Population Health

A Partnership Between Researchers and the Navajo Nation to Study a Junk Food Tax

Blog graphic for A Partnership Between Researchers and the Navajo Nation to Study a Junk Food Tax




Co-Authored By
Regina Eddie, Ph.D., Northern Arizona University School of Nursing
Hendrik “Dirk” de Heer, Ph.D., Department of Health Sciences, Northern Arizona University
Del Yazzie, M.P.H., Navajo Epidemiology Center

Eight years ago, the Navajo Nation enacted the first junk food tax within the United States and the first in any sovereign tribal nation in the world. The Healthy Diné Nation Act (HDNA) of 2014 created a 2% tax on foods and beverages that had little to no nutritional value. A companion piece of legislation removed the usual sales tax (then 5%, now 6%) for healthy foods, including water, nuts, fruits, and vegetables. The revenue from the unhealthy food tax is designated for local wellness projects in the 110 local communities that make up the Navajo Nation.

Because they are sovereign nations, tribal nations are uniquely able to implement policies aimed at improving public health that may be difficult to implement in other places. Through partnerships with researchers at academic institutions, tribal nations can also measure the effects of these policies and share that information widely. Continue reading “A Partnership Between Researchers and the Navajo Nation to Study a Junk Food Tax”


The Dementia Epidemic Among Older Black Americans

Dementia Blog
Dementia Blog

Photo of Drs. Hayward and FarinaCo-authored by

Mark D. Hayward, Ph.D.
University of Texas at Austin

Mateo P. Farina, Ph.D. 
University of Southern California 

November is Alzheimer’s Awareness month. While it is a time to recognize the importance of supporting persons living with dementia, it is also a time to acknowledge the glaring disparities in dementia in our country. One such disparity is the epidemic levels of dementia among older Black Americans compared to White Americans.

The prevalence of dementia among Black Americans aged 65 years and older is about 2.5 times that for White Americans of the same age. In 2012, for example, a nationally representative study reported that 19.3% of older Black people had dementia compared to 7.4% of older White people1. These differences are starker at older ages. For Black persons aged 75 years and older, the prevalence of dementia is 31%, compared to 9% for White persons of that age2. Research reporting race differences in dementia onset—that is, new cases of dementia—document a similar race gap: Black people have about a 2.7 times greater risk of onset compared to White people3. These numbers translate into an extraordinary and disproportionate burden for Black individuals, their families, and their communities. This burden is often compounded by older Black Americans having fewer personal, social, economic, clinical, and community resources compared to White Americans. Moreover, the COVID-19 pandemic has increased these inequities, making care more difficult to obtain and placing a greater burden on familial caregivers. Continue reading “The Dementia Epidemic Among Older Black Americans”


Helping Youth from Racial and Ethnic Minority Groups Access Effective ADHD Treatment

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By Lauren Haack, Ph.D.
Associate Professor
Department of Psychiatry and Behavioral Sciences
University of California, San Francisco

Photo of Dr. Lauren HaackAttention-Deficit, Hyperactivity/Impulsivity Disorder (ADHD) is one of the most common mental health disorders impacting approximately 5% of children across cultures.1 Brain differences related to ADHD influence those affected in several ways.1,2 To begin, new or challenging tasks seem overwhelming, making it hard to map out a plan for completion and self-motivate initiation.3 In addition, individuals with ADHD have a tendency to over-perceive negative feedback and under-perceive positive feedback,2,4 which relates to difficulty regulating emotions.2 Unfortunately, as children with ADHD reach school age, they encounter more difficulties and more opportunities for critical rather than positive feedback from parents, teachers, and peers.2,5 As a result, ineffective patterns of interaction between children with ADHD and others in their lives can become entrenched, contributing to stress, confusion, and even hopelessness.4,5 Continue reading “Helping Youth from Racial and Ethnic Minority Groups Access Effective ADHD Treatment”


Community Organizations Lead Structural Interventions Research with Novel NIH Initiative

By Nathan Stinson Jr., Ph.D., M.D., M.P.H.
Director, Division of Community Health and Population Science
National Institute on Minority Health and Health Disparities

Dr. Nathan Stinson

To make greater advances in promoting health and preventing disease among populations experiencing health disparities, NIH launched the Community Partnerships to Advance Science for Society (ComPASS) Program. The program aims to put community organizations at the helm of research programs that will help accelerate discoveries in research to improve health equity across all populations. Traditionally, academic institutions have led research efforts with engagement from community partners. ComPASS, however, is novel because it’s transformative, and it has the potential to develop a new health equity research model for community-led, multisectoral structural intervention research across NIH and other federal agencies.

Continue reading “Community Organizations Lead Structural Interventions Research with Novel NIH Initiative”


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”


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

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”


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”


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”


Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health

Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health

By Shameka Poetry Thomas, Ph.D.
Postdoctoral Fellow
NIH Intramural Research Program
Health Disparities Unit
Social and Behavioral Research Branch
National Human Genome Research Institute

Dr. Shameka Poetry Thomas

Dr. Shameka Poetry Thomas

My grandmother was a traditional healer and a medicine-woman in Georgia’s rural South. Although I grew up in Miami’s Opa-Locka (a small urban neighborhood tucked between Miami-Gardens and the cusp of Hialeah / Little Havana), I spent most summers near middle Georgia’s farmland, listening to my grandmother. I observed how grandmother, who did not have a Ph.D., gathered Black women in circles. She described the process of listening to Black women’s pregnancies, births, and wellness experiences as “chitchatting and holding space.

Learning how to ‘hold space’ is what draws me to narrative medicine. My first dose of learning how to conduct narrative medicine, I suppose, came from my grandmother. This methodology (before I knew it was such) was simply understood as the process of sitting in kitchens and beauty salons in the South—just listening. During childhood, I was merely curious about how Black women described their pregnancies, births, and reproductive health—from their side of the story. Thus, when it came to reproductive health, my grandmother taught me a powerful tool: how to “hold space” for people’s narratives. Continue reading “Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health”


All Health is Local: Measuring the Burden of Disease by U.S. County, Race/Ethnicity, and Socioeconomic Status

All Health Is Local

Ali H. Mokdad, Ph.D.
Chief Strategy Officer, Population Health

Professor, Health Metrics Sciences
Institute for Health Metrics and Evaluation
University of Washington, Seattle

Ali Mokdad, Ph.D.

Ali Mokdad, Ph.D.

Despite greater public awareness about the social determinants of health, health inequities in the United States remain severe. Reducing disparities in health outcomes are a persistent challenge for policymakers, public health officials, and medical professionals. Due in part to these gaps, the U.S. underperforms against other industrialized countries in key health metrics, such as overall and healthy life expectancy. The reasons that the U.S. lags behind its peers are manifold. Most importantly, however, are the health discrepancies by geographic location, race/ethnicity, and socioeconomic status (SES). Understanding and reducing disparities among those most affected must be of central interest to policymakers to ensure that every person in the U.S. can lead a healthy life. A dearth of sufficient evidence on local health patterns produced from high-quality scientific research weakens our ability to understand the problem and design interventions. A particularly pressing need is for comprehensive and comparable examination of health outcomes for individuals in the U.S. by race/ethnicity and SES at the local level. Continue reading “All Health is Local: Measuring the Burden of Disease by U.S. County, Race/Ethnicity, and Socioeconomic Status”