Emerging evidence indicates that there are ethnicity-specific differences in the profile of biochemical, metabolic and physiological perturbations associated with obesity. The implications of these ethnic differences remain to be further defined. Several epidemiologic studies have shown that vascular disease and its cardiovascular complications, carry significantly higher morbidity and mortality in African Americans compared with Caucasians.1-3 These observations may be partly explained by a higher prevalence of cardiovascular disease risk factors, such as essential hypertension, diabetes mellitus, and tobacco use among African Americans.4-6 However, the pathophysiological processes underlying this racial predisposition have not been fully elucidated.7 It is likely that the etiologic basis of ethnic disparities in cardiovascular disease is multi-factorial and involves dynamic gene-environment interactions in which variances in behavior and the social context are critical determinants.

The proposed Program recognizes the importance of incorporating both biological factors and social determinants in the analysis of cardiovascular disparities

Inclusion Criteria:

Our methodological approach will involve a random digit-dialing cross-sectional survey of 4000 Metro Atlanta area AA and white residents (ages 30-65 years). This aim will focus on using well-validated survey instruments to examine self-reported perceptions of psychosocial stress, neighborhood segregation factors and health beliefs related to weight/weight control. These parameters will be assessed in relation to the differential prevalence of three major outcomes: (1) self-reported maladaptive cardiovascular behaviors that predispose to obesity-related CVD (ie high fat/sodium and low fruit/vegetables dietary intake and physical inactivity); (2) obesity; and (3) hypertension.

This study will address the following research questions: Are the observed racial differences in maladaptive health behaviors (diet/inactivity) and MetS components (obesity, hypertension) associated with: a) perceived psychosocial stress, and if so, does depression, neighborhood factors or health beliefs around weight and weight control modify this relationship?

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Exclusion Criteria:

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