Dr. Nancy Breen
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.
Dr. Nancy Breen
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.
Continue reading “For the First Time, Healthy People Initiative Focuses on Social Determinants of Health”
By Kelli Carrington, M.A.
Director, Office of Communications and Public Liaison
National Institute on Minority Health and Health Disparities
Ms. Kelli Carrington
Many of us know what it’s like to feel overwhelmed during a doctor’s visit by information about health conditions, medicines, and behavior recommendations. For patients who don’t speak or understand English fluently, the situation can be more than overwhelming—it can be dangerous. Patients with limited English proficiency (LEP) are nearly three times more likely to have an adverse medical outcome.1
Language is one of the most significant barriers to health literacy, the ability to understand the basic health information needed to make good health decisions. Patients who lack health literacy are often unable to read or understand written health information or to speak with their healthcare providers about their symptoms or concerns. These patients are less likely to follow important health recommendations or be able to give informed consent.2
Continue reading “Introducing the Language Access Portal”
By Tiffany Haynes, Ph.D.
Assistant Professor, Department of Health Behavior and Health Education
Fay W. Boozman College of Public Health
University of Arkansas for Medical Sciences, Little Rock, AR
Dr. Tiffany Haynes, Ph.D.
Rural African Americans are disproportionately exposed to numerous stressors, such as poverty, racism, and discrimination,1–5 that place them at risk for experiencing elevated levels of depressive symptoms.6 Elevated levels of depressive symptoms can lead to a host of negative outcomes, including poor management of chronic illnesses (e.g., hypertension, diabetes), poor social and occupational functioning, and development of clinical depression.7 Although effective treatments for decreasing depressive symptoms exist, structural barriers (e.g., lack of available services, transportation) and perceptual barriers (e.g., stigma, fear of misdiagnosis) impede the use of traditional mental health services within these communities, resulting in a significant unmet psychiatric need. Failure to develop culturally appropriate strategies to provide adequate, timely care to rural African Americans can result in a significant public health crisis.
African American churches have been identified as potential venues for providing depression education and treatment for rural African Americans.8 Within the African American rural community, churches represent a key portal through which as much as 85% of the community can be reached.9 Churches have been used to address physical health outcomes in those communities, but few have focused primarily on addressing mental health outcomes10-11. Through the NIMHD-funded project entitled “Faith Academic Initiatives to Transform Health (FAITH) in the Delta,” our partnership, consisting of faith community leaders and University of Arkansas for Medical Science researchers, conducted formative work in the Arkansas Delta. Data suggested that community members consider elevated depressive symptoms to be a significant unmet need. Furthermore, community members suggested that attempts to improve depressive symptoms should do the following:
Continue reading “Addressing Mental Health in African Americans Through FAITH”
By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities
The National Institutes of Health (NIH) Medical Research Scholars Program (MRSP) is an excellent research enrichment opportunity for promising students from diverse backgrounds to gain real-life experience in NIH laboratories and patient care areas. NIMHD is proud to participate with other NIH Institutes and Centers in the MRSP. Our goal is to introduce the MRSP to medical, dental, and veterinary students from diverse racial and ethnic backgrounds and encourage them to consider biomedical research as a career.
A medical researcher at work.
The U.S. population continues to increase in diversity, and there is an urgent need to ensure that the scientific talent which is key to our nation’s success is nurtured, recognized, and supported across all demographic groups. We need more researchers from diverse backgrounds to contribute minority perspectives and priorities to the research agenda, and advance the likelihood that underserved or health disparity populations participate in and benefit from health research.
Continue reading “Apply Now to the 2017–2018 NIH Medical Research Scholars Program”
By Linda Burhansstipanov, M.S.P.H., Dr.P.H.
Founder, Native American Cancer Research Corporation and President, Native American Cancer Initiatives, Inc., Pine, Colorado
Linda U. Krebs, RN, Ph.D., AOCN, FAAN
Associate Professor (retired), College of Nursing, University of Colorado at Denver, Anschutz Medical Campus
American Indians and Alaska Natives (AI/ANs) have long experienced lower health status than other U.S. populations do. AI/ANs born in 2011 have a lower life expectancy than all other U.S. populations (73.7 years vs. 78.1 years). The poverty level among AI/ANs is nearly twice that of the overall U.S. population, and only half as many AI/ANs have health insurance.
