RFA-DP-23-001, Simulation Model of Interventions Linking Evidence to SDOH (SMILES)

PROJECT SUMMARY/ABSTRACT
To support the Centers for Disease Control and Prevention (CDC) and states and communities in identifying
programs, policies, or practices (PPP) that can reduce the ever-widening gaps in chronic disease incidence
and mortality in the United States, we will develop a model to explore the impacts of social determinants of
health (SDOH) factors on chronic disease incidence, mortality, and disparities over the next 5 to 30 years.
We will use a systems science approach to create a mathematical simulation model that integrates risk and
SDOH factors for the incidence of heart disease, stroke, diabetes, CKD, cancer, and Alzheimer’s disease,
accounting for the interconnectedness and feedback loops between SDOH and chronic disease. The model
will incorporate evidence-based strategies for addressing SDOH factors in each of the five priority areas for
CDC’s National Center for Chronic Disease Prevention and Health Promotion: the built environment,
community-clinical linkages, food and nutrition security, tobacco-free policy, and social connectedness. By
generating synthetic populations to represent the SDOH-related characteristics (e.g., race/ethnicity, sex,
age, income, education, and urban vs. rural status) and chronic disease risk factors of the selected county
or state population, the model will produce valid results for each county and state in the United States.
The model will also be calibrated to national surveillance data. We will develop a multi-user, web-based,
public-use version of the model to operate on CDC’s web platforms. CDC and public health partner groups
can run scenarios using the model to explore which combinations of PPPs would have the greatest impact
on reducing chronic disease disparities and outcomes and how PPPs compare in terms of costs and cost-
effectiveness. Results from the model will inform future public health practices related to SDOH. Moreover,
the publicly available model will allow community members and public health interest groups to create
scenarios and explore the impacts of various PPPs on health outcomes and disparities, thus encouraging
the use of community-based participatory processes and decision-making around solutions to address
SDOH and reduce disparities in chronic disease risk factors, incidence, and mortality.

Grant Number: 5U01DP006758-03
NIH Institute/Center: ALLCDC
Principal Investigator: Benjamin Allaire