NIMHD Insights Blog Posts: 2023

Posted August 30, 2023

By Paul Cotton, Ph.D., RDN
Director, Office of Extramural Research Activities
National Institute on Minority Health and Health Disparities

Today, we have an exciting development to discuss—the adoption of a federal standard acronym, "NOFO," by the National Institute on Minority Health and Health Disparities (NIMHD) and the National Institutes of Health (NIH) to replace the familiar "FOA" (Funding Opportunity Announcement). In this article, we will delve into the reasons behind this change, the benefits it brings, and what it means for researchers and grant applicants.

The Need for Clarity and Consistency:
In the realm of grant funding, clarity and consistency are paramount. Over time, the use of different acronyms, such as "FOA," "RFA," and "PA," has led to confusion and hindered effective communication across federal agencies. Recognizing the importance of a unified approach, NIMHD and NIH have taken the initiative to adopt the federal standard acronym "NOFO" for their funding announcements. This change aims to streamline the process, enhance transparency, and eliminate ambiguity.

Introducing NOFO: Notice of Funding Opportunity:
The transition from FOA to NOFO represents a shift towards a more standardized and intuitive terminology. The acronym "NOFO," or Notice of Funding Opportunity, provides a clear and concise description of the purpose and nature of the funding announcement. It offers a straightforward way for researchers, institutions, and organizations to identify and engage with relevant funding opportunities, regardless of the federal agency involved.

Improved Understanding and Accessibility:
By adopting the NOFO acronym, NIMHD and NIH seek to improve understanding and accessibility for grant applicants. The consistent use of the term across federal agencies will reduce confusion and allow researchers to more easily identify funding opportunities aligned with their research interests and objectives. This change aligns with broader efforts to enhance transparency and promote equitable access to funding opportunities for the scientific community.

Navigating the Transition:
While the adoption of NOFO brings positive changes, it is essential for researchers and grant applicants to familiarize themselves with the new terminology. Understanding the nuances and implications of NOFOs will allow applicants to navigate the funding landscape more effectively and align their proposals with the specific objectives outlined in each opportunity. Staying updated with the latest guidance and resources provided by NIMHD, NIH, and other federal agencies will ensure a smooth transition and maximize the chances of success.

Conclusion:
The adoption of the federal standard acronym "NOFO" by NIMHD and NIH marks a significant step towards clarity, consistency, and improved accessibility in grant funding. By embracing this change, researchers and grant applicants can expect a more streamlined, transparent, and user-friendly experience when exploring funding opportunities. As we move forward, let us embrace the NOFO era, leveraging its benefits to advance research, address health disparities, and drive innovation for the betterment of society.

Posted July 17, 2023

Co-authored by

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

Shannon N. Zenk, Ph.D., M.P.H., RN, FAAN; Director, National Institute of Nursing Research

Why does the statement “Your ZIP code is more important to your health than your genetic code” surprise people but resonate with many population scientists?

In the United States, 21 percent of the population lives in concentrated poverty areas, limiting access to health-promoting resources and services. Research shows people living in concentrated poverty areas have poorer health outcomes across a wide range of diseases and conditions and are also more likely to die than those living in other areas.

Recognition that concentrated poverty along with other social and economic factors have profound and prolonged impacts on health has recentered attention on identifying evidence-based solutions to address them.

Social determinants of health (SDOH) have emerged as an increasingly high-priority research area for the National Institutes of Health (NIH), other Federal agencies, and organizations across a variety of sectors and NIH is at the forefront of building this evidence base to improve health and advance health equity.

The NIH-wide Social Determinants of Health Research Coordinating Committee (SDOH RCC), established in 2022, was created out of an urgent need to develop a coordinated strategy to propel discoveries to improve individual and population health, reduce health disparities, and advance health equity. Growing out of a grassroots effort by staff across NIH, the SDOH RCC’s overarching goal is to accelerate NIH-wide SDOH research across diseases and conditions, populations, stages of the life course, and SDOH domains. It also focuses on effectively leveraging SDOH investments and innovations across NIH Institutes, Centers, and Offices (ICOs) to advance discoveries in this dynamic multi-disciplinary scientific field, ranging from foundational research to intervention research to implementation science. Importantly, it is a cross-cutting effort with 20 ICOs participating in the leadership committee and even more represented in the larger SDOH RCC.

