Obesity and related chronic diseases, type 2 diabetes, non-alcoholic fatty liver disease, and dyslipidemia continue to increase in the U.S., and Latinos are disproportionally affected. These disparities begin in early life, occur within families, and are driven by multi-level factors, including individual (diet, eating behaviors), social (cultural values, economic factors), and environmental (access to healthy foods, chemical exposures such as air pollution). These factors interact to affect Latino health but are rarely studied in a holistic manner. Our overarching goal is to understand how these multi-level factors contribute to multiple chronic disease disparities in Latinos across the life course, and to develop and evaluate family-based, culturally sensitive solutions. We propose to accomplish this ambitious goal by establishing the Southern California Center for Chronic Health Disparities in Latino Families and Children (SCC-CHDLFC), a coalition of academic, clinical, government, and community stakeholders across the region that is home to 10.8 million Latinos representing 45.2% of the population. The Center is led by Drs. Goran (Children’s Hospital Los Angeles; CHLA) and Baezconde-Garbanati (Univ. of Southern California; USC), who provide complementary expertise in Latino health disparities research. The Administrative Core provides leadership, oversight, communication, and evaluation to strengthen and build collaboration, accelerate research, and drive innovation to ensure Center success and impact. Project 1 (led by Dr. Goran, CHLA) utilizes an ongoing birth-cohort to examine how early-life nutrition, environment, and social factors affect chronic disease risk by age 5y, and how these factors affect response to family-based interventions in Projects 2 and 3. Project 2 (led by Dr. Boutelle, UC San Diego) tests a parent-only intervention for treatment of obesity and chronic disease risk in Latino children. The intervention, designed to address cultural issues relevant to Latino families, is delivered by telehealth to parents only, increasing dissemination potential. Project 3 (led by Dr. Cohen, Kaiser Permanente) examines the efficacy of an affordable grocery delivery program (at a cost not exceeding SNAP dollars), in conjunction with culturally appropriate meal planning, on chronic disease risk reduction in Latino multi-generation households. We will support synergy and collaboration across these projects and build the research enterprise through Center Cores. The Methods & Data Sub-Core led by Dr. Espinoza (CHLA) will provide expertise in assessment of diet, social, environmental, and geospatial factors, and data analysis and management, to support data harmonization and sharing. The Investigator Development Core led by Drs. Spruijt-Metz and de la Haye (USC) and Elder (San Diego State Univ.) will establish a mentoring network and pilot study program to support early-stage or underrepresented researchers, while also promoting team science. The Community Engagement Core led by Drs. Kipke (CHLA) and Baezconde-Garbanati (USC) engages the community in the research process via bi-directional interaction with the overall goal to accelerate the impact of Center findings on the Latino community to mitigate chronic disease risk across the region.

Southern California consists of 10 contiguous Counties and is home to 10.8 million Latinos (representing 45.2% of the population) who are disproportionally affected by multiple and co-occurring chronic diseases, namely obesity, type 2 diabetes, nonalcoholic fatty liver disease, and dyslipidemia. This disparity begins to develop early in life, occurs within families, is magnified by inter-generational transmission, and is driven by multi-level factors including diet, cultural values, social determinants, economic factors, and environmental-level factors like access to healthy foods and other chemical exposures such as air pollution. Our overall goal is to understand how the complex inter-play between these multi-level factors contribute to multiple chronic disease disparities in Latinos across the life course, and to develop and evaluate the acceptance, delivery, and clinical efficacy of family- based, culturally sensitive solutions by establishing the Southern California Center for Chronic Health Disparities in Latino Families and Children (SCC-CHDLFC).