Dr. Linda Burhansstipanov
The socioeconomic conditions where people live and work have a substantial influence on health, and effects are cumulative over a lifetime., In the United States, educational attainment and income are the indicators most commonly used to measure the effect of socioeconomic status on health.3 Compared with other populations, AI/ANs are more likely to have lower socioeconomic status and to live in poverty, leading to less access to cancer prevention and screening and other healthcare services. Additionally, 20 percent of AI/ANs have not completed high school, compared with 8 percent of non-Hispanic Whites. Not completing high school has been associated with unhealthy and risk-taking behaviors.
Continue reading “Health Disparities Among American Indians and Alaska Natives: Enormous Hurdles and Opportunities to Advance Health Status”
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.
One 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
Continue reading “Mental Health Risk Factors and Interventions for American Indian and Alaska Native People”
UPDATE: Click here to access the Loan Repayment Program Technical Assistance webinar that NIMHD hosted on September 15, 2016.
By Dorothy M. Castille, Ph.D.
Health Scientist Administrator, Division of Scientific Programs
National Institute on Minority Health and Health Disparities,
Education is the foundation of our nation’s biomedical research enterprise. But a college education is expensive, and a post-graduate education is even more expensive, with the average cost of medical, veterinary, and dental school totaling more than $200,000. In exchange for a commitment to conduct biomedical or behavioral research, the National Institutes of Health (NIH) will repay up to $70,000 of student loan debt (over two years) per two-year contract through the NIH Loan Repayment Programs (LRPs).
If you are a qualified health professional who agrees to engage in NIH mission–relevant research for at least 20 hours per week at a nonprofit or government institution, you may be eligible to apply to one of the five extramural LRPs:
- Clinical Research Extramural LRP: Patient-oriented research conducted with human subjects
- Clinical Research for Individuals from Disadvantaged Backgrounds Extramural LRP: Research conducted by clinical investigators from disadvantaged backgrounds
- Contraception and Infertility Research Extramural LRP: Research on conditions affecting the ability to conceive and bear young
- Health Disparities Research Extramural LRP: Research that focuses on minority and other health disparity populations
- Pediatric Research Extramural LRP: Research that is directly related to diseases, disorders, and other conditions in children
Continue reading “Apply Now to NIMHD Loan Repayment Programs”
By Eliseo J. Pérez-Stable, M.D.
Today I’m delighted to share some exciting news. The National Institutes of Health (NIH) is launching recruitment for the Adolescent Brain Cognitive Development (ABCD) Study. This is the largest long-term study of brain development and child health in the United States. NIMHD is one of eight NIH institutes, centers, and offices along with the Centers for Disease Control and Prevention (CDC) supporting this landmark study.
Adolescence, the transitional stage between childhood and adulthood, is an important period in human development. While major physical and psychological changes are happening, teenagers are testing their independence and exploring their self-identity. All the while, the brain is undergoing dramatic changes in structure and function.
Continue reading “NIH Begins Recruitment for Landmark Adolescent Brain Cognitive Development Study”
At the one-year anniversary of my appointment as director of NIMHD, I’m excited to welcome you to our new blog, NIMHD Insights.
NIMHD leads scientific research in two distinct but overlapping areas: minority health and health disparities. But first of all, what do these terms mean?
Minority health concerns the health of the five U.S. racial and ethnic minorities who have historically faced discrimination and social disadvantage. These groups are defined by the U.S. Census and include African Americans/Blacks, Latinos/Hispanics, Asians, American Indians/Alaska Natives, and Native Hawaiians/other Pacific Islanders. All of these populations are usually not included as participants of all types of biomedical research and most are also underrepresented as members of the scientific workforce. At NIMHD, we are committed to addressing health issues within each of the minority groups independent of whether the outcome is worse, better or similar to that of the White comparison group. We value research that emphasizes mechanisms by which health differs within these race/ethnic groups, as well as comparisons to each other and Whites.
Continue reading “Welcome to NIMHD Insights, the New NIMHD Blog”