As a leader in research discovery and funding, a unified conceptualization of SDOH is essential for NIH-wide coordination and strategic growth of the evidence base for SDOH impacts on health and mechanisms, advancement of methods, and intervention development and testing. The conceptualization that the SDOH RCC developed builds on existing conceptualizations but is refined to help the NIH effectively communicate with the scientific community and, over time, continue to strengthen and expand a framework for SDOH research. The NIH conceptualization underscores that SDOH are the conditions in which people are born, grow, learn, work, play, live, and age and the broader set of structural factors shaping the conditions of daily life. These structural factors include social, economic, and legal forces, systems, and policies that determine opportunities and access to high-quality jobs, education, housing, transportation, information and communication infrastructure, food and health care; the social environment; and other conditions of daily life. Our conceptualization recognizes that SDOH can improve, maintain, or hinder health through multiple direct, indirect, and interacting mechanistic pathways. And SDOH may have different health consequences within and across populations due to differences in exposure or susceptibility to health-promoting or health-compromising conditions of daily life. The unequal allocation and distribution of power and resources based on race, ethnicity, sex, gender identity, sexual orientation, socioeconomic position, geography, and their intersections manifest in inequitable conditions of daily life, contributing to the large and persistent health disparities we see in this country.

In fiscal year 2022, NIH invested about $4.1 billion, funding more than 8,300 SDOH research and training programs. In addition, not only does NIH’s 2021-2025 strategic plan call for research on SDOH, but most NIH ICOs explicitly mention SDOH in their strategic plans. Further, several NIH-wide research initiatives were established to specifically focus on advancing SDOH research. Here are a few examples of NIH-wide SDOH research initiatives and their aims:

• The Community Partnerships to Advance Science for Society (ComPASS) Program seeks to 1) develop, share, and evaluate community-led health equity structural interventions that leverage partnerships across multiple sectors to reduce health disparities and 2) develop a new health equity research model for community-led, multisectoral structural intervention research.
• Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities is a cross-collaborative initiative, encompassing 14 ICOs that is supporting 38 applications with more than $125 million committed over 5 years for 1) observational research to understand the role of structural racism and discrimination (SRD) in causing and sustaining health disparities, and 2) intervention research that addresses SRD in order to improve minority health or reduce health disparities. This funding opportunity has been reissued by NIMHD, NINR, and other ICOs.
• Firearm Injury and Mortality Prevention Research complements existing ICO initiatives focused on many types of violence like child maltreatment, intimate partner violence, or elder abuse. Since fiscal year 2020, Congress has appropriated $12.5 million a year to NIH for firearm injury and mortality prevention. Initiatives using the appropriated funds have focused on a wide range of populations and settings, capacity building, and research on implementing and testing innovative community-level interventions that address SDOH in various ways.

There are many more Notices of Funding Opportunities (NOFOs) focused on SDOH in addition to parent NOFOs that provide opportunities for scientists to propose new SDOH research.

NIH seeks research that yields rigorous and actionable evidence, including a focus on:

• Upstream structural factors to address the fundamental causes of poor health and health disparities and involves meaningful partnerships with communities; local, state, and federal agencies; and multiple sectors.
• Viewing and approaching SDOH research through a lens of intersectionality.
• Linkable high-quality data and measures of SDOH at multiple levels to comprehensively understand independent and combined contributions and to identify intervention targets and policy levers.

As we continue to expand and innovate in accelerating SDOH research, we invite you to visit the respective ICO websites and reach out to program officers that align with your research to understand SDOH priorities and to view current and upcoming SDOH NOFOs.

SDOH research is essential to fulfilling NIH’s mission of enhancing health for all people. The progress in recent years has increased the depth and breadth of the NIH SDOH research portfolio, but there is more to be done. The SDOH RCC is committed to integrating and accelerating SDOH research across NIH. The ultimate goal of this coordinated effort is to increase the impact of the research so that the findings support individuals, communities, and populations in a manner that improves health, reduces health disparities, and advances health equity.

So, the answer is yes. Your residential zip code may be more important to your health than your genetic code. Like gene therapy, “zip code therapy” will entail new scientific challenges. The prospect of discovering structural interventions that will eliminate disparities and achieve equity makes it a frontier well worth our collective commitment.

