Bronx Neighborhood Redevelopment and CVD in mid-life and older adults

Summary/Abstract

Cardiovascular disease (CVD) accounts for 1 in 4 deaths a year in the US. CVD-related risk factors such as hypertension and diabetes emerge in mid-life (50-64 years old) compromising healthy aging into older adulthood (65 yrs+). Mid-life also shows a widening in socio-demographic disparities in CVD-related risk factors. Disparities (e.g., those related to income, race, and ethnicity) are driven in part by availability of neighborhood resources.

Resources—including healthful food and amenities for physical activity—tend to be fewer in number and lesser in quality in certain neighborhoods. Recognizing this reality, there is increasing policy interest in redeveloping under-resourced neighborhoods. “Neighborhood redevelopment” is a process through which rezoning and capital investment can bring new resources to neighborhoods—e.g., sources of healthful food and amenities for physical activity. While redevelopment might support better health (including health related to CVD), potential benefits may not be realized equally among all socio-demographic groups. For example, if housing costs increase as neighborhood resources improve, residents having lower income or fixed budgets may be increasingly challenged to afford other health- related needs.

In fact, the net impact of neighborhood redevelopment among different socio-demographic groups is not clear. Better data is needed to understand how redevelopment could affect health and health disparities. Furthermore, public health agencies and health systems can leverage electronic health record data at local levels of geography to develop mitigation strategies to prevent adverse health outcomes among residents that may be associated with local redevelopment. To examine the relationship between neighborhood redevelopment and CVD-related health/health disparities, the proposed study will use three complementary approaches: (1) a natural experiment, (2) qualitative analysis, and (3) micro-simulation and systems dynamics modeling.

We will take advantage of a redevelopment initiative in the Bronx, NY, where a largely commercial area is being rezoned and capital investments are being made to increase healthful neighborhood resources. Using a primary care sample identified through electronic health records, we will follow cohorts of mid-life and older patients in both the redevelopment area and a comparison area.

Grant Number: 5R01HL166318-03
NIH Institute/Center: NIH
Principal Investigator: Earle Chambers