD interventions for all populations are gained.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Brown, Vanisha L.vlbrown10@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSonger, Thomas Jtjs@pitt.eduTJS
Committee MemberBarinas-Mitchell, Emmabarinas@edc.pitt.eduEJB4
Committee MemberTalbott, Evelyn Oeot1@pitt.eduEOT1
Committee MemberKip, Kevin Ekkip@health.usf.edu
Committee MemberMulukutla, Sureshmulukutlasr@upmc.eduSRM12
Date: 28 September 2010
Date Type: Completion
Defense Date: 8 July 2010
Approval Date: 28 September 2010
Submission Date: 27 July 2010
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 323
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Built Environment; Cardiovascular Disease (CVD); GIS; Kappa; Race
Other ID: http://etd.library.pitt.edu/ETD/available/etd-07272010-001145/, etd-07272010-001145
Date Deposited: 10 Nov 2011 19:54
Last Modified: 16 May 2018 18:13
URI: http://d-scholarship.pitt.edu/id/eprint/8665

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