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.
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.
|Shi, Lu; Zhang, Donglan; van Meijgaard, Jeroen et al. (2015) The Interaction Between an Individual's Acculturation and Community Factors on Physical Inactivity and Obesity: A Multilevel Analysis. Am J Public Health 105:1460-7|
|Zhang, Donglan; van Meijgaard, Jeroen; Shi, Lu et al. (2015) Does neighbourhood composition modify the association between acculturation and unhealthy dietary behaviours? J Epidemiol Community Health 69:724-31|