NIH’s Minority Health and Health Disparities Strategic Plan 2021-2025: A Path to the Future

By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

The COVID-19 pandemic has brought minority health and health disparities new attention on the national stage. COVID-19 has disproportionately affected African Americans, American Indians and Alaska Natives, Native Hawaiians and Pacific Islanders, and Latinos and Latinas.

This is a microcosm of the health equity challenge that plagues the U.S.

As in most conditions with health disparities, the causes are complex. People from some of these groups are less likely to have health insurance than Whites. Inequities in access to quality education and limited economic opportunities for many, mean that many minority groups are disproportionately represented among the ranks of essential workers, such as those who work in farms, grocery stores, and support staff in health care settings and long-term care facilities, and less able to avoid the virus at work than people who work in office jobs.

In this moment when so many Americans are looking to the biomedical research enterprise for help, we are proud to be able to provide a strategic, concrete plan for advancing minority health and health disparities research, capacity building and outreach. Today, I am proud to share the new NIH-Wide Minority Health and Health Disparities Strategic Plan 2021-2025: Taking the Next Steps.

Thanks in large part to investment through the NIH, healthier lifestyles, and medical advances have made it possible for Americans to live longer and healthier lives than ever before. However, not all Americans have benefited equally from these advances. Health disparities persist, disproportionately affecting racial and ethnic minority populations, people with less privileged socioeconomic status, underserved people who live in rural areas, and sexual and gender minorities.

At NIMHD we are working toward a future in which all populations will have an equal opportunity to live long, healthy, and productive lives. Part of how we honor this commitment is through the programs we support directly and the work of our own intramural researchers. But we also have a role that spans the 27 institutes and centers that make up the National Institutes of Health. We at NIMHD are tasked with coordinating NIH’s research related to minority health and health disparities. As part of that we have led the process to develop a strategic plan for research in these vital areas for all of NIH.

This strategic plan charts the course for NIH to advance research on minority health and health disparities. In the plan, we lay out a focused vision for advancing the field of minority health and health disparities over the next 10 to 15 years.

The core of minority health science is understanding why a racial or ethnic minority group has specific health outcomes. Minority health research intends to identify factors contributing to health conditions—whether or not a health disparity is identified and including conditions where a minority population has better outcomes.

Health disparities arise from the relationship of a wide range of factors, from biological and behavioral factors, to the physical environment, to sociocultural factors and to societal policies and practices such as housing and hiring discrimination. These and other determinants of health interact to lead to poor health outcomes. The complex interrelationships between these factors challenge researchers to uncover the mechanisms and develop interventions that may help reduce health disparities.

The plan encompasses three priority areas: scientific research; research-sustaining activities; and outreach, collaboration, and dissemination of this work. Within each priority area are two to four goals; each goal is supported by strategies, intended to capture ways in which NIH can advance the sciences of minority health and health disparities.

• For example, in the priority area of scientific research, one of our goals is to improve the methods and tools that support health disparities research, and one of the strategies supporting that goal is to develop common metrics that can be used to measure health disparities across different health conditions and populations.
• In the research-sustaining activities priority area, one goal relates to increasing the racial and ethnic diversity of the biomedical workforce; one of the strategies that will move us closer to that goal is to promote programs at research-intensive institutions that expand the pool of applicants from health disparity populations.
• In the area of outreach, collaboration, and dissemination, one goal is to cultivate and expand the community of researchers and advocates in minority health and health disparities. One of our strategies is to promote collaboration across the federal government.

These are just three examples of the many goals and strategies that are part of our strategic plan. In addition, the Strategic Plan lists specific leap goals linked to topic areas and potentially achievable in the next 5 to 10 years. Together, these make up a concrete, actionable document that will guide NIH’s minority health and health disparities research program for years to come. We have heard from many voices in the process of developing this strategic plan, and we are excited for the future.

While NIH cannot solve the problem of systemic racism alone, we can apply the science of minority health and health disparities to understand the mechanisms by which discrimination and racism lead to poor health outcomes, then develop and disseminate science-based methods for mitigating these issues, improving the health of minorities, and decreasing health disparities. With the help of this plan, NIH can continue to produce meaningful, measurable improvements in minority health and reductions in health disparities, through the end of the pandemic, over the next five years, and beyond. Through these efforts, we will advance health equity and help ensure a long and healthy life for all Americans.