Enhancing Mexican Capacity for CVD Policy Research

描述（由调查者提供）：墨西哥的肥胖率正以惊人的速度增长，按照世卫组织的标准，现在有超过4000万人超重或肥胖。成人糖尿病患病率目前为14%（是美国的两倍多），其他心脏病风险因素的发病率也在增加。在不久的将来，墨西哥将面临心血管死亡率和发病率的大幅增加，并带来相应的经济和社会代价。墨西哥的决策者和公共卫生界需要可靠的、以证据为基础的工具来规划公共卫生方案和分配资源。临床相关的、基于证据的政策决策在墨西哥特别重要和可行，因为目前有一半以上的人口通过政府健康计划获得保险。目前已有估算公共卫生政策或临床政策变化对心血管结果影响的模型，但没有一种模型适用于墨西哥。我们建议与墨西哥的一个优秀团队合作，创建一个综合的冠心病（CHD）政策模型的新计算机模拟模型，该模型将包括额外的效果修饰符和额外的疾病状态，并将适应于模拟墨西哥的疾病，即“CVD政策模型-墨西哥”（具体目标1）。利用创建CVD政策模型-墨西哥的过程，提高墨西哥国内的能力，了解将为该模型提供输入的流行病学和医疗保健数据源以及针对特定疾病的动态计算机模型的原则（具体目标2），并将新创建的CVD政策模型-墨西哥应用于与墨西哥相关的公共卫生问题，并对以下问题进行比较政策评估

DESCRIPTION (provided by investigator): Rates of obesity are increasing with extraordinary rapidity in Mexico, with over 40 million people now overweight or obese by WHO criteria. Diabetes prevalence in adults in now at 14% (over twice the level in the US) and rates of other heart disease risk factors are also increasing. In the near future, Mexico will face an enormous increase in cardiovascular mortality and morbidity with commensurate economic and social costs. Mexico's policy makers and public health community need reliable, evidence-based tools with which to plan public health programs and allocate resources. Clinically relevant, evidence-based, policy decision making is exceptionally important and feasible in Mexico, as more than half the population are currently insured through a government health plan. Models that estimate the impact of public health policy or clinical policy changes on cardiovascular outcomes are available, but none has been adapted for use in Mexico. We propose to collaborate with an outstanding team in Mexico to create an integrated new computer simulation model of the Coronary Heart Disease (CHD) Policy Model that will include additional effect modifiers and additional disease states and will be adapted to simulate disease in Mexico, the "CVD Policy Model- Mexico" (Specific Aim 1), to use the process of the creation of the CVD Policy Model-Mexico to increase capacity within Mexico to understand the epidemiological and healthcare data sources that will provide the inputs to the model and the principles of dynamic disease-specific computer models (Specific Aim 2), and to apply the newly created CVD Policy Model-Mexico to public health issues of relevance in Mexico and to develop comparative policy evaluations of