The majority of the U.S. adult population is affected by one or more cardio-metabolic conditions: 40% of adults have obesity, 12% diabetes, 15% CKD, and 48.0% CVD. This study will identify the age-specific patterns of multi-morbidity incidence and the divergent trajectories leading to race-ethnic, geographic, and economic disparities in multi-morbidity. This research will build on the methodological advances of our ongoing NIH-funded research in harmonizing and bridging multiple national datasets for longitudinal analyses. We will take advantage of 5 high-quality longitudinal national cohort studies: the National Longitudinal Study of Adolescent Health (Add Health), the Panel Study of Income Dynamics (PSID), the National Longitudinal Study of Youth (NLSY-79 and NLSY-97 samples), and the Reasons for Regional Differences in Stroke Study (REGARDS). The goals of this research include determining the age-specific national prevalence of multi-morbidity across adulthood in the U.S by race-ethnicity, socioeconomic status, sex, and region, identifying the ages at which prominent race-ethnic, geographic, and economic disparities in multi-morbidity emerge; estimating the progression rate to multi-morbidity by race-ethnicity, geographic region, sex and socioeconomic status, identifying the sentinel conditions which are associated with higher risks of progressing to additional morbidities; identifying which race-ethnic, geographic, and economic groups experience rapid progression to multi-morbidity after a first chronic condition and estimate what the differences in progression would be after adjusting for differential mortality among these groups.
05/01/2022 to 04/30/2026