Minority Health

The Power of Trust and Truth

CEAL OpEd Social Card_English 11.20.2020

Getting and sharing the facts about COVID-19, trusting science can help turn tide for pandemic-strapped communities of color

NOTE: This post originally appeared as an Op-Ed on BlackDoctor.org and in La Vision Newspaper

Co-authored by
Gary H. Gibbons, M.D., Director National Heart, Lung, Blood Institute
Eliseo J. Pérez-Stable, M.D., Director National Institute on Minority Health and Health Disparities

COVID-19 has killed more than 230,000 people in the U.S., and the death toll continues to rise at a rate of about 1,000 per day [see recent data at CDC]. We know, however, that families and communities don’t count their losses in thousands or hundreds; they count them one-by-one – a father, a teacher, a sister, a friend, a nurse, a son, a Tribal elder, a church member. And these losses hurt. Continue reading “The Power of Trust and Truth”


Amplifying the Voice of Native Hawaiian and Pacific Islander Communities Amid the COVID-19 Crisis

Photo of Dr. Joseph Keawe‘aimoku Kaholokula

Dr. Joseph Keawe‘aimoku Kaholokula

Joseph Keawe‘aimoku Kaholokula, Ph.D.
Professor and Chair
Department of Native Hawaiian Health
John A. Burns School of Medicine
University of Hawai‘i at Mānoa

The coronavirus disease 2019 (COVID-19) pandemic has spotlighted the health inequities of Native Hawaiians and Pacific Islanders (NHPI) and provided the podium from which to amplify their voices.

Historically, the voices of NHPI were drowned out by other numerically larger health-disparate racial/ethnic groups in the U.S. Their unique health concerns are often overlooked because their data has been aggregated—grouped together—with those of Asian Americans, an arbitrary practice that has done a disservice to both groups.1 NHPI know that resources follow the data, which is why they have been voicing their support for disaggregating—separating out—the data for NHPI and Asian Americans for decades, but to little avail.

Along comes COVID-19 to amplify their voices as to why data disaggregation is important. Continue reading “Amplifying the Voice of Native Hawaiian and Pacific Islander Communities Amid the COVID-19 Crisis”


Carving My Own Path: From First-Generation Latina Undergraduate Student to Minority Health Researcher

Coreas Saida Headshot_

By Saida Coreas, B.S.
Postbaccalaureate IRTA Fellow
Division of Intramural Research, National Heart, Lung, and Blood Institute

Saida Coreas, B.S. Postbaccalaureate IRTA Fellow

Saida Coreas, B.S. Postbaccalaureate IRTA Fellow

Hoping to build a stable life away from civil war, my parents immigrated to the United States from El Salvador. Growing up, I experienced firsthand the barriers to health care access and utilization within my household and in my community. My mother and father suffered from heart disease and cancer, respectively. Like many immigrant families, my siblings and I often served as translators and health advocates when it came to doctor visits or medication use/instructions. As a child, I would have never imagined how these cumulative actions would lead to my pursuit in understanding the need to reduce and encourage the elimination of health disparities in my adult life. Today, I am a part of that driving force to make a positive change for my family, my community, and generations after me.

About a year and a half ago, I packed my bags and moved across the country from Los Angeles to begin my post-baccalaureate Intramural Research Training Award (Postbac IRTA) fellowship in Bethesda, Maryland. The NIH Postbac IRTA fellowship is a 1-to 2-year research opportunity for recent college graduates interested in applying to graduate or professional health school (e.g., medicine, dental, nursing, veterinary sciences). Continue reading “Carving My Own Path: From First-Generation Latina Undergraduate Student to Minority Health Researcher”


NIMHD Investigator Forums on the Impact of COVID-19 on Research Communities

NIMHD Co-authors - COVID-19 PI Forum

Jennifer Alvidrez, Ph.D.
Rick Berzon, Dr.P.H., P.A.
Dorothy Castille, Ph.D.
Nancy L. Jones, Ph.D., M.A.
CDR Nadra Tyus, Dr.P.H., M.P.H.
Division of Scientific Programs

The impact of the COVID-19 outbreak has strained daily life for people living in the United States, affecting nearly every sector including biomedical research. The disruption has also disproportionally affected the lives and livelihoods of populations that experience health disparities, which are also the populations that NIMHD’s research addresses.

To provide an opportunity to better understand the impact of COVID-19 on researchers and research funded by the institute, NIMHD hosted four COVID-19 NIMHD Investigator Forums this summer. NIMHD staff who hosted the events were Drs. Jennifer Alvidrez, Rick Berzon, Dorothy Castille, Nancy Jones and Nadra Tyus.  We knew that the COVID-19 pandemic created many challenges for our research community and learned of the creative strategies they developed to navigate these challenges using their extensive connections with health disparity communities.  We structured the forum to hear directly from NIMHD Principal Investigators (PIs) about their observations and thoughts in three areas:

1) Impact of COVID-19 on the communities where research is conducted
2) Strategies to modify recruitment, data collection, and/or intervention protocols
3) Understanding and addressing the impact of the pandemic on study outcomes. Continue reading “NIMHD Investigator Forums on the Impact of COVID-19 on Research Communities”


National Minority Mental Health Awareness Month Blog Series

July Is the Best Month to Start a
New Year of Working on Mental Health

Harold W. Neighbors, Ph.D.
Division of Intramural Research
National Institute on Minority Health and Health Disparities

Dr. Harold W. Neighbors

Dr. Harold W. Neighbors

When I started graduate school in the mid-1970s, I had just one seemingly simple research question. I wanted to know: “Who had the higher rate of mental illness, Black or White Americans?” I remember the puzzled looks from fellow students, as most of them already knew the answer – “Blacks of course!” Their reasoning made good sense – life was harder for Blacks in the United States, and a life spent fighting against racial discrimination can lead to emotional damage.

So, I began my investigation, uncovering layer after layer of complexity surrounding what I thought was a simple question. My motivations were both professional and personal. Personally, like many families, Black and White, mine had revealed a few semi-private stories about “bad nerves” (the preferred language of emotional distress used to describe mental health problems) that were offered for consumption in the smallest of morsels. And even though my curiosity was never quite satisfied, I instinctively knew not to push for too many details. Professionally, there was my first “big” assignment as a graduate research assistant on a new, innovative study, the “National Survey of Black Americans”1. I wrote my dissertation on one aspect of the subject: help-seeking behavior for mental health problems, using data from the National Survey of Black Americans. My dissertation research told me that Black Americans need to stop, look, listen, and most importantly, tell the truth about our feelings. The key to sound mental health is what people of color decide to do about profound sadness, feelings of helplessness resulting from attacks on our self-esteem, and hopelessness due to unjust institutional impediments that erode aspirations for achieving one’s best life2. My investigation revealed that when feelings become unbearably painful, they are symptoms. Once you are symptomatic, you need to get help. It is just that simple; and difficult; and complicated. Continue reading “National Minority Mental Health Awareness Month Blog Series”


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”


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?”


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”


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”


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”