# Examining racial segregation and underlying mechanisms related to VCID and incident stroke in the REGARDS study

> **NIH NIH RF1** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $2,258,218

## Abstract

Racial inequity in the development of neurological conditions as people age is a major public health issue.
While many individual risk factors have been identified as predictors of both vascular contributions to cognitive
impairment and dementia (VCID), as well as stroke, these individual factors do not fully explain the stark Black-
White disparities existing in these outcomes. Moreover, the structural mechanisms shaping these outcomes
are far less understood; in particular, the racially unequal socio-environmental contexts that limit opportunities
and resources based on race. Race-based school segregation and racial residential segregation (RRS) are
two, critical, structural racism and discrimination (SRD) factors of hypothesized importance in how SRD
contributes to inequalities in VCID and stroke, yet few studies exist in this area. At the intersection of chronic
disease, life course, and spatial epidemiology emerges a unique opportunity to address this critical gap. This
study leverages an ongoing, large-scale, population-based study: The REasons for Geographic And Racial
Differences in Stroke (REGARDS) Study. REGARDS is a national sample of over 30,000 adults (45 years and
older) with oversamples of persons self-identifying as non-Hispanic Black and people living in the stroke belt.
The proposed study takes advantage of the longitudinal assessments of both VCID and stroke in this diverse
cohort, and several other retrospective and prospective data related to biological, clinical (e.g., vascular health
conditions), behavioral (e.g., health behaviors), socio-cultural (e.g., social support, social cohesion, perceived
discrimination, social networks), and built and social environment (BSE) factors across multiple levels of
influence (individual, interpersonal, community, and societal) collected through the parent study and two
ancillary studies. These data include state-based and school-level school segregation measures for each
school participants attended; objective, county-level educational quality measures for each year of schooling;
historical participant residences that will be used to create a life course RRS exposure (median of 51 years) in
the proposed study; and 9 BSE measures (food retail, parks, crime, commercial physical activity, healthcare,
neighborhood SES, places of worship, social engagement, and social service institutions) for over 40,000
geocoded locations in middle and older ages that will be expanded upon in the proposed study via additional
locations and years of data. The proposed study aims to: 1) Determine the association between school
segregation on incident VCID and incident stroke later in life; the potential mediating role of educational quality;
and to examine moderation by race, 2) Examine the association of RRS over the life course on incident VCID
and incident stroke; and to examine moderation by race, and 3) Explore features of the residential
neighborhood and interpersonal factors that may mediate the link b...

## Key facts

- **NIH application ID:** 10474231
- **Project number:** 1RF1NS127606-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** NATALIE COLABIANCHI
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $2,258,218
- **Award type:** 1
- **Project period:** 2022-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10474231

## Citation

> US National Institutes of Health, RePORTER application 10474231, Examining racial segregation and underlying mechanisms related to VCID and incident stroke in the REGARDS study (1RF1NS127606-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10474231. Licensed CC0.

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