NATIONAL INSTITUTES OF HEALTH
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
NIH Health Disparities Strategic Plan and Budget
Fiscal Years 2009-2013
NIH Health Disparities Strategic Research Plan and Budget, Fiscal Years 2009-2013
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TABLE OF CONTENTS
Acronyms of NIH Institutes, Centers, and Offices 4
Foreword 5
Executive Summary 7
Section I: Introduction 10
Performance Measures 12
Section II: Background on Minority Health and Health Disparities 13
A. Definition of Health Disparities 13
B. Determinants of Health Disparities 15
Physical Environment 16
Social Environment 17
Behavior 17
Biology 17
C. NIH Strategy to Address Health Disparities 18
Research 18
Research Capacity-Building 18
Community Outreach, Information Dissemination, & Public Health 19
Integration of Research, Capacity-Building, and Outreach 20
Citations 20
NIH Health Disparities Strategic Research Plan and Budget 23
NIH Health Disparities Budget - FY 2010 Actual & FY 2011 Estimate 24
I. Research 25
a.
Genetics and Biological Factors 25
b.
Behavioral and Social Sciences 38
c.
Clinical and Translational Research 49
d.
Comparative Effectiveness Research 74
e.
Social Determinants of Health 78
f.
Health Services Research 82
g.
Innovative Health Technologies 85
h.
Global Health 89
NIH Health Disparities Budget – Research 93
NIH Health Disparities Strategic Research Plan and Budget, Fiscal Years 2009-2013
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II.
Research Capacity-Building 94
a.
Research Infrastructure Enhancement 94
b.
Development of a Diverse Workforce 98
c.
Health Disparities Informatics Capacity 122
NIH Health Disparities Budget – Research Capacity-Building 125
III.
Community Outreach, Information Dissemination and
Public Health Education 126
a.
Public Awareness Campaigns 126
b.
Public/Private Partnerships 141
c.
Diverse Participation in Clinical Trials 153
d.
Social Networking 157
NIH Health Disparities Budget – Community Outreach, Information Dissemination,
and Public Health Education 160
IV.
Integration of Research, Research Capacity-Building and Outreach 161
a.
Transdisciplinary Centers of Excellence 161
b.
Community-Based Participatory Research 165
c.
Partnerships/Networks 170
NIH Health Disparities Budget – Integration of Research, Research
Capacity-Building and Outreach 174
NIH Health Disparities Strategic Research Plan and Budget, Fiscal Years 2009-2013
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Foreword
The remarkable progress seen in biomedical science in recent years has improved the health and extended
the average lifespan of most Americans to 77.9 years (Health, United States, 2010). However, due to a
dauntingly complex set of factors, some of our citizens (often the most vulnerable) have lagged behind
others in enjoying the fruits of our scientific and medical advances. This remains an unacceptable
situation, and the National Institutes of Health (NIH) remains firmly and substantially committed to
changing it for the better. As long as even one of our fellow Americans encounters barriers to optimal
care—whatever the reason—our work is unfinished.
To combat the disparities in health suffered by specific populations, we must first understand how, where,
why, and for whom they arise. The scientific community has documented well that these conditions are
extraordinarily complex and multi-factorial in nature. They originate from ever-evolving interactions of
genetic, biological, environmental, social, economic, and psychological influences. Clearly, to gain the
understanding necessary to make substantial progress in efforts to eliminate health disparities, an
ambitious and far-reaching research program is needed. A portfolio of efforts that will facilitate intensive
exploration of how those areas interact to contribute to imbalances in health and inequities in health care
is required.
With its wide-ranging expertise and robust resource base, the NIH is uniquely qualified to fashion and
implement such a program, and the agency has long been committed to an ambitious health disparities
research enterprise, NIH-wide and within each of its Institutes and Centers (ICs) and Office of the
Director Program Offices. This NIH Health Disparities Strategic Research Plan and Budget, Fiscal
Years 2009-2013, represents the renewal and expansion of that commitment to improve the health of
individuals and ultimately eliminate health disparities in the United States.
To accomplish this, NIH has also long recognized the necessity to aggressively leverage the new
knowledge that emerges from research to ameliorate health disparities whenever and wherever they
occur—in racial/ethnic minorities, and in other medically-underserved populations such as individuals of
low socioeconomic status or those who live in rural areas with limited access to care. The transfer and
application of important new knowledge is a core element of our ongoing programs and initiatives related
to health disparities.
Translating discoveries can take many forms, such as new drugs or medical devices, new behavioral
interventions, new outreach and education activities, and many other types of innovative solutions. But as
exciting as it may be, a discovery is of little value if it never achieves a life beyond the confines of the
academic journal or the scientific meeting. NIH devotes considerable resources and efforts to ensuring
that innovations are disseminated so as to have maximum impact upon the problems they address. In
many cases, that means working very closely with the myriad stakeholders associated with health
disparity populations. Often, those meaningful collaborations involve as much listening as speaking and
as much learning as teaching.
Increasing diversity in the biomedical enterprise to better reflect the diversity of the Nation’s population
is another core concept underlying NIH efforts to combat health disparities. Across the agency and
within its ICs, scores of programs devote sizeable human and financial resources to the recruitment,
education, training, and career development of scholars involved in the many facets of health disparities
research. Those efforts are designed to maintain and increase participation in health disparities research
NIH Health Disparities Strategic Research Plan and Budget, Fiscal Years 2009-2013
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by recruiting and nurturing the next generation of scientists in the field, and provide enhanced
opportunities for young people from health disparity populations to enter and stay in the field. Programs
offering those opportunities span from K-12 through the undergraduate, graduate, post-graduate, and
early- and mid-career levels, ensuring a richly diverse pipeline of well-trained, well-educated scientists.
The NIH Health Disparities Strategic Plan and Budget is designed to be an evolving document through
the course of its life span, as the agency and its ICs respond to future scientific opportunities and public
input from affected communities.
We invite and encourage your feedback, ideas, and suggestions as we constantly strive to improve and
refine our strategies for meeting the profound challenges involved in improving the health and well being
of all Americans by combating the health disparities that still pervade our society.
Francis S. Collins, M.D., Ph.D. John Ruffin, Ph.D.
Director Director
National Institutes of Health National Institute on Minority Health and
Health Disparities
National Institutes of Health