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  • Rural Health is a Global Issue

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    By Priscah Mujuru, DrPH, MPH, RN, COHN-S
    Scientific Program Officer, Community Health and Population Sciences
    National Institute on Minority Health and Health Disparities

    Rural health to me, is a lived experience. I was born in the rural areas of Zimbabwe. In my village, when a pregnant woman couldn’t make it to the hospital, there were no gloves, clean working stations, or sanitized rooms to ensure safe childbirth. A female in labor would be aided in her delivery by other village women who used what they had: hot water, rags, old razors, and even twine made of tree bark to help with the delivery. We never thought we were poor, and in fact we were proud and happy of who we were.

    I was fortunate that my father valued education and sent all his children, 6 girls and 4 boys, to primary and secondary schools. He felt that it did not matter if you were a boy or girl, man or woman, everyone should be given an opportunity to get an education. In a small village, to send so many children to school when there was work to be done, was very rare.

    I took my father’s lessons to heart and continued my education. I spent almost 10 years in nursing and midwifery practice, and served as a clinical trials research nurse. I also obtained a degree in Occupational /Industrial Hygiene. My education took me to many wonderful places and I eventually landed a position as an Assistant Professor and Occupational Health Nurse Specialist at the Institute of Occupational and Environmental Health and Community Medicine in the School of Medicine at West Virginia University. My first significant assignment was to research public health needs for an MPH program in rural WV. I was mystified that the idea of “rural” had any sort of existence in West Virginia, let alone the United States of America!

    That is when I realized that rural public health is a global issue and it affects people in varying degrees all over the world. At least 20% of the United States population live in the rural areas. At NIMHD, I am well positioned to address the health disparities issues within diverse rural populations of whites, blacks, Hispanics, Native Americans and U.S. immigrants. There is a need for researchers to address the many social determinants of health in rural populations.

    November is designated National Rural Health Month. I invite you to join NIMHD and other NIH Institutes and Centers for the Inaugural Rural Health Seminar.

    Date: Monday, November 18, 2019
    Time: 9:30 a.m. – Noon ET
    Location: NIH Main Campus, Natcher Conference Center (Building 45, Rooms A/B)

    The seminar will bring together researchers, medical practitioners and others to explore topics in rural health, and to share research ideas about how innovations in clinical and translational science could improve rural health outcomes.

    You can register for the seminar here or you can watch the NIH Videocast live or later. To join the conversation on social media, please use hashtag #RuralHealth.

    I hope you will join us for this event.

  • My Message to African American Men: There’s No Shame in Seeking Help with Mental Health

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    By David E. Marion, Ph.D.
    Licensed Professional Counselor, and Marriage and Family Therapist
    Grand Basileus
    Omega Psi Phi Fraternity, Inc.

    Growing up, in my community, it was frowned upon to ask for help outside of your family. You were forbidden to talk to non-family members about your feelings and especially forbidden to talk about what was going on in your house. There was the inaccurate perception that counseling was for “White folks.” If you needed counseling or medication, that meant to the world you were “crazy,” a layman’s term incorrectly used to label many mental health conditions and challenges. In all my years of counseling, I have never seen the term “crazy” in any diagnostic manual.

    It is unfortunate for someone to know they need help and not seek it. As a licensed professional counselor, what I have seen are individuals who became overwhelmed by life. I have seen those who were tired of hurting. They had tried everything they knew and been unable to find peace. They couldn’t move on from their past. They couldn’t forgive themselves. They didn’t seem to be able to stop making the same choices repeatedly, expecting different results. Counseling was their last resort. They somehow found the courage to come and felt healing and peace when they found they were not “crazy.”

    I have provided counseling to many individuals and their families, and I have seen firsthand that African Americans are cautious about seeking mental health services. In the African American community, we seek advice from lawyers, accountants, pastors, and others. We talk at length with friends and family. Why not talk to a seasoned, licensed professional counselor about the difficulties of living life on life’s terms? Many African Americans have found religion to be a great source of peace for them. I have found peace as well when I go to church or when I pray. Counseling, I have found, can also be a spiritual experience if it is helpful to the individual and/or family.

    I love it when African Americans come to treatment to see “Dr. Marion” and discover, with sighs of relief, that I am African American. It is gratifying to make this initial step much easier. Counseling is not advising. In counseling, one should feel they have the undivided attention of the counselor; that they are heard and believed; and that what they say will be held in confidence unless they are a threat to themselves or others. We might all benefit from this type of interaction.

