scholarly journals Addressing Racial Disparities in NIH Funding

2021 ◽  
Vol 18 (04) ◽  
Author(s):  
Nicole Comfort
Keyword(s):  
Racial Disparities ◽  
Peer Review ◽  
Minority Groups ◽  
Positive Impact ◽  
Ethnic Disparities ◽  
The United States ◽  
Early Career ◽  
Biomedical Sciences ◽  
Grant Funding

The United States (US) must strategically invest in diversifying its biomedical workforce to retain global leadership in biomedical research and to reduce racial and ethnic disparities in the US. The under-representation of minority groups in the biomedical sciences is influenced by the National Institutes of Health (NIH) grant funding process which relies heavily on peer review subject to bias. Despite recent initiatives to combat structural racism within the NIH, the NIH has done little to rectify racial disparities in funding allocation that have been known for over a decade. In this report, I evaluate current NIH proposals to reduce bias in peer review and present stronger policy options for reducing inequity in grant funding. I recommend that the NIH treat the race/ethnicity funding disparity as it did the early career investigator disparity and immediately relax paylines and simultaneously prioritize research topics that align with interests of under-represented investigators, while working to develop a modified lottery for grant funding as a long-term solution to the biases that can influence grant peer review. Policies to address disparities in grant funding will diversify the biomedical workforce and have a profound and long-term positive impact on providing equitable access to science careers, regardless of race.

Racial and Ethnic Disparities in the Treatment of Chronic Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Mary E Morales ◽  
R Jason Yong
Keyword(s):  
Chronic Pain ◽  
Racial Differences ◽  
Current Literature ◽  
Ethnic Disparities ◽  
The United States ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Sociodemographic Profile

Abstract Objective To summarize the current literature on disparities in the treatment of chronic pain. Methods We focused on studies conducted in the United States and published from 2000 and onward. Studies of cross-sectional, longitudinal, and interventional designs were included. Results A review of the current literature revealed that an adverse association between non-White race and treatment of chronic pain is well supported. Studies have also shown that racial differences exist in the long-term monitoring for opioid misuse among patients suffering from chronic pain. In addition, a patient’s sociodemographic profile appears to influence the relationship between chronic pain and quality of life. Results from interventional studies were mixed. Conclusions Disparities exist within the treatment of chronic pain. Currently, it is unclear how to best combat these disparities. Further work is needed to understand why disparities exist and to identify points in patients’ treatment when they are most vulnerable to unequal care. Such work will help guide the development and implementation of effective interventions.

scholarly journals A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States

2021 ◽  
Author(s):  
Lauren C Zalla ◽  
Chantel L Martin ◽  
Jessie K Edwards ◽  
Danielle R Gartner ◽  
Grace A Noppert
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Structural Racism ◽  
Public Health Response ◽  
Health Response ◽  
The Us ◽  
Racialized Minority ◽  
Racial And Ethnic Minority ◽  
Disproportionate Burden

Abstract Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the US. Higher risks of infection and mortality among racialized minorities are a consequence of structural racism, reflected in specific policies that date back centuries and persist today. Yet, our surveillance activities do not reflect what we know about how racism structures risk. When measuring racial and ethnic disparities in deaths due to COVID-19, the CDC statistically accounts for the geographic distribution of deaths throughout the US to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions than that of the larger US. In this commentary, we argue that such an approach misses an important driver of disparities in COVID-19 mortality, namely the historical forces that determine where individuals live, work, and play, and consequently determine their risk of dying from COVID-19. We explain why controlling for geography downplays the disproportionate burden of COVID-19 on racialized minority groups in the US. Finally, we offer recommendations for the analysis of surveillance data to estimate racial disparities, including shifting from distribution-based to risk-based measures, to help inform a more effective and equitable public health response to the pandemic.

scholarly journals Factors Underlying Racial Disparities in Sepsis Management

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 133
Author(s):  
Matthew DiMeglio ◽  
John Dubensky ◽  
Samuel Schadt ◽  
Rashmika Potdar ◽  
Krzysztof Laudanski
Keyword(s):  
Racial Disparities ◽  
Racial Differences ◽  
Minority Groups ◽  
The United States ◽  
Racial Groups ◽  
Sepsis Management ◽  
Treatment Protocols ◽  
Common Causes ◽  
Standardized Treatment ◽  
Wide Variability

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis.

