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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Suggested Citation:"Index." Institute of Medicine. 2006. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Washington, DC: The National Academies Press. doi: 10.17226/11602.
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Index A Allostatic loading, 30­31, 152 American Cancer Society (ACS), 232, 241, 244 ACS. See American Cancer Society American Heart Association (AHA), 242, 244 Advisory Council, 11, 19, 76­77 American Indian/Alaska Native, 4, 17, 22­24, Advisory responsibilities 26, 32, 45, 125, 128­129, 141, 194­ expertise in, 8 195, 218 in health professions education in health American Indian Youth Initiative, 203 disparities and cultural competency, American Lung Association, 244 109­110 American population, diversity of, 169 African Americans, 4, 17, 22, 24, 26­28, 32, Annual Reports, 10, 60, 71 45, 123, 125, 127­129, 131, 134, 139­ Asian and Pacific Islander American Health 143, 149­150, 152, 165, 168, 194­195, Forum, 118, 204 218, 239­241, 245 Health Information Network, 204 Age adjustment, 21 Asian/Pacific Islanders, 4, 17, 21, 24, 26, 32, Agency for Healthcare Research and Quality 42, 122, 125, 127, 129­131, 141, 194 (AHRQ), 9, 16, 28, 43, 58, 61, 85, 115, Association of American Indian Physicians, 244 168, 186, 203, 232, 235 Association of Black Cardiologists, 244 Evidence-based Practice Centers Program, Association of Minority Health Professions 241 Schools, 116 EXCEED (Excellence Centers to Eliminate Association of Physicians of Indian Origin, 244 Ethnic/Racial Disparities), 244 Audiences, 237­239 Office of Extramural Research, Education, segmenting, 237­238 and Priority Populations, 19 AHA. See American Heart Association AHRQ. See Agency for Healthcare Research B and Quality AIDS. See HIV and AIDS Basic research Alaska Native. See American Indian/Alaska in the Health Disparities Report, 266 Native in the Minority Health Report, 261 Alcohol effects, 151 291

292 INDEX Behavioral factors, 16 Chronic conditions, 137­138 affecting health, 149­152 Chronic stress, 151­152 in understanding health disparities, 30 Clinical research in the Health Disparities Biological factors, in understanding health Report, 266­267 disparities, 15­16, 29, 198 non-targeted research, 266 Biomedical Research and Development Price targeted research, 266 Index (BRDPI), 46­47 Clinical research in the Minority Health Report, Birth weight, very low, 21 261­263 Blacks. See African Americans non-targeted clinical research, 262­263 BRDPI. See Biomedical Research and targeted clinical research, 262 Development Price Index Clinical trials, 46 Budget and finances, 60­71 in the 2002 and 2004 Strategic Plans, 46­49 availability of budget information, 60 Phase III, 48, 82 of the Committee, 258 CMS. See Centers for Medicare and Medicaid incremental funding for the NIH Minority Services Health and Health Disparities Research Collaborations, among ICs, 76 program, 61­64 Committee for the Assessment of NIH Minority interpretation of budget information, 60­61 Health Research Training Programs, 45 NIH budget allocations for health disparities, Committee on Minority Health and Health 64­71 Disparities Research Definitions and Budget Office, 11, 64 Application Methodology, 13, 56­57, Built environment, in understanding causes of 60, 64, 79­80, 86­87, 113, 179, 186, health disparities, 147 254­271 activities of, 270­271 budgets of, 258 C charge to, 18­19, 112 Final Report (Revised January 2004), 254­ Cable TV, 226 258 Cancer Control Planet, 232 Guidelines for Minority Health and Health Cancer PLANET, 232­233 Disparities Reporting, 260­269 Carcinogens, 29, 146 membership of, 258 CARDIA sample, 152 process of, 19­20 Centers for Disease Control and Prevention Committee on National Needs for Biomedical (CDC), 16, 43, 84­85, 115, 117, 144, and Behavioral Scientists, 45 149, 151, 203, 232, 235, 241, 249 Committee