Time-varying residential neighborhood effects on cardiometabolic health

Cardio-metabolic (CM) diseases are one of the leading causes of premature death worldwide and a major contributor to health disparities. Epidemiology has traditionally focused on the various intertwined individual-level risk factors of CM diseases, such as physical inactivity, unhealthy diet, obesity, hypertension, type 2 diabetes, and dyslipidemia. The metabolic syndrome is defined as a cluster of major biological CM risk factors and is a strong risk factor for cardiovascular diseases. Environmental causes for CM diseases remain poorly understood at the population level, and are barely tackled by public health interventions. Though some host-related factors do play a role, the dramatic increase in CM diseases over recent decades is more likely to be related to changes in the socio-economic environment in which behavioral patterns occur, and in the physical environment – urban sprawl,amenities, transport infrastructure, etc. – than to genetic changes. Changes have resulted in the dramatic development, although socially patterned, of motorized transportation, increased fast-food consumption, sedentary occupations and leisure activities, which together constitute a breeding ground for CM-related disorders.The MET’HOOD project investigates the relationships over nine years between the time-varying socio-economic and physical environmental characteristics of residential neighborhoods, behavioral CM risk factors, and the metabolic syndrome. This proposal addresses several gaps in neighborhood and CM health research: i) it will examine the long-term effects of time-varying environmental exposure; ii) it will involve a country-wide, population-based longitudinal study in Europe (Luxembourg), which is commonly overlooked in longitudinal neighborhood-CM health research; and iii) it will investigate social disparities in time-varying neighborhood effects. Being developed by a team of health and urban geographers, epidemiologists, nutritionists, and sports scientists,with the support of local stakeholders in public health and urban planning, this project will provide timely, robust,and representative evidence to i) identify specific environmental characteristics that increase or reduce CM risk factors, ii) target sub-populations and neighborhoods at risk of less favorable CM risk profiles, iii) help tailor land use interventions in Europe aiming at reducing CM risk factors and related social disparities.