Posted July 10, 2023

By Joshua A. Gordon, M.D., Ph.D.
Director, National Institute of Mental Health

At the National Institute of Mental Health (NIMH), we have made it a priority to advance science focused on decreasing youth mental health disparities by 2031. In this message, I’d like to focus specifically on one group: Hispanic and Latino youth. When it comes to mental health research, Hispanic and Latino youth have been woefully understudied, but the research we do have suggests a real cause for concern. Evidence indicates that Hispanic and Latino youth have pressing mental health needs and are not receiving adequate mental health care. The dramatic, and dramatically unequal, effects of the COVID-19 pandemic have further disproportionately affected youth from minority communities and exacerbated these disparities.

It’s important to understand the specific factors Hispanic and Latino youth may experience—including discrimination, exposure to traumatic events, and migration experiences—that are contributing to these mental health concerns. It’s also important to understand the barriers—including stigma, racism, and lack of cultural understanding, as well as cost and insurance coverage—that may make it difficult for Hispanic and Latino youth to access mental health care.

NIMH is committed to advancing research that seeks to understand the varied experiences of Hispanic and Latino youth and identify the most effective ways to meet their mental health needs.

What Is NIMH Doing?

To ensure that research will have direct, real-world relevance, NIMH is supporting research that engages Hispanic and Latino youth and families in community-based settings.

For example, in one NIMH-supported project out of the University of California, San Francisco, researchers are taking a participatory approach to involve youth, caregivers, health care providers, and community members in the design and implementation of a digital mental health tool called 4Youth. The researchers plan to test the digital intervention at school-based wellness centers and primary care practices that primarily serve Latino, Black, and Asian youth and young adults. The hope is that 4Youth will offer a scalable, culturally responsive digital tool that can help connect youth in these communities with mental health care when they need it.

In another NIMH-funded project, researchers at the University of Miami Coral Gables are adapting an existing, evidence-based parenting intervention so that it can be delivered to Hispanic youth in primary care settings. The researchers will test whether the enhanced intervention—called eHealth Familias Unidas—is effective in preventing or reducing symptoms of depression and anxiety and suicide-related behavior among youth receiving care at one of 18 primary care clinics.

In addition, NIMH supports research aimed at addressing mental health disparities by improving the quality of mental health care received by Hispanic, Latino, and other racial and ethnic minority youth. For example, researchers at the University of Washington are rolling out a training program for school mental health clinicians that aims to support equitable and sustainable implementation of measurement-based care. The researchers will examine whether this approach effectively improves clinicians’ practices and, if so, whether those improvements lead to better mental health outcomes among Latino and Black youth.

Barriers to access, including a lack of culturally informed approaches to care delivery, contribute to lower engagement in care by Hispanic and Latino youth, who are less likely to continue treatment for serious mental illness. To help engage youth in the treatment process, NIMH is funding a study to adapt and test an intervention focused on increasing the engagement of racial and ethnic minority young adults in treatment as a way of decreasing mental health disparities.

NIMH is also focused on efforts to improve research practices so that interventions reflect and respond to the needs of Hispanic and Latino communities. For example, the NIMH Office for Disparities and Workforce Diversity is hosting a webinar during National Hispanic Heritage Month this September titled, “Engaging Community Stakeholders to Reduce Mental Health Inequities in the Hispanic Community.” The webinar will explore the impact and significance of engaging community stakeholders in developing culturally responsive interventions and the need for implementation science to improve mental health care uptake in the Hispanic community. The webinar will also explore ways to bridge the gap between implementation science and health disparities research to address health inequities experienced by racial and ethnic communities that have been historically marginalized in health care.

Envisioning the Future

These projects reflect a small sample of NIMH activities focused on Hispanic and Latino youth. We know that Hispanic and Latino communities are diverse, with unique cultural identities and sources of resilience. Identifying effective evidence-based interventions requires a community-focused approach—what works for people in one neighborhood or city won’t necessarily work elsewhere. By supporting culturally responsive research that engages families and communities, we hope to push the field forward to address the pressing mental health needs of Hispanic and Latino youth.

