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 collaborative study called the Global Burden of Disease U.S.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. During FY23, NIMHD began updating and building upon comprehensive database to study county level morbidity and mortality in the United States over a 20-year period, and assess differences across age, sex, and race and ethnicity. The current contract will allow IHME to generate measures of disease morbidity (e.g., years of healthy life lost due to disability), continue to update with newly released data and methodology, separate Asian and Native Hawaiian/Pacific Islander into separate racial groups and add multiracial group to all analyses. IHME will also generate and analyze individual and neighborhood measures of social determinants of health (e.g., educational attainment, environmental exposures) and other risk factors (e.g., obesity) to identify mechanisms that lead to racial-ethnic disparities in morbidity and mortality. Assessments of geographic variation in SDOHs and disparities will allow for the identification of communities and areas that could be targeted for intervention. 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. 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. During FY23, we finalized the list of descriptors for race, ethnicity, country of origin, and population groups for NLM to implement into the MeSH system. Personnel. During FY 23, we hired a new staff assistant, Kennedy Bowen. She monitors program activities, sets priorities, and provides assistance, coordination, and follow-up to ensure the Division's progress toward the NIMHD mission. She also worked on developing the SOPs and process and procedure of the NIMHD policy within the division of intramural research. NIH Health Disparities Interest Group and NIMHD DIR Seminars. NIMHD DIR provides financial and administrative support to Health Disparities Interest Group. During FY23, NIMHD DIR hosted 4 Health Disparities Interest Group Seminar and 6 DIR seminars on every 2nd Tuesday of each month. The seminars are available via NIH video cast to increase access to the seminar series for both internal and external interested group. Examples of presenters are below. Title: Pregnancy: A Window to Address Health Inequities Across the Lifecourse Presenter: Claire E. Margerison, PhD, Associate Professor, Department of Epidemiology & Biostatistics, Michigan State University Title: Strengths, Community, and Frameworks to Advance American Indian and Alaska Native Health Equity Presenter: Katie Schultz, PhD, MSW, Associate Professor of Social Work, University of Michigan Title: The "Getting-to-Equity in Obesity Prevention Framework (GTE)": Early Experience and Potential Next Steps Presenter: Shiriki Kumanyika, PhD, MPH, Professor Emerita of Epidemiology, University of Pennsylvania Perelman School of Medicine