By Nancy Jones, Ph.D., M.A.
Scientific Program Officer, Community Health and Population Sciences
National Institute on Minority Health and Health Disparities
This blog series includes perspectives from authors of the American Journal of Public Health supplement, New Perspectives to Advance Minority Health and Health Disparities Research. The supplement highlights strategies to stimulate research for improving minority health and closing the gap in health disparities.
In 2015, the National Institute on Minority Health and Health Disparities (NIMHD) began an initiative to create a scientific vision to transform minority health and health disparities. I served as a co-chair for one of the three pillars for the visioning process with several other NIMHD colleagues and guest editor for a supplement of the American Journal of Public Health (AJPH), entitled New Perspectives to Advance Minority Health and Health Disparities Research.
The science visioning initiative sought to do something that had not been done before: tackle health disparities across diseases. Health disparities arise from multiple upstream factors from the sociocultural and physical/built environments interacting with downstream behavioral and biological mechanisms. These pathways result in worse health outcomes for many diseases and conditions for racial/ethnic minorities and other health disparity populations. Often, scientific visioning at the National Institutes of Health (NIH) develops research strategies to address a single disease or condition. This visioning process envisioned a roadmap that can catalyze research to understand and address health disparities across multiple diseases and conditions.
Thus, NIMHD brought together experts from a range of scientific disciplines and worked with Institutes, Centers, and Offices from across NIH. The goal was to identify research strategies to be able to better measure health disparities, to fill knowledge gaps in the causes of health disparities, and to determine what types of interventions are the most likely to reduce and eventually eliminate health disparities. With input from hundreds of stakeholders, through committees, workshops, and direct public input through a request for information, 30 research strategies emerged. It is hard to convey how daunting yet energizing the visioning process was. First, it was truly awe-inspiring to appreciate the rich diversity and unparalleled passion of those who identify as minority health and health disparity researchers. As the convener, NIMHD facilitated connecting scientific experts who had never interacted before and watched them discover how their research intertwined. For example, researchers focused on early life stage mechanisms were interacting with researchers who were experts on the adult and geriatric life stages; genetic and molecular biologists interacted with population and social scientists; and mental health scientists interacted with cardiovascular disease scientists. These scientific experts and community stakeholders demonstrated determination and personal investment to bridge historical scientific silos, muck through field-specific scientific lingo, and defy self-promoting priorities to advance strategies that can provide universally applicable research findings.
In January 2019, 30 cross-cutting strategies were announced through the AJPH supplement. Several themes arose across the 30 strategies. Here are a few:
- Prioritizing the crucial role that upstream social determinants, as well as racism and other forms of discrimination, play in shaping health and health disparities
- Using system and transdisciplinary approaches necessary to address the complex, dynamic interactions of multiple multilevel determinants that result in health disparities
- Using a life course perspective that accounts for how the lived experience across human development influences health
- Exploring key common biological systems and pathways operating in many diseases and conditions that are influenced by social, environmental, and cultural factors
- Examining the role that the health care system can play in addressing or exacerbating health disparities
It can be disheartening to consider how entrenched health disparities are. However, this science vision gives me hope. As we move toward celebrating a milestone year for the Institute and its predecessors in 2020, NIMHD will host a special blog post series from authors of these essays and editorials to discuss how to operationalize the vision.
My personal request is that all minority health and health disparities researchers take a few moments each month to ponder the strategies and envision how you personally can put them into action in your own research. At NIMHD, we continue to be deeply grateful for all those who took part in the visioning process, because we know the effort it required to bring the supplement to completion. But we are even more grateful for the talented, inspiring researchers who are committed to make the NIMHD vision—an America in which all populations will have an equal opportunity to live long, healthy, and productive lives—a reality.