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, education, 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 FY22, the U.S. Burden of Health Disparities project produced, for the first time, county-level estimates of life expectancy by five race and ethnicity groups and by sex over a 20-year time series. Modeling both geographically and by race and ethnicity offers granular insight into the progress or lack thereof in peoples longevity over the first two decades of the 21st century. IHMEs life expectancy estimates represent the initial offering of an ongoing series of US county-level analyses by race and ethnicity. By revealing the large geographic variation within and across race and ethnicity groups, these findings allow decision-makers to develop more tailored, nuanced policies so that everyone can live healthy and full lives. Highlights of these analyses follow: Life expectancy overall in the US improved by 2.3 years between 2000 and 2019, but by race and ethnicity group, national life expectancy improvements ranged from 0 years for the American Indian and Alaska Native (AIAN) population to 3.9 years for the Black population. Within each race and ethnicity group, life expectancy varied widely at the county level. For instance, life expectancy for the Latino population in 2019 ranged from 71.3 years in Huerfano County, Colorado, to 94.9 years in the Aleutians West Census Area, Alaska. From 2000 to 2019, 88% of counties experienced an increase in life expectancy. At least 75% of counties saw increases for the Black, Asian or Pacific Islander (API), White, and Latino populations. By contrast, estimated life expectancy declined for the AIAN population in nearly 62% of counties. This analysis covering the two decades preceding the COVID-19 pandemic demonstrates the pressing need to reduce, and ultimately eliminate, racial and ethnic health disparities, as well as disaggregate Pacific Islanders from Asians and other major groups. The project also aims to estimate at least four other summary measures of health at the US county level by race and ethnicity and education. Researchers are hard at work computing years of life lost (YLLs, or years lost due to premature mortality), years lived with disability (YLDs, or years lived in less than full health), disability-adjusted life years (DALYs, or the sum of YLLs and YLDs), and healthy life expectancy (HALE, or a measure of life expectancy that considers mortality and nonfatal outcomes). We are also estimating prevalence and incidence of select diseases; exposure to risks like high fasting plasma glucose, high systolic blood pressure, and high body mass index; and the population attributable fractions for those risk factors. Due to the increased scale and dimensions of results for this project, researchers must modify key components of the existing computational framework to produce these summary metrics at the county level. Senior Advisor to the Scientific Director. In FY22, 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. She co-authored with the Scientific Director a publication that examined racial-ethnic differences in willingness to be vaccinated for COVID-19 and is co-authoring a paper on racial-ethnic disparities in COVID-19-related psychological distress, along with several others. 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. DIR worked with the National Library of Medicine (NLM) to obtain approval to add 80 terms and concepts, and 24 new Medical Subject Headings (MeSH) related to social determinants of health (SDOH), which became available November 2021. For FY22, building on this work, NIMHD DIR is working with NLM to develop more nuanced MeSH terms to identify racial/ethnic/tribal populations in the literature. This work has included engaging subject matter experts and public listening sessions to ensure terms are thoughtfully developed. This will result in an improved ability to index and identify journal articles and books addressing minority health/health disparities research.