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

Public Health Relevance

to the US and Mexico (Specific Aim 3). Through this innovative approach, we will create both a useful tool for the evaluation of clinical and public health interventions in Mexico, build capacity within Mexico for the further development and use of this tool within the Mexican context, and develop collaborations for future comparative work of public health interventions in Mexico and the US. This research will be done primarily in Mexico at the Instituto Nacional de Salud Publica in collaboration with Dr. Simon Barquera, as an extension of Grant-in-Aid from the American Heart Association that will serve as the parent grant for this application. The parent grant, entitled Adaption of the Coronary Heart Disease Policy Model to US Subpopulations (09 GRNT2060096). FIRCA eligibility is established through R01 from the NIDDK (Grant # R01DK090272). PUBLIC HEALTH RELEVANCE: Mexico's policy makers and public health community need reliable, evidence based tools with which to plan public health programs and allocate resources to reduce cardiovascular disease, particularly in light of recent increases in obesity and diabetes. Computer models that estimate the impact of public health policy or clinical policy interventions on cardiovascular outcomes are available, but none has been adapted for use in Mexico. This project brings together teams from the University of California, San Francisco and from the Instituto Nacional de Salud Publica, Cuernavaca, to build a CVD Policy Model-Mexico and to create capacity within Mexico to use the Model to conduct Mexico and global comparative policy oriented research.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Small Research Grants (R03)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-PSE-N (57))
Program Officer
Light, Enid
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
Zip Code
Barquera, Simón; Schillinger, Dean; Aguilar-Salinas, Carlos A et al. (2018) Collaborative research and actions on both sides of the US-Mexico border to counteract type 2 diabetes in people of Mexican origin. Global Health 14:84
Medina, C; Janssen, I; Barquera, S et al. (2018) Occupational and leisure time physical inactivity and the risk of type II diabetes and hypertension among Mexican adults: A prospective cohort study. Sci Rep 8:5399
Denova-Gutiérrez, Edgar; Muñoz-Aguirre, Paloma; Shivappa, Nitin et al. (2018) Dietary Inflammatory Index and Type 2 Diabetes Mellitus in Adults: The Diabetes Mellitus Survey of Mexico City. Nutrients 10:
Mendoza-Herrera, Kenny; Quezada, Amado D; Pedroza-Tobías, Andrea et al. (2017) A Diabetic Retinopathy Screening Tool for Low-Income Adults in Mexico. Prev Chronic Dis 14:E95
Barquera, Simon; Pedroza-Tobias, Andrea; Medina, Catalina (2016) Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol 27:329-44
Medina, Catalina; Barquera, Simon; Katzmarzyk, Peter T et al. (2015) Physical activity during recess among 13-14 year old Mexican girls. BMC Pediatr 15:17
Barquera, Simon; Pedroza-Tobías, Andrea; Medina, Catalina et al. (2015) Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease. Arch Med Res 46:328-38
Pedroza-Tobias, Andrea; Trejo-Valdivia, Belem; Sanchez-Romero, Luz M et al. (2014) Classification of metabolic syndrome according to lipid alterations: analysis from the Mexican National Health and Nutrition Survey 2006. BMC Public Health 14:1056