Multidisciplinary Hispanic health study receives $21 million NIH grant

A multidisciplinary team of University of Miami researchers studying factors associated with health outcomes and disease risk in the Hispanic community has received a $21 million grant from the National Institutes of Health (NIH). The high-impact grant will extend the national Hispanic Community Health Study/Study of Latinos (HCHS/SOL), initially launched in 2008, to 2033. As one of only four U.S. sites selected for the study, the University of Miami has built a collaborative and multidisciplinary research team that has generated many new insights into cardiovascular disease, diabetes, cancer, risk behaviors and other health issues affecting South Florida's diverse Hispanic community.

"The College of Arts and Sciences is thrilled that the National Institutes of Health has renewed funding for this landmark study, which has been housed in the Department of Psychology for 18 years," said Leonidas Bachas, dean of the College of Arts and Sciences. "This study is critically important in providing a deeper understanding of chronic diseases in Hispanic and Latino populations. I feel confident that, under the capable leadership of Professor Frank Penedo and his colleagues, Professors Maria Llabre and Christina Cordero in the Department of Psychology, as well as collaborators across the Miller School of Medicine, it will continue to positively impact communities throughout the United States."

Findings from the ongoing research – including dozens of related studies that build off the cohort – are influencing clinical care and prevention strategies."

Frank J. Penedo, Ph.D., principal investigator for the HCHS/SOL study

Dr. Penedo is the associate director for Population Sciences at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, and a professor in the Departments of Psychology and Medicine.

Joining Dr. Penedo in the fourth phase of the study as co-principal investigators are Maria Llabre Ph.D., professor of psychology and education; Claudia Martinez, M.D., associate professor of clinical medicine in the cardiovascular division; and Christina Cordero, Ph.D., assistant professor of psychology and HCHS/SOL project director.

"I am incredibly proud to be part of the team leading this study at the University of Miami," said Dr. Cordero. "This grant award will enable us to expand upon the extensive data and discoveries gathered since the cohort's inception. Our work continues to uncover novel insights into how biologic, genetic/multi-omic, behavioral, environmental, and social factors influence health and disease in diverse Hispanic/Latino groups across the U.S."

Advancing precision prevention and medicine for Hispanics

HCHS/SOL is the most comprehensive, epidemiological longitudinal study among U.S. Hispanics/Latinos, with 4,000 participants recruited at each of the four sites: Miami, Chicago, San Diego, and the Bronx in New York City. Each site will receive $21 million in the fourth phase of the grant, which includes support from the National Heart Lung and Blood Institute and six other contributing NIH institutes.

The study participants will represent diverse Hispanic background, including Mexican, Puerto Rican, Cuban, and Central and South American heritages, and will take part in in-depth clinical exams, blood and imaging tests, as well as nutritional, behavioral and psychosocial assessments.

"This groundbreaking study advancing our understanding of unique risk factors among diverse Hispanics and informing targeted precision prevention and medical care in cardiovascular diseases, as well as many other conditions such as diabetes and cancer," said Dr. Penedo. "Our comprehensive clinical exam and assessments capture critical information, including genetic data, social determinants of health, social processes, and emotional well-being. This approach allows us to more precisely identify risk determinants and modifiable risk factor to improve health outcomes in this population."

If serious health issues are identified, participants are referred to their primary care providers or community-based organizations serving uninsured individuals.

They have already discovered that the risk of cardiovascular disease is similar across Hispanic groups, and 71 percent of women and 80 percent of men have at least one risk factor for cardiovascular disease. Conversely, they have found significant differences in risk factors in different Hispanic populations, such as higher rates of diabetes in participants of Mexican, and Central and South American backgrounds. Strikingly, in the entire cohort, over 40 percent of the individuals who were diabetic were not aware of their condition, added Dr. Penedo, and multiple barriers impacted cancer screening behaviors that did not generally meet recommended prevention guidelines.

"This points to the importance of targeted strategies to increase awareness and hopefully prevent the onset of diabetes, cancer and other metabolic diseases," he said.

The study was initially conceptualized and led by Neil Schneiderman, Ph.D., an expert in tackling health disparities and a professor in the College of Arts and Sciences, who passed away in 2023. Since the study launched, University researchers have used the wealth of data from the first three phases of HCHS/SOL to conduct 28 ancillary studies, focusing on cancer, vascular dementia, obstructive sleep apnea, COVID-19 and other issues. About 4 percent of participants were diagnosed with cancer upon the start of the cohort.

"In general, Hispanics have lower rates of common cancers, but a higher rate of advanced disease," he said. "There are also cultural issues, such as a sense of fatalism that is related to poor adherence to screening guidelines for colorectal cancer."

The continuation of this NIH grant will allow researchers to collect additional longitudinal data and conduct more sophisticated modeling for risk factors, disease progression, and clinical outcomes, with opportunities to incorporate emerging novel analytic tools such as artificial intelligence and machine learning methodologies to predict disease onset.

New research opportunities

The research group expects about 80 percent of the 4,000 Miami-Dade participants in prior HCHS/SOL study phases to participate in the fourth visit. To this date, over 500 scientific papers have been published from this cohort, and with the renewal to continue the study, there will be ample opportunities to examine long-term associations among multi-level disease risk and protective factors in the Hispanic community. 

Furthermore, the team encourages University students, trainees and faculty to take advantage of the wealth of information in the study's open-access database and capitalize on the research opportunities the data presents.

Reflecting on the 18 years of the HCHS/SOL study, Dr. Cordero added, "Our success in achieving the highest retention rates across the four sites is a testament to the exceptional dedication of our research staff and the trust of our participants. Together, we strive to make a lasting and meaningful impact on the health of Hispanic/Latino communities."