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Minorities and Mental Health: Moving Beyond Stigma

By Dr. Courtney Ferrell Aklin
Chief of Staff, National Institute on Minority Health and Health Disparities

By Dr. Marcia M. Gómez
Health Science Policy Analyst, National Institute on Minority Health and Health Disparities

Dr. Courtney Ferrell Aklin

   Dr. Courtney Ferrell Aklin

Demographic trends in the United States have continued to change rapidly. Projections indicate that within the next 30 years, the majority of the United States will be non-White.1 Among the racial and ethnic groups that will make up the majority, there is significant heterogeneity, making healthcare delivery even more challenging.

Mental illness is one of the most prevalent health problems in the United States and one of the most taxing on the healthcare system. In addition, mental illness carries the highest disease burden among all diseases, with devastating effects on daily functioning; personal, social, and occupational impairment; and premature death if left untreated.2 One in 10 children and one in five adults are affected by mental illness.3

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Improving the Health Status of African American Males

By Wayne T. Harris, Ph.D.
Project Director and Contact Principal Investigator
Hampton University Minority Men’s Health Initiative

Dr. Wayne T. Harris

Dr. Wayne T. Harris

It gives me great pleasure to contribute to the National Institute on Minority Health and Health Disparities (NIMHD) blog, NIMHD Insights. While the health status of all groups in the United States has improved over the past century, significant gaps remain between the health status of African Americans and other minority groups, and that of the general population. For example, in 1950,1 the life expectancy of an African American male at birth was 59, while that of a Caucasian male was 68. In 2014,1 the life expectancy at birth for an African American male increased to 72.0 while that for a Caucasian male increased to 76.5. Similar gaps exist in the health status and health outcomes of minority populations using a variety of measures, and clearly more work needs to be done.

The Hampton University Minority Men’s Health Initiative (MMHI) exists to contribute to the achievement of one of the overarching goals of Healthy People 2020: “to achieve health equity, eliminate disparities, and improve the health of all groups.” Research has consistently shown that disease management and prevention efforts related to chronic diseases such as diabetes, cardiovascular diseases, cancer, and asthma lead to long-term improvement in outcomes.2 But these research findings have not been translated into sustainable, community-based programs. Furthermore, violence prevention efforts are clearly needed to reduce the significant loss of life due to homicide – the eighth leading cause of death among African Americans in 2014, and the fifth leading cause of death among African American males in 2014.1 MMHI is a program based on collaboration between selected regional Historically Black Colleges and Universities (HBCUs) to leverage resources in order to increase research into the causes and solutions for health disparities, increase community outreach and education, and promote effective prevention and/or treatment activities. As part of the National Institutes of Health and NIMHD’s efforts to advance engaged and transdisciplinary research, MMHI serves as a Transdisciplinary Collaborative Center (TCC) for research on minority men’s health.

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Contradicting the Myth of the Model Minority Through a Population Health Equity Approach

By Chau Trinh-Shevrin, DrPH
Principal Investigator, NYU Center for the Study of Asian American Health
Associate Professor, Departments of Population Health and Medicine
Vice Chair for Research, Department of Population Health
Director, Section for Health Equity
NYU School of Medicine

Diabetes management class participants perform group exercises.

Diabetes management class participants perform group exercises.

Asian Americans do not need an apple a day to keep the doctor away. Research suggests that doctors are less likely to follow evidence-based guidelines and meet standards of care with their Asian American patients compared with other racial groups in preventing and managing chronic conditions.1,2 Asian Americans, however, face just as many health challenges, including an increasing rate of diabetes and certain cancers.

This neglect seems to be linked to the “model minority” stereotype of Asian Americans, promoted in American culture and media, which portrays them as uniformly hardworking, affluent, and healthy. Yet, Asian Americans are not all alike: There are substantial differences in language, migration, and social experiences across Asian subgroups whose ancestral heritages hail from East, South, and Southeast Asia, and health concerns and risks vary across and within these communities.3

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Stroke Ready: Partnering to Increase Acute Stroke Treatment Rates in Flint, Michigan

By Lesli Skolarus, M.D., M.S.
Associate Professor, Neurology, University of Michigan

Sarah Bailey, M.A.
Executive Director, Bridges into the Future, Flint, MI

Dr. Leslie Skolarus (left) and Elder Sarah Bailey (right)

May is Stroke Awareness Month, and we would like to share some information about stroke and our research with you. Each year, about 800,000 people in the United States have a stroke. Disability is the greatest challenge facing survivors and their families. About two thirds of stroke survivors are left with a disability.