    One of the most memorable counseling sessions I have ever conducted was with a woman who had been sexually assaulted almost two decades earlier. She shared with me, “You are my last resort,” and talked the entire hour-long session. At the end of the session, she said, “That was the best counseling session I have ever been in.” I assessed what I had done so well, only to realize that I had said no profound or prophetic words but had allowed the process to unfold. That is counseling at its best.

    Omega Psi Phi Fraternity, Inc. (OPPF) promotes the importance of seeking help for mental health problems through our joint program with the National Institute on Minority Health and Health Disparities (NIMHD), called Brother, You’re on My Mind (BYOMM). In 2014, OPPF met with NIMHD staff to see if we could form a partnership around mental health, targeting African American families and African American men specifically. The goal was to reduce the stigma attached to mental illness and to get help once diagnosed.

    Out of that meeting came the BYOMM initiative. Today, the 750 OPPF chapters in the U.S. and abroad are directed to bring mental health experts into their meetings and to community events to discuss the signs and symptoms of mental illness and where to get help. Members within our organization are continuously reflecting on how the program is giving them a way to open up.

    Let National Minority Mental Health Awareness Month serve as a reminder that mental health challenges are real. Through BYOMM, OPPF is committed to help eradicate the stigma of mental health challenges and to encourage our people to seek professional help/counseling.

  • 50 Years After Stonewall, Celebrating Progress and Striving for LGBTQ Health Equity

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    By Brian Mustanski, Ph.D.
    Director, Institute for Sexual and Gender Minority Health and Wellbeing
    Co-Director, Third Coast Center for AIDS Research
    Co-Director, Center for Prevention Implementation Methodology
    Professor, Department of Medical Social Sciences
    Northwestern University
    Member, National Advisory Council on Minority Health and Health Disparities

    In June 1969, the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community led historic riots against discriminatory police raids of the Stonewall Inn, a gay bar in Greenwich Village. The Stonewall riots galvanized the LGBTQ community to come together in a nationwide movement in pursuit of equality.

    Growing up as a young gay man in Minnesota, I had no knowledge of Stonewall. With the Internet still in its infancy, there were limited resources to learn about the LGBTQ community. I resorted to secretly reading my high school encyclopedia’s entry on “homosexuality,” which that edition still described as a psychiatric disorder. Media coverage of homosexuality was dominated by the emerging AIDS crisis. I often heard people say, “AIDS is God’s punishment.” With no access to alternative information, it was hard to reject these messages.

    Years later, I began pursuing a career in science. My undergraduate faculty mentor warned me not to “come out,” as it could hurt my chances of graduate admission. Evidence is just emerging on how sexual and gender minority (SGM) people experience structural and interpersonal barriers to STEM careers.1

    In graduate school, I was heavily impacted by a report showing that the majority of SGM teens came out online before they did in the “real world.”2 This information emerged alongside evidence of alarmingly high HIV prevalence among young gay and bisexual men.3 It was then that I realized that the Internet might be the only way to reach this group with resources and education at a critical point: before they may be at risk of HIV.

    e-Health approaches to HIV prevention have continued to be a major focus of my research—particularly with young gay and bisexual men, among whom HIV diagnoses continue to increase.4 In 2018, my team published the first study to show significant effects of an e-Health HIV prevention program on a biomedical outcome (sexually transmitted infections),5 and we’re studying implementation of the program nationally.6 With support from NIMHD, my team is studying a package of developmentally adapted e-Health HIV prevention programs for teenage gay/bisexual boys.6 Both projects are simultaneously studying implementation and effectiveness to quickly move evidence into practice.7

    HIV research on gay/bisexual men represents the majority of NIH funding for SGM health.8 But research on the entire SGM community is critical if we are going to remediate health disparities. For example, despite being at increased risk, lesbian and bisexual women are less likely to receive cancer screenings.9 Transgender people are more likely to be uninsured, experience rampant discrimination in health care settings, and delay care as a result of that stigma.10

    These aren’t just disturbing statistics—they are devastating realities. At the root of this inequity is the same discrimination that the Stonewall activists rioted against 50 years ago. We are only beginning to uncover how prejudice and discrimination “get under the skin,”11 with toxic effects on SGM health.

    That’s not to say we haven’t seen progress. SGM representation in STEM disciplines is becoming more of a priority. My academic home, Northwestern University, appointed me as director of the first university wide institute focused exclusively on SGM health and well-being (ISGMH). In 2016, through the leadership of NIMHD Director Dr. Pérez-Stable, the National Institutes of Health formally recognized our community as a health disparity population for research purposes, opening up new doors for research funding.