Additional Resources

• NIMH webinar: Engaging Community Stakeholders to Reduce Mental Health Inequities in the Hispanic Community
• Behavioral Health Equity: Hispanic and Latino Americans
• Mental Health Resources for Latinx/Hispanic Community
• Publicaciones acerca trastornos de la salud mental y temas relacionados

Posted June 22, 2023

By Leonardo Mariño-Ramírez, Ph.D.
Earl Stadtman Investigator
Epidemiology and Genetics Branch
Division of Intramural Research

I was born and raised in Bogotá, a city of seven million people situated on the altiplano (high planes) of the Andes mountain range in the South American country of Colombia. I studied microbiology as an undergraduate at the University of Los Andes and came to the United States on a Fulbright Scholarship to pursue a Ph.D. in biochemistry at Texas A&M University. Later, I started as a postdoc at the NIH’s National Center for Biotechnology Information (NCBI), where I cultivated my passion for bioinformatics and computational genomics. After years of working at NCBI, my work on human genomics eventually took me back to Colombia, an unexpected development that forever changed the trajectory of my career and ultimately brought me to NIMHD.

Colombia is well known among scientists as a global hotspot for biodiversity, think of this as biological diversity, hosting close to 10 percent of the earth’s biodiversity despite making up one percent of its landmass. What is far less well known, but no less important in my estimation, is the fact that Colombia is also a hotspot of human genetic diversity. Colombia is a remarkably diverse and multiethnic society made up of descendants of the original Indigenous inhabitants of the region, Spanish colonizers, and enslaved Africans brought by force to the New World. These three main groups of people have mixed continuously over the centuries, via the process known as mestizaje, to produce a modern, cosmopolitan population that is characterized by high levels of interbreeding. The clear racial boundaries so easily recognized in the U.S. are thoroughly blurred in Colombia. In Colombia, we are all Mestizos, bound up by a common culture, set of values, and a shared sense of destiny.

My own research on Colombian genomes shows that mestizaje is also written in our DNA. Virtually all Colombians have substantial amounts of African, European, and Indigenous genetic ancestry. It was this profound genetic diversity that could be found in the Colombian population, which finally led me to work on health disparities.

Photo Caption: Dr. Leonardo Mariño (4th from left) in December 2022 with scientific colleagues in the Colombian Andes Mountains. From L to R: Andrés Moreno Estrada, Angélica Borbón, Karla Sandoval, Leonardo Mariño, King Jordan, Alejandro Matamoros, Juan Esteban Gallo, Augusto Valderrama.

Over the last decade, it has become increasingly apparent that genomics research is failing on diversity. The so-called “genomics research gap” refers to the fact that the vast majority of human genetics research cohorts are made of participants with European ancestry. This lack of diversity threatens to exacerbate existing health disparities, since results of studies on European ancestry cohorts may not transfer to other ancestry groups, particularly individuals of African descent who already bear a disproportionate burden of morbidity and mortality in the U.S.

Although, I did not set out to work on health disparities, it became apparent to me that our work on genetically diverse Colombian genomes was exactly the kind of research that was needed to ensure that the benefits of the precision medicine revolution can be shared more broadly – among all people, everywhere. I have since become convinced that genomic diversity is a powerful tool that can and must be leveraged in support of health equity. This is the central theme of my research group – to use genetic diversity in support of epidemiological studies of health disparities in complex, common diseases.

Our focus is not limited to genetics, however. We are relentlessly focused on understanding on how genetics, the environment, and interactions between these two classes of exposures, contribute to disparate health outcomes. In particular, we are using genetic ancestry inference as a means to disentangle genetic, social, and environmental risk factors of health disparities. This approach relies on the fact that genetic ancestry is a characteristic of the genome, which can thus be defined independently of the social dimensions of race and ethnicity, thereby allowing us to partition the genetic and environmental variance components of human health within and between population groups. Publications in [PubMed].

* Mestizaje: A Spanish phrase that refers to racial mixing.

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Rachel Zajdel, Ph.D., M.A., M.S., Postdoctoral Fellow
Sana Rahman, B.A., Special Volunteer
Chelsea Truong, B.S. Postbaccalaureate Fellow
Erik Rodriquez, Ph.D., M.P.H., Staff Scientist
Division of Intramural Research
National Heart, Lung, and Blood Institute

Since the 1964 Smoking and Health Report of the Advisory Committee to the Surgeon General, public discussion in the U.S. surrounding the use of tobacco has emphasized its detrimental health effects. Through public health efforts, cigarette smoking rates have decreased among adults and youth since that time. However, as the prevalence of cigarette smoking has dropped, these successful efforts have led to a diminished sense of urgency among the public, with people questioning whether tobacco use remains a prominent public health issue. The World Health Organization’s “World No Tobacco Day,” occurring each year on May 31, aims to refocus attention to the dangers of smoking and their relevance today.

