Health Disparities: Research That Matters

Abstract

Health advances have not benefited all people equally. Health equity remains an aspirational goal, but research that enhances health equity is the highest priority at the National Institutes of Health. Here, we propose a call to action and outline current National Institutes of Health programs that aim to eliminate health disparities both broadly and in high priority areas. Discussed topics include stroke as an indicator of broad health inequity, challenges, and opportunities in health disparities research, the need to diversify the research workforce, and the ongoing efforts and struggles to establish trust with disadvantaged communities during the COVID-19 pandemic.

Keywords: goals; health equity; pandemic; trust; workforce.

Figure 1-

Map of the US depicting Age-Adjusted Average Annual Deaths per 100,000 people in adults age 35 or older (2017-2019). Darker purple represents increasing average annual stroke deaths. Schieb, L. Centers for Disease Control and Prevention. Quick Maps of Heart Disease, Stroke, and Socioeconomic Conditions. https://www.cdc.gov/dhdsp/maps/national_maps/stroke_all.htm. Accessed 10/04/2021.

Figure 2-

A promotional flyer for NIH’s Mind Your Risks® public health campaign. The National Institute of Neurological Disorders and Stroke (2021). Mind Your Risks® social media graphic. https://www.mindyourrisks.nih.gov/. Accessed 10/04/2021.

Figure 3-

A representation of the translational science spectrum that depicts each stage of research along the path from the biological basis of health and disease to interventions that improve the health of individuals and the public. The spectrum is not linear or unidirectional; each stage builds upon and informs the others. National Center for Advancing Translational Sciences (2021). Translational Science Spectrum. https://ncats.nih.gov/translation/spectrum. Accessed 10/04/2021.

Figure 4-

The NIMHD Minority Health and Health Disparities Research Framework reflects an evolving conceptualization of factors relevant to the understanding and promotion of minority health and to the understanding and reduction of health disparities. The framework serves as a vehicle for encouraging NIMHD- and NIH-supported research that addresses the complex and multi-faceted nature of minority health and health disparities, including research that spans different domains of influence (Biological, Behavioral, Physical/Built Environment, Sociocultural Environment, Healthcare System) as well as different levels of influence (Individual, Interpersonal, Community, Societal) within those domains. The framework also provides a classification structure that facilitates analysis of the NIMHD and NIH minority health and health disparities research portfolios to assess progress, gaps, and opportunities. Examples of factors are provided within each cell of the framework (e.g., Family Microbiome within the Interpersonal-Biological cell). These factors are not intended to be exhaustive. Health disparity populations, as well as other features of this framework, may be adjusted over time. National Institute on Minority Health and Health Disparities (2017). NIMHD Research Framework. Retrieved from https://www.nimhd.nih.gov/about/overview/research-framework.html. Accessed on 10/04/2021.