Biomarker Cross-Calibration to Investigate International Health Inequalities

 描述（由申请人提供）：即使使用客观测量的生物健康标志物，人口健康的跨国比较仍然是一个重大挑战。该项目将对应对这一关键的科学和政策挑战产生重大和持续的影响。该应用程序解决了最近美国国家科学院审查的前3项建议，该审查强调了与大多数其他主要发达国家相比，美国的健康结果令人惊讶地差：（1）提高可用于跨国健康比较的数据来源的质量和一致性（目标3），（2）完善跨国健康研究的分析方法和研究设计（目标3-5）;（3）启动研究，致力于了解造成美国健康劣势的因素（目标1和2）。我们建议协调来自一些发达国家和发展中国家的越来越多的生物标志物数据，以增加这些对世界经济，老龄化和健康趋势日益重要的贡献者的健康差异的信息来源。至关重要的是，为了实现我们的目标，我们将对特定国家的生物标志物数据进行急需的交叉校准，以便根据客观测量的健康参数进行直接比较研究。这将使比较健康研究超越以前的努力，这些努力在很大程度上限于现有的死亡率或自我报告数据。本R 01的拟议目标将导致19个发达国家和发展中国家基于人群的成人样本的客观测量的生物标志物数据的协调。当前分析中包括的生物标志物（C反应蛋白[CRP]、糖化血红蛋白[HbA 1c]、HDL和总胆固醇）反映了与发病率和死亡率主要原因相关的主要病理生理过程。目前项目的具体目标包括：对代表19个国家的11项主要人口健康调查的生物标志物数据进行交叉校准/统一;记录和传播编制统一生物标志物数据的方法，供更广泛的研究界使用;并通过描述和比较交叉，基于原始和校准数据的关键生物风险概况的国家差异，并描述和比较关键人口和社会经济特征之间关系的跨国差异（例如，年龄、性别、教育、经济资源）和基于原始与校准生物标志物的4个生物参数的分布。拟议的目标将产生一组关于HbA 1c、血脂和CRP的公开、交叉校准数据，用于代表19个国家的11项主要人口健康调查，沿着利用这些数据进行分析的结果，这些数据解决了与美国相对健康状况以及经济发展与健康之间关系有关的问题。

 DESCRIPTION (provided by applicant): Cross-country comparisons of population health remain a substantial challenge even using objectively measured biological health markers. This project will have a significant and sustained impact on addressing this key scientific and policy challenge. This application addresses the top 3 recommendations from a recent National Academy of Science review that highlighted the surprisingly poor US health outcomes as compared with those of most other major developed countries : (1) improve the quality and consistency of data sources available for cross-national health comparisons (Aim 3), (2) refine analytic methods and study designs for cross-national health research (Aims 3-5) and (3) initiate research devoted to understanding factors responsible for the US health disadvantage (Aims 1 & 2). We propose to harmonize the growing body of biomarker data from a number of developed and developing countries to increase the source of information on health differences in these increasingly important contributors to world economic, aging and health trends. Crucially, to accomplish our aims, we will implement critically needed cross-calibration of country-specific biomarker data to allow for direct comparative research based on objectively measured health parameters. This will move comparative health research beyond prior efforts that were largely restricted to available mortality or self-report data. The proposed aims of this R01 will result in harmonization of objectively measured biomarker data for population-based samples of adults in 19 developed and developing countries. Biomarkers included in the current analyses (C-reactive protein [CRP], glycosylated hemoglobin [HbA1c], HDL and total cholesterol) reflect major pathophysiological processes linked to major causes of morbidity and mortality. Specific aims of the current project include: implementing cross-calibration/harmonization of biomarker data for 11 major population-based health surveys representing 19 countries; documenting and disseminating methods to produce harmonized biomarker data for use by the broader research community; and illustrating the impact of calibration by describing and comparing cross-national differences in key biological risk profiles based on raw and calibrated data and describing and comparing cross-national differences in relationships between key demographic and socio-economic characteristics (e.g., age, sex, education, economic resources) and distributions of the 4 biological parameters based on raw vs. calibrated biomarkers. Proposed aims will result in a set of publicly available, cross-calibrated data on HbA1c, lipids and CRP for 11 major population health surveys representing 19 countries along with findings from analyses leveraging those data that address questions relating to both the relative health status of the US and relationships between economic development and health.