Tobacco continues to kill more than 8 million people worldwide and is the leading preventable cause of death in the U.S. Additionally, while the increased risk of lung and throat cancer among smokers is widely known, smoking is also the second leading cause of cardiovascular disease (CVD), with one in every four deaths from CVD caused by smoking. Considering that CVD is the leading cause of death in the U.S., continued advocacy through events such as “World No Tobacco Day” can help improve U.S. health outcomes.

While 7 million worldwide deaths due to tobacco are a result of direct tobacco usage, 1.2 million people each year die because of secondhand exposure to smoking. Research has shown that there is no safe level of secondhand smoke exposure, with even short term exposure heightening the risk of heart attacks. Secondhand smoke has also been identified as a cause of stroke. Increasing awareness about the risks of secondhand smoke exposure remains a key focus in anti-tobacco public health efforts.

The harmful effects of tobacco use are not evenly distributed across the population. In the U.S., commercial tobacco product use is higher among members of groups that have been marginalized, including American Indian or Alaska Native (AI/AN) individuals; lesbian, gay, or bisexual persons; and those with lower levels of education and income. Individuals with multiple social identities that have been marginalized may be particularly affected by tobacco use. Inequitable exposure to tobacco industry marketing and access to cessation therapies contribute to these disparities in tobacco use by race and ethnicity, sexual orientation and gender identity, and socioeconomic status.

Not only have tobacco companies targeted specific populations within the U.S., but they have also turned their attention to international targets as the tobacco market in the U.S. has shrunk. Tobacco use remains high in low- and middle-income countries (LMICs), where 80% of the world’s tobacco users live. Tobacco companies have leveraged their economic influence to prevent implementation of tobacco control policies, sponsor tobacco-farming communities, and target children and women in LMICs. As a result, compared to high-income countries (HICs), a lower proportion of LMICs have implemented tobacco control measures including anti-tobacco campaigns, tobacco taxes, age requirements, graphic packaging, flavor bans, or comprehensive cessation services.

“World No Tobacco Day” reminds us that these glaring national and international inequalities in tobacco use persist, and in some cases are even widening. Researchers at the National Institutes of Health have heeded this call to action by illuminating disparities in tobacco use by social characteristics and demonstrating the significant harms to population health wrought by the tobacco industry. Research in the lab of Dr. Eliseo J. Pérez-Stable in the National Heart, Lung, and Blood Institute has shown that smoking susceptibility and exposure to tobacco marketing are predictive of cigarette smoking even after accounting for the use of electronic nicotine delivery systems. In addition, Dr. Kelvin Choi’s lab in the National Institute on Minority Health and Health Disparities has established that concern about COVID-19 discrimination, an experience disproportionately borne by Asian and Asian American individuals, is associated with increased cigarette consumption. This research can be used to inform policies and interventions addressing the mechanisms underlying tobacco use and the many health disparities they generate.

Various interventions, such as raising the price of tobacco products, passing smoke-free policies in public places, and increasing equitable cessation access, can help further reduce tobacco exposure and its associated health consequences. Specific tactics to ban the sale of flavored tobacco products, restrict price promotions, and implement culturally-informed anti-smoking campaigns can begin to address the disparities caused by the tobacco industry’s legacy of targeting AI/AN, Black, Latino, sexual and gender minority, and low income communities.

Nevertheless, we must also turn our collective attention to think beyond tobacco control and reach for a tobacco endgame, with an emphasis on the upstream causes of tobacco use. With respect to an endgame strategy, policies could be implemented to regulate the content of nicotine in tobacco products, which could reduce it to a non-addictive level, as well tobacco industry marketing at the point of sale, including characteristics of tobacco package labeling and warnings. Among the upstream causes, dismantling the drivers of structural racism could also advance progress towards tobacco health equity. In summary, systematic social changes will be needed before we truly see a “World No Tobacco Day.”

Posted March 24, 2023

By Triesta Fowler, M.D.

Scientific Diversity Officer, National Institute on Minority Health and Health Disparities

Monica Webb Hooper, Ph.D.

Deputy Director, National Institute on Minority Health and Health Disparities

March is women’s history month, and we thank and celebrate women across the U.S. and globally for their many essential contributions to science and medicine. Entering and succeeding in a field of study and/or professional practice, especially as a member of an underrepresented group is no small feat. Getting there often means beating the odds and rising above continual challenges. Women’s history includes many exemplars of such formidable efforts, people who are deserving of celebrations this, and every, month.

