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Environmental Risk Factors for Prostate Cancer in Overburdened, Understudied Populations

By Lauren Hurwitz, Ph.D., MHS
2022 Coleman Research Innovation Awardees
National Institute on Minority Health and Health Disparities
Postdoctoral Fellow
National Cancer Institute

Prostate cancer is the second most frequently diagnosed cancer among men globally, and the leading cause of cancer death among men in 48 countries, most of which are in Africa, the Caribbean, and South America1. In the United States, prostate cancer is also the cancer with the largest disparities by race, with incidence rates 60-70% higher and mortality rates 100-120% higher in Black men as compared to non-Hispanic White men2. The underlying drivers of prostate cancer racial disparities are not well understood but likely involve a complex interplay of genetic, social, structural, and environmental factors2.

As a Postdoctoral Fellow at the National Cancer Institute (NCI), I am part of group studying environmental and occupational risk factors for prostate cancer, including how they may be inequitably distributed and contributing to these disparities. Using studies of highly exposed occupational groups in the U.S., we have been investigating pesticide exposure and its potential impact on prostate cancer risk among farmers. Evidence from the Agricultural Health Study, a large prospective cohort study, suggests that specific pesticides (certain organophosphate and organochlorine insecticides) are associated with risk of more aggressive forms of prostate cancer3, 4. Similar associations have been observed in case-control studies as well5. While informative, the prior studies have one major limitation—most studies of pesticides and prostate cancer risk have been conducted in non-Hispanic White populations. Continue reading “Environmental Risk Factors for Prostate Cancer in Overburdened, Understudied Populations”

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Striving Towards Health Equity: Understanding the Impact of Discrimination on LGBTQ+ Communities

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UPDATED June 27, 2022

By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

NIMHD Director, Dr. Eliseo J. Pérez-Stable

Sexual and gender minority (SGM) populations, including those who are lesbian, gay, bisexual, transgender, or queer (LGBTQ+)1, experience health disparities and face barriers to accessing health care.  SGM populations have higher burdens of certain diseases, such as depression, certain cancers, and tobacco-related conditions. But the extent and causes of health disparities are not fully known, mechanisms remain unclear, and more research on how to close these gaps is needed.

Stigmatization, hate-related violence, and discrimination are still major barriers to the health and well-being of SGM populations. SGM individuals who are also from racial, ethnic, and/or immigrant minority communities may be even more vulnerable because they face similar barriers, discrimination, and health challenges that are unique to those experienced by all minority populations.

Continue reading “Striving Towards Health Equity: Understanding the Impact of Discrimination on LGBTQ+ Communities”

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HDPulse: A Comprehensive Resource to Access Health Disparities Data and Minority Health Resources

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Tilda Farhat, Ph.D., M.P.H.
Director, Office of Science Policy, Planning, Evaluation, and Reporting

National Institute on Minority Health and Health Disparities

Tilda Farhat, Ph.D., M.P.H.It has been 37 years since the release of the ground-breaking Heckler report underscoring the disproportionate burden of  premature illness and death experienced by people from racial and ethnic minority groups in the U.S. Since then, great strides have been made in addressing and improving minority health and health disparities through improved data collection, research opportunities, and proven interventions. However, despite these efforts, health disparities persist and progress to date is suboptimal.

While minority health and health disparities researchers, intervention developers, and public health professionals strive to reduce health disparities, some may have difficulty accessing data and evidence-based resources that can help them design, implement, and evaluate health disparities-related programs. They often rely on multiple sources that may differ in data quality, completeness and other important attributes. The HDPulse resource, developed by the National Institute on Minority Health and Health Disparities (NIMHD), is perhaps the most comprehensive resource that provides national, state, and county level data on minority health and health disparities, as well as evidence-based interventions and accompanying tools and materials. Continue reading “HDPulse: A Comprehensive Resource to Access Health Disparities Data and Minority Health Resources”

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Boost Your Community: NIMHD’s Role in Increasing COVID-19 Vaccine Uptake and Community Interventions

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By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

Photo of Dr. Eliseo J. Perez-Stable, NIMHD Director

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April is National Minority Health Month (NMHM), and this year we are joining the U.S. Department of Health and Human Services Office of Minority Health to highlight the key role individuals and organizations can play in helping to reduce health disparities and improve the health of people who are disadvantaged by social and economic conditions, geographic location, or the environment in which they live.

