Health Disparities

National Minority Mental Health Awareness Month Blog Series

American Indian/Alaska Native Mental Health: Our Voices, Traditions and Values to Strengthen our Collective Wellness

Victoria M. O’Keefe, Ph.D. (Cherokee/Seminole Nations of Oklahoma)
Mathuram Santosham Endowed Chair in Native American Health, Assistant Professor, Licensed Clinical Psychologist
Associate Director, Center for American Indian Health
Department of International Health, Social & Behavioral Interventions
Johns Hopkins Bloomberg School of Public Health

Dr. Victoria M. O’Keefe

Dr. Victoria M. O’Keefe

 

My late grandma, Virginia Feather Revas, was a Cherokee Nation citizen, a fluent speaker of ᏣᎳᎩ ᎦᏬᏂᎯᏍᏗ (Cherokee language), and a Community Health Representative (CHR) for our tribe. CHRs are embedded within their tribe and serve important roles in health promotion for their communities.1 My grandmother served our tribe proudly and instilled in me the importance of working on behalf of our people. My favorite memories with her, from visits to Oklahoma, were going to our family’s creek to catch ᏥᏍᏛᎾ (crawfish) for dinner, attending stomp dances and pow wows, and admiring her talent for beadwork and quilt making. These memories are important teachings that I value now more than ever.

Continue reading “National Minority Mental Health Awareness Month Blog Series”

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Can Paid Maternity Leave Help Address Disparities in Maternal Mortality?

By Rada Dagher, Ph.D., M.P.H.
Program Director
Division of Scientific Programs
Clinical and Health Services Research
National Institute on Minority Health and Health Disparities

Dr. Rada Dagher

Dr. Rada Dagher

Maternal mortality rates in the United States have reached an all-time high. While these rates have dropped globally in the last few decades1, in the United States, they have more than doubled between 1987 and 20152. The picture is even grimmer for racial and ethnic minority communities, where African American and American Indian/Alaska Native women have the highest maternal mortality rates of all racial/ethnic groups2.

While most of the discussions about the maternal mortality crisis focus on the physical causes of death, the relationship between maternal mental health and mortality rates is largely ignored. For example, postpartum depression leads the list of mental health conditions affecting new mothers, and women experiencing this disorder may have suicidal thoughts and thoughts of harming the baby3. The novel coronavirus (SARS-CoV-2) pandemic that is causing COVID-19 disease outbreaks is another factor to consider. Due to social distancing, women have much lower access to the usual support systems (e.g. family, doulas) that promote their mental health during the vulnerable period of transitioning into motherhood. Recently published data from China on the impact of the COVID-19 pandemic suggests increased rates of postpartum depression4 among Chinese women. Moreover, a recent report from a convenience sample of U.S. mothers of children of ages 0-18 months, shows elevated depression (34.1%) and anxiety (34.6%) rates5. Yet, the currently proposed interventions to address maternal mortality do not consider approaches to prevent and/or treat postpartum depression. One such approach is providing paid leave for new mothers. Continue reading “Can Paid Maternity Leave Help Address Disparities in Maternal Mortality?”

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Racism and the Health of Every American

NIMHD Director's statement on racism and the health of every American
NIMHD Director's Statement

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

The past few weeks have been an extremely difficult time in the United States. George Floyd’s death was so painful to witness. Even more painful is the knowledge that he was only one in a long, long line of African American men and women who have been killed by police in America. It is a relentless, terrible history, and his death was yet another reminder of injustice in our lives. It is the same injustice that American Indians suffered in colonial times and the 19th century, losing their lands and being victimized by war. It is the same injustice that led to mass deportation of Mexican Americans—people born in the United States—in the 1930s. It is the same injustice that led to the internment of Japanese Americans during World War II. This is our history.