In this blog, we commemorate the work and legacies of pioneering women whose historic accomplishments made critical strides toward improving minority health, reducing disparities, and advancing health equity, from the late 1800s to today.

Trailblazing Women in Science

In 1864, Dr. Rebecca Lee Crumpler (1831-1895) became the first African American woman to obtain an M.D. degree at the New England Female Medical College in Boston, Massachusetts. Dr. Crumpler provided medical care to formerly enslaved people at the Freedmen’s Bureau in Richmond, Virginia, and later took care of patients in her home in Boston regardless of their ability to pay. She also published the first medical text by an African American author in 1883 entitled A Book of Medical Discourses, which focused on women and children’s health and was based on journal notes she kept while in practice.

In 1933, Dr. Inez Beverly Prosser (unknown birth year – 1934) became the first African American woman to earn a Ph.D. in psychology from the University of Cincinnati in Ohio. With a passion for education, she taught at Historically Black Colleges and Universities (HBCUs) and was interested in personality, self-esteem, and adjustment among children. Her research focused on the impact of racism on the education and educational experiences of African American children and was cited in the debates leading to the landmark 1954 civil rights case, Brown v. Board of Education of Topeka, Kansas.

Drs. Crumpler and Prosser were remarkable women who blazed the trails so that we could follow in their footsteps. They overcame racial discrimination, biases, segregation, and societal and cultural norms that prevented women from working outside of the home, and barred Black women from educational opportunities. They helped launch the cross-cutting fields of minority health and health disparities research. And while there has been some progress, there remains much more work to be done. About 37.1% of total active physicians are women (American Medical Association 2021), but only 2.8% are Black women. About 69% of psychologists are women, but just 5% are Black (women and men combined).

NIMHD’s Very Own Trailblazer

We also acknowledge and celebrate a modern-day pioneer in the field, Dr. Anna María Nápoles, Scientific Director of the Division of Intramural Research at NIMHD, who retired from federal service on February 28, 2023. Dr. Nápoles is a behavioral epidemiologist and the first Latina named to the position of Scientific Director at an NIH Institute. She worked tirelessly to grow the Division and maintained a steadfast commitment to mentorship and sponsorship. We benefitted tremendously from her expertise and outstanding leadership.

We honor the legacies of these amazing individuals with a daily commitment to mentor and sponsor the next generation of scientists as they maximize their potential. We encourage others to learn about the many historic women in science and medicine, and to emulate their persistence and determination for improving the health of populations with health disparities.

NIMHD is committed to supporting the careers of all women, and a culture that supports recruitment and retention. In science and medicine, we know that this must include opportunities for mentorship, professional network development^, and research funding, which are associated with increased productivity, career satisfaction, and achievement of professional goals and skills.

NIMHD Supports Women

Funding Opportunities

We strongly encourage investigators supported by eligible grants to identify and support scientists through our funding mechanisms.

• Research Diversity Supplements
• Career Development Awards

Training Opportunities

Our flagship program, the annual Health Disparities Research Institute, is a big draw for early career investigators and an opportunity to foster peer relationships and expand professional networks. The idea of a shared vulnerability and the ability to connect is key to building knowledge and skills and promoting wellness.

In short, NIMHD has resources in place to support women’s professional trajectories and success. And we are proud that over half of principal investigators supported by grants awarded by NIMHD identify as women.

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Dr. Triesta Fowler leads NIMHD diversity, equity, inclusion, and accessibility efforts in collaboration with NIMHD leadership and staff. She was previously a medical officer and Director of Communications and Outreach within the Division of Intramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), leading key diversity activities. She began her work in diversity outreach and engagement at NICHD in 2007 as the director and creator of The National Child and Maternal Health Education Program.

Dr. Monica Webb Hooper is an internationally recognized translational behavioral scientist and licensed clinical health psychologist. She has dedicated her career to science that benefits and serves communities with a focus on chronic illness prevention and health behavior change. Her overarching goal is to do the work necessary to produce meaningful, positive change and assure health equity. Before joining NIMHD, Dr. Webb Hooper was a tenured Professor of Oncology, Family Medicine & Community Health, and Psychological Sciences at Case Western Reserve University and Associate Director for Cancer Disparities Research at Case Comprehensive Cancer Center.

