The is a multipurpose panel survey following more than 34,000 individuals in 288 communities throughout China across nine exams from 1989 to 2011. This in-depth multipurpose survey has collected a diverse set of sociodemographic, economic, and health data. In the 2009 survey biomarkers derived from fasting blood on all respondents aged 7 year and older, toenail biomarkers on all respondents aged 2 and older and genome-wide association [GWA] data on a subsample of 9,600 respondents were obtained. The 20-year span of coverage and the geographic scope provide substantial temporal and spatial variability across contextual, household, and individual levels. We propose to further enhance the value of this unique survey by adding a follow-up survey to collect a second wave of fasting blood and other biomarkers to provide incidence data across cardio metabolic, toxicological and other outcomes, and to complete GWA on the remaining 9,000 individuals with blood samples and in all children aged 0 to 7 years using buccal swabs. Furthermore, we will continue the collection of all sociodemographic data. We will conduct biomarker analysis on the fasting blood samples to replicate the set of 26 biomarkers (CVD, nutritional, inflammatory markers); extract and store DNA from all individuals' buffy coat and buccal swab samples; blood spots for scholarly community use; and work with our Chinese collaborators to get GWA and toenail analyses funded for the new CHNS2014 specimens. This will encompass 37 trace element biomarkers, including micronutrients and chemical pollutants (e.g. arsenic, lead), and GWA for any individuals without GWA data. Furthermore, a blood spot and biomarker data base will be established for future users, including -80 degree storage of CHNS2014 blood samples and blood spots as well as 2009 blood spots. The spatial data collection allows users to propose further spatial data collection and/or linkage with extant data with CHNS communities. The resulting data resource will be unparalleled. Currently there are 15,284 unique users with over 1,219 journal publications. The release in Dec. 2012 of the fasting blood results will enhance usage as will the cleaned toenail and GWAs data, both handled in year 1 of the proposed grant. The second wave of biomarker data will provide data to examine incidence in a variety of cardiovascular-, nutrition-, and toxicological-related outcomes, coupled with continued heterogeneity in social, economic, and health status across time in modernizing China. The multilevel data structure allows clustered research at the individual-, household-, community-, and province-levels.