Impact of Interventions on Future Trends in Subnational Burden of Cardiovascular Diseases in the US

干预措施对美国地方心血管疾病负担未来趋势的影响

基本信息

批准号：
10471773
负责人：
Gregory Andrew Roth
金额：
$ 80.4万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-22 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10471773
关键词：
Address Age Age-Years Aging Air Pollution Antihypertensive Agents Aortic Aneurysm Behavior Therapy Blood Pressure Body mass index Cardiovascular Diseases Cardiovascular Models Categories Cause of Death Cessation of life Cholesterol Chronic Kidney Failure Chronic Obstructive Pulmonary Disease Complex Computer Simulation Data Death Rate Diet Education Ethnic Origin Ethnic group Future Geography Glucose Goals Health Health Policy Health Status Health system Healthy People 2020 Heart Heart failure Hydroxymethylglutaryl-CoA Reductase Inhibitors Incidence Income Individual Intervention LDL Cholesterol Lipoproteins Life Cycle Stages Link Longitudinal trends Masks Methods Minnesota Modeling Myocardial Ischemia Obesity Oklahoma Past Trends Pattern Peripheral Vascular Diseases Pharmaceutical Preparations Pharmacotherapy Plasma Policies Population Population trends Primary Prevention Race Reporting Risk Risk Factors Risk Reduction Role Source Stroke Surveys Testing Time Variant Weight Gain Work adherence rate age group base blood pressure reduction burden of illness cardiometabolic risk cardiometabolism cardiovascular disorder prevention cardiovascular disorder risk computer infrastructure computing resources data infrastructure data resource design diabetes prevention program disability-adjusted life years disease disparity econometrics epidemiological model evidence base exhaustion geographic difference geographic disparity health care availability health data health disparity improved intervention program medication compliance migration models and simulation mortality outreach population based population health premature prevent preventive intervention programs racial and ethnic racial and ethnic disparities sex surveillance data trend webinar young adult

项目摘要

PROJECT SUMMARY Geographic and racial/ethnic disparities in cardiovascular diseases (CVD) – the leading cause of death in the U.S. – remain large. Since 2010, CVD death rates are no longer declining in many states, and for some groups, mortality is increasing. Reduction in CVD disparities is a major stated goal of U.S. health policy, but national-level strategies, such as Healthy People 2020 and the Million Hearts campaign, do not directly address these large geographic differences in CVD between states. The U.S. is rich in local health data, yet it is poorly integrated, so there is little evidence available to guide states or local health systems when selecting among primary prevention interventions and policies. Health policy models are an important way to integrate complex patterns of risk exposure and disease burden with other population trends including income, education, aging, migration, and health care access. Previous CVD forecasts and policy models have produced only single geography – primarily national – estimates, which cannot provide the evidence needed to address geographic disparities. The overarching goal for this study will be: a systematic analysis of why CVD patterns vary by age, sex, race/ethnicity, and state in the U.S.; how this variation will lead to future divergence in CVD mortality rates; and the variable impact that similar risk reduction strategies will then have on different U.S. states. For this work, we will adapt econometric, geospatial, and epidemiologic modelling methods by leveraging the large data and computational resources of the Global Burden of Disease Study. Aim 1 is a CVD population health projection that will estimate future burden of CVD for each U.S. state by age, sex, and race/ethnicity. Using observed past trends in CVD and major modifiable causal risk factors, we will project health loss due to CVD, including disability-adjusted life years (DALYs), through 2040 for each U.S. state. We will integrate multiple sources of existing health surveillance data with the results of state-level health examination surveys. Estimates will be produced separately by sex and 5-year age groups, for four collectively exhaustive race/ethnicity categories for CVD overall, and separately for ischemic heart disease, heart failure, stroke, peripheral vascular disease, aortic aneurysm, and chronic kidney disease. Aim 2 is a new set of CVD health policy models that estimate the impact within each state of interventions shown to improve the delivery of pharmacotherapies that lower blood pressure and LDL-cholesterol. Aim 3 is a new set of CVD health policy models that estimate the impact of behavioral interventions shown to reduce CVD risk factors. Projections and policy models for CVD are a necessary step in reducing U.S. health disparities. Our results will be able to guide local decision-makers considering a range of policy options to reduce the burden of CVD. We will then implement a broad dissemination plan designed to expand the impact of our work beyond academic audiences, providing webinars, policy reports, and outreach to health departments and other stakeholders actively engaged in policy work in key states.

项目概要心血管疾病（CVD）的地理和种族/民族差异——心血管疾病的主要原因美国——自 2010 年以来，许多州以及部分州的 CVD 死亡率不再下降。减少 CVD 差异是美国卫生政策的主要既定目标，但国家层面的战略，例如“健康人民 2020”和“百万爱心运动”，并不直接解决各州之间 CVD 的巨大地理差异美国拥有丰富的当地健康数据，但它综合性较差，因此几乎没有证据可以指导各州或地方卫生系统在选择时初级预防干预措施和政策之间的整合是整合卫生政策模式的重要途径。风险暴露和疾病负担与其他人口趋势（包括收入）的复杂模式先前的 CVD 预测和政策模型已经仅产生了单一地理（主要是国家）的估计，无法提供所需的证据这项研究的首要目标是：系统分析 CVD 的原因。模式因年龄、性别、种族/民族以及美国的州而异，这种变化将如何导致未来的分歧； CVD 死亡率；以及类似的风险降低策略对不同的风险产生的不同影响对于这项工作，我们将采用计量经济学、地理空间和流行病学建模方法。利用全球疾病负担研究的大数据和计算资源，目标 1 是 CVD。人口健康预测将按年龄、性别和年龄来估计美国各州未来的 CVD 负担利用观察到的过去的 CVD 趋势和主要可改变的因果风险因素，我们将预测到 2040 年，美国各州因 CVD 造成的健康损失，包括伤残调整生命年 (DALY)。将把现有健康监测数据的多个来源与州级卫生结果相整合考试调查将按性别和 5 岁年龄组分别进行，共四个组。 CVD 总体的详尽种族/民族类别，以及缺血性心脏病、心力衰竭、中风、周围血管疾病、主动脉瘤和慢性肾脏病是一组新的 CVD。卫生政策模型可估计每种干预措施的效果，以改善交付降低血压和低密度脂蛋白胆固醇的药物疗法的目标 3 是一套新的 CVD 健康政策。估计行为干预的影响的模型可减少 CVD 风险因素。 CVD 政策模型是减少美国健康差距的必要步骤。然后，我们将指导当地决策者考虑一系列政策选择，以减轻心血管疾病的负担。实施广泛的传播计划，旨在将我们工作的影响扩大到学术之外受众，提供网络研讨会、政策报告以及对卫生部门和其他利益相关者的宣传积极参与重点国家的政策工作。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Open Data Challenge to Examine the Impact of Social Determinants of Health on Stroke.

开放数据挑战赛旨在检验健康的社会决定因素对中风的影响。

DOI：
10.1161/strokeaha.123.042645
发表时间：
2023
期刊：
Stroke
影响因子：
8.3
作者：
Hall,JenniferL;Roth,GregoryA
通讯作者：
Roth,GregoryA

Impact of the COVID-19 Pandemic on Cardiovascular Health in 2020: JACC State-of-the-Art Review.

DOI：
10.1016/j.jacc.2022.06.008
发表时间：
2022-08-09
期刊：
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
影响因子：
24
作者：
Roth, Gregory A.;Vaduganathan, Muthiah;Mensah, George A.
通讯作者：
Mensah, George A.

Fatal police violence by race and state in the USA, 1980-2019: a network meta-regression.

DOI：
10.1016/s0140-6736(21)01609-3
发表时间：
2021-10-02
期刊：
Lancet (London, England)
影响因子：
0
作者：
GBD 2019 Police Violence US Subnational Collaborators
通讯作者：
GBD 2019 Police Violence US Subnational Collaborators

Life Expectancy for White, Black, and Hispanic Race/Ethnicity in U.S. States: Trends and Disparities, 1990 to 2019.

DOI：
10.7326/m21-3956
发表时间：
2022-08
期刊：
Annals of internal medicine
影响因子：
39.2
作者：
Johnson CO;Boon-Dooley AS;DeCleene NK;Henny KF;Blacker BF;Anderson JA;Afshin A;Aravkin A;Cunningham MW;Dieleman JL;Feldman RG;Gakidou E;Mokdad AH;Naghavi M;Spencer CN;Whisnant JL;York HW;Zende RR;Zheng P;Murray CJL;Roth GA
通讯作者：
Roth GA