Simulation Modeling and Disparities in Obesity and Chronic Disease

肥胖和慢性病的模拟建模和差异

• 批准号: 10376787
• 负责人: STEVEN L GORTMAKER
• 金额: $ 39.88万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10376787
• 关键词: Accounting; Adolescent obesity; Adult; Age; Alaska; Behavioral; Body mass index; Cardiovascular system; Characteristics; Chronic; Chronic Disease; Clinical; Communities; Complex; Cost Effectiveness Analysis; Data; Diabetes Mellitus; Diet; Disease Outcome; Economics; Effectiveness; Effectiveness of Interventions; Environment; Epidemic; Ethnic Origin; Evaluation; Future; Gender; Geographic state; Geography; Goals; Growth; Hawaii; Health; Health Care Costs; Heart Diseases; Intervention; Intervention Studies; Life Cycle Stages; Link; Malignant Neoplasms; Methods; Mississippi; Modeling; Morbidity - disease rate; New York; North America; Obesity; Outcome; Physical activity; Population; Prevalence; Preventive; Preventive treatment; Publishing; Race; Reduce health disparities; Research; Resources; Risk; Risk Behaviors; Risk Factors; Social Policies; Socioeconomic Status; Taxes; Testing; Uncertainty; United States; Washington; West Virginia; Work; adult obesity; cost; cost effective intervention; cost effectiveness; disease disparity; effective intervention; ethnic health disparity; health disparity; improved; innovation; intersectionality; intervention cost; models and simulation; mortality; obesity in children; obesity prevention; obesity risk; obesity treatment; population health; prevent; racial and ethnic; racial and ethnic disparities; relative cost; simulation; sociodemographic factors; sugar; sweetened beverage; theories; tool

Childhood obesity is epidemic in the United States, and a leading cause of diabetes, cardiovascular heart disease, cancer, and other chronic conditions. Disparities in childhood obesity prevalence are found across US states and by age, gender, socioeconomic status, and race/ethnicity. Interventions with effectiveness to reduce childhood obesity have been developed, but little is known about their overall impact on obesity and subsequent chronic disease, their cost-effectiveness, and their potential to reduce health disparities. Our team’s preliminary work in developing cost-effectiveness simulation models of leading preventive and treatment interventions for childhood obesity (e.g. excise taxes on sugar sweetened beverages) has documented dramatic differences in population health impact and cost-effectiveness. But what is not known is the impact of these preventive health interventions on reducing health disparities and cost-effectiveness of the interventions in the context of intersectional health disparities. The planned research will build on our team’s prior work in developing accurate simulation models of the growth of BMI by gender and race/ethnicity over the life course. We aim to develop a microsimulation model to project the 10- and 30-year national impact of six widely studied and effective childhood obesity preventive and treatment interventions, evaluating cases of obesity prevented, cost-effectiveness metrics, chronic disease, and disparities metrics in outcome by race/ethnicity. Secondarily, we will test impacts at the intersection of race/ethnicity and place among six states: West Virginia, New York, Mississippi, Washington, Alaska, and Hawaii, with the goal of identifying interventions that can both cost-effectively improve population health and reduce racial/ethnic disparities in obesity and future chronic disease. Our specific aims: 1) Systematically evaluate evidence for effect, reach, obesity risk factors, costs and implementation – and differences in these characteristics – of six effective interventions for reducing obesity in children. 2) Develop a microsimulation model to accurately project nationally, over 10 and 30 years, the impact on obesity, chronic disease, cost-effectiveness and racial/ethnic disparities of the six interventions, accounting for effectiveness, reach, obesity risks, implementation and uncertainty. 3) Adapt the microsimulation model to six states and project the cost-effectiveness, impact on obesity, chronic disease, and impact on racial/ethnic disparities of the six interventions, accounting for local characteristics including effectiveness, reach, obesity risks, implementation, and accounting for uncertainty. Decision makers have limited resources to use in reducing obesity prevalence. While there is evidence for effective preventive and treatment interventions, there is limited cost-effectiveness analysis. If successful, this project will create a new paradigm for evaluating obesity interventions, emphasizing cost-effectiveness, population health impact, and health disparities metrics, providing decision makers with the tools to identify cost-effective interventions that reduce health disparities while improving overall population health.

儿童肥胖在美国是流行病，是糖尿病的主要原因，心血管心脏 儿童肥胖症患病率在我们各地发现 国家和年龄，性别，社会经济地位和种族/种族。干预措施有效减少 童年肥胖已经开发出来，但对它们对肥胖和的总体影响知之甚少 随后的慢性病，​​其成本效益以及减少健康分布的潜力。我们的 团队在开发领先的预防性和 儿童肥胖的治疗干预措施（例如，糖甜卧室的消费税） 记录了人口健康影响和成本效益的巨大差异。但是不知道的是 这些预防性健康干预措施对降低健康差异和成本效益的影响 在交叉健康差异的背景下进行的干预措施。计划的研究将基于我们团队的 先前通过性别和种族/种族对BMI增长的准确模拟模型的先前工作 生活课程。我们旨在开发一个微仿真模型，以投射10年和30年的国家影响 广泛研究有效的儿童肥胖预防和治疗干预措施，评估 肥胖阻止，成本效益指标，慢性病和差异指标 种族/种族。次要，我们将在种族/种族的交汇处和六个州的地位上测试影响： 西弗吉尼亚州，纽约，密西西比州，华盛顿，阿拉斯加和夏威夷，目的是确定干预措施 这既可以成本地改善人口健康，又可以减少肥胖和种族/种族差异 未来的慢性病。我们的具体目的：1）系统地评估效果，触及，肥胖风险的证据 六个有效干预措施的因素，成本和实施以及这些特征的差异 减少儿童的肥胖症。 2）开发一个微仿真模型，以准确地在全国范围内准确投影，超过10个 30年，对肥胖，慢性疾病，成本效益和种族/种族差异的影响 干预措施，考虑到有效性，覆盖范围，肥胖风险，实施和不确定性。 3）适应 微观仿真到六个州，并投射成本效益，对肥胖，慢性病和 对六种干预措施的种族/种族差异的影响，考虑到当地特征 有效性，覆盖范围，肥胖风险，实施和考虑不确定性。决策者拥有 减少肥胖症患病率的资源有限。虽然有证据表明有效的预防和 治疗干预措施，成本效益分析有限。如果成功，该项目将创建一个新的 评估肥胖干预措施，强调成本效益，人口健康影响和 健康差异指标，为决策者提供识别具有成本效益的干预措施的工具 减少健康分布，同时改善总体人口健康。