    But movement often feels like two steps forward and one step back. SGM-focused data collection, which is critical to understanding the health needs of our community, may be discontinued from federal surveys. Our online outreach is increasingly met with hateful messages (e.g., “You deserve extermination”) that we have never seen at this frequency before.

    The Healthy People 2020 report ended on a powerful conclusion—that “understanding LGBT health starts with understanding the history of oppression and discrimination that these communities have faced.” This Pride Month, 50 years after Stonewall, we’ll reflect on that history and celebrate our resilience. We’ll also continue to push forward and commit to continuing to advance SGM health equity.


    References

    1 Freeman, J. (2018). LGBTQ scientists are still left out. Nature, 559(7712), 27–28. doi:10.1038/d41586-018-05587-y.
    2 Kryzan, C., Walsh, J., !OutProud!, The National Coalition for Gay, Lesbian, Bisexual, and Transgender Youth, & Oasis Magazine. (1998). !OutProud!/Oasis Internet Survey of Queer and Questioning Youth, August to October 1997.
    3 Valleroy, L. A., MacKellar, D. A., Karon, J. M., Rosen, D. H., McFarland, W., Shehan, D. A., . . . Janssen, R. S. (2000). HIV prevalence and associated risks in young men who have sex with men. Young Men’s Survey Study Group. JAMA, 284(2), 198–204. doi:10.1001/jama.284.2.198.
    4 Centers for Disease Control and Prevention. (2018). Estimated HIV incidence and prevalence in the United States, 2010-2015. HIV Surveillance Supplemental Report, 23(No. 1).
    5 Mustanski, B., Parsons, J. T., Sullivan, P. S., Madkins, K., Rosenberg, E., & Swann, G. (2018). Biomedical and behavioral outcomes of Keep It Up!: An eHealth HIV prevention program RCT. American Journal of Preventive Medicine, 55(2), 151–158. doi:10.1016/j.amepre.2018.04.026.
    6 Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH). (n.d.). Keep It Up!
    7 Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012). Effectiveness-implementation hybrid designs: Combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care, 50(3), 217–226. doi:10.1097/MLR.0b013e3182408812.
    8 National Institutes of Health. (2018). Sexual & gender minority research portfolio analysis (FY 2016).
    9 American Cancer Society. Cancer facts for lesbians and bisexual women. (2018).
    10 Centers for Disease Control and Prevention. (2018). Patient-centered care for transgender people: Recommended practices for health care settings.
    11 Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707–730. doi:10.1037/a0016441.

  • Addressing Social Needs and Structural Inequities to Reduce Health Disparities: A Call to Action for Asian American and Pacific Islander Heritage Month

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    By Marshall H. Chin, M.D., M.P.H.
    Richard Parrillo Family Professor of Healthcare Ethics in the Department of Medicine,
    University of Chicago
    Member, National Advisory Council on Minority Health and Health Disparities


    When I was a kid, every Saturday my parents would pack my older sister, younger brother, and me into the family station wagon, and we’d drive 40 minutes on Route 2 East from Boston’s western suburbs into Chinatown. There we gathered with aunts, uncles, and cousins in the home of my grandparents, immigrants from Toisan in southern China. The conversations were loud, the play was very lively, and the wonderful aromas of roast chicken, fried noodles, and sizzling stir-fried vegetables filled the air.

    An impressionable young child, I watched intently as my uncles played poker, cigar smoke wafting into the nighttime air. They taught me how to play poker at the ripe old age of 8, and I filled in when one had to take a break for a hand or two. Most of my paternal uncles worked in the laundries. My mother’s side was noodles. My uncles were bright men, but the bamboo ceiling—basically, exclusion from good jobs—limited their opportunities. “I don’t have a Chinaman’s chance,” they’d say as they folded a losing hand of cards.1

    Running around Chinatown with my cousins, I saw that my uncles weren’t the only ones whose opportunities were limited. Housing was crowded, and the streets were dirty and smelled of garbage. Years later, when I worked part-time at the Federally Qualified Health Center in Boston’s Chinatown, I cared for many non–English speaking immigrants with limited education. They faced uphill battles as they dealt with their chronic health conditions, paid medical bills without health insurance, and attempted to advance in society.