I have watched the protests—at times coupled with violence but mostly peaceful—and been heartened by the Americans of all races who have continued to show up, day after day, to say that Black lives matter and structural racism must end. This is a society that is proud to say that all are created equal, with liberty and justice for all, but the history of injustice is clear. People are not standing for it anymore. Continue reading “Racism and the Health of Every American”

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Spotlight on COVID-19 and Health Disparities: Opportunities to Achieve Better Understanding and Equality for Vulnerable Populations

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

Photo of NIMHD Director Eliseo J. Perez-Stable

The year 2020 will be remembered in history as one that changed the way we live as a result of a new global pandemic and the unequal effects on specific communities. The novel SARS-Cov-2 virus that has caused the COVID-19 global pandemic, has caused a societal awakening to the issues of existing health disparities and inequities in health care. The data we have for race and ethnicity present a stark reality: African American, Latino, American Indian and Pacific Islander populations are bearing a disproportionate burden of the disease.

As the NIMHD Director, I have had multiple opportunities to discuss the impact of COVID-19 on disparity and other vulnerable populations and share my thoughts on what the biomedical community can do and is doing in response to the COVID-19 pandemic. In this blog post, I will highlight two recent examples of these opportunities to place a spotlight on mitigating the COVID-19 burden on minority health and health disparities. Continue reading “Spotlight on COVID-19 and Health Disparities: Opportunities to Achieve Better Understanding and Equality for Vulnerable Populations”

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The Way Forward for Sleep Health Disparities Research

By Nancy Jones, Ph.D., M.A.
Scientific Program Officer, Community Health and Population Sciences
National Institute on Minority Health and Health Disparities

Dr. Nancy Jones

Dr. Nancy Jones

Populations that experience health disparities also experience sleep deficiencies, such as insufficient or long sleep duration, poor sleep quality, and irregular timing of sleep. These sleep experiences are associated with a wide range of suboptimal health outcomes, high risk health behaviors, and poorer overall functioning and wellbeing. In 2018, the National Institute on Minority Health and Health Disparities, along with our NIH colleagues at the National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research convened a workshop with experts in sleep, circadian rhythms and health disparities to stimulate research that would address two questions, 1) what are the underlying health disparity causal pathways contributing to sleep health disparities (SHDs) and 2) could SHDs, at least in part, explain disparities in other health outcomes for these populations?

The Workshop Report1 published in the Sleep journal is the distillation of hundreds of ideas into five areas and nine strategies. Continue reading “The Way Forward for Sleep Health Disparities Research”

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The Future of Minority Health and Health Disparities Research Blog Series

Yukiko Asada, Ph.D.
Associate Professor, Department of Community Health and Epidemiology, Faculty of Medicine
Dalhousie University
Nova Scotia, Canada

 

A Lesson from Alice and the Cheshire Cat in Health Disparities Wonderland  

“Would you tell me, please, which way I ought to go from here?”
“That depends a good deal on where you want to get to,” said the Cat.
“I don’t much care where—” said Alice.
“Then it doesn’t matter which way you go,” said the Cat.
“—so long as I get somewhere,” Alice added as an explanation.
Oh, you’re sure to do that,” said the Cat, “if you only walk long enough.”
(Alice’s Adventure in Wonderland1)

Photo of Dr. Yukiko Asada

Dr. Yukiko Asada

Expressing truth about life, this conversation between Alice and the Cheshire Cat is beloved and used in many contexts. Its profound power as a metaphor can also be applied to the science of measurement of health disparities. In Health Disparities Wonderland, Alice might ask, “Would you tell me, please, which way I ought to go from here to put an end to health disparities?” “That depends a good deal on what you mean by health disparities and how you measure and understand them,” would reply the Cat.

In “Harmonizing health disparities measurement” in the special issue of American Journal of Public Health,2 we argued for the science of measurement of health disparities. We believed by now few health disparities researchers and policy-makers would actually answer as Alice would, “I don’t much care about measurement.” But it is not enough for each of us to care. In the article, we urged all of us in the field of health disparities to engage in a community-wide consensus building for harmonization in measurement practice. Continue reading “The Future of Minority Health and Health Disparities Research Blog Series”

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The Future of Minority Health and Health Disparities Research

Diverse group of students eating lunch
Obesity Post - school lunch v2

Co-authored by
Tanya Agurs-Collins, Ph.D., RD
Health Behaviors Research Branch
Division of Cancer Control and Population Sciences
National Cancer Institute, NIH 

