Rationale and Design of the Hamburg City Health Study
Authors: Jagodzinski Annika , Johansen Christoffer , Koch-Gromus Uwe , Aarabi Ghazal , Adam Gerhard , Anders Sven , Augustin Matthias , der Kellen Ramona B. , Beikler Thomas , Behrendt Christian-Alexander , Betz Christian S. , Bokemeyer Carsten , Borof Katrin , Briken Peer , Busch Chia-Jung , Büchel Christian , Brassen Stefanie , Debus Eike S. , Eggers Larissa , Fiehler Jens , Gallinat Jürgen , Gellißen Simone , Gerloff Christian , Girdauskas Evaldas , Gosau Martin , Graefen Markus , Härter Martin , Harth Volker , Heidemann Christoph , Heydecke Guido , Huber Tobias B. , Hussein Yassin , Kampf Marvin O. , von dem Knesebeck Olaf , Konnopka Alexander , König Hans-Helmut , Kromer Robert , Kubisch Christian , Kühn Simone , Loges Sonja , Löwe Bernd , Lund Gunnar , Meyer Christian , Nagel Lina , Nienhaus Albert , Pantel Klaus , Petersen Elina , Püschel Klaus , Reichenspurner Hermann , Sauter Guido , Scherer Martin , Scherschel Katharina , Schiffner Ulrich , Schnabel Renate B. , Schulz Holger , Smeets Ralf , Sokalskis Vladislavs , Spitzer Martin S. , Terschüren Claudia , Thederan Imke , Thoma Tom , Thomalla Götz , Waschki Benjamin , Wegscheider Karl , Wenzel Jan-Per , Wiese Susanne , Zyriax Birgit-Christiane , Zeller Tanja , Blankenberg Stefan 
Published: November 2019

Abstract
The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinations. The protocol includes validate self-reports via questionnaires regarding lifestyle and environmental conditions, dietary habits, physical condition and activity, sexual dysfunction, professional life, psychosocial context and burden, quality of life, digital media use, occupational, medical and family history as well as healthcare utilization. The assessment is completed by genomic and proteomic characterization. Beyond the identification of classical risk factors for major chronic diseases and survivorship, the core intention is to gather valid prevalence and incidence, and to develop complex models predicting health outcomes based on a multitude of examination data, imaging, biomarker, psychosocial and behavioral assessments. Participants at risk for coronary artery disease, atrial fibrillation, heart failure, stroke and dementia are invited for a visit to conduct an additional MRI examination of either heart or brain. Endpoint assessment of the overall sample will be completed through repeated follow-up examinations and surveys as well as related individual routine data from involved health and pension insurances. The study is targeting the complex relationship between biologic and psychosocial risk and resilience factors, chronic disease, health care use, survivorship and health as well as favorable and bad prognosis within a unique, large-scale long-term assessment with the perspective of further examinations after 6 years in a representative European metropolitan population.