    Entering Asian American and Pacific Islander Heritage Month, a cutting-edge issue is addressing social determinants of health, which are especially critical among diverse Asian American ethnic groups that vary in education, income, and acculturation. For example, some Southeast Asian immigrants were forced to leave their countries because of the Vietnam War and have suffered piercing intergenerational trauma, socioeconomic deprivation as refugees, and major health disparities. Health care organizations are exploring ways to screen patients for social needs, refer them to community partners in fields such as housing and food security, and integrate their medical and social care.

    Federally Qualified Health Centers are pioneers. The Association of Asian Pacific Community Health Organizations (AAPCHO), the National Association of Community Health Centers (NACHC), and the Oregon Primary Care Association (OPCA) have created the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE) tool to screen for needs such as housing, employment, transportation, safety, and social support.2 AAPCHO, NACHC, and colleagues at the University of Chicago are currently investigating ways to score this screening instrument to identify high-risk patients for intervention, with support from the National Institute of Diabetes and Digestive and Kidney Diseases–funded Chicago Center for Diabetes Translation Research. Under global payment mechanisms and alternative payment models such as Accountable Care Organizations (ACOs), health systems have strong incentives to improve care for their most costly resource-intensive patients, who often have significant social needs.

    Yet a deeper issue beyond caring for individual patients is inherent within social determinants of health: addressing the underlying structural drivers of inequities that faced my uncles and the many low-income Asian American immigrants I saw at the South Cove Community Health Center. We must have free, frank, and fearless discussions about structural racism and social privilege, the systems that insidiously drive many health disparities.3 Inequities in fields that ultimately affect health—such as employment, housing, education, and the criminal justice system—are the result not only of individuals’ implicit biases but also of concrete laws, regulations, and business decisions that have marginalized the poor and racial/ethnic minorities. These structural determinants have created an unequal playing field that contributes to health disparities. Solutions include intersectoral partnerships—collaborations of health and non-health sectors, drawing upon community assets—and recognizing that eliminating health disparities is a moral and social justice issue.4 Inspirational grantees in our Merck Foundation Bridging the Gap: Reducing Disparities in Diabetes Care program are transforming diabetes care and engaging in innovative community partnerships around challenges such as food security and medical/legal services for immigrants.5

    Ultimately, our nation will need to align key stakeholders to achieve health equity. In the Robert Wood Johnson Foundation’s Advancing Health Equity: Leading Care, Payment, and Systems Transformation program, state Medicaid agencies, Medicaid managed care organizations, health care organizations and systems, patients, and consumers will develop and evaluate innovative care transformation and payment efforts to achieve health equity.6 Research addressing individual patient and societal factors will be critical for achieving health equity7 and for blasting through the bamboo ceiling and other structural and exclusionary barriers that limit the health of Asian Americans.

    References

    1 Liu E. A Chinaman’s Chance: One Family’s Journey and the Chinese American Dream. New York: PublicAffairs, 2014.
    2 Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences. PRAPARE: Available at: http://www.nachc.org/research-and-data/prapare/. Accessed April 18, 2019.
    3 Chin MH, King PT, Jones RG, Jones B, Ameratunga SN, Muramatsu N, Derrett S. Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health Policy 2018; 122:837-853. pii: S0168-8510(18)30131-3. doi: 10.1016/j.healthpol.2018.05.001.
    4 Chin MH. Movement advocacy, personal relationships, and ending health care disparities. J Nat Med Assoc 2017; 109:33-35.
    5 Bridging the Gap in Diabetes Care: Reducing Disparities in Diabetes Care. http://bridgingthegapdiabetes.org. Accessed April 18, 2019.
    6 Advancing Health Equity: Leading Care, Payment, and Systems Transformation. http://www.solvingdisparities.org. Accessed April 18, 2019.
    7 National Institute on Minority Health and Health Disparities Research Framework. https://www.nimhd.nih.gov/about/overview/research-framework/nimhd-framework.html. Accessed April 18, 2019.

  • Find Your Path to an Active and Healthy Lifestyle

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    By U.S. Surgeon General Jerome Adams, M.D.
    Department of Health and Human Services

    CAPT Felicia Collins, M.D.
    Deputy Assistant Secretary for Minority Health and Director, Office of Minority Health
    Department of Health and Human Services

    As National Minority Health Month enters its last week, it has been inspiring to experience and learn about the events and activities taking place across the nation in support of minority health.

    Each year, the Office of Minority Health (OMH) works with partners and other stakeholders to coordinate the Department of Health and Human Services (HHS) observance of National Minority Health Month, which dates back more than 100 years, to a 1915 campaign by Dr. Booker T. Washington. The 2019 theme is Active & Healthy, and throughout the Department, we have been encouraging all Americans to live healthier by being physically active.

