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Phase 1 involves the use of qualitative methods to understand the impact of the built environment on stress and the negative effect it has on cardiovascular disease risk factors among African Americans living in high crime, high poverty, and racially segregated neighborhoods. We will employ key stakeholder interviews, focus groups, and photovoice methodology. Key stakeholders include multidisciplinary leaders in the community who work in healthcare, public education, public housing, churches, police departments, fire departments, community-based organizations, and other civic agencies. Focus groups will include community members from 10 target zip codes within Milwaukee who have been diagnosed with type 2 diabetes, hypertension, stroke, or chronic kidney disease to provide feedback on our proposed community health worker interventions. In addition, focus groups will be held with community members who do not have chronic disease to understand the broader social determinants of health in the target zip codes that impact overall health and quality of life.

Phase 2 will involve initiating a longitudinal cohort in the high risk zip codes identified in Milwaukee (53206, 53216, 53205, 53210, 53218, 53209, 53225, 53212, 53224, 53223) and testing novel lifestyle interventions throughout the community.

Throughout the 6 year project, we will also develop and implement a number of efforts to recruit and train the next generation of change agents combating health disparities in Milwaukee, as well as, disseminating novel and high impact strategies to eliminate health disparities at the organizational and department level. These efforts will include pipeline programs spanning from middle school through graduate school, development of an applied postdoctoral training program in health disparities research, and recruitment of faculty members focused on health disparities research. In addition, we will conduct annual one-day health fairs to showcase best practices in academic-community partnerships focused on eliminating health disparities, and an annual one-day State of the Science conference in health disparities to highlight innovative interventions and future directions.