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Dataset: Mexican Health and Aging Study (MHAS)

Basic Information
Dataset full name: Mexican Health and Aging Study
Dataset acronym MHAS
Summary The Mexican Health and Aging Study (MHAS) is an ongoing, nationally representative longitudinal study of adults in Mexico aged 50 years or older and their spouse and/or partner. The MHAS was designed to prospectively evaluate the impact of disease on the health, function and mortality of adults over the age of 50 in both urban and rural areas of Mexico. The objective of the study is to examine the aging process and its disease and disability burden in a large representative panel of older Mexicans, using a wide socioeconomic perspective. The study protocols and survey instruments are highly comparable to the Health and Retirement Study (HRS). In 2012, a new sample of participants was added to the ongoing cohort interviewed in 2001 and 2003 who remained in the study for the third follow-up interview. A subsample of 2,086 participants provided data on biomarkers: HbA1c, total and high-density cholesterol, gait speed, and vitamin D. The fourth wave of data collection began in 2015 following up with the approximately 18,000 study participants. A sub-sample (n=3,000) of this wave will receive a visit in 2016 to perform an in-depth cognitive assessment.
Key Terms International, Aging, Health, Disability, Cognition, Migration, Mexico
Study Design Longitudinal
Data Type(s) Survey
Sponsoring Agency/Entity National Institutes of Health/ National Institute on Aging, Instituto Nacional de Estadı´stica, Geografia e Informa´tica (INEGI) in Mexico. Waves 1 and 2: supported by collaborative effort of researchers from the Universities of Pennsylvania, Maryland and Wisconsin in the U.S. and the Instituto Nacional de Estadı´stica, Geografia e Informa´tica (INEGI) in Mexico. Waves 3 and 4: supported by collaborative effort from the University of Texas Medical Branch (UTMB), the University of Wisconsin, the Instituto Nacional de Geriatrı´a (INGer, Mexico) and the Instituto Nacional de Salud Pu´blica (INSP, Mexico).
Health conditions/Disability measures
Health condition(s) Health in multiple domains (self-report of global health, chronic conditions, symptom reports, functionality, depression, cognition) Hypertension, Diabetes, Cancer (& location), Lung disease, Heart attack, Stroke, Arthritis,
Disability Measures Activities of Daily Living, Instrumental Activities of Daily Living, Mobility, Upper Limb Disability, and Cognition
Measures/outcomes of interest
Topics Health : self-report of global health, chronic conditions, symptom reports, functionality, depression, cognition, Socioeconomic conditions: (current and in childhood), work history, health insurance, health expenditures. Family background (family structure, transfer behaviors, care arrangements, health and migration histories of respondents, parents and children), children (regardless of place of residence), household residents, income, assets, pension history, current housing, quality of the built environment. Biomarker Data: Blood pressure, waist circumference, gait speed, Handgrip strength, Hemoglobin, vitamin D, and cholesterol.
Sample
Sample Population Individuals 50 years of age and older selected from residents of both rural and urban areas distributed in all 32 states in the Mexico. Oversample of households in the six states with a high–U.S.-migration state (accounting for 40% of all migration to the US) Individual and Households level
Sample Size/Notes Baseline Wave 1, 2001: 15,186 interviewed individually.In 2001 - a random sub-sample of 2,573 completed anthropometric measures (height, weight, waist circumference, hip circumference, knee height, and calf circumference).Wave 2, 2003: 14,250 interviewed individually (added 125 new spouses).Wave 3, 2012: 18,465 interviewed individually (added 385 spouses and 6,259 new individuals) and a subsample of 2086 provided data on biomarkers.Wave 4, 2015: follow-up the whole sample from 2012
Unit of Observation Individual
Geographic Coverage All 32 states in Mexico.
Geographic specificity N/A
Data Collection
Data Collection Mode In person interviews (proxy interviews performed in cases of poor health or temporary absence). All interviews were conducted by trained full-time interviewers of the Instituto Nacional de Estadistica y Geografia (INEGI) of Mexico.
Years Collected 2001, 2003, 2012, 2015
Data Collection Frequency Timing between waves varies (2-9 years)
Strengths and limitations
Strengths The MHAS offers a unique opportunity to examine ageing in developing countries. The study provides three waves of data focusing on ageing in Mexico that is highly comparable to the US Health and Retirement Study (HRS). Cross-national comparisons of ageing can be possible to other developing countries. Large sample size and 4 waves of data collection. The long panel period from baseline to 2012 allows for full estimation of the transitions in physical and mental health, functionality, labor force and migration over time. The cumulative number of deaths (n=3,200) by 2012, provides sufficient statistical power to study the association between exposure, migration, physical health, cognition, and mortality. Health sector reforms. Implementation of universal health care Seguro Popular (a health insurance system for the uninsured in 2003) between the waves permits the study to evaluate the impact of the new health policy. The biomarkers data is available for doing clinical research. The study has completed approximately a cumulative total of 4,500 next-of-kin interviews across the four waves. This implies that the study of the cohort mortality and its determinants has become increasingly powerful.
Limitations Data is not linked to health system data, so health service utilization research is not possible.
Data details
Primary Website http://www.mhasweb.org/
Data Access http://www.mhasweb.org/Data.aspx
Data Access Requirements Data Use agreement, No cost
Summary Tables/reports

Codebooks with frequencies: http://mhasweb.org/DocumentationQuestionnaire.aspx Rebeca Wong, Alejandra Michaels-Obregon, and Alberto Palloni. Cohort Profile: The Mexican Health and Aging Study (MHAS), 2015 Int. J. Epidemiol. first published online January 27, 2015 http://ije.oxfordjournals.org/content/early/2015/01/24/ije.dyu263.full.pdf+html

Selected papers
Technical Mexican Health & Aging Study Documentation: http://www.mhasweb.org/DocumentationQuestionnaire.aspx 
Other Papers

A comparison of the health of older Hispanics in the United States and Mexico: methodological challenges. Angel RJ1, Angel JL, Hill TD. J Aging Health. 2008 Feb;20(1):3-31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000710/ Wong R, Obregon AM, and Palloni A. Cohort Profile: The Mexican Health and Aging Study (MHAS). Int J. Epidemiology, 2015 Jan 27. http://ije.oxfordjournals.org/content/early/2015/01/24/ije.dyu263.short?rss=1  Díaz-Venegas C, Wong R. Trajectories of limitations in activities of daily living among older adults in Mexico, 2001-2012. Disability Health J. 2016 Feb. http://www.ncbi.nlm.nih.gov/pubmed/26993585  Kumar A, Wong R, Ottenbacher K, and Al Snih S. Prediabetes, undiagnosed diabetes, and diabetes among Mexican adults: findings from the Mexican Health and Aging Study. Annals of Epidemiology, 26(3), 2016. http://www.sciencedirect.com/science/article/pii/S1047279716300035 


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