In this work related to the prevalence of type 2 diabetes, we investigated the different factors that may influence participation of populations in the RECORD Cohort Study.
Epidemiologists usually pay a particular attention to "selection processes" that lead to retain in or exclude from their studies people who are particular with respect to the exposures or to the health outcomes of interest.
In the RECORD Study interested in the effects of geographic life environments, an important question is to know whether residents of the 2218 neighborhoods from Ile-de-France covered by the study all had comparable odds of participation, according to the different characteristics of their residential environment.
In these analyses, we found that a high individual education level and that residing nearby the health centers involved in the recruitment, in a socially advantaged neighborhood, or in a low population density neighborhood were associated with increased odds of participation in the RECORD Study.
In our work interested in the relationship between neighborhood socioeconomic status and type 2 diabetes, we showed that it is possible in certain cases to account for these selection biases in the analyses.
The final version of the article can be downloaded here.
On June 23 2010, Cinira Leal will present her work during an oral communication at the Society for Epidemiologic Research at Seattle in the United States of America.
In her work, she demonstrates that important disparities in body mass index and waist circumference exist between the 111 municipalities and 10 districts of Paris investigated in the study. The analyses show that the average education level of the neighborhood is strongly associated with these indicators of excess weight and fat accumulation, after controlling for individual characteristics. The neighborhood education level seemed to be more strongly associated with body mass index and waist circumference when it was measured within 500 m radius circular areas than in broader or more local areas.
In these analyses, we compare classical statistical analyses with a more complex approach in which the participants from advantaged and disadvantaged neighborhoods are matched with each other based on their propensity score to be exposed. The powerpoint presentation can be downloaded here.
The third information letter of the RECORD Cohort Study has just been sent to the 7250 participants of the study.
This letter includes 3 articles that report information and findings obtained from our analyses. The first article is interested in the social disparities in resting heart rate that exist between socially advantaged and disadvantaged individuals and neighborhoods, and in the mechanisms that contribute to these inequalities. The objective of the second article is to identify the sociodemographic profiles of underweight, overweight, and obese participants, while taking into account the social origins of participants. In a third article, we describe some of the strategies to measure the characteristics of residential neighborhoods that are implemented in the RECORD Study.
Enjoy your reading!
We are preparing the second RECORD Study wave. In this context, about 7250 participants will be invited to a second health examination.
Epidemiologic research relies to a large extent on "cohort studies" in which a number of participants are surveyed and examined at a given point in time and followed over time. Cohort studies are based on the idea that to examine if a specific exposure (e.g., an environmental one) is related to a given health problem, it is relevant to measure the exposure at a certain moment in time and assess whether the exposure leads to the incidence of the health problem in the follow-up period among people who were free of this health condition at the beginning of the study. In other words, epidemiologic studies often need data collected at different points in time (i.e., longitudinal data) to attempt to identify causes of health problems.
Inviting the participants to a second health examination will allow us to obtain a second measures of a number of clinical and biological risk factors of cardiovascular diseases that are of particular interest to us (weight and waist circumference, blood pressure, cholesterol, etc.). Based on these data, we will be able to investigate changes in these metabolic parameters over a 5 year period and the social and environmental exposures that are associated with the incidence of metabolic conditions over the follow-up.
In this second study wave, survey questionnaires and different assessment tools will be used to better understand the relationships that exist between geographic life environments and cardiovascular health.
The RECORD group is preparing a project interested in the investigations of social and spatial disparities in healthcare utilization.
This project is based on the reimbursement data from the National Health Insurance System (SNIIR-AM) that have been merged to the RECORD database for each participant, after allowance from the National Data Protection Authority. These healthcare utilization data for the RECORD participants are exclusively manipulated at Inserm with a high degree of confidentiality.
Based on these healthcare utilization data merged to the RECORD database, the aim is to investigate social and spatial disparities in healthcare utilization that exist in the population. Do people from different neighborhoods have an equal access to preventive care? Are there barriers in the access to healthcare services such as specialty care in certain neighborhoods? In case of metabolic problems, e.g., hypertension, do people from different neighborhoods have comparable access to recommended medical treatments? Our aim will be to address these questions and others in our investigations of healthcare utilization behavior in the RECORD Study.