Social and physical environments and disparities in risk for cardiovascular disease: the healthy environments partnership conceptual model.

Abstract

The Healthy Environments Partnership (HEP) is a community-based participatory research effort investigating variations in cardiovascular disease risk, and the contributions of social and physical environments to those variations, among non-Hispanic black, non-Hispanic white, and Hispanic residents in three areas of Detroit, Michigan. Initiated in October 2000 as a part of the National Institute of Environmental Health Sciences' Health Disparities Initiative, HEP is affiliated with the Detroit Community-Academic Urban Research Center. The study is guided by a conceptual model that considers race-based residential segregation and associated concentrations of poverty and wealth to be fundamental factors influencing multiple, more proximate predictors of cardiovascular risk. Within this model, physical and social environments are identified as intermediate factors that mediate relationships between fundamental factors and more proximate factors such as physical activity and dietary practices that ultimately influence anthropomorphic and physiologic indicators of cardiovascular risk. The study design and data collection methods were jointly developed and implemented by a research team based in community-based organizations, health service organizations, and academic institutions. These efforts include collecting and analyzing airborne particulate matter over a 3-year period; census and administrative data; neighborhood observation checklist data to assess aspects of the physical and social environment; household survey data including information on perceived stressors, access to social support, and health-related behaviors; and anthropometric, biomarker, and self-report data as indicators of cardiovascular health. Through these collaborative efforts, HEP seeks to contribute to an understanding of factors that contribute to racial and socioeconomic health inequities, and develop a foundation for efforts to eliminate these disparities in Detroit.

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Scholars@Duke

James

Sherman A. James

Susan B. King Distinguished Professor Emeritus of Public Policy

Sherman A. James is the Susan B. King Distinguished Professor Emeritus of Public Policy at the Sanford School of Public Policy, Duke University. He also held secondary professorships, at Duke, in Sociology, Community and Family Medicine, and African and African American Studies. Prior to Duke, he taught in the epidemiology departments at the University of North Carolina-Chapel Hill (1973-89) and at the University of Michigan (1989-03). At Michigan, he was the John P. Kirscht Collegiate Professor of Public Health, the Founding Director of the Center for Research on Ethnicity, Culture and Health (CRECH), Chair of the Department of Health Behavior and Health Education, and a Senior Research Scientist in the Survey Research Center at the Institute for Social Research.

Dr. James was awarded the A.B. degree (Psychology and Philosophy) in 1964 from Talladega College (AL), and the PhD degree (Psychology) in 1973 from Washington University in St. Louis. His research focuses on the social determinants of US racial, ethnic, and socioeconomic disparities in health and health care. He is the originator of the John Henryism Hypothesis which posits that repeated high-effort coping with chronic social and economic adversity rooted in structural racism is an important factor in the early onset of hypertension and related cardiovascular diseases in African Americans.

Dr. James was elected to the National Academy of Medicine (formerly the Institute of Medicine) of the National Academy of Sciences in 2000. In 2001, he received the Abraham Lilienfeld Award from the Epidemiology section of the American Public Health Association for career excellence in the teaching of epidemiology; a Health Policy Investigator Award from the Robert Wood Johnson Foundation in 2008; the John Cassel Distinguished Lecture and Award from the Society for Epidemiologic Research in 2013; the Wade Hampton Frost Award from the Epidemiology Section of the American Public Health Association for career contributions to the field of epidemiology in 2016; the Kenneth J. Rothman Career Accomplishment Award from the Society for Epidemiologic Research in 2019; and a residential fellowship at the Stanford University Center for Advanced Study in the Behavioral Sciences in 2019-2019.

Dr. James is a Fellow of the American Academy of Political and Social Science, the American Epidemiological Society, the American College of Epidemiology, the American Heart Association, and the Academy of Behavioral Medicine Research. In 2007-08, he served as president of the Society for Epidemiologic Research, the largest professional society of epidemiologists in the world. 



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