Advancing the Science of Minority Health and Health Disparities

Dr. Eliseo Perez-Stable
Dr. Eliseo J. Pérez-Stable, director of the National Institute on Minority Health and Health Disparities

NIMHD’s Scientific Advancement Plan (SAP) is a transformative agenda that champions the fields of minority health and health disparities research. Its purpose is to contribute to the scientific advances that are improving public health. Research in precision medicine, genomics, and health information technology, for example, hold promise for more effective chronic disease management, treatment and personalized prevention measures that will improve health outcomes. This approach to research in minority health and health disparities considers the current state-of-the-science in these areas and opportunities to improve health equity for all populations.

Since the early 1990s, researchers have been working to identify, understand, and address health disparities—health differences that adversely affect disadvantaged populations. Over the years, research in minority health and health disparities has evolved from a basic descriptive understanding of what health disparities are and who is most affected to discovering the complexity of factors involved in health and its outcomes. These are recognized as determinants of health—the individual factors and the conditions in which we live, learn, work, and play that influence health status.

Today, NIMHD delves deeper, introducing new approaches to the fields of minority health and health disparities research. The SAP takes into account the complexity of this research and allows for flexibility as it moves forward to address current and emerging issues affecting health disparity populations.

“What we’re learning about health disparities today has the potential to transform health for all populations,” says Dr. Eliseo J. Pérez-Stable, NIMHD director. “The plan serves as a roadmap to get us there.”

Recent discoveries are revealing underlying causes of health disparities across the health spectrum. For example, research has shown marked differences in drug effectiveness for racial and ethnic minorities, where a commonly prescribed asthma medication has been found less effective for Puerto Rican and African American children—two groups with higher asthma prevalence and mortality rates compared to other populations. Studies also suggest geographic disparities in health and life expectancy, where living in particular zip codes directly correlates to poorer health status and higher mortality, particularly for racial and ethnic minorities and persons of less socioeconomic privilege. Additionally, chronic stress has been linked to reduced telomere length, which can impact life expectancy and increase vulnerability to chronic diseases, such as cardiovascular disease, diabetes, and stroke—conditions highly prevalent in some racial and ethnic minorities.

“These studies indicate that ameliorating health disparities means gaining a deeper understanding of underlying mechanisms causing disparities,” says Dr. Pérez-Stable. “To do so, we must ensure adequate inclusion of racial and ethnic minorities in all clinical research. It’s simply good science.”

Today, we know that the inclusion of minorities in research is essential for relevant, impactful research outcomes. We also know that adverse health conditions may not be the result of a single factor or incidence. Instead, they may result from multiple factors that can take place over a lifetime. The SAP considers these and other determinants that influence health outcomes, along with the need to increase the number of underrepresented minority scientists to help improve inclusion and the quality of research.

The SAP focuses on four themes that aim to (1) strengthen research in minority health and health disparities from understanding etiology to improving methods and developing interventions, (2) increase investigator-initiated research, (3) strengthen research evaluation and reporting, and (4) support expansion of workforce diversity.

Components of the plan include the following:

Science Visioning, which aims to guide and highlight the research for improving minority health and reducing health disparities;

Research Framework, which illustrates the web of factors that influence minority health and health and health disparities and serves as a guide for research in these disciplines;

Health Disparities Research Institute, which supports career development for promising early-career minority health and health disparities research scientists; and

Scientific Interest Areas, which aim to strengthen the science in minority health and health disparities. These include three areas of research:

  • Clinical and Health Services Research to generate new knowledge to improve health outcomes and quality of health care for minority and underserved populations;
  • Integrative Biological and Behavioral Research to investigate how biological and behavioral mechanisms and pathways influence resilience and susceptibility to adverse health conditions that disproportionately affect health disparity populations; and
  • Community Health and Population Sciences to study the causes, prevention, screening, early detection and management of disease using large studies that reflect health of overall minority and underserved populations.

Click here to learn more about the NIMHD Scientific Advancement Plan.

Posted August 29, 2018