    The theme is designed to promote the new Physical Activity Guidelines for Americans and the Move Your Way Campaign developed by the HHS Office of Disease Prevention and Health Promotion (ODPHP). According to the guidelines, adults need 150 to 300 minutes of moderate-to-vigorous aerobic activity and at least two days of moderate or greater intensity muscle-strengthening activities a week.

    Being physically active is one of the best things we can do to improve our health. It is particularly important in improving health outcomes that can reduce health disparities for racial and ethnic minorities.

    In 2018, just 21.7 percent of Latinos and 19.9 percent of African Americans met ODPHP’s aerobic activity and muscle-strengthening guidelines. And the numbers weren’t much better for whites. Just 26 percent of white Americans met both guidelines. So, it is clear that Active & Healthy is an important message for every community.

    Being physically active doesn’t necessarily have to happen at the fitness center, in spin class or on the treadmill. For some of us, it can mean walking the dog for longer periods of time or at a quicker pace. Others might be physically active on the soccer field or basketball court, or the dance floor. The other good news is that any amount of physical activity counts toward the weekly total and has real health benefit. You don’t have to train to run a marathon to be Active & Healthy! Just aim to sit less and move more throughout the day.

    At HHS, being Active & Healthy has been happening at places like the campus of the National Institutes of Health, where the National Institute on Minority Health and Health Disparities (NIMHD) hosted its 3rd Annual Minority Health 5K Walk/Run on April 24.

    In addition, on April 24, the Health Resources and Services Administration and the Centers for Disease Control and Prevention hosted a discussion about the impact of the social determinants of health –including physical activity — on physical and mental health, and other conditions that are more common among racial and ethnic minorities.

    On April 17, OMH joined the HHS Assistant Secretary for Health, NIMHD, ODPHP and others for a Twitter Chat to promote physical activity and staying healthy.

    And on April 1, Rear Admiral Sylvia Trent-Adams, Principal Deputy Assistant Secretary for Health, joined more than 50 HHS staff members for the kickoff walk of the OMH Active & Healthy Challenge. Visit the OMH website to learn how you can join the month-long challenge by converting all of your physical activity for the entire month into steps. The winner will be announced after the challenge ends.

    We are in the final days of the Active & Healthy Challenge! However, we will continue to promote the benefits of physical activity throughout the year with the goal of encouraging more Americans to incorporate the Active & Healthy lifestyle into their daily and weekly routines.


  • National Nutrition Month: It’s Your Time to Win!

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    By Patrice Armstrong, Ph.D., M.P.H.
    Office of Science Policy, Strategic Planning, Analysis, Reporting, and Data
    National Institute on Minority Health and Health Disparities

    Happy and healthy “National Nutrition Month!” Whether your journey for optimal health is progressing or needs a boost, congratulations on taking strides toward a healthier lifestyle.

    Healthy eating is shaped by each person’s life, personal preferences, cultural influences, traditions, and access to food. Nutrition-related health disparities persist disproportionately for chronic conditions among minority populations, compared to non-Hispanic Whites in the United States. In 2009–2012, significantly more Black men (43%) and women (44%) had high blood pressure than their White counterparts.1 Hispanics are 50% more likely to die from diabetes,2 and obesity rates of 38% for Blacks and 32% for Hispanics3 are of epidemic proportions. High blood pressure, diabetes, and obesity also increase the risk for heart disease.

    NIMHD is addressing these disparities with research on genetic determinants of fat and their role in heart disease risk, assessing diabetes in high-risk minority populations, and promoting healthy lifestyle behaviors to address obesity-related complications. The first NIH-wide Nutrition Strategic Plan, scheduled for release later this year, addresses health disparities as a cross-cutting effort throughout NIH.

    Build a Healthy Eating Style4

    As a nutritional biologist, I offer 4 tips to improve your nutrition, not only during National Nutrition Month but for a lifetime.

    1. All food and beverage choices matter.

    2. Aim low.

    Choose an eating style low in saturated fat, sodium, and added sugars. Lowering your intake of saturated fat and added sugars can help manage your calories and prevent overweight and obesity. And eating foods with less sodium can reduce your risk for high blood pressure. You can follow these suggestions by

    reading Nutrition Facts labels and ingredient lists to find amounts of saturated fat, sodium, and added sugars in the foods and beverages you choose; and

    • looking for food and drink choices that are low in saturated fat, sodium, and added sugar.

