Summary
This project aims to develop a comprehensive understanding of the onset and progression of multimorbidity in U.S. adults by harmonizing national longitudinal health data, estimating progression rates, and identifying disparities across various demographic groups.
What they want
The project involves harmonizing and bridging seven national longitudinal cohort datasets (Add Health, NLSY79, NLSY97, PSID, REGARDS, H-EPESE, HRS) to create a synthetic nationally representative cohort of over 1.7 million person-years, tracking chronic disease incidence from age 30. It will estimate age-specific progression rates of common chronic disease clusters and identify sentinel conditions associated with higher risks of progression. The project will also develop measures of age-specific and lifetime risk of multimorbidity for the U.S. adult population, including years spent with multimorbidity. Furthermore, it will identify sentinel conditions, age-specific progression, and lifetime risk of multimorbidity for major race-ethnic, sex, economic, and geographic groups, quantifying the implications of reducing these disparities on disease-free life expectancy, with adjustments for biases due to differential mortality and institutionalization. The methodology includes bridging and reweighting procedures for data infrastructure, Poisson regression to model age-specific disparities, and Kaplan-Meier survival probabilities and Greenwood’s estimator to quantify disparities.
Deliverables
- Synthetic nationally representative cohort of adults starting at age 30 years
- Estimates of age-specific progression rate of common chronic disease clusters
- Identification of sentinel conditions associated with higher risks of progression to additional diseases
- Measures of age-specific risk of multimorbidity for the US adult population
- Calculations of lifetime risk of developing multimorbidity and years spent with multimorbidity
- Identification of sentinel conditions, age-specific progression, and lifetime risk of multimorbidity for major race-ethnic, sex, economic, and geographic groups
- Quantification of implications of reducing disparities on disease-free life expectancy
- Data infrastructure made available to the research community
Technical requirements
- Bridging and reweighting procedures for data infrastructure development
- Poisson regression to model ages at which disparities in multi-morbidity emerge
- Estimation of probability of experiencing an additional (k+1th) condition for those with k prior chronic conditions
- Cumulative probabilities based on Kaplan-Meier survival probabilities
- Greenwood’s estimator for quantifying disparities
