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)，以对比其他族裔/种族群体，研究加州拉丁裔健康和长寿的驱动因素，并阐明文化适应对发病率和死亡率的贡献，根据在美国生活的时间和移民美国的年龄来定义。拟议的项目将分析差异的原因以及体力活动干预措施对健康结果和差异的缓解效果。这项研究将促进对加州不断变化的人口概况和人口健康结果的相关变化做出更积极和有效的政策反应，并将为美国其他预计将发生类似人口变化的地区提供范本。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。种族/族裔和社会经济群体之间和内部在发病率和死亡率方面存在差异。总体而言，加利福尼亚州的拉美裔美国人的死亡率低于非拉美裔美国人，但根据移民年龄和在美国的年数将拉美裔人分成几个亚组，可以更好地理解发病率方面的复杂差异。尽管整体健康状况更好，但随着拉美裔在美国呆的时间更长，他们比大多数其他亚群更容易肥胖，并患有糖尿病和/或心血管疾病。拉美裔人口的快速增长，预计到2020年将成为加州最大的种族群体，同时健康状况随着在美国的时间推移而恶化，这增加了更好地了解健康结果可能如何演变以及如何利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是在七年的时间里开发的，它全面评估和预测与加州可预防和/或可减少的健康不良和伤害相关的未来健康结果。加州大学洛杉矶分校的高频傅立叶变换使用微刺激来模拟个体一生的健康状况。它结合了人口统计学、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，它有能力评估一系列能够改善人口健康和改善差距的政策选择。我们建议扩展加州大学洛杉矶分校的高频交易，以(1)纳入关于加州拉美裔移民的信息，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的未来趋势，(3)检查加州拉美裔与其他族裔/种族群体相比缺乏体育活动、吸烟和肥胖的死亡率、疾病和风险因素趋势，(4)分析不同健康行为对拉美裔和其他群体健康差异的贡献，以及(5)估计几种旨在增加体力活动的循证干预措施的效果，关于拉美裔人的健康和健康方面的差距。 与公共卫生的相关性：各族裔群体之间和内部的健康状况存在差异。值得注意的是，拉美裔人在出生地和居住在美国的时间上表现出差异。我们将通过使用基于计算机的模拟模型来研究这些差异的原因，估计考虑到移民模式的加州人健康的未来变化，并比较促进体力活动的不同干预措施改善居住在加州的拉美裔人健康的可能性。

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.