Enhancing Mexican Capacity for CVD Policy Research

描述（由研究者提供）：在墨西哥，肥胖率以惊人的速度增加，按照世卫组织的标准，目前有4000多万人超重或肥胖。糖尿病在成年人中的患病率现在为14%（是美国水平的两倍多），其他心脏病风险因素的比率也在增加。在不久的将来，墨西哥将面临心血管病死亡率和发病率大幅上升的问题，并为此付出相应的经济和社会代价。墨西哥的政策制定者和公共卫生界需要可靠的、基于证据的工具来规划公共卫生项目和分配资源。在墨西哥，临床相关的、基于证据的政策决策是非常重要和可行的，因为超过一半的人口目前通过政府健康计划投保。估计公共卫生政策或临床政策变化对心血管结局影响的模型是可用的，但没有一个适用于墨西哥。我们建议与墨西哥的一个杰出团队合作，创建一个新的冠心病政策模型的综合计算机模拟模型，该模型将包括额外的效应调节剂和额外的疾病状态，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），使用CVD政策模型的创建过程-墨西哥将提高墨西哥国内了解流行病学和保健数据来源的能力，这些数据来源将为模型提供投入，根据动态疾病特异性计算机模型的原则（具体目标2），将新创建的CVD政策模型-墨西哥应用于墨西哥相关的公共卫生问题，并对以下方面进行比较政策评估：

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