This year’s theme, “Give Your Community a Boost!,” focuses on the continued importance of COVID-19 vaccination, including COVID-19 boosters, and sharing credible information as important tools to end the COVID-19 pandemic that has disproportionately affected communities already dealing with long-standing social and health inequities. Ongoing vaccination against COVID-19 is the single most important way to blunt the effects of severe disease, the consequences of stress on the health care system, and excess deaths of the most vulnerable people.

Continue reading “Boost Your Community: NIMHD’s Role in Increasing COVID-19 Vaccine Uptake and Community Interventions”

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A Different Kind of Leader

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A Different Kind Leader

Giselle Corbie, M.D., MSc
Kenan Distinguished Professor of Social Medicine
Director, Center for Health Equity Research
University of North Carolina School of Medicine

As a female scholar of color, early in my career I often sought out leaders that embodied the characteristics that I hoped to cultivate throughout my career—a different way of leading that harnesses the power of diverse perspectives. More recently, I began reflecting on the early days of my career and wished my younger self had had access to the insights and pieces of wisdom from leaders from diverse backgrounds. While I do not have the ability to time travel, I do have a voice and passion for telling the stories of diverse leaders. It was realizing that there was still a void that those voices could fill that led to the creation of the podcast A Different Kind of Leader. For over two years, four seasons, and 48 episodes, A Different Kind of Leader (DKL) has been dedicated to featuring incredible, diverse leaders and their journeys, insights, and experiences in their personal and leadership journey. In this day and age, the problems that our organizations face are complex, and we benefit from having as many perspectives and voices as possible to help develop the most creative and sustainable solutions.

Continue reading “A Different Kind of Leader”

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The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health

The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health blog post
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Celia B. Fisher, Ph.D.
Marie Ward Doty University Chair in Ethics
Professor of Psychology
Director, Center for Ethics Education
Director, HIV/Drug Abuse Prevention Research Ethics Institute
Fordham University

Social Card for Insights Blog postPeople from racial and ethnic minorities in the United States have borne a disproportionately higher burden of COVID-19 infection and mortality. During the pandemic, depression and anxiety among American Indian/Alaska Native (AI/AN), Asian, Black, and Hispanic people have also increased. These disparities are rooted in long-standing racial and ethnic inequities in medical and behavioral health treatment utilization and access to culturally relevant health services.

Racial discrimination has long been documented as a psychosocial stressor among racial and ethnic minority individuals and national surveys indicate racism increased during the current pandemic. During the pandemic racially and ethnically marginalized persons in the U.S. were also more likely to be employed in the health care work force or as frontline workers in industries such as food services, pharmacies, personal care and public transportation. Employment in these positions not only increased risk of COVID-19 infection, but increased public perception that racial and ethnic groups were more likely to be infected with the coronavirus. Simultaneously, the U.S, saw an upsurge in racially based hate crimes, particularly directed against Asian Americans. The surge in racial bias and violence underscores the urgency of studying the effects of pandemic-related forms of victimization and discrimination on the mental health of racial and ethnic youth and adults in the U. S. Continue reading “The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health”

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NIH FIRST: Strengthening Inclusive Excellence in Biomedical Research

NIH FIRST: Strengthening Inclusive Excellence in Biomedical Research

Photo of Drs. Norman E. Sharpless and Eliseo J. Perez-Stable

Co-authored by
Norman E. Sharpless, M.D., Director, National Cancer Institute
Eliseo J. Pérez-Stable, M.D., Director, National Institute on Minority Health and Health Disparities

Year after year, the number of students from historically underrepresented groups that participate in biomedical research training has slowly increased. Yet today, individuals from underrepresented groups still remain much less likely to be hired as independently funded faculty researchers. This gap is untenable if science is to thrive in the future. NIH is committed to supporting institutions and programs to change this trajectory.

In September 2021, NIH announced the initial set of awards in the Faculty Institutional Recruitment for Sustainable Transformation (FIRST) program. FIRST funds and supports institutions to recruit diverse cohorts of new faculty and implement and sustain cultures of inclusive excellence where these faculty can thrive, excel, and become independently funded investigators. NIH expects to announce a second set of FIRST awards this summer.

