Office of the Scientific Director

National Institute On Minority Health And Health Disparities

Investigators

Abstract

U.S. Burden of Health Disparities Project. In FY 19, NIMHD DIR launched a landmark 3-year collaborative study called the U.S. Burden of Health Disparities and continues to work collaboratively with the Contractor, Institute of Health Metrics and Evaluation, to produce U.S. county-level estimates of the burden of disease stratified by race/ethnicity, SES, sex, and age. NIMHD DIR seeks to produce a comprehensive report on the state of the U.S. burden of disease, providing detailed assessments of patterns of health status indicators and risk factors by race/ethnicity, sex, SES, age, and location, with a public platform for downloading the data and data visualizations. NIMHD DIR and the U.S. Burden of Health Disparities Working Group (with representation from multiple NIH Institutes and Centers) have been guiding the work of the Contractor. September 2021 will mark the end of the 2nd year of the 3-year contract with IHME. During FY21, IHME continued to seek access to county-level BRFSS data, which requires securing state-by-state approval for access to the data. Thus, far, IHME has received responses from 45 states and received data from 10 states. Follow-up is on-going. IHME has organized population and covariate data in databases and are implementing a solution to address missingness on education in mortality and birth data. They have continued to identify and extract additional data sources for use in modeling of nonfatal outcomes and risk factors. For mortality modeling, they have continued to develop cause-specific mortality estimates by race/ethnicity and educational attainment. They have continued iterations of all-cause nonfatal models, cause-specific nonfatal models using years of life lost (YLL) estimates as inputs, and cause-specific nonfatal models that incorporate clinical data. Regarding risk factor modeling, IHME has continued exploring methods to produce population attributable fractions (PAFs) and has made progress on both tobacco use and high BMI models that incorporate BRFSS data. Finally, they have continued discussions with the overall IHME team to strategize key analytic approaches and engineering solutions required to meet our goals. Two manuscripts are under review, one focused on life expectancy by county and race/ethnicity and another on fatal police violence in the U.S. by race and state. New Tenure-track Investigator. In FY21, NIMHD DIR added one Stadtman Tenure-Track Investigator, Dr. Kosuke Tamura, who was hired on August 16, 2021. Dr. Tamura completed his PhD in Health and Kinesiology at Purdue University in December 2015. Prior to that, he obtained a MS degree in Health Economics and Spatial Economics at Purdue University and a MA degree in International Affairs/African Development and Environmental Economics from Ohio University. He completed a 2-year post-doctoral fellowship in Population Health at NYU Grossman School of Medicine where he studied food environments and childhood obesity. At the time of his hire by NIMHD DIR, he was in his 4th year of a post-doctoral fellowship in Social Epidemiology with Dr. Tiffany Powell-Wiley (an NIMHD DIR Adjunct Investigator) at NHLBI intramural (Social Determinants of Obesity and Cardiovascular Risk Laboratory). Dr. Tamura comes to NIMHD with exceptional training in novel, cutting edge research methods related to spatial statistics, longitudinal and multi-level analyses, geographical information systems (GIS), and global positioning system (GPS) technologies. These skills can be readily applied to conduct innovative minority health and health disparities research to identify mechanisms of disparities and potential interventions to address these. Senior Advisor to the Scientific Director. In FY 21, Dr. Anita Stewart continued as a Senior Advisor to the Scientific Director and continues to mentor early-stage investigators, provide scientific input on future directions for the NIMHD DIR, and serve as a methodological expert on survey methods, health measures and health disparities research methods. Dr. Harold Neighbors, Senior Advisor, elected to terminate his contract with NIMHD DIR as of June 2021. Three Nationally Representative COVID-19 Surveys. In FY21, DIR Investigators launched 3 nationally representative surveys to assess the disproportionate impact of the COVID-19 pandemic on racial/ethnic, rural and low-income populations in the U.S. One survey focused on the impact of COVID-19 on physical and mental health, health behaviors, and financial well-being, another survey focused on the interplay of racism, discrimination, and health outcomes during the pandemic, and the third focused on changes in smoking and nicotine product use behaviors among smokers and former smokers. In total, these surveys reached 15,700 persons from these populations. The 3 surveys were completed during the December 2020-February 2021 peak in the pandemic, and a 6-month follow-up survey to one of the surveys is in process. Data analyses and manuscript writing are in progress and 3 manuscripts have been submitted to date. NLM Collaboration on MeSH. NIMHD DIR continues to build its capacity and leverage NIH-wide facilities and collaborations to advance research on health disparities and minority health at NIH. For FY21, as part of the NIH UNITE initiative focused on ending structural racism, DIR worked with the National Library of Medicine to obtain approval to add 80 terms and concepts, and 24 new Medical Subject Headings related to social determinants of health (SDOH), which will be available November 2021. This will result in an improved ability to index and identify journal articles and books addressing SDOH. A similar effort to improve the MeSH for identification of research related to the NIMHD-recognized U.S. racial/ethnic minority populations is underway. Also, in FY21, the DIR initiated a project with broad NIH intramural representation to identify common data elements for SDoH for proposed adoption by the NIH Clinical Center (CC) for uniform and routine collection of this data on all CC study participants.