on the Organizational Structure of National Center for Health Statistics, 22­23, the National Institutes of Health, 79 28 Communal function, of health communication, Office of Minority Health, 19 221­222 Centers for Medicare and Medicaid Services Communication inequality, 222 (CMS), 235, 249 Community-based organizations, 52 Centers of Excellence program, 18, 101­103, in the 2002 and 2004 Strategic Plans, 202, 274­276 49­50 Project EXPORT, 73, 76 participatory research by, 49, 76 for research education and training, 101­103 Community Networks to Reduce Cancer Health Chain of risk, 163­164 Disparities through Education, Channel selection, 242­245 Research and Training Program, 244 demographics, 243 Community outreach, 76 lifestyle and orientation, 244 in the 2002 and 2004 Strategic Plans, 39, race or ethnicity, 243­244 52­55 Charge, to the Committee, 3­4, 18­19 Computer databases, 55 Chemical substances, 29

INDEX 293 Computer Retrieval of Information on Differences in health care Scientific Projects (CRISP), 61, 255, defining, 24­25 265, 268­269 schematic diagram showing, 175 coders determining relevance for a term with Disability, excessive, 16 the CRISP emphasis codes (P, S, T), Discrimination in health care 268­269 schematic diagram showing, 175 in the Guidelines for Minority Health and in understanding health disparities, 31, 149, Health Disparities Reporting, 268­269 151, 158 primary emphasis "P," 268­269 Disparities in health care, 127­139 secondary emphasis "S," 269 in the 2002 and 2004 Strategic Plans, 42­43 tertiary emphasis "T," 269 defining, 24­25 thesaurus terms to identify low-SES and mechanisms underlying, 152­169 rural health disparities activities, 268 as processes, 168 Conceptual models, in understanding health race/ethnicity, 127­131 disparities, 31 rural health, 136­139 Conforming provision, regarding definitions, SES, 132­136 111 Distinction, between difference and disparity in Congress, 9, 12, 16, 35, 200 defining health disparities, 24­25 Congressional Commission on the Diversity, of American population, 169 Advancement of Women and Division of Cancer Control and Population Minorities in Science, Engineering, and Sciences, 232 Technology Development, 45 Documentation, moving beyond, 143­152 Conscience, of a nation, 15 Conscientiousness, 134 Consensus, in defining health disparities, lack E of, 25 EARDA. See Extramural Associates Research Coordination Development Award assessing adequacy of, 18 Educational factors, 15, 134­136 of communication programs, 8, 54 a basis of health disparities, 197­198 of an interdisciplinary approach in minority sheepskin effect, 135 health and health disparities, 84­87, Effective date provisions, 111 199­200 Endowment program awardees, NCMHD, 277 Council of Public Representatives, 83 Environmental factors in understanding causes CRISP. See Computer Retrieval of Information of health disparities, 16, 146­149 on Scientific Projects built environment, 147 Cultural issues, a basis of health disparities, environmental exposures, 146­147 198­199 social environment, 147­149 EPC. See Evidence-based Practice Centers D Program Ethnicity. See Race/ethnicity Data Evidence-based Practice Centers (EPC) in the 2002 and 2004 Strategic Plans, Program, 241 validity and reliability of, 50­51 EXCEED (Excellence Centers to Eliminate relating to race or ethnicity, collection of, Ethnic/Racial Disparities), 203, 244 107­108 Exemplification, 240 Demographics, 243 Extramural Associates Research Development Depression, 195 Award (EARDA), 263 DHHS. See U.S. Department of Health and Extramural Clinical Research Loan Repayment Human Services Program for Individuals from Diabetes. See Type 2 diabetes Disadvantaged Backgrounds, 73­74

294 INDEX Extramural Loan Repayment Program for HBCUs. See Historically black colleges and Minority Health Disparities Research, universities 103 Health, United States, 2002, 195 Health, United States, 2004, 127, 136, 149 Health and Retirement Study, 166 F Health behaviors in understanding causes of health disparities, 149­152 Faith-based organizations, 52 exposure to stress, 151­152 Fear appeals, 239 obesity, 150­151 Feedback loops, 221, 246 smoking, 149­150 FIC. See Fogarty International Center Health capital, 161­162 Final Report (Revised January 2004), 254­258 Health care, 144­145 of the Committee on Minority Health and access and quality in understanding health Health Disparities Research Definitions disparities, 29 and Application Methodology, 254­ schematic diagram showing differences, 258 disparities, and discrimination in, 175 Health Disparities Report, 256­258 Health communication Minority Health Report, 255­256 functions of, 221­222 Finances. See Budget and finances inequalities in, 8 Fogarty International Center (FIC), 75 Health disparities, 4­5, 21­33 Framing, 240­241 as defined by the Strategic Plan, 9­10, 56­59 defining, 15­16, 24­26, 57, 123­124 different approach to, 121­122 G efforts to reduce and ultimately eliminate, Gender factors, 124­127, 140, 143, 158 201­204 Genetic factors, 15, 123, 145­146 HHS efforts, 201­202 Goals to reduce and ultimately eliminate health NCMHD efforts, 202­204 disparities, 206­208 NIH efforts, 204 in the 2002 and 2004 Strategic Plans, 38, 39 implications for the NIH research agenda, community outreach, information 31­33 dissemination, and public health measuring, 26­29 education, 207­208 research by agency, 105­107 research, 206 understanding, 29­31, 143­152 research capacity, 207 approaches to understanding causes of Grants for health professions education, 108­109 health disparities, 144­152 Guidelines for Minority Health and Health behavioral factors, 30 Disparities Reporting, 257, 260­269 biological factors, 29 CRISP coders determining relevance for a conceptual models, 31 term with the CRISP emphasis codes discrimination, 31 (P, S, T), 268­269 environmental factors, 146­149 CRISP thesaurus terms to identify low-SES genetic factors, 145­146 and rural health disparities activities, health behaviors, 149­152 268 health care, 144­145 general reporting principles, 260­261 health care access and quality, 29 Health Disparities Report, 264­268 physical environment, 29­30 Minority Health Report, 261­264 social environment, 30 stress, 30­31 Health Disparities Ambassadors, 202 H Health Disparities Report, 61, 63, 256­258, 264­268 Hawaiians. See Asian/Pacific Islanders basic research, 266 HBCU Research Scientist Award, 263 clinical research, 266­267

INDEX 295 Final Report, 256­258 Hispanics, 4, 17, 21, 26­28, 32, 49, 125, 129­ in the Guidelines for Minority Health and 131, 139­143, 164­167, 238, 242 Health Disparities Reporting, 264­268 paradox involving, 168 infrastructure, 267 Historically black colleges and universities non-targeted research, 257 (HBCUs), 249, 263 outreach, 267­268 HIV and AIDS, in minority health and health Research Training and Career Development, disparities, 21­22, 129, 195, 241 267 Homicide, 22 targeted infrastructure, 257 Hypertension, 21, 147 targeted outreach, 257 targeted research, 257 targeted research training and career I development, 257 ICPS. See Interamerican College of Physicians Health Disparities Research Loan Repayment and Surgeons Program, 73­74 Immune responses, 155 Health disparity groups, 24­26, 125­127 IMPAC II Population Tracking database (POP current approaches to, 127­139 tracking), 262­264 the distinction between difference and Impact sought, and timetable, 245 disparity, 24­25 Improvement of minority health and reducing lack of appropriate measures of health status, health disparities through the NIH, 97­ 25­27 104 lack of consensus definition, 25 Centers of Excellence for research education Health Information National Trends Survey and training, 101­103 (HINTS), 223, 228 establishment of NCMHD, 97 Health Information Network, 204 extramural Loan Repayment Program for Health literacy, 230 Minority Health Disparities Research, Health professions education, 108­110 103 advisory responsibilities in health disparities general provisions regarding the Center, and cultural competency, 109­110 103­104 grants for, 108­109 Loan Repayment Program for Minority in health disparities, 108 Health Disparities Research, 103 National Conference on Health Professions purpose of Center, 97­101 Education and Health Disparities, 109 report regarding resources of NIH dedicated Health Resources Services Administration, 249 to minority and other health disparities Office of Rural Health Policy, 16 research, 104 Health Status of Minorities and Low-Income Income distribution. See Socioeconomic status Groups, The, 15 Incremental funding, for the NIH Minority Health Disparities Strategic Plan Fiscal Years Health and Health Disparities Research 2004-2008, Volume I (draft), 176­214 program, 61­64 Healthy immigrant effect, 131 Indexing terms, 269 Healthy People 2000, 2, 15 Indian Health Network, 203 Healthy People 2010: Understanding and Indian Health Service, Tribal Epidemiology Improving Health, 2, 15, 28, 143, 168, Centers program, 203 195, 201 Inequalities. See also Health disparities HHS. See U.S. Department of Health and in communication, 222 Human Services Infant mortality, in minority health and health HINTS. See Health Information National disparities, 129, 194 Trends Survey Information dissemination, in the 2002 and Hispanic Association of Colleges and 2004 Strategic Plans, 52­55 Universities, 117 Information technologies, impact on access, Hispanic Communications Initiative, 244 226

296 INDEX Informational function, of health M communication, 221 Infrastructure MacArthur Network on Socioeconomic Status in the Health Disparities Report, 267 and Health, 157­160 in the Minority Health Report, 263 Mammogram use, 230 Initiative to Eliminate Racial and Ethnic Management of the Strategic Plan and Minority Disparities in Health, 201 and Health Disparities Research, 12­ Injury, 136 14, 78­87 Institute of Medicine (IOM), 18, 25, 48, 57, the challenge of structuring a trans-NIH 192, 235, 254­255 Health Disparities Research Program Institutes and Centers (ICs), 3­4, 9, 13­14, 17­ and Strategic Plan, 78­84 19, 32­34, 47, 54­56, 61, 64­71, 77­ coordination of the Strategic Plan and 80, 181, 187­188, 199, 212­214, 235­ Minority Health and Health Disparities 237, 249, 254, 270 Research, 84­87 independence of, 14 Measurement of health disparities, 26­29 Institutions of Emerging Excellence, 17 data on racial and ethnic health disparities, Instrumental function, of health 26 communication, 221 data on rural health disparities, 27 Interamerican College of Physicians and data on socioeconomic health disparities, Surgeons (ICPS), 203 26­27 Internet, 247 interactions among sociodemographic factors IOM. See Institute of Medicine associated with disparities, 27­28 Isolation, social, 147 recent progress, 28­29 Measurement of health status, lack of appropriate, 25­27 J Mechanisms underlying disparities, 152­169 Mental disability, 36 Joint Center for Political and Economic Mental health, in minority health and health Studies, 116 disparities, 194­195 The message, 239­241 theories of, 239 K Message effects, 239­241 exemplification, 240 Kellogg Foundation, 49 fear appeals, 239 Knowledge transfer, 232­234 framing, 240­241 enabling, 234 narratives, 240 public health communication, 220 sensation seeking, 239­240 research dissemination, 220­221 Methodological Issues in Measuring Health Disparities, 28 L Mexican Americans. See Hispanics MHIRT. See Minority Health and Health Latinos. See Hispanics Disparities International Research Lesbian, gay, bisexual, and transgender Training Program community, 36 Minority groups, defining, 58n, 62, 185 Life course factors, 153­154, 157 Minority health and health disparities, 194­200 Life expectancy, 15, 122 cancer, 194 Lifestyle factors, 149, 244 coordination of an interdisciplinary Loan Repayment