Posted March 8, 2023

By Jordan J. White, DrPH, MSW
Assistant Professor
Bachelors of Social Work Department
School of Social Work
Morgan State University

In the 1990s, I witnessed several community members and relatives pass away from HIV/AIDS. These experiences piqued my interest in the role of social networks, assets, and resources in health promotion in minority communities. Family members (grandparents, parents, uncles, aunts, siblings) , many of whom attended Historically Black Colleges and Universities (HBCUs), supported my interests.

I am a tenure-track Assistant Professor of Social Work at Morgan State University in Baltimore, Maryland. I am also an NIMHD Diversity Supplement awardee. I have worked in HIV prevention and community health across government, academic, corporate and community-based settings for the past decade. My Diversity Supplement has allowed me to better understand gaps in HIV care as well as strategies to address COVID-19 and Mpox (formerly known as monkeypox) vaccine hesitancy among sexual minority men.

In 2019, I was honored to become the first graduate of the Lesbian, Gay, Bisexual, Transgender and Queer Public Health Certificate Program from the Johns Hopkins Bloomberg School of Public Health, due to my longstanding interest in sexual minority health.

My main research interests focus on advancing the health and wellbeing of populations experiencing disadvantage, particularly Black and Latino sexual minority men, in the United States. While there are many inequities and health disparities that urgently need to be addressed among these populations, HIV continues to be one of the most complex. The research for my supplement was primarily conducted during the COVID-19 pandemic and Mpox outbreaks of 2022 and 2023. Black and Latino sexual minority men were two of the most affected demographic groups. A key lesson or theme from this ongoing work is the need to encourage communication between providers and patients to promote healthy sexual practices within shifting health, clinical, and sociocultural contexts.

My research has primarily focused on HIV prevention, treatment and care among these populations. I have used qualitative and quantitative methodologies to explore factors that promote health and resilience among these populations. I have engaged hundreds of Black and Latino sexual minority men in qualitative and survey research over the past decade. Anecdotally, my research during the COVID-19 pandemic and Mpox outbreak period (2020-2023) documented some of the most intersectional, challenging, and dire outcomes that I have ever encountered. One example is how Black and Latino sexual minority men are less likely to be virally suppressed than White sexual minority men, thus leading to worse Mpox outcomes.

My hope is that some of these findings and counter-narratives may help to address gaps in our knowledge of resilience and its multi-level determinants among Black and Latino sexual minority men. Future resilience-based public health interventions, policies and practices for these populations are critical to increasing health equity.

HIV continues to have a devastating impact on Black and Latino sexual minority male populations throughout the United States. The persistently high community viral load and gaps in retention in care are increasingly recognized as contributing factors to these HIV-related racial disparities. Viral suppression rates are high among Black and Latino sexual minority men who are engaged in care. Many Black and Latino sexual minority men are living with stress and stress-related comorbidities that exacerbate HIV-related racial disparities. Psychosocial approaches emphasize that subjective experiences can produce acute and chronic stress which affect physical and mental health outcomes. For some sexual minority populations, the house and ballroom community are considered sources of resilience and social support that protect members from various stressors. Understanding how a disproportionately affected subpopulation of Black and Latino sexual minority men adjust or readjust to stressors can inform future behavioral resilience interventions and may help reduce HIV-related racial disparities.

Receiving the NIMHD Diversity Supplement funding was invaluable to my research. It has allowed me to conduct primary data collection, analysis, build my research program, and provided pilot data that I hope will inform future NIH grant applications. It also has fostered collaboration between Morgan State University and the Johns Hopkins Bloomberg School of Public Health.

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Dr. Jordan White is an Assistant Professor of Social Work at Morgan State University in Baltimore, MD. He is trained as a public health and social work scientist. Dr. White’s research and practice are centered on understanding and addressing health disparities and inequities among minority populations particularly sexual minority men in the United States.

Posted on February 28, 2023

NOTE: For Black History Month, NIMHD Insights is reposting this piece with permission from the National Library of Medicine’s blog, Musing from the Mezzanine.

By Triesta Fowler, M.D.
Scientific Diversity Officer, National Institute on Minority Health and Health Disparities

Monica Webb Hooper, Ph.D.
Deputy Director, National Institute on Minority Health and Health Disparities

In honor of Black History Month 2023, we are highlighting positive and protective factors that raise awareness of and show appreciation for the myriad of cultural and community strengths that facilitate safe spaces, where the health of children and adolescents can be fortified and maintained.

