Social Determinants of Health

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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NIMHD Director Statement in Support of NIH Efforts to Address Structural Racism

NIH Ending Structural Racism initiative
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By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

NIH Ending Structural Racism initiativeOn March 1, NIH Director Francis S. Collins, M.D., Ph.D., announced the launch of UNITE, a new NIH initiative aimed at bringing an end to structural racism in biomedical research. In his statement, Dr. Collins recalled the agency’s longstanding support of programs to expand the diversity of the scientific workforce, but he acknowledged shortfalls in NIH’s efforts to bring “…diverse perspectives, backgrounds, and skillsets to complex scientific problems.” As the Director of NIMHD, I enthusiastically endorse this newly stated goal for NIH to address, manage and eliminate systemic racism and discrimination embedded in policies and practices in the biomedical research enterprise. Since its beginnings as an Office more than three decades ago, NIMHD has promoted and supported the recruitment and training of a diverse workforce as part of its mission in research and training. We will continue that work while contributing our knowledge, experience, training programs, and tools to our collective goal of ending structural racism and discrimination, by building a biomedical workforce that reflects the populations we serve at all levels of authority within NIH and in our grantee institutions.

Continue reading “NIMHD Director Statement in Support of NIH Efforts to Address Structural Racism”

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

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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”

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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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Addressing Social Needs and Structural Inequities to Reduce Health Disparities: A Call to Action for Asian American and Pacific Islander Heritage Month

Dr. Marshall H. Chin
Dr. Marshall H. Chin

By Marshall H. Chin, M.D., M.P.H.
Richard Parrillo Family Professor of Healthcare Ethics in the Department of Medicine,
University of Chicago
Member, National Advisory Council on Minority Health and Health Disparities

Photo of Dr. Marshall H. Chin

Dr. Marshall H. Chin

When I was a kid, every Saturday my parents would pack my older sister, younger brother, and me into the family station wagon, and we’d drive 40 minutes on Route 2 East from Boston’s western suburbs into Chinatown. There we gathered with aunts, uncles, and cousins in the home of my grandparents, immigrants from Toisan in southern China. The conversations were loud, the play was very lively, and the wonderful aromas of roast chicken, fried noodles, and sizzling stir-fried vegetables filled the air.

An impressionable young child, I watched intently as my uncles played poker, cigar smoke wafting into the nighttime air. They taught me how to play poker at the ripe old age of 8, and I filled in when one had to take a break for a hand or two. Most of my paternal uncles worked in the laundries. My mother’s side was noodles. My uncles were bright men, but the bamboo ceiling—basically, exclusion from good jobs—limited their opportunities. “I don’t have a Chinaman’s chance,” they’d say as they folded a losing hand of cards.1

Running around Chinatown with my cousins, I saw that my uncles weren’t the only ones whose opportunities were limited. Housing was crowded, and the streets were dirty and smelled of garbage. Years later, when I worked part-time at the Federally Qualified Health Center in Boston’s Chinatown, I cared for many non–English speaking immigrants with limited education. They faced uphill battles as they dealt with their chronic health conditions, paid medical bills without health insurance, and attempted to advance in society. Continue reading “Addressing Social Needs and Structural Inequities to Reduce Health Disparities: A Call to Action for Asian American and Pacific Islander Heritage Month”

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