Non-communicable diseases (NCDs) represent 84% of the burden of disease in Chile, with evidence of a social gradient. Reducing the clinical, population, and economic consequences of NCDs and associated health inequities are National Health Objectives, driving health reform and policy innovations, including the health care guarantees system for priority diseases. Two national household surveys have been implemented to study the prevalence of NCDs, their risk factors and access to health services in Chile´s adult population, disaggregated by socioeconomic characteristics: 1) the cross-sectional National Health Survey (NHS, 2003, 2009), which includes questionnaire data and biophysical and biomarker measurements for ~5,900 individuals; and 2) the longitudinal Social Protection Survey (EPS), with four waves (2004, 2006, 2009 and 2012) following ~16,000 subjects.
The School of Public Health has established a research line to study NCDs and socioeconomic disparities, which exploit the under- analyzed data sets of these surveys. The Chilean researchers received a national grant to study how specific socioeconomic trajectories experienced across the life course influence NCD incidence and inequities in effective coverage of these conditions, using the EPS panel data to constitute a prospective cohort. To complement the EPS grant, the team will also analyze the cross-sectional 2009 NHS. Currently, they are negotiating with the Ministry of Health to pair the NHS database with the national mortality database to study the predictive value of risk factors on mortality, using an index of cardiovascular health. These results could be compared with Columbia University´s Multi-Ethnic Study of Atherosclerosis (MESA), which is an ongoing cohort study of cardiovascular and pulmonary disease funded by the NIH. We propose to initiate a research collaboration between the two Universities that involves (a) collaborative analysis of the national survey databases, and (b) sharing of research expertise, networking, and training. The products will include journal publications and scientific events.