Asian American Community Cohort of the New York Metropolitan Area - ABSTRACT Asian Americans (AsA) are the fastest growing racial/ethnic group in the US, projected to double to 43 million people by 2050; however, our understanding of the factors that lead to disease or health in AsA is limited because AsA overall and specific AsA subpopulations have been severely under-represented in medical research. To address key population health research gaps, the NIH has called for a new epidemiologic cohort among AsA and Native Hawaiian/Pacific Islanders (NHPI). We propose to serve in this nation-wide initiative as a Clinical/Community Field Center for AsA in the New York Metropolitan Area. The overarching rationale for a national Asian American Community Cohort (here named the AACC) is to examine from a “populomics” perspective, the biological, lifestyle, behavioral/environmental and sociocultural factors that impact the health of AsA, with the ultimate goal of reducing morbidity and mortality. In the NY area, the AACC-NY will enroll Korean American adults—the most understudied AsA group—and Chinese American adults—the largest AsA group. A strong feature of AACC-NY is our capacity to target often-marginalized, low- income, non-English speaking communities in the NY area, who most often experience social and health disparities and who are often under-represented in epidemiologic research. The New York Metropolitan Area is home to the largest and most diverse AsA population of any urban region in the US, comprising 3.2 million residents, of which ~40% are Korean or Chinese American. In the longer term, CVD and other metabolic diseases such as type II diabetes will be our priority; however, the cohort also supports aims related to broad health outcomes, particularly through collaborations within the overall national cohort framework. In this funding period, leveraging our exceptionally strong community outreach, engagement, and community based participatory research programs with AsA communities, in Aim 1 we will enroll a cohort of 3200 AsA (age 25–64 years, including 1600 Korean and 1600 Chinese) and conduct participant follow up and surveillance activities, including ascertainment of events of clinical significance. In Aim 2 we will complete baseline exam, including questionnaire survey, physical exam, subclinical measure of CVD, and biospecimen collection. In Aim 3, we will complete data harmonization and sharing with Other Clinical/Community Field and Coordinating Centers. Aim 4 will focus on short-term research studies to examine the effect of sociocultural, diet/exercise, environment, and biological (genetics, microbiome) factors in relation to subclinical markers for cardiometabolic disease in overall and Korean and Chinese ethnic subgroups. The AACC is a unique urban platform with integrated community participation to address priority knowledge gaps regarding cardiovascular health and its disparities in specific AsA subpopulations. This research will provide the scientific basis for addressing these challenges in AsA communities, including the often marginalized and underserved.