As the study group includes both migrants from Japan and Hawaii-born men, there is a spectrum of cultural lifestyles and varying grades of acculturation which are being examined as risk factors for cardiovascular and other chronic diseases. The existing baseline and follow-up examination data and the surveillance information on the incidence of most major diseases provide opportunities for a great variety of research projects concerning the predictors of cardiovascular disease, as well as studies of the broader concepts of health and disease in the aging population. The low out-migration rate and the well-defined sources of medical care have provided an ideal setting for maintaining disease morbidity and mortality surveillance; nearly 100 per cent of hospital discharge episodes have been recorded. As the study participants range in age from 75-95 in 1996, the rates of coronary heart disease, stroke, and other chronic diseases are increasing rapidly and thus are providing a large number of disease endpoints for study. Other Institutes are also currently supporting activities which utilize the original cohort.