Susan Persky, Ph.D.
Associate Investigator and Head of the Communication, Attitudes, and Behavior Unit
Immersive Virtual Environment Testing Area, Social and Behavioral Research Branch
National Human Genome Research Institute, NIH 

Disparities in Obesity Require Multilevel Approaches
Multilevel Approaches Require More Research

Photo of Dr. Tanya Agurs-Collins

Dr. Tanya Agurs-Collins

Photo of Dr. Susan Persky

Dr. Susan Persky

As part of the NIMHD special issue New Perspectives to Advance Minority Health and Health Disparities Research, we and our co-authors focused on designing and assessing multilevel interventions to improve minority health and reduce health disparities.1 Multilevel interventions, based on the socioecological framework2, involve intervening on at least two levels of influence at the same time. We chose this topic because multilevel interventions are an extremely challenging and often expensive undertaking that require myriad decisions and plans, yet it is becoming clear that such interventions are a necessary approach for overcoming great disparities evident in the public’s health, particularly for conditions like obesity. Continue reading “The Future of Minority Health and Health Disparities Research”

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The Future of Minority Health and Health Disparities Research Blog Series

Silhouette of twins

By Arline T. Geronimus, Sc.D.
Professor, Health Behavior and Health Education, School of Public Health
Research Professor, Population Studies Center, Institute for Social Research
University of Michigan

Understanding Health Disparities through the Life Course

Photo of Dr. Arline T. Geronimus

Dr. Arline T. Geronimus

My monozygotic twins—now young men—never engaged in parallel play with each other. Parallel play is a type of toddler-to-preschool play where, even though two or more children are in the same room or even the same sandbox, they each remain absorbed in their own personal activity and do not interact. Yet before they could walk or talk, my sons delighted in playing together, cooperating on projects, and putting on musical performances that they would end by bowing in unison, each one’s arm around the other’s waist. They scaled higher heights, literally, than playing alone. We found them lying on the tops of our highest kitchen cabinets, giggling together, when they were 2. Even strapped into their stroller, they enacted perfectly synchronized and complexly coordinated routines we called “stroller surfing,” which were at once wonderful and hair-raising to watch and noticeably enchanting to passersby. Continue reading “The Future of Minority Health and Health Disparities Research Blog Series”

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New Blog Series on the Future of Minority Health and Health Disparities Research

AJPH Cover Images
Introduction Image_AJPH Cover

By Nancy Jones, Ph.D., M.A.
Scientific Program Officer, Community Health and Population Sciences
National Institute on Minority Health and Health Disparities

AJPH Cover ImagesThis 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. Continue reading “New Blog Series on the Future of Minority Health and Health Disparities Research”

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Exploring the Potential of Artificial Intelligence to Improve Minority Health and Reduce Health Disparities

By Natasha Williams, Ph.D., J.D., LL.M., M.P.H.
Legislative Liaison
National Institute on Minority Health and Health Disparities

Photo of Dr. Natasha Williams

Dr. Natasha Williams

Over the last 20 years, the diagnosis and treatment of disease has advanced at breakneck speeds. Currently, we have technologies that have revolutionized the practice of medicine, such as telemedicine, precision medicine, Big Data, and medical artificial intelligence (AI). These technologies, especially AI, promise to improve the quality of patient care, lower health care costs, and better patient treatment outcomes. However, the impact of AI on minority health and health disparities has been largely understudied.

What is AI? The definition of AI is broad and varied and has many subareas. However, the common theme is the ability to “automate or replicate intelligent behavior.”1 Machine learning, which is a subcategory of AI, is the ability of computers to teach themselves and create their own programming. Deep learning, another AI technique, mimics the human brain by creating an artificial neuronal network. Natural language processing (NLP), which was applied by the National Institute on Minority Health and Health Disparities (NIMHD)–funded researchers at the Medical University of South Carolina (MUSC) and is discussed later in the post, helps computers interpret human language. These methods recognize patterns in the data. Since AI is fueled by data, it is imperative that the data be of good quality, inclusive, and free from bias.2 If we fail to ensure these three principles, we could exacerbate health disparities. Continue reading “Exploring the Potential of Artificial Intelligence to Improve Minority Health and Reduce Health Disparities”

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