This K01 award will allow the candidate, Dr. Mario Sims, to gain the skills, knowledge and experience required to become an independent investigator in health disparities research. Using data from the Jackson Heart Study (JHS), Dr. Sims will examine the extent to which neighborhood socioeconomic status (SES) and key psychosocial factors (discrimination, stress, and social support) impact coronary heart disease (CHD) in African Americans in Mississippi. The JHS is the largest epidemiologic, population-based study of cardiovascular disease (CVD) among African Americans, and one of its primary aims - to develop young talented minority investigators in the field of CVD research - will be accomplished through this KO1 award. CHD is the leading cause of CVD mortality in America, and Mississippi has the highest overall CVD mortality rate in the nation. Moreover, the cardiovascular health disparity between African Americans and whites is widening. Mississippi's CHD mortality rate is higher than the U.S. rate. African Americans have higher CHD prevalence and mortality rates than whites, and they also have a higher prevalence of risk factors associated with CHD such as hypertension, diabetes mellitus, and obesity which clearly might influence the higher prevalence of CHD mortality. To achieve his research and career development goals, Dr. Sims will follow a career development plan at the University of Mississippi Medical Center, designed to provide knowledge, skills, and experience in 6 core competencies required to be a successful independent investigator in health disparities research: 1) research excellence in the area of CHD disparities, 2) advanced statistics and study design, 3) research ethics, 4) leadership and management, 5) presentation and teaching, and 6) scientific writing. This will be accomplished through implementation of an individualized learning plan that includes: 1) academic coursework to develop cardiovascular disease disparity research skills; 2) mentorship and consultation with nationally and internationally recognized experts in cardiovascular disease epidemiology and health disparities research; 3) mentorship by faculty sensitive to the unique needs and issues facing minority academic faculty; and 4) innovative research using a multi-dimensional framework for examining how CHD prevalence among African Americans is influence by neighborhood environments, perceived discrimination, stress, and social support. The proposed mentored research has three specific aims: 1) to examine the extent to which neighborhood SES is associated with CHD among African Americans; 2) to determine the degree to which perceived racial discrimination, stress and social support are associated with CHD among African Americans; and 3) to analyze the extent to which the association of neighborhood SES and CHD is mediated by psychosocial factors among African Americans. This is the first study of its kind to examine multiple pathways by which neighborhood SES and key psychosocial factors impact CHD risk in African Americans in Mississippi, a state with the highest CHD rate in the nation. This research will enable health-care providers to adequately serve their patients with CHD knowing that where they live and their exposure to discrimination, stress, and a lack of social support are sequelae to CHD. This research will also show which factors health policy makers need to focus on in order to address and eliminate CHD disparities.