Tuesday, May 7, 2024
5/7/2024
PROJECT SUMMARY/ABSTRACT Chronic Kidney Disease (CKD) prevalence is socially patterned and geographically clustered. Emerging studies have suggested that various neighborhood characteristics, such as social disadvantage, food environments, and walkability, contribute CKD incidence and progression as well as its disparities. However, existing research has several limitations, including systematic misclassification of neighborhood exposures, inadequate assessment of secular changes in neighborhood factors, and lacking careful considerations of co- occurring neighborhood conditions as confounders or effect modifiers. Moreover, no study has examined the causal effects of neighborhood changes, although identifying specific neighborhood characteristics, particularly built environments, as modifiable factors to address CKD burden is a promising avenue for health equity work. The goal of this K01 award is to address gaps in the literature while also supporting the candidate’s goal of transitioning to an independent scholar focused on identifying and addressing upstream neighborhood determinants of CKD. Through formal coursework, workshops, mentored research, and attendance at scientific conferences, Dr. Kim will gain expertise in the social and spatial epidemiology of CKD outcomes, and will pursue methodological training in quasi-experimental study design, EHR-based analyses, and rigorous ascertainments of outcomes using computable phenotyping. Building on Dr. Kim’s prior training as a social/spatial epidemiologist, these complementary training and research aims will allow Dr. Kim to elucidate nuanced causal mechanism of neighborhood effects on CKD and will provide him with a combination of methodological tools that can be flexibly applied to future research questions at the nexus of CKD epidemiology and health disparities. The proposed research will leverage EHR data from a national cohort of U.S. veterans to examine associations between various sets of neighborhood characteristics and CKD outcomes within a novel quasi-experimental framework, exploiting individual-level changes in neighborhood characteristics based on residential mobility. The proposed aims 1) quantify the individual and joint impacts of neighborhood characteristics on CKD incidence/progression, 2) examine potential causal pathways between neighborhood characteristics and CKD via its clinical causes, and 3) conduct a quasi-experimental study of the causal impacts of changing built environments on CKD incidence/progression. This work is in line with NIDDK’s strategic goals to elucidate drivers of population disparities in CKD and to leverage natural experiment conditions. By providing salary support, training, and a formal mentorship structure, this award will facilitate Dr. Kim’s transition to an independent career focused on the study of spatial epidemiology of CKD.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
