Acculturation and physical activity: Forecasting and improving Latino health

描述（由申请人提供）：我们建议扩展加州大学洛杉矶分校健康预测工具（UCLA HFT），与其他族裔/种族群体相比，研究加州拉美裔人健康和寿命的驱动因素，并阐明文化适应（由在美国居住的时间和移民到美国的年龄定义）对疾病和死亡率的贡献。拟议的项目将分析差异的原因，以及身体活动干预对健康结果和差异的缓解作用。这项研究将促进对加州不断变化的人口状况和人口健康结果的相关变化作出更积极和有效的政策反应，并将作为该国其他预计发生类似人口变化的地区的典范。该项目还将展示对大规模实施卫生干预措施的潜在影响进行可靠的、基于证据的估计的方法。发病率和死亡率在种族/族裔和社会经济群体之间和内部存在差异。总的来说，加利福尼亚的拉美裔人的死亡率比非拉美裔人低，然而，根据移民年龄和在美国居住的年限将拉美裔人分解成亚组，可以更有力地了解发病率的复杂差异。尽管整体健康状况较好，但由于拉美裔人在美国生活的时间更长，他们比大多数其他亚群体更容易肥胖、患糖尿病和/或心血管疾病。拉丁裔人口的快速增长，预计到2020年将成为加利福尼亚州最大的种族群体，随着在美国的时间推移，健康状况也在恶化，这增加了更好地了解健康结果如何演变以及如何使用计划和政策来改善未来健康结果的紧迫性。加州大学洛杉矶分校的HFT已经开发了七年，全面评估和预测与加州可预防和/或可减少的疾病和伤害相关的未来健康结果。加州大学洛杉矶分校的高频交易使用微刺激来模拟个人整个生命周期的健康状况。它纳入了关于人口统计、行为风险因素和其他健康决定因素、相关疾病和健康状况的数据。最重要的是，它有能力评估能够改善人口健康和缩小差距的各种政策选择。我们建议扩大加州大学洛杉矶分校的HFT，以(1)纳入加州拉丁裔移民的信息，包括他们在美国的时间长度；(2)估计糖尿病、心血管疾病和死亡率发病率的未来趋势；(3)与其他族裔/种族群体相比，检查加州拉丁裔与缺乏运动、吸烟和肥胖有关的死亡率、疾病和风险因素趋势。(4)分析不同的健康行为对拉美裔和其他群体之间健康差异的贡献；(5)估计几种旨在增加身体活动的循证干预措施对拉美裔健康和健康差异的影响。

DESCRIPTION (provided by applicant): We propose to expand the UCLA Health Forecasting Tool (UCLA HFT) to examine drivers of health and longevity in Latinos in California compared to other ethnic/racial groups, and to elucidate the contribution of acculturation, as defined by time lived in the U.S. and age at immigration to the U.S., on rates of disease and death. The proposed project will analyze causes of disparities and the mitigating effects of physical activity interventions on health outcomes and disparities. This research will facilitate more proactive and effective policy responses to California's changing demographic profile and related changes in population health outcomes, and will serve as a model for other regions of the country where similar demographic shifts are expected. The project will also demonstrate methodology for generating sound, evidence-based estimates of the potential impact of large-scale implementation of health interventions. Disparities in morbidity and mortality exist between and within racial/ethnic and socioeconomic groups. Overall, Latinos in California exhibit lower mortality rates than non-Latinos, however disaggregation into subgroups based on the age of immigration and number of years in the U.S. permits a more robust understanding of complex disparities in morbidity. Despite better overall health outcomes, as Latinos spend more time in the U.S. they are more likely to be obese and have diabetes and/or cardiovascular disease than most other sub-populations. The rapid increase in the Latino population, expected to become the largest ethnic group in California by 2020, along with a health profile that deteriorates with time spent in the U.S., adds urgency to better understanding how health outcomes may evolve and how programs and policies may be used to improve future health outcomes. The UCLA HFT, which has been developed over the course of seven years, comprehensively evaluates and forecasts future health outcomes associated with preventable and/or reducible ill-health and injury in California. The UCLA HFT uses micro stimulation to model individuals' health over the entire life span. It incorporates data on demographics, behavioral risk factors and other determinants of health, related disease and health conditions. Most important is its ability to evaluate a broad range of policy alternatives that can improve population health and modify disparities. We propose to expand the UCLA HFT to (1) incorporate information on the migration of Latinos in California, including the length of time they have been in the U.S., (2) estimate future trends in the incidence rates of diabetes, cardiovascular disease and mortality, (3) examine mortality, disease and risk factor trends in relation to physical inactivity, smoking and obesity for Latinos in California compared to other ethnic/racial groups, (4) analyze the contribution of differential health behaviors on health disparities among Latinos and other groups, and (5) estimate the effects of several evidence-based interventions, designed to increase physical activity, on the health of Latinos and disparities in health. PUBLIC HEALTH RELEVANCE: Disparities in health are seen between and within ethnic groups. Notably, Latinos exhibit disparities associated with place of birth and time lived in the United States. We will examine the causes of these disparities through the use of a computer-based simulation model, estimate future changes in the health of Californians that take into account migration patterns, and compare the potential for different interventions that promote physical activity to improve the health of Latinos living in California.