US National Institutes of Health to increase emphasis on minorities

HOUSTON To increase emphasis on minority health problems, the National Center on Minority Health and Health Disparities (NCMHD) was established this month and John Ruffin appointed its first director. Part of the National Institutes of Health, NCMHD will conduct and support research, training and dissemination of information about minority health conditions and about populations with health disparities. Establishing a strong focal point for health research on minorities could promote increased R&D funding. The funding level for minority health research had been about $86 million. The Act of Congress creating NCMHD authorised more than $130 million to set up the new centre and increase research funding.Ruffin said, "While the diversity of the American population is one of the nation's greatest assets, one of its greatest challenges is reducing the profound disparity in health status of America's racial and ethnic minorities, Appalachian residents, and other similar groups, compared to the population as a whole. Although some of the causes of disparate health outcomes — such as differences in access to care — are beyond the scope of biomedical and bio-behavioural research, the NIH can play a vital role in addressing and easing health disparities involving cancer, diabetes, infant mortality, AIDS, cardiovascular illnesses, and many other diseases. The NIH has made health disparities a budget priority and an area of emphasis. " He noted, "The National Institutes of Health has always been at the forefront of progress in the area of minority health from the first centres in the early 1970s to study sickle cell disease, a genetic disorder that primarily affects African Americans, to the more recent studies in the areas of HIV/AIDS, diabetes, cardiovascular disease, and cancer. We want to encourage more research in the field of minority health so that all Americans may share equally in the benefits of biomedical and behavioural research." The NIH is seeking to improve the visibility of minority health disparities research and other health disparities research as well as expand the role of such research in learning why some groups have disproportionately high rates of disease. In addition to awarding research grants and contracts independently, NCMHD will support programs of health disparities research with a focus on basic and clinical research, training and the dissemination of health information. The specific goals and purposes of NCMHD include: • To assist in the development of an integrated national health research agenda, across disciplines, that reflects the current and emerging health needs of racial and ethnic minorities and other health disparity groups. • To promote and facilitate the creation of a robust minority health research environment with sustained funding for a wide breadth of studies. These include basic, clinical, and population research; studies on the influences of health processes; and research on the societal, cultural, and environmental dimensions of health. All are aimed at identifying potential risk factors for disparate health outcomes. • To promote, assist, and support research capacity building activities in the minority and medically-underserved communities, focusing on research infrastructure development, faculty career development, and increasing the number of underrepresented minority students and students from health disparity groups with an interest in careers in biomedical and bio-behavioural research.Ongoing research includes the 'Genomic analysis of diseases that disproportionately affect minorities' project, a collaborative research effort with five sites in West Africa. The study will produce population-based data on genetic and epidemiological factors that contribute to the disproportionate increase in complex diseases such as cancer and diabetes in African Americans. The identification of genes underlying susceptibility to common diseases and an understanding of the function of these genes and their interaction with environmental factors will lead to improved management and treatment of the diseases.Another project, 'Diabetes/obesity genes: Treatment and prevention in minorities', is targeted at the greater incidence of diabetes and obesity in some minority groups. The project is aimed at understanding interactions of the genes that regulate body weight, energy expenditure and body composition in order to determine their role in the pathogenesis of obesity and diabetes in various ethnic populations. Genetic influences on Alzheimer's disease risk among patients and their siblings in the Caribbean Hispanic population in New York City and in the Dominican Republic are under investigation in an additional study. The goal is to identify which chromosomes contain genes that may increase the risk of Alzheimer's disease in members of this ethnic group. The Genetics of Alcoholism is an investigation aimed at increasing understanding of the genetic susceptibility to alcoholism and alcoholism risk among African Americans. Howard University was added as an eighth site in a collaborative program with the long-term goal of elucidating novel heritable phenotypes that contribute to alcoholism susceptibility and severity.Meanwhile, the National Institute of Environmental Health Sciences, in collaboration with six other National Institutes of Health units and the National Institute for Occupational Safety and Health, will fund 12 five-year projects. These will provide a better understanding of how social and physical environmental factors interact to impoverish the health of racial and ethnic minorities. Total funding for these projects is roughly $33 million over the five-year period. The partnership is the first trans-NIH collaboration designed to address the Department of Health and Human Services' 'Initiative to eliminate racial and ethnic disparities in health'.Other NIH participants are the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Child Health and Human Development, the National Heart, Lung and Blood Institute, the National Institute of Mental Health and the Office of Behavioral and Social Sciences Research.These projects — original research rather than codification of existing work — will be complex because genetic factors interact with environmental and social ones to determine health outcomes. For example, Brian S. Schwartz at Johns Hopkins University School of Hygiene & Public Health will explore how lead absorption, genetics, social and behavioural factors, social context and blood pressure contribute to the racial and socio-economic disparity in the decline in cognitive functioning that occurs in elderly people. The investigators propose to test a diverse sample of 900 subjects to see whether lead burden does indeed contribute to a more rapid decline in cognitive function. The results of NCMHD-sponsored research could also improve the health of citizens of many third world countries who have genetic heritages similar to those of US minority groups.

US National Institutes of Health to increase emphasis on minorities

To increase research on minority health problems, the US government has established the National Center on Minority Health and Health Disparities.

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