“It takes a village” is a proverb that has been attributed to African cultures. For example, in Lunyoro—the language of Bunyoro, a Bantu kingdom in Western Uganda—“Omwana takulila nju emoi,” means “A child does not grow up only in a single home.” The idea behind the proverb is that although parents have the primary responsibility for raising children, the “village,” or their community, also plays an important role in how a child is raised. It is a longstanding belief that the community should and can create a safe and healthy environment in which the child grows. This belief in the power of community is an important component and strength of African American culture.

Members of the village become part of a redefined extended family that share a common culture, values, and customs. These members may include other relatives, close friends, neighbors, and a trusted religious community. These connections have been defined as “fictive kin,” or people who reinforce and extend the familial bonds beyond a biological relationship.

One area that is impacted by the village concept is caring for children, which becomes a shared responsibility across all the members of the fictive kin. Parents and their children are given the opportunity to be supported by and connected to additional community resources and to gain an increased awareness and access to what is available in the community, including opportunities to enhance a child’s learning and developmental processes. The village can also have positive effects on a child’s well-being and physical and mental health. Indeed, the social support and perceptions of cohesion in such neighborhoods are related to fewer symptoms of anxiety and depression.

As children grow up surrounded by fictive kin, they develop their own sense of community and connection to their village. Conscious community-building can also spark a sense of responsibility to give back to the community and its members beyond any personal benefit. This sense of community consists of four components: a sense of belonging, a belief that you can make a difference in your community, a feeling that needs will be met through the resources provided by the community, and an emotional connection that results from shared experiences.

This emotional connection can help address the feeling of isolation that may arise from the pressures of society such as systemic racism, and surrounding children with people who share these experiences help can increase positive coping skills and reduce mental health concerns. That is, the community has the power to act as a buffer and offer needed protection to children and adolescents.

For generations, the idea of “it takes a village” has been at the center of African American culture because it creates an environment of love, support, and protection for all its children. It highlights the belief that the environment provided by the extended family gives children the best start in life and is an investment in their future. This concept will never grow old and is something that everyone from all cultures can actively support.

During Black History Month and beyond, we encourage advocates for holistic physical and mental wellness to learn more about the importance of community-level social support—the village—and fictive kin.

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Dr. Triesta Fowler leads NIMHD diversity, equity, inclusion, and accessibility efforts in collaboration with NIMHD leadership and staff. She was previously a medical officer and Director of Communications and Outreach within the Division of Intramural Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) leading key diversity activities. She began her work in diversity outreach and engagement at NICHD in 2007 as the director and creator of The National Child and Maternal Health Education Program.

Dr. Monica Webb Hooper is an internationally recognized translational behavioral scientist and licensed clinical health psychologist. She has dedicated her career to science that benefits and serves communities with a focus on chronic illness prevention and health behavior change. Her overarching goal is to do the work necessary to produce meaningful, positive change and assure health equity. Before joining NIMHD, Dr. Webb Hooper was a tenured Professor of Oncology, Family Medicine & Community Health, and Psychological Sciences at Case Western Reserve University and Associate Director for Cancer Disparities Research at Case Comprehensive Cancer Center.

Posted on February 22, 2023

By Shelly Pollard, MBA
NIMDH Insights Blog Editor
National Institute on Minority Health and Health Disparities

At NIMHD, we have the privilege of sharing informative and thought-provoking blog posts with our subscribers each month. In case you missed some of the highlights from last year, here is a list of the top five most popular blog posts for 2022.

1. The COVID-19 Pandemic Has Amplified the Effects of Racism on Mental Health
2. HDPulse: A Comprehensive Resource to Access Health Disparities Data and Minority Health Resources
3. Community Organizations Lead Structural Interventions Research with Novel NIH Initiative
4. Striving Towards Health Equity: Understanding the Impact of Discrimination on LGBTQ+ Communities
5. A Different Kind of Leader

For 2023, the NIMHD Insights blog has a new address and a brand-new look and feel. The blog will continue to tell stories about research, resources, people, and NIMHD-supported funding mechanisms, making the science relatable and engaging to readers. Please bookmark the new NIMHD Insights homepage https://blog.nimhd.nih.gov/ and stay tuned for more!