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.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-07272010-001145 |
| Date | 28 September 2010 |
| Creators | Brown, Vanisha L. |
| Contributors | Thomas J. Songer, PhD, Kevin E. Kip, PhD, FAHA, Evelyn O. Talbott, Dr PH, Emma Barinas-Mitchell, PhD, Suresh Mulukutla, MD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-07272010-001145/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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