Post-stroke disability is substantially reduced by acute stroke treatments, which include intravenous tissue plasminogen activator (tPA) and intra-arterial treatment. Unfortunately, these treatments are underutilized—administered to less than 5 percent of U.S. stroke patients. Treatment with tPA must be given in the emergency department (ED) within 4.5 hours of the start of stroke symptoms. 1 The main reason stroke patients do not receive tPA is that they wait too long to call 911. 2 Think of tPA like Drano® for your brain: We want to get the plugged pipe—in the case of stroke, the plugged artery—open as soon as possible. The less time the artery is plugged, the lower the chance of brain damage, so it is extremely important that a person who is experiencing stroke symptoms calls 911 right away.

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For the First Time, Healthy People Initiative Focuses on Social Determinants of Health

By Nancy Breen, Ph.D.
Economist, Office of Strategic Planning, Analysis and Reporting, NIMHD and NIMHD Representative to the Healthy People Social Determinants of Health Workgroup

Healthy People Background

The Healthy People initiative is a federal program that provides “science-based, 10-year national objectives for improving the health of all Americans.” For the past 40 years, Healthy People has monitored the health of Americans and set benchmarks for how we can all be healthier. You can read more about Healthy People online at www.healthypeople.gov.

Nancy Breen, Ph.D.

Nancy Breen, Ph.D.

Healthy People provides a national 10-year framework for health promotion and disease prevention, with measurable objectives and goals, and it invites states and localities to use the national framework and objectives for their own plans. While the focus has always been health promotion and disease prevention, the Healthy People 2020 agenda is the first to use social determinants of health (SDOH) to frame the conceptual understanding of health. For 2000, an overarching goal to “reduce health disparities” was introduced, partly in response to the 1985 Report of the Secretary’s Task Force Report on Black and Minority Health (often referred to as the “Heckler Report”).1 For 2010, that goal was strengthened to “eliminate health disparities.” For Healthy People 2020, one of the overarching goals is to “achieve health equity, eliminate disparities, and improve the health of all groups.”2 The graphic from Healthy People 2020 shows that the overarching goals emphasize the determinants of health.

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Mental Health Risk Factors and Interventions for American Indian and Alaska Native People

By Spero M. Manson, Ph.D.
Distinguished Professor of Public Health and Psychiatry; Director, Centers for American Indian and Alaska Native Health; and The Colorado Trust Chair in American Indian Health and Associate Dean for Research at the Colorado School of Public Health, University of Colorado Denver

Over the past 20 years, as research on alcohol, drug, and mental health disorders has advanced, scientific inquiry among American Indian and Alaska Native (AI/AN) people has shifted from a primary focus on describing the prevalence of such problems to explorations of ways to address well-documented health disparities.

smmanson_portraitOne example involves detecting and managing depression and subsequent alcohol and substance abuse, risk of suicide, and, more recently, trauma among patients in large primary care settings operated by tribal health programs. In 2001, the Southcentral Foundation’s Primary Care Center in Anchorage, Alaska, initiated Screening, Brief Intervention, and Referral for Treatment (SBIRT) among Alaska Native patients age 18 and older.1 Their efforts, which integrated masters-level behavioral health clinicians within the care teams, demonstrated that such evidence-based practices could be tailored to this population in scientifically sound and clinically meaningful ways.2 Over a 5-year period beginning in 2004, 55 percent of the 8,000 patients who scored positive for alcohol use disorder agreed to follow-up treatment. Thanks to those results, the state of Alaska authorized Medicaid reimbursement for SBIRT, leading to the service becoming fully self-sustainable. This approach has been expanded to other tribal primary care settings in Alaska and in rural, reservation, and urban clinics in the lower 48 states. It now includes AI/AN youth ages 12 to 17 and covers other conditions, notably suicide risk and trauma.3

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