The Survey of the Health of Wisconsin (SHOW) Program: An infrastructure for Advancing Population Health Sciences

Abstract

Purpose: The Survey of the Health of Wisconsin (SHOW) was established in 2008 by the University of Wisconsin (UW) School of Medicine and Public Health (SMPH) within the Department of Population Health Sciences with the goals of 1) providing a timely and accurate picture of the health of the state residents; and 2) serving as an agile resource infrastructure for ancillary studies. Today SHOW continues to serve as a vital population health research infrastructure supporting studies examining interactions of multiple social determinants of health in the prevalence and etiology of multiple chronic diseases across the life-course. Detailed questionnaire, physical exam and wearable data combined with an extensive biorepository supports translational and multi-omics research to better understand how life experiences and exposures contribute to health disparities and aging processes in a diverse urban and rural population. Participants: SHOW currently includes 5,846 adult and 980 minor participants recruited between 2008-2019 in four primary waves. WAVE I (2008-2013) includes annual statewide representative samples of 3,380 adults ages 21 to 74 years. WAVE II (2014-2016) is a triannual statewide sample of 1957 adults age 18 years and over, and 645 children residing in 10 randomly selected counties. WAVE III (2017) consists of follow-up of 725 adults from the WAVE I and baseline interviews of 222 children in selected households. WAVES II and III include stool samples collected as part of an ancillary study in a subset of 784 individuals. WAVE IV includes geographically focused samples recruited from Milwaukee county, WI, focusing on recruitment of traditionally under-represented populations in biomedical research including African Americans and Hispanics. The WAVE IV samples consist of 517 adults and 113 children. Findings to Date: The ongoing cohort is geographically, racially and metabolically diverse. The core study provides applied public health practitioners data for monitoring population health and policy development. Blood, urine and DNA, along with questionnaire data, were collected in all WAVES. WAVES II - IV include accelerometry-based physical activity and sleep, and expanded biomarkers to whole blood RNA collection with ancillary support of microbiome samples in a subset. Over 59 publications have been written and cover a broad range of topics including the impacts of altered metabolic health on chronic disease prevalence, urban and rural disparities in food security and cardio-metabolic disease, differential impacts of smoking on gene expression among obese and non-obese and lead exposures associate with increased multi-drug resistance and altered gut dysbiosis. Future Plans: The SHOW cohort is available for continued longitudinal follow-up including biospecimen collection for advancing novel biomarker and microbiome research. During the 2020 COVID-19 pandemic, SHOW is maintaining the cohort through web-based surveys of health impacts and conducting serological antibody testing among WAVE II and WAVE IV participants. The biorepository includes over 210,000 DNA, plasma, serum, urine, whole blood DNA, whole blood RNA and stool for future unspecified research. Data are available upon request.

Identification of novel plasma lipid markers of cardiovascular disease risk in White and Black women

“…Our goal was to identify novel circulating lipid markers of CVD in White and Black women in the USA. We obtained clinical data on 119 women from SHOW, a human study with banked plasma that represents a diverse intersection of the population including urban and rural, a range of socioeconomic classes, and both Black and White participants (19). SHOW samples were stratified by race and BP status, where systolic > 120 or diastolic > 80 mmHg was considered HBP (Table 1) (19,20).…”

“…We obtained clinical data on 119 women from SHOW, a human study with banked plasma that represents a diverse intersection of the population including urban and rural, a range of socioeconomic classes, and both Black and White participants (19). SHOW samples were stratified by race and BP status, where systolic > 120 or diastolic > 80 mmHg was considered HBP (Table 1) (19,20). We used HBP as the readout of CVD risk because it is one of the most prevalent markers of CVD risk across multiple populations including White and Black women (21,22).…”

The Survey of the Health of Wisconsin (SHOW) Program: An Infrastructure for Advancing Population Health

“…In addition to the statewide representative sample, the SHOW program has made a concerted effort to engage with and recruit from populations traditionally under-represented in biomedical research. In 2018–2019, SHOW conducted focused recruitment to increase the number of African American and Latino participants ( 27 ). Compared to the SHOW statewide cancer survivorship prevalence of 12%, the 2018–2019 sample of largely African Americans had a lower prevalence of cancer survivorship, around 9%.…”

The Population-based Microbiome Research Core: a longitudinal infrastructure for assessment of household microbiome and human health research

“…The PMRC leverages the existing Survey of the Health of Wisconsin (SHOW), a populationbased health examination survey established in 2008. Details of SHOW data collection have been previously described 21,22 . In brief, the core SHOW study includes a randomly selected statewide population-based sample on over 5,000 state residents.…”