No problem can be solved from the same level of consciousness that created it. – Albert Einstein
By Nancy Breen, Ph.D.
National Institute on Minority Health and Health Disparities
While 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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By George F. Koob, Ph.D.
Director, National Institute on Alcohol Abuse and Alcoholism
Supporting 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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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
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”
By Shameka Poetry Thomas, Ph.D.
NIH Intramural Research Program
Health Disparities Unit
Social and Behavioral Research Branch
National Human Genome Research Institute
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”
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.
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”