    3. Make small changes to create a healthier eating style.

    • Make half your plate fruits and vegetables.
      • Focus on whole fruits.
      • Vary your veggies.
    • Make half your grains whole grains.
    • Move to low-fat or fat-free milk or yogurt.
    • Vary your protein routine.

    4. Support healthy eating for everyone.

    • It is up to everyone, policymakers, industries, consumers, individuals, and communities to make healthy eating available and affordable.

    Be well and may you have continued success in creating and maintaining a healthy lifestyle that is right for you and your family!

    References

    1. Centers for Disease Control and Prevention. (2015). Health, United States, 2014. Table 60. Retrieved from https://www.cdc.gov/nchs/data/hus/hus14.pdf
    2. Centers for Disease Control and Prevention. (2015). Hispanic Health. Retrieved from https://www.cdc.gov/vitalsigns/hispanic-health/index.html
    3. Centers for Disease Control and Prevention. [ca. 2017]. Adult Obesity Prevalence Maps. Retrieved from https://www.cdc.gov/obesity/data/prevalence-maps.html
    4. United States Department of Agriculture. (2019). Start Simple with MyPlate. Retrieved from https://www.choosemyplate.gov/MyPlate

  • Learn How to Protect Your Heart for American Heart Month

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    By Lenora Johnson, Dr.P.H., M.P.H.
    Director of the Office of Science Policy, Engagement, Education and Communications
    National Heart, Lung, and Blood Institute

    Heart disease is the number one cause of death in the United States for both men and women. Sadly, one in four people die of it each year. Yet, despite progress in reducing these rates overall, the disease continues to impact communities of color in a disproportionate and troubling way.

    African Americans, Hispanics, American Indians, and Alaska Natives all experience higher rates of both heart disease and its associated conditions—diabetes, hypertension, and obesity. Disturbingly, within these already hard-hit populations, women often bear an even greater burden. African American women, for example, have higher rates of heart disease and are more likely to die of it than White women.

    But the disparities don’t stop there. Certain geographic regions, especially the South, see higher rates of deaths from the disease. The states at the top of the list in 2016 were Alabama, Arkansas, Louisiana, Mississippi, and Oklahoma.

    The National Heart, Lung, and Blood Institute (NHLBI)—part of the National Institutes of Health—funds a number of large-scale studies to help reduce these kinds of health disparities and inequities. The Jackson Heart Study, which NHLBI co-sponsors with the National Institute on Minority Health and Disparities, is the largest investigation of causes of cardiovascular disease among African Americans. The Strong Heart Study, the largest epidemiologic study of American Indians, examines cardiovascular disease and its risk factors in that population. The Hispanic Community Health Study/Study of Latinos is the most comprehensive study of Hispanic/Latino health and disease in the United States.

    One bright spot is that prevention is possible, at any age. That’s why this February, during American Heart Month, NHLBI is educating Americans about heart disease and how to protect against it. The Institute is also launching #OurHearts to encourage Americans to improve their heart health by making lifestyle changes—together. Research shows that support from others can make it a lot easier to get regular physical activity, eat healthy, lose weight, and quit smoking.

    Want to make your own heart healthier and help others, too? Here are four ways to participate in American Heart Month:

    1. Wear Red on the First Friday of February. Grab your friends, family, and coworkers for National Wear Red Day® by donning red on the first Friday of February each year. It’s a visual way to bring greater attention to heart disease awareness.
    1. Get Moving. Inactivity is one of the major risk factors for heart disease. At work, challenge colleagues to take the stairs, schedule walking meetings, and use a standing desk. At home, break your daily activity into manageable chunks: go for a quick walk around the block with family, start a spontaneous dance party in your kitchen, or do any kind of physical activity for just 15 minutes. Small amounts add up.
    1. Mind Your Diet. Unhealthy food choices can raise your risk of heart disease because they contribute to risk factors. Try to limit foods that are high in saturated fat, cholesterol, sodium, and added sugars, and avoid trans fats. Adopt a healthy eating plan, such as the Dietary Approaches to Stop Hypertension eating plan, or go to NHLBI’s Facebook page on February 26 for a live heart-healthy cooking demo.
    1. Share Your Progress: During February, share your #OurHearts stories and photos on social media to show what you and your friends, family, or coworkers are doing to be heart-healthy. Let’s encourage and motivate each other this month and beyond. Find out what’s happening near you at nhlbi.nih.gov/ourhearts.

    #OurHearts are healthier together.