EPOCH : Description

Title: Environmental Profile of a Community's Health (EPOCH) 
 
Project description 
 
Cardiovascular problems and cognitive dysfunction have substantial effects on quality of life and life expectancy. It is essential to understand the early determinants of such dysfunction and its progression to clinical events. The growing prevalence of cardiovascular diseases and of risk factors that lead to dysfunction is putting pressure on the financial viability of Canadian and international health systems.
 
Despite significant medical advances in this field, gaps continue to exist. The relationships between socio-environmental context (societal structure, built environment, nutrition environment, smoking, social environment and access to health services) and cardiovascular risk factors at individual and population levels are core themes we must continue to document.
 
Objectives
 
1.    Enhance understanding of the influence of socio-environmental context on cardiovascular risk factors, subclinical vascular diseases, and incidence of cardiovascular events at individual and population levels.
 
2.    Link socio-environmental context to differences in cardiovascular disease incidence (i.e. rural vs. urban settings, Eastern Canada vs. Western Canada) and their relative impacts, compared to individual factors.
 
Methodology
 
 In this large study, Lise Gauvin will oversee an audit in over 400 forward sortation areas (FSA) in Québec. An FSA corresponds to the first three characters of the postal code. The audit will examine environments where people live and work, and how those environments influence lifestyles and behaviours, including exercise habits, food choices, and alcohol and tobacco use.
 
Routes determined by Canada Post based on forward sortation areas were considered the best unit of measurement to study socio-environmental contexts.  Socioeconomic data are available for 1577 FSA territories in Canada.
Statistic Canada's 2006 census data can be aggregated by FSA. EPOCH, an audit tool, will be used to obtain an environmental profile of a community's health. Through observation, the audit will measure a range of environmental characteristics potentially associated with risk factors for cardiovascular diseases and dysfunctions. The observational audit will be used to collect information on FSA by assessing connectivity, access to resources, goods and services, and visible advertisements. It will also evaluate products available in a food store, a restaurant and businesses where alcohol and tobacco are sold in each FSA.
 
Results
 
Results will focus on associations between socio-environmental context, such as level of individuals' exposure to elements identified in the EPOCH audit, and risk factors for cardiovascular disease. Results will be presented in scientific articles and through knowledge sharing and utilization activities.
 
Funding 
 
This survey is funded by Canadian Partnership Against Cancer and Heart and Stroke Foundation of Canada.
(EPOCH)