The National Center on Minority Health and Health Disparities (NCMHD) is a division of the National Institutes of Health in the U.S. Department of Health and Human Services. NCMHD was established by the United States Congress through the Minority Health and Health Disparities Research and Education Act of 2000 to promote equality in health outcomes for all citizens through research and education.

According to NCMHD’s director Dr. John Ruffin, a health disparities population “is a population where there is significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates as compared to the health status of the general population.” According to Ruffin, the following populations are classified as specific health disparity populations: African Americans, Hispanics/Latinos, Native Americans, Alaska Natives, Asian Americans, Native Hawaiians, Pacific Islanders and the medically underserved, such as individuals from the Appalachian region.

The mission of the NCMHD is to reduce and eventually eliminate minority health disparities through conducting and supporting research, training, disseminating information and providing outreach to communities with health disparities.

To accomplish this goal, the NCMHD has a number of federally funded programs: the Research Infrastructure in Minority Institutions Program, the Research Endowment Program, Project EXPORT Centers of Excellence Program and the Loan Repayment Programs. Ruffin states that in the fiscal year 2002, the NCMHD “made $74.5 million in awards to support extramural research and provided over $65 million of support to other NIH institutes and centers to co-fund projects related to minority health or health disparities research and training.”

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What are some examples of disparities in health among various racial and ethnic groups in the U.S.?

“Compared to Caucasians, African-American adults are twice as likely to develop type 2 diabetes, and Hispanic adults are 1.9 times more likely to develop the disease. American Indians have the highest prevalence of type 2 diabetes. Over 25% of all adults with diabetes in the U.S. are minorities.

“In 1999, age-adjusted death rates for the African-American population exceeded those for the Caucasian population by 38% for strokes and 28% for heart disease.

In addition, death rates for stroke were 31-40% higher for middle-aged Asian-American males than for middle-aged Caucasian males.

“African Americans are about 30% more likely to die of cancer than are Caucasians and more than two times more likely to die of cancer than any other racial and ethnic group. Hispanics have higher rates of cervical, esophageal, gallbladder and stomach cancer. The difference in cancer mortality is about 12% higher for Hawaiian men and 20% higher for Hawaiian women than that of Caucasian Americans.”

Can you describe the Research Infrastructure in Minority Institutions program and the Research Endowment Program?

“The Research Infrastructure in Minority Institutions provides support for institutions that enroll a significant number of students from minority health disparity populations to develop and enhance their capacity and competitiveness to conduct biomedical or behavioral research. For fiscal year 2002, the NCMHD issued $5.6 million in awards to six biomedical and behavioral research institutions. The Research Endowment Program generates funds to help build research and training capacity in institutions that make significant investments in the education and training of underrepresented minority and socio-economically disadvantaged individuals.

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“This past year the NCMHD has funded a number of programs. Here’s just one example: The University of Montana will expand its infrastructure capacity to offer graduate degrees with an increased focus on minority health disparities research. Additionally, funds generated from the endowment award will be used to establish new tenure track faculty positions for minority professors with a special emphasis on American Indians.”

What are some of the research topics of the health professionals supported by the NCMHD?

“NCMHD-supported health professionals are working on a broad range of scientific topics. Examples of these projects include: (1) mechanisms for racial disparity in pre-term births; (2) Hispanic/non-Hispanic disparities in health-related quality of life and the accessibility and quality of health services; (3) American Indian child development; (4) underrepresentation of African Americans in clinical research; (5) weight loss and obesity in African American individuals with type 2 diabetes; (6) diabetes education multimedia for vulnerable populations; (7) mental health, substance abuse and welfare reform among African Americans; (8) health disparities among infants and children; (9) HIV prevention in communities of color; (10) cultural differences in familial response to heroin dependence; (11) ethnic, racial and gender contributions to understanding suicidal and mental health risk, dysfunction and adaptation; (12) reaching Vietnamese American women to prevent cervical cancer; (13) racial and ethnic health disparities in Arkansas; (14) intervention to prevent Latino youth drug use; and (15) cultural competence in the physician/patient relationship in depression management.”

What are some examples of NCMHD’s Project EXPORT Centers of Excellence Program initiatives funded in 2002?

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“The Center for Research and Outreach in Hispanic Mental Health at Carlos Albizu University in Puerto Rico , facilitates research on health disparities with a special focus on the diagnosis, prevention and treatment of mental health disorders in Hispanics and also conducts research on hypertension and HIV/AIDS.

“Another project, the Health Disparities Research with Indian Tribes in Montana and Wyoming , in conjunction with Black Hills State University in North Dakota , will develop a research infrastructure to address health disparities issues affecting the American Indian population of the Northern Plains.

“The initiative Reducing Health Disparities in Alabama ‘s Black Belt with Tuskegee University and University of Alabama, Tuscaloosa, focuses on minority health disparities, bioethics and rural health in Alabama ‘s African-American community. Partnerships for Diabetes Related Disparities in Health with the University of Hawaii at Manoa and the Medstar Research Institute will establish the Hawaii EXPORT Center, a research center whose mission is to reduce and eliminate diabetes related health disparities in Native Hawaiians and Pacific Peoples.”

Can you describe the Loan Repayment Programs?

“The Health Disparities Research Loan Repayment Program is the congressionally mandated extramural loan repayment program for minority or other health disparities research. The objective is to recruit and retain highly qualified health professionals to research careers that focus on minority health or other health disparities issues. In fiscal year 2002, the NCMHD issued $5.04 million in awards to 112 health professionals engaged in health disparities research.

“The objective of the Extramural Clinical Research Loan Repayment Program for Individuals from Disadvantaged Backgrounds is to recruit and retain highly qualified and culturally competent health professionals from disadvantaged backgrounds into the clinical research field. In fiscal year 2002, the NCMHD issued $2.02 million in awards to 41 health professionals from disadvantaged backgrounds engaged in clinical research.”

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What does the NCMHD see as its top priority today?

“Through its mandated programs and collaborations throughout the country, the NCMHD is committed to building a solid and diverse national biomedical research enterprise of individuals and institutions with the goal of eliminating health disparities and ensuring the health of all Americans. Our top priority is to expand these programs and develop new ones to meet the ever increasing health needs of minority and underserved populations in the United States .”

How can someone interested in learning more about or participating in the work of the NCMHD get involved?

“Information about the NCMHD and its programs may be found on the NCMHD Web site http://www.nimhd.nih.gov/.”

National Center on Minority Health and Health Disparities

National Institutes of Health

6707 Democracy Blvd., Suite 800

MSC-5465

Bethesda , Md. 20892

Info: (301) 402-1366
http://www.nimhd.nih.gov/

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