FIRST has a target budget of $241 million over 9 years, subject to the availability of funds. The NIH Common Fund leads in managing this NIH-wide program, but there is also robust engagement by others across NIH. The NIH Scientific Workforce Diversity Office, the National Cancer Institute (NCI), the National Institute on Minority Health and Health Disparities (NIMHD), the National Heart, Lung, and Blood Institute, and the National Institute of Neurological Disorders and Stroke all collaborate in managing FIRST. Continue reading “NIH FIRST: Strengthening Inclusive Excellence in Biomedical Research”

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Big Problems, Big Data, Bigger Possibilities in Health Disparities Research

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No problem can be solved from the same level of consciousness that created it. – Albert Einstein

By Nancy Breen, Ph.D.
Economist
National Institute on Minority Health and Health Disparities

Photo of Dr. Nancy BreenWhile at NIMHD, I was asked to lead the Methods and Measurement Science pillar, one of four pillars of the NIMHD Visioning Process. The tasks of this pillar were to establish definitions, harmonize outcomes, and present scientific insights. The objectives were to expand and strengthen analytic methods and to offer guidelines for consistent measurement.  Results are published the NIMHD AJPH Supplement, New Perspectives to Advance Minority Health and Health Disparities Research. Health disparity outcome measures are defined in “Overview”1, “Methodological Approaches to Understanding Causes of Health Disparities” are emphasized2, and recommendations are offered for “Harmonizing Health Disparities Measurement”3.  Evaluation4, an under-used tool in health disparities research, is encouraged with guidelines provided. This blog enhances findings from “Translational Health Disparities Research in a Data-Rich World”5.

The role of big data in health disparities research is a burning question.  Our interdisciplinary team explored how big data can contribute to reducing health disparities. The collaboration resulted in years of challenging and productive transdisciplinary teamwork that yielded two articles6,7 and the editorial for NIMHD’s AJPH Supplement, New Perspectives to Advance Minority Health and Health Disparities Research5. Continue reading “Big Problems, Big Data, Bigger Possibilities in Health Disparities Research”

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Embracing Community and Culture to Prevent Underage Drinking

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By George F. Koob, Ph.D.
Director, National Institute on Alcohol Abuse and Alcoholism

Photo of NIAAA Director, Dr. George F. KoobSupporting research to better understand and address alcohol-related health disparities and improve the health of underserved populations is one of the highest priorities of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Among our efforts is NIAAA’s long-term investment in preventing underage drinking. Early initiation of alcohol consumption and heavy drinking increases the risk of alcohol use disorder (AUD) and related consequences over a person’s lifetime, and alcohol intervention efforts started at a young age can positively influence a young person’s path in life. Research indicates that prevention efforts involving the community and/or informed by the community’s cultural beliefs hold promise for preventing and reducing underage drinking.

In a decades-long project supported by NIAAA, Stacy Rasmus, Ph.D., at the University of Alaska, Fairbanks, in collaboration with the Yup’ik Native Alaskan community, is examining how tapping into a community’s culture can provide a cornerstone for youth substance misuse and suicide prevention efforts. Together, they developed the Qungasvik (Tools for Life)” Toolbox” intervention, which uses community, cultural, and historical connectedness to build protective factors against suicide and alcohol misuse at individual, family, and community levels. Research findings have shown that Qungasvik is effective in reducing co-occurring youth alcohol misuse and suicide risk, and ultimately, AUD and death by suicide. Continue reading “Embracing Community and Culture to Prevent Underage Drinking”

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Breast Cancer Is a Complex Journey

Breast Cancer Is A Complex Journey  
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By Faustine Williams Ph.D., M.P.H., M.S.
Stadtman Tenure-Track Investigator and NIH Distinguished Scholar
Health Disparities & Geospatial Transdisciplinary Research Program
Division of Intramural Research
National Institute on Minority Health and Health Disparities

Photo of Dr, Faustine Williams Although we have seen substantial progress over the last 30 years in breast cancer incidence and outcomes, geographical and racial/ethnic disparities across the cancer care continuum persist.1, 2  As shown in the NIMHD research framework, the factors contributing to these disparities are complex, numerous, and interrelated sets of individual, interpersonal, community, and societal determinants.3 However, early breast cancer detection or diagnosis and treatment initiation can lead to better outcomes. For example, the 5-year relative survival rate for localized-stage disease that has not spread to other sites/organs is 99.0%.4

Despite the advances in medicine and technology, cancer is still the word no one wants to hear. Years ago, when I interviewed breast cancer survivors about their experiences, they described it as a family experience because they could not have gone through it without the support from family and friends that helped them cope.5 The journey from diagnosis and treatment to survivorship does not just touch the affected individual, but family, friends, and loved ones as well. I thought I understood their stories, but I was wrong until I became the de facto caregiver to my friend/sister Yaa. Continue reading “Breast Cancer Is a Complex Journey”

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