Health Disparities

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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Heartfelt Thanks to the NIMHD Scientific Community in the Time of COVID-19

NIMHD leadership say thank you
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Co-authored by
Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

Monica Webb Hooper, Ph.D.
Deputy Director, National Institute on Minority Health and Health Disparities

NIMHD leadership say thank you

As leaders of the National Institute on Minority Health and Health Disparities (NIMHD), we want to express our sincerest thanks to the NIMHD scientific community and staff for their efforts as we continue to experience the most challenging public health crisis in over a century. Your rapid-response efforts to document, understand, and address the undue burden of COVID-19 among populations with health disparities—the very groups already dealing with longstanding disparities in life expectancy and overall well-being—have not gone unnoticed. We deeply appreciate your unwavering commitment to research designed to uncover the causes of health disparities, develop interventions to address them, and promote health equity.

Since March 2020, the COVID-19 pandemic has radically affected us in our daily lives—as individuals, families, and as members of the biomedical research workforce. We have all had to manage unfathomable adjustments and elevated stress both personally and professionally. The pandemic has disproportionately affected the lives and livelihoods of populations that experience health disparities in even more pronounced ways. And these groups—racial and ethnic minority communities, socioeconomically disadvantaged persons, people who live in rural underserved areas and sexual and gender minority persons—are prioritized by NIMHD. Continue reading “Heartfelt Thanks to the NIMHD Scientific Community in the Time of COVID-19”

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

All Health Is Local
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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”

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NIH’s Minority Health and Health Disparities Strategic Plan 2021-2025: A Path to the Future

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NIH’s Minority Health and Health Disparities Strategic Plan

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

Photo of Dr. Eliseo J. Perez-Stable, NIMHD DirectorThe COVID-19 pandemic has brought minority health and health disparities new attention on the national stage. COVID-19 has disproportionately affected African Americans, American Indians and Alaska Natives, Native Hawaiians and Pacific Islanders, and Latinos and Latinas.

This is a microcosm of the health equity challenge that plagues the U.S.

As in most conditions with health disparities, the causes are complex. People from some of these groups are less likely to have health insurance than Whites. Inequities in access to quality education and limited economic opportunities for many, mean that many minority groups are disproportionately represented among the ranks of essential workers, such as those who work in farms, grocery stores, and support staff in health care settings and long-term care facilities, and less able to avoid the virus at work than people who work in office jobs. Continue reading “NIH’s Minority Health and Health Disparities Strategic Plan 2021-2025: A Path to the Future”

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National Minority Mental Health Month: Reflections and Resources

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stock image of minorities in counseling circleMental illness does not discriminate, and more than 40 million Americans experience them each year regardless of race, ethnicity, gender identity, or socioeconomic status. July is National Minority Mental Health Month—a time to raise awareness about the unique psychological struggles that people from racial and ethnic minority communities face.

For National Minority Mental Health Month, NIMHD is sharing reflections and resources about the challenges, stigma, and access to mental health providers minorities often experience. We encourage you to educate yourself, your families, and your communities about mental health and emotional wellbeing. Continue reading “National Minority Mental Health Month: Reflections and Resources”

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A Black Doctor and Scientist on Vaccinating Minorities

Photo of Dr. Roderic I. Pettigrew getting a COVID-19 vaccine
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NOTE: For National Minority Health Month, NIMHD Insights Blog is sharing this timely op-ed that was printed with permission from the Houston Chronicle from former and founding Director of NIH’s National Institute of Biomedical Imaging and Bioengineering, Dr. Roderic I. Pettigrew.

By Roderic I. Pettigrew, Ph.D., M.D.
CEO of Engineering Health

Executive Dean of Engineering Medicine
Texas A&M University and Houston Methodist Hospital
Former and Founding Director, National Institute of Biomedical Imaging and Bioengineering

Photo of Dr. Roderic I. Pettigrew getting a COVID-19 vaccine

Dr. Roderic I. Pettigrew getting his COVID-19 vaccine

When it was first announced that a COVID-19 vaccine was authorized for emergency use by the Federal Drug Administration in the United States, the scientific community was finally able to exhale. As a Black physician and member of the scientific community, I was particularly encouraged because of the disproportionately higher rates of hospitalizations and deaths from COVID-19 among the Hispanic, Black, and Indigenous American populations.

My relief, however, was short-lived. We continue to see troubling inequities with new reports showing that many people from the minority community are among the lowest currently receiving the new vaccines, and the highest to be hesitant about its safety and effectiveness. According to Pew Research Center1, just 42 percent of Black adults are inclined to get vaccinated, compared to 63 percent of white adults and 83 percent of adult Asian Americans.

Continue reading “A Black Doctor and Scientist on Vaccinating Minorities”

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