Health Disparities

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”

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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”

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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

Graphic for blog post on 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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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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NIMHD Lauds New Awards on Innovative Health Disparities and Health Equity Research

NIMHD Lauds New Awards on Innovative Health Disparities and Health Equity Research
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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 DirectorWe at the National Institute on Minority Health and Health Disparities are excited and proud to be a part of the Transformative Research to Address Health Disparities and Advance Health Equity initiative, a new effort coordinated by the NIH Common Fund. This new set of 11 grants provides roughly $58 million over five years to support innovative, creative translational health disparities research projects across the country. This new initiative speaks directly to NIMHD’s mission to improve minority health, reduce health disparities, and promote health equity, and encourages bold new solutions to solve enduring problems.

Despite scientific and technological discoveries that have improved the health of the U.S. population overall, racial, and ethnic minority populations, socioeconomically disadvantaged groups, underserved rural populations, and sexual and gender minorities in the U.S. share an unfair burden of diseases such as diabetes, heart and respiratory diseases, HIV, and obesity. The recent COVID-19 pandemic has further underscored how disease can disproportionately affect vulnerable populations the hardest.

In our work, characterizing the drivers of health inequities demands a better understanding of social determinants of health, complex underlying causes of health disparities, and effective interventions specifically designed to reduce disparities in these populations. Continue reading “NIMHD Lauds New Awards on Innovative Health Disparities and Health Equity Research”

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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
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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”

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