Investigator-Initiated Research on Minority Health and Health Disparities Program

Program Description

Advances in medical research are improving the health of the U.S. population overall, yet many populations are not experiencing the same health outcomes. Diseases such as cancer, diabetes, and heart disease disproportionately affect racial and ethnic minority, socioeconomically disadvantaged, and rural populations with higher prevalence, earlier onset, faster progression, and poorer outcomes.

The NIMHD investigator-initiated R01 research program will support research projects in two broad areas: basic and applied biomedical research; and social, behavioral, health services and policy research that focus on one or more health disparity populations. Populations for this research program include African Americans, Hispanics, American Indians and Alaska Natives, Asians, Native Hawaiians and other Pacific Islanders, socioeconomically disadvantaged populations and rural populations.

I. Basic Applied Biomedical Research

NIMHD supports innovative basic and applied research on fundamental biological mechanisms involved in disease conditions that disproportionately affect racial and ethnic minority populations and other health disparity populations and on therapies or interventions that can directly or demonstrably contribute to reducing or eliminating health disparities. Investigators are encouraged to conduct studies in a broad area of disease conditions associated with significant morbidity and mortality in health disparity populations, with a focus on etiology, genetics, diagnosis, and intervention.

A. Biological and Genetic Mechanisms of Disease

NIH-supported research and advances in biological and genetic mechanisms have contributed to the development of drugs and therapies that improve health and prevent disease, but translating these findings into improved health among health disparity populations remains a challenge. Potential biological mechanisms and pathways of disease conditions with significant mortality and burden of disease among these populations warrant investigation. Possible research topics include the following:

  • Health conditions not adequately studied in health disparity populations (e.g., glomerular diseases, scleroderma, neonatal asphyxia, asthma, autoimmune disorders, pancreatic disorders, traumatic brain injury)
  • The biological and molecular bases of psychosocial stress and allostatic load
  • Genetic susceptibility to common and rare disease among racial and ethnic minorities
  • Pharmacogenomic studies to determine medication response and optimal dosing
  • Gene–environment interactions (i.e., epigenetic mechanisms of health disparities)
  • How gestational and prenatal physiology affect health disparities later in life
  • Bioinformatics tools and modeling approaches to identify genetic variation and susceptibility to disease among racial and ethnic minorities
  • Analysis of existing genotype and phenotype data sets to identify novel loci of susceptibility
  • Development of modeling tools for systematic data mining and linking of existing data sets on minority populations

B. Clinical and Translational Research

Clinical trials and other forms of clinical research in health disparity populations are vital to improving our understanding of the causes of many diseases that affect those populations. New insights or potential treatments gleaned from such studies can transform medical practice in targeted populations. Possible research topics include the following:

  • Clinical and translational research on prospective biomarkers for disease diagnostics and prognosis in health disparity populations
  • Establishment and use of biorepositories containing specimens from health disparity populations
  • Development of novel technologies, diagnostic imaging, and other diagnostic procedures in health disparity populations
  • Pilot studies, case control studies, efficacy studies, and randomized controlled trials to test existing pharmacological or other biologically based treatments, interventions, and/or novel interventions in health disparity populations
  • Use of health information technology for prevention, early detection, and treatment

II. Social, Behavioral, Health Services, and Policy Research on Minority Health and Health Disparities Research

NIMHD supports original and innovative social, behavioral, clinical, health services, and policy research directed toward improving minority health and eliminating health disparities. Projects may be descriptive or interventional and may involve primary data collection or secondary analysis of existing datasets.

A. Social and Behavioral Research

There is growing recognition of the importance of social, cultural, and environmental factors in driving or sustaining health disparities. More work is needed to understand how these factors can be addressed to achieve meaningful and lasting changes in health and health behavior at the individual and community level. Possible research topics include the following:

  • Social, behavioral, cultural, or environmental risk and protective factors related to the development of health conditions
  • Individual- and family-level strategies to cope with disability
  • The impact of racism, discrimination, and segregation on health and health behavior and strategies to ameliorate these effects
  • Promotion of health literacy at the community level
  • Use of health information technologies and/or social media to promote health
  • Strategies to promote greater participation of health disparity populations in clinical research and clinical trials
  • Preventive or health improvement interventions in nonmedical organizational settings, such as schools or workplaces
  • Preventive or health improvement interventions at the family, neighborhood, or community level

B. Health Services Research

Disparities in health care are a clear contributor to disparities in health outcomes. Differences in utilization patterns and quality-of-care indicators between health disparity populations and the general population have been well documented. More work is needed to understand how to best eliminate these inequities. Possible research topics include the following:

  • Potential for health information technologies to improve access to existing services
  • Interventions to improve providers' cultural competence that demonstrate a clear link to improvement in patient outcomes
  • Initiatives to increase the supply of health care practitioners in medically underserved areas
  • Use of paraprofessionals or peer-led health services to supplement existing health care services
  • Use of alternative or complementary medicine in conjunction with formal health care services
  • Strategies to organize, manage, finance, and deliver quality health care
  • Strategies to minimize unconscious bias, discrimination, and stereotyping in clinical decisionmaking and priority setting that lead to differential health outcomes in health disparity populations and identification of patient-provider communication patterns that affect health disparities
  • Feasibility and effectiveness of health care delivery in nonmedical settings, such as schools or workplaces
  • Patient preferences regarding help-seeking, treatment options, and adherence

C. Policy Research

Public- and private-sector policies have great potential to influence minority health and health disparities in both positive and negative directions. Research advances identifying successful strategies to reduce health disparities are unlikely to have a sustained or widespread impact unless they can directly inform and shape policy. At the same time, the impact of new or existing policies on minority health and health disparities may not be evident in the absence of rigorous research evaluation. Possible research topics include the following:

  • Analysis of local, state, or national health policies that increase or reduce health disparities, such as policies related to insurance coverage or reimbursement, organization of government-run or -funded health care services, or regulation of environmental hazards
  • Analysis of local, state, or national policies not specifically related to health that increase or reduce health disparities, including policies related to zoning or housing, government entitlements, public education, immigration, and criminal justice
  • Analysis of workplace policies in the public or private sector that affect health
  • Analysis of initiatives to increase the supply of health care practitioners in medically underserved areas and/ or of initiatives to increase enrollment of students from health disparity backgrounds in health practitioner programs
  • Identification of geographic, political, and sociocultural factors that predict or affect the impact of policy initiatives designed to reduce health disparities in different settings

Eligibility

NIMHD awards Investigator-Initiated Research on Minority Health and Health Disparities grants to organizations of all types, including universities, colleges, small businesses, governments, for-profits, nonprofits, and faith-based or community-based groups.