Islanders in the US-Affiliated Pacific Islands (USAPI) experience some of the highest mortality rates resulting from non-communicable diseases (NCD) in the world, yet they are excluded from national health surveys such as the National Health and Nutrition Examination Survey and the National Health Interview Survey. The absence of longitudinal health data on populations makes it extremely difficult to truly understand their health disparities they face and restricts the ability to address their long-term health needs. The intent of this project is to establish the baseline of a generational epidemiologic cohort, with a focus on cardiometabolic risk factors, in Guam and Pohnpei. Approximately 1,100 children and parents (or 550 dayds) will be recruited to obtain information on NCD lifestyle factors from two generations of USAPIs.
The specific aims are to: 1) estimate the prevalence of NCD lifestyle factors (acculturation, alcohol, betel nut, diet, hypertension, obesity, physical activity, sleep, stress, and tobacco use), 2) estimate the prevalence diabetes mellitus (DM) and dyslipidemia through biomarkers, and 3) validate the association of DM and acanthosis nigricans. The children will be recruited from the Early Hearing and Detection Intervention birth cohorts in Guam and Pohnpei. The research staff will be trained in the ethics and methods involved in population health research. Data collection will include survey questionnaires and the collection of biospecimens for the verification of cardiometabolic biomarkers. Throughout the research process, the proposed partnerships (among the University of Guam and College of Micronesia programs, the public health laboratories, community partners, and government and non-government agencies with some form of data linkage infrastructure), will be further developed. The epidemiologic cohort will be sustained through the institutionalization and sharing of the work among partners. Over time the data will provide critical information on the cardiometabolic risk in Guam and Pohnpei and will be used to refine health messages and intervention strategies, as well as improve the equality of health care practices relevant to USAPI populations. 1

Public Health Relevance

This project addresses the need for population health research in the US-Affiliated Pacific Islands (USAPI) where non-communicable diseases, especially cardiometabolic diseases, are the leading cause of death. The data collected will help researchers better understand the health disparities experienced among USAPI populations, while the institutionalization of the proposed epidemiologic cohort will ensure the sustainability of population health data collection. The information will continue to inform the prevention and control of cardiometabolic diseases, as well as overall health promotion in the USAPIs. 1

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Resource-Related Research Projects--Cooperative Agreements (U24)
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Special Emphasis Panel (ZMD1)
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Alvidrez, Jennifer L
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University of Guam
Other Health Professions
Sch Allied Health Professions
United States
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