Racial Health Disparities and Questions of Evidence

2016 ◽  
Author(s):  
Carolyn Moxley Rouse
Keyword(s):  
Health Disparities ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Structural Data ◽  
The United States ◽  
National Average ◽  
Healthy People ◽  
Making Sense ◽  
Socially Constructed ◽  
Healthy People 2010

The United States Healthy People 2010 initiative, designed to focus nationally funded health research and care on achieving a set of nationwide goals, was directed toward the elimination of racial and ethnic health disparities. While racial and ethnic disparities are complex (with the health of some minority groups surpassing the national average), the health of black Americans continues to fall short of the national average. By focusing on the presumptions embedded in the design of health disparities research, this chapter addresses why Healthy People 2010 largely failed to reduce racial health inequality. Importantly, in thinking about health inequalities, researchers initially failed to consider how race is socially constructed; how data collection is never value-neutral (see King, chapter 8, this volume); and, finally, the limits of randomized control trials (deductive methods) when it comes to making sense of complex behavioral and structural data. The chapter ends by describing how ethnographic insights can help complicate the assumptions and conclusions of health disparities research.

scholarly journals Using the payback framework to evaluate the outcomes of pilot projects supported by the Georgia Clinical and Translational Science Alliance

2020 ◽  
pp. 1-9
Author(s):  
Latrice Rollins ◽  
Nicole Llewellyn ◽  
Manzi Ngaiza ◽  
Eric Nehl ◽  
Dorothy R. Carter ◽  
...  
Keyword(s):  
Positive Impact ◽  
Early Stage ◽  
Pilot Project ◽  
Economic Benefits ◽  
Early Career ◽  
Evaluation Framework ◽  
Translational Science ◽  
Pilot Projects ◽  
Payback Framework

Abstract Introduction: The Clinical and Translational Science Awards (CTSA) program of the National Center for Advancing Translational Sciences (NCATS) seeks to improve population health by accelerating the translation of scientific discoveries in the laboratory and clinic into practices for the community. CTSAs achieve this goal, in part, through their pilot project programs that fund promising early career investigators and innovative early-stage research projects across the translational research spectrum. However, there have been few reports on individual pilot projects and their impacts on the investigators who receive them and no studies on the long-term impact and outcomes of pilot projects. Methods: The Georgia CTSA funded 183 pilot projects from 2007 to 2015. We used a structured evaluation framework, the payback framework, to document the outcomes of 16 purposefully-selected pilot projects supported by the Georgia CTSA. We used a case study approach including bibliometric analyses of publications associated with the selected projects, document review, and investigator interviews. Results: These pilot projects had positive impact based on outcomes in five “payback categories”: (1) knowledge; (2) research targeting, capacity building, and absorption; (3) policy and product development; (4) health benefits; and (5) broader economic benefits. Conclusions: Results could inform our understanding of the diversity and breadth of outcomes resulting from Georgia CTSA-supported research and provide a framework for evaluating long-term pilot project outcomes across CTSAs.

School Physical Education, Extracurricular Sports, and Lifelong Active Living

2008 ◽  
Vol 27 (2) ◽  
pp. 155-166 ◽  
Author(s):  
Jason Bocarro ◽  
Michael A. Kanters ◽  
Jonathan Casper ◽  
Scott Forrester
Keyword(s):  
Physical Education ◽  
Positive Impact ◽  
The United States ◽  
After School ◽  
Active Living ◽  
Physically Active ◽  
Obesity Epidemic ◽  
Intramural Sports

The purpose of this article is to examine the role of school-based extracurricular initiatives in facilitating immediate and long-term positive impact on physical activity, healthy behavior, and obesity in children. A critique of the role of various sports-related initiatives that have been developed to address the obesity epidemic currently facing children within the United States is provided, with a specific emphasis on intramural sports as a preferred mechanism to encourage long-term involvement in sport and physically active pursuits. The article presents support for the notion that a physical education curriculum that includes intramurals before, during, and after school can help children learn the skills to enjoy participation in a variety of sports designed to facilitate lifelong active living.

scholarly journals Warming temperatures lead to reduced summer carbon sequestration in the U.S. Corn Belt

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Zhongjie Yu ◽  
Timothy J. Griffis ◽  
John M. Baker
Keyword(s):  
Crop Yields ◽  
Positive Impact ◽  
Dynamic Control ◽  
Primary Source ◽  
The United States ◽  
Corn Belt ◽  
Natural Ecosystems ◽  
Crop Growth Stage ◽  
Global Carbon

AbstractThe response of highly productive croplands at northern mid-latitudes to climate change is a primary source of uncertainty in the global carbon cycle, and a concern for future food production. We present a decadal time series (2007 to 2019) of hourly CO2 concentration measured at a very tall tower in the United States Corn Belt. Analyses of this record, with other long-term data in the region, reveal that warming has had a positive impact on net CO2 uptake during the early crop growth stage, but has reduced net CO2 uptake in both croplands and natural ecosystems during the peak growing season. Future increase in summer temperature is projected to reduce annual CO2 sequestration in the Corn Belt by 10–20%. These findings highlight the dynamic control of warming on cropland CO2 exchange and crop yields and challenge the paradigm that warming will continue to favor CO2 sequestration in northern mid-latitude ecosystems.

scholarly journals Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination

2021 ◽  
Vol 18 (18) ◽  
pp. 9904
Author(s):  
Anuli Njoku ◽  
Marcelin Joseph ◽  
Rochelle Felix
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Structural Barriers ◽  
Structural Racism ◽  
Vaccination Rates ◽  
Promising Solution ◽  
The Impact

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the United States. Although a promising solution of the COVID-19 vaccination offers hope, disparities in access again threaten the health of these communities. Various explanations have arisen for the cause of disparate vaccination rates among racial and ethnic minorities, including discussion of vaccine hesitancy. Conversely, the role of vaccine accessibility rooted in structural racism as a driver in these disparities should be further explored. This paper discusses the impact of structural barriers on racial and ethnic disparities in COVID-19 vaccine uptake. We also recommend public health, health system, and community-engaged approaches to reduce racial disparities in COVID-19 disease and mortality.

Abstract P169: Ethnic Disparities In Short- And Long-term Prognosis After A First Cardiovascular Hospitalization

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Louise Van Oeffelen ◽  
Charles Agyemang ◽  
Carla Koopman ◽  
Karien Stronks ◽  
Michiel Bots ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
Readmission Rates ◽  
Majority Population ◽  
Short And Long Term ◽  
Migrant Groups ◽  
Long Term Mortality

Introduction: Ethnic disparities in prognosis after a cardiovascular event have been reported. We investigated differences in mortality and readmission after a first hospital admission for total cardiovascular disease (CVD), AMI, CVA, peripheral arterial disease (PAD), and congestive heart failure (CHF) between several ethnic minority groups and the Dutch majority population. Methods: A nationwide prospective cohort of CVD patients hospitalized between 1998 and 2010 was constructed (N=776,574). Differences in short- and long-term mortality and readmission (0-28 days after admission and 28 days-5 years after admission respectively) between first generation ethnic minority groups (henceforth: migrants) and the Dutch majority population were calculated using multivariable Cox proportional hazard models . Results: In particular mortality after AMI and CVA was higher in migrants compared to the Dutch majority population, except for Moroccans. Short- (HR 1.36; 1.07-1.74) and long-term ( HR 1.45; 1.20-1.75) mortality after CVD was the highest in Chinese migrants. Short-term readmission rates were similar between migrants and the Dutch majority population, except after AMI where mainly lower rates were found (HR:0.37-1.26). Long-term readmission rates were also similar to the Dutch majority population, except after CHF where readmission rates were lower (HR varies between 0.67-0.95), and after AMI where readmission rates for AMI were higher (HR varies between 1.24-1.83). Conclusion: Short- and long-term mortality after CVD is higher in migrant groups than in the Dutch majority population, except after CHF. Differences in readmission rates were more similar to the Dutch majority population, with some fluctuations between sub diseases and migrant groups.

scholarly journals 0361 Birthplace Moderates Racial/Ethnic Disparities in Multiple Sleep Characteristics Among Non-Hispanic Whites and Hispanic/Latino Heritage Groups in the United States

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A138-A138
Author(s):  
S A Gaston ◽  
E E Martinez-Miller ◽  
S Nguyen-Rodriguez ◽  
A Aiello ◽  
J McGrath ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Poor Sleep ◽  
Foreign Born ◽  
Poor Sleep Quality ◽  
Environmental Health Sciences ◽  
Racial Ethnic

Abstract Introduction Sleep duration disparities by Hispanic/Latino heritage exist; however, few studies have additionally investigated sleep quality disparities by heritage and birthplace, nor have studies compared foreign-born to US-born Non-Hispanic Whites (NHWs). Methods Using pooled 2004-2017 National Health Interview Survey data, we investigated whether sleep disparities varied by birthplace among adult NHWs and Hispanic/Latino heritage groups. Adjusting for sociodemographic and behavioral/clinical characteristics, survey-weighted Poisson regressions with robust variance estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of self-reported sleep characteristics. Sleep characteristics were compared among foreign-born NHWs and Hispanic/Latino heritage groups vs. US-born NHWs. Sleep characteristics were also compared across Hispanic/Latino heritage groups vs. foreign-born NHWs. Results Among 254,699 participants (Meanage±SE: 47±0.9 years; 49% female), 81% self-identified as NHW (n=207,154), 12% Mexican (n=30,100), 2% Puerto Rican n=5,077), 1% Cuban(n=2,518), 1% Dominican (n=1,658), and 3% Central/South American (n=8,162). Compared to US-born NHWs, foreign-born NHWs were more likely to report >9-hours sleep duration (PR=1.11[95% CI: 1.01-1.21]) and poor sleep quality (e.g., PRtrouble staying asleep=1.27[1.17-1.37]), and US-born Mexicans were no more likely to report shorter sleep duration while foreign-born Mexicans were less likely (PR<6-hours=0.52[0.47-0.57], PR6-<7-hours=0.72[0.68-0.76]). Although US-born and foreign-born Mexicans had lower prevalence of poor sleep quality compared to US-born NHWs, PRs were lowest for foreign-born Mexicans. Compared to foreign-born NHWs, US-born Mexicans were more likely to report shorter sleep duration, but foreign-born Mexicans were no more likely. Regardless of birthplace, Puerto Ricans were more likely (e.g., PR<6-hours=1.37[1.24-1.60]) and Cubans were less likely (e.g., PR<6-hours=0.81[0.68-0.96]) to report shorter sleep duration vs. US-born NHWs. Compared to US-born NHWs, Dominicans reported better sleep duration and quality. Sleep duration and quality did not differ among Dominicans vs. foreign-born NHWs. Conclusion Sleep disparities varied by birthplace and Hispanic/Latino heritage. Birthplace of both NHWs and racial/ethnic minority groups should be considered in disparities research. Support This work was funded by the Intramural Program at the National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS, Z1AES103325-01) and the Division of Intramural Research, National Institute on Minority Health and Health Disparities.

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