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

• 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
• 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

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.

项目摘要 心血管疾病（CVD）的地理和种族/民族差异-美国人的主要死亡原因 美国- 保持大。自2010年以来，许多州的心血管疾病死亡率不再下降， 群体，死亡率在上升。减少心血管疾病的差异是美国卫生政策的一个主要目标， 国家级战略，如《健康人民2020》和“百万心”运动， 解决这些国家之间CVD的巨大地理差异。美国拥有丰富的当地健康数据，但它 综合性很差，因此在选择时，几乎没有证据可以指导州或地方卫生系统 初级预防干预措施和政策。卫生政策模式是整合的重要途径 风险暴露和疾病负担的复杂模式与其他人口趋势，包括收入， 教育、老龄化、移民和医疗服务。先前的CVD预测和政策模型 只产生了单一的地理-主要是国家-估计，这不能提供所需的证据， 解决地域差异。这项研究的总体目标是：系统分析为什么CVD 在美国，模式因年龄、性别、种族/民族和州而异;这种变化将如何导致未来的分歧 心血管疾病死亡率;和变量的影响，类似的风险降低策略，然后将有不同的 美国states.在这项工作中，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量数据和计算资源。目标1是CVD 人口健康预测，将估计未来的心血管疾病的负担，为每个美国国家的年龄，性别， 种族/民族。利用观察到的心血管疾病过去的趋势和主要的可改变的因果风险因素，我们将预测 心血管疾病造成的健康损失，包括美国各州到2040年的残疾调整生命年（DALLS）。我们 将现有健康监测数据的多个来源与州一级健康监测结果相结合。 考试调查。估计数将按性别和5岁年龄组分别编制， CVD总体的详尽人种/种族分类，以及单独的缺血性心脏病、心力衰竭， 中风、外周血管疾病、主动脉瘤和慢性肾病。Aim 2是一套新的CVD 卫生政策模型，用于估计每种干预措施在改善交付方面的影响 降低血压和低密度脂蛋白胆固醇的药物疗法。目标3是一套新的心血管疾病健康政策 模型，估计行为干预的影响，以减少心血管疾病的危险因素。预测和 CVD的政策模式是减少美国健康差距的必要步骤。我们的结果将能够 指导地方决策者考虑一系列政策选择，以减轻心血管疾病的负担。然后我们将 实施广泛的传播计划，旨在扩大我们的工作的影响超越学术 受众，提供网络研讨会、政策报告并与卫生部门和其他利益相关者进行外展 积极参与关键国家的政策工作。

项目成果

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.

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

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

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)
• 作者: GBD 2019 Police Violence US Subnational Collaborators