AS220 - Neighborhoods, women, and coronary heart disease: a prospective study

Investigator Names and Contact Information

Chloe Bird (chloe@rand.org)

Introduction/Intent

Introduction/Intent

To test whether aspects of the built environment predict the development of CHD in a longitudinal cohort of middle aged and elderly women after controlling for baseline sociodemographic and CHD risk factors.

Materials/Methods

Data: Individual data on CHD and associated risk factors came from the Observational Study (OS) and Clinical Trial (CT) arms of the Women’s Health Initiative (WHI). Additional data were obtained from RAND’s Center for Population Health and Health Disparities data core, which contains geocoded, census-tract level information on the sociodemographic and built environment.

Methods: We estimated multi-level models, where the built environment was used to predict CHD outcomes. All models controlled for a comprehensive set of individual and neighborhood sociodemographic characteristics, as well as health habits and baseline health status.

Results/Findings

To date, we have found significant relationships between the development of CHD, other CHD-related outcomes (e.g. BMI) and cognition, and aspects of the built and social environment. In particular, we have found that neighborhood socioeconomic status (SES), urban sprawl, and proximity to fast food outlets, are predictive of poor outcomes, whereas proximity to grocery stores is predictive of better outcomes. These relationships are robust to extensive controls for individual characteristics, health behaviors, and health history.

Some of the publications related to this ancillary study are:

Ms703 - Griffin BA, Eibner C, Bird CE, Jewell A, Margolis K, Shih R, Ellen Slaughter M, Whitsel EA, Allison M, Escarce JJ. The relationship between urban sprawl and coronary heart disease in women. Health Place. Health Place. 2012 Dec 7;20C:51-61. [Epub ahead of print]

Ms726 - Dubowitz T, Ghosh-Dastidar M, Eibner C, Slaughter ME, Fernandes M, Whitsel EA, Bird CE, Jewell A, Margolis KL, Li W, Michael YL, Shih RA, Manson JE, Escarce JJ. The Women's Health Initiative: the food environment, neighborhood socioeconomic status, BMI, and blood pressure. Obesity (Silver Spring). 2011 Jun 9. [Epub ahead of print]

Ms854 - Shih RA, Griffin BA, Salkowski N, Jewell A, Eibner C, Bird CE, Liao D, Cushman M, Margolis HG, Eaton CB, and Whitsel EA. Ambient particulate matter air pollution and venous thromboembolism in the Women’s Health Initiative Hormone Therapy Trials. Environ Health Perspect. 29 Oct 2010. [Epub ahead of print]

Ms1149 - Shih RA, Ghosh-Dastidar B, Margolis KL, Slaughter ME, Jewell A, Bird CE, Eibner C, Denburg NL, Ockene J, Messina CR, Espeland MA. Neighborhood socioeconomic status and cognitive function in women. Am J Public Health. 2011 Jul 21. [Epub ahead of print]

For a complete, up-to-date list of WHI papers related to this ancillary study, please use the searchable Bibliography section of this website. To search for papers by study number, access the Simple Search, and enter the study number in the “Related Studies” field.

References (as of the August 2012 Progress Report)

Shih RA, Ghosh-Dastidar M, Margolis KL, Slaughter ME, Jewell A, Bird CE, Eibner C, Denburg NL, Ockene J, Messina CR, Espeland MA. “Neighborhood Socioeconomic Status and Cognitive Function in Women.” American Journal of Public Health. 101(9):1721-8. Epub 2011 Jul 21.

Shih RA, Griffin BA, Salkowski, N, Jewell A, Eibner C, Bird CE, Cushman M, Liao D, Eaton CB, Margolis HG, Whitsel EA. 2011. Ambient particulate matter air pollution and venous thromboembolism in the Women’s Health Initiative Hormone Therapy Trials. Environmental Health Perspectives, 119(3): 326-331.

Tamara Dubowitz, Madhumita Ghosh-Dastidar, Christine Eibner, Mary E. Slaughter, Meenakshi Fernandes, Eric A. Whitsel, Chloe E. Bird, Adria Jewell, Karen L. Margolis, Wenjun Li, Yvonne L. Michael, Regina A. Shih, JoAnn E. Manson and José J. Escarce. 2012. “The Women’s Health Initiative: The Food Environment, Neighborhood Socioeconomic Status, BMI, and Blood Pressure.” Obesity. 20(4):862-71: Jun 9. doi: 10.1038/oby.2011.141. [Epub ahead of print]

Griffin, BA, Andersen, G, Shih, R, Whitsel, E. Use of Alternative Time Scales in Cox Proportional Hazard Models: Implications for Time-Varying Environmental Exposures. 2012. DOI: 10.1002/sim.5347. Statistics in Medicine.​

Data Dictionaries and Study Documentation

This section displays all study-related data dictionaries and study-related files. The investigators for this study will upload the datasets, data dictionaries, and other study-related files. Study-related files will be made available to the public one year after the completion of the ancillary study, with the exception of the datasets, which will only be available to those with a Data Distribution Agreement. Those will be available to those with permission to download and will appear as a download link next to the data dictionary

Data Dictionaries

Study Documents

Name
Description
No results found

Related Papers

Application of isocaloric substitution analysis in nursing research: Exemplars from the Women’s Health Initiative Study

Approved Manuscript, Su, Yan et al., 2021/10 MSID: 4453
Keywords: Fatigue; Substitution; Food; Macronutrient; Total Energy Intake
Related Studies: 220, 286, 340

Mediterranean diet and change in physical function over time in older women

Approved Manuscript, Su, Yan et al., 2024/5 MSID: 4604
Keywords: Physical Function; Alternate Mediterranean Diet; Change Over Time; Diabetes; Mixed Linear Model
Related Studies: 220, 286, 340

Ambient particulate matter air pollution and venous thromboembolism in the Women’s Health Initiative Hormone Therapy Trials

Regina Shih et al., 2010/10 PubMed #21036692 MSID: 854
The putative effects of postmenopausal hormone therapy on the association between particulate matter (PM) air pollution and venous thromboembolism (VTE) have not been assessed in a randomized trial of hormone therapy, despite its widespread use among postmenopausal women.In this study, we examined whether hormone therapy modifies the association of PM with VTE risk.Postmenopausal women 50-79 years of age (n = 26,450) who did not have a history of VTE and who were not taking anticoagulants were e...
Keywords: Deep Vein Thrombosis; Pulmonary Embolism; Air Pollution; Socioeconomic Status
Related Studies: 140, 220, W6

The relationship between urban sprawl and coronary heart disease in women

Beth Ann Griffin et al., 2012/11 PubMed #23376728 MSID: 703
Studies have reported relationships between urban sprawl, physical activity, and obesity, but - to date - no studies have considered the relationship between sprawl and coronary heart disease (CHD) endpoints. In this analysis, we use longitudinal data on post-menopausal women from the Women's Health Initiative (WHI) Clinical Trial to analyze the relationship between metropolitan statistical area (MSA)-level urban compactness (the opposite of sprawl) and CHD endpoints including death, any CHD eve...
Keywords: Coronary Heart Disease; Built Environment; Urban Sprawl
Related Studies: 220

Neighborhood socioeconomic status and cognitive function in women

Regina Shih et al., 2011/7 PubMed #21778482 MSID: 1149
We examined whether neighborhood socioeconomic status (NSES) is associated with cognitive functioning in older US women and whether this relationship is explained by associations between NSES and vascular, health behavior, and psychosocial factors.We assessed women aged 65 to 81 years (n = 7479) who were free of dementia and took part in the Women's Health Initiative Memory Study. Linear mixed models examined the cross-sectional association between an NSES index and cognitive functioning scores....
Keywords: Cognitive Function; Socioeconomic Status; Social Environment; Cardiovascular
Related Studies: 39, 220

A longitudinal analysis of the impact of neighborhood SES on coronary heart disease among women

Approved Manuscript, Bird, Chloe et al., 2009/9 MSID: 704
Keywords: Coronary Heart Disease; Socioeconomic Status; Social Environment
Related Studies: 220

The Women's Health Initiative: the food environment, neighborhood socioeconomic status, BMI, and blood pressure

Tamara Dubowitz et al., 2011/6 PubMed #21660076 MSID: 726
Using data (n = 60,775 women) from the Women's Health Initiative Clinical Trial (WHI CT)-a national study of postmenopausal women aged 50-79 years-we analyzed cross-sectional associations between the availability of different types of food outlets in the 1.5 miles surrounding a woman's residence, census tract neighborhood socioeconomic status (NSES), BMI, and blood pressure (BP). We simultaneously modeled NSES and food outlets using linear and logistic regression models, adjusting for multiple s...
Keywords: Framingham Risk Score; Blood Pressure; Obesity; Food Availability; Food Prices
Related Studies: 220

Neighborhood racial composition and risk of coronary heart disease: artifact of neighborhood socioeconomic status?

Approved Manuscript, Shih, Regina et al., 2010/9 MSID: 824
Keywords: Coronary Heart Disease; Racial Segregation; Economic Segregation; Disparities; Inequality; Social Environment
Related Studies: 220

Neighborhood SES, diet, physical activity, smoking and alcohol consumption in women

Approved Proposal, Dubowitz, Tamara et al., 2009/8 MSID: 1088
Keywords: Neighborhood Socioeconomic Status; Diet; Physical Activity; Smoking; Alcohol Consumption
Related Studies: 220

Lactation, neighborhood SES, and coronary heart disease in women

Approved Proposal, Schwarz, Eleanor et al., 2009/10 MSID: 1093
Keywords: Neighborhood Socioeconomic Status; Lactation
Related Studies: 220

A longitudinal analysis of the relationships between neighborhood SES, neighborhood residential stability, and mortality among women in the U.S.

Approved Manuscript, Bird, Chloe et al., 2010/9 MSID: 1096
Keywords: Mortality; Socioeconomic Status; Social Environment
Related Studies: 220

Ambient air pollution and lung cancer risk among never-smokers in the Women’s Health Initiative

Publication, Gowda, Shilpa et al., 2018/12 MSID: 1159
Keywords: Air Pollution; Particulate Matter; Environment; Exposure; Cancer Incidence
Related Studies: 140, 150, 220

Neighborhood predictors of mortality among stroke survivors: the Women’s Health Initiative

Approved Proposal, Allen, Norrina et al., 2012/10 MSID: 1803
Keywords: Stroke; Outcomes; Neighborhood
Related Studies: 220

Individual and neighborhood socioeconomic status and the association between air pollution and cardiovascular disease

Gloria Chi et al., 2016/5 PubMed #27138533 MSID: 1696
BACKGROUND: Long-term fine particulate matter (PM2.5) exposure is linked with cardiovascular disease, and disadvantaged status may increase susceptibility to air pollution-related health effects. In addition, there are concerns that this association may be partially explained by confounding by socioeconomic status (SES). OBJECTIVES: We examined the roles that individual- and neighborhood-level SES play in the association between PM2.5 exposure and cardiovascular disease. METHODS: The study popul...
Keywords: Air Pollution; Pm2.5; Cardiovascular Disease; Socioeconomic Status; Neighborhood Socioeconomic Status
Related Studies: 220

Long-term air pollution and risk of amyotrophic lateral sclerosis mortality in the Women’s Health Initiative Cohort

Evelyn Talbott et al., 2022/10 PubMed #36220441 MSID: 3712
Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no cure. Although the etiology of sporadic ALS is largely unknown, environmental exposures may affect ALS risk. Objective: We investigated relationships between exposure to long-term ambient particulate matter (PM) and gaseous air pollution (AP) and ALS mortality. Methods: Within the Women's Health Initiative (WHI) cohort of 161,808 postmenopausal women aged 50-79 years at baseline (1993-1998), we performed a ne...
Keywords: Als; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Air Pollution; Environmental Exposures; Risk Factors
Related Studies: 140, 220, 251, 264, 315

Farming history and pesticide exposure as risk factors for ALS deaths within the Women’s Health Initiative Observational Cohort; A nested case control study

Approved Proposal, Talbott, Evelyn et al., 2020/10 MSID: 4313
Keywords: Als; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Occupational; Environmental Exposures; Pesticides; Risk Factors
Related Studies: 140, 220, 251, 264, 315, 593

Adherence to the American Cancer Society Guidelines on nutrition and physical activity for cancer prevention and obesity-related cancer risk and mortality in Black and Latina Women's Health Initiative participants

Margaret Pichardo et al., 2022/10 PubMed #35996861 MSID: 3804
Background: Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI). Methods: Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in ...
Keywords: Nutrition; Physical Activity; Obesity; Lifestyle; Mortality; Obesity-Related Cancer; Hispanic; Black
Related Studies: 220

Intergenerational Occurrence of Premature Birth and Reproductive Health in Prematurely-Born Women in the Women's Health Initiative

Mary Sullivan et al., 2024/10 PubMed #39192085 MSID: 4541
Objective: To compare reproductive history and postmenopausal health by birth status (preterm vs. full term) in a U.S. longitudinal study of postmenopausal women. Birth status was examined according to region of residence, household, and neighborhood socioeconomic status (SES). Methods: In the Women's Health Initiative Observational Study, 2271 women were born prematurely (< 37 weeks). ANOVA and Chi-square determined birth status differences of reproductive history, pregnancy, and postmenopausal...
Keywords: Preterm Birth; Preterm-Born Adults; Reproductive Health; Intergenerational
Related Studies: 220

Neighborhood socioeconomic status, green space, and walkability and risk for falls among postmenopausal women: The Women’s Health Initiative

Marilyn Wende et al., 2023/5 PubMed #37149415 MSID: 4068
Purpose: This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence. Methods: The Women's Health Initiative recruited a national sample of postmenopaus...
Keywords: Built Environment; Neighborhood; Falls; Physical Activity; Injury
Related Studies: 140, 220, 251, 252, 264, 315, 442, 481

How neighborhood socioeconomic status, green space, and walkability are associated with risk for fracture among postmenopausal women: The Women’s Health Initiative

Marilyn Wende et al., 2023/7 PubMed #37149415 MSID: 4069
Purpose: This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence. Methods: The Women's Health Initiative recruited a national sample of postmenopaus...
Keywords: Neighborhood Socioeconomic Status; Walkability; Green Space; Fracture; Postmenopausal
Related Studies: 140, 220, 251, 252, 264, 315, 442, 481

Air pollution-associated changes in biomarkers of diabetes risk

Katie Holliday et al., 2019/8 PubMed #31538138 MSID: 1464
Background: Ambient particulate matter (PM) and nitrogen oxide (NOx) air pollution may be diabetogenic. Objective: To examine longitudinal associations of short- and longer-term mean PM =10 µm (PM10), PM =2.5 µm (PM2.5), and NOx concentrations with five biomarkers of diabetes risk. Methods: We studied a stratified, random minority oversample of nondiabetic Women's Health Initiative clinical trials participants with biomarkers and geocoded participant address-specific mean air pollution concentra...
Keywords: Ambient Air Pollution; Neighborhood Environment; Diabetes; Glucose Homeostasis; Biomarkers; Measurement Error; Selection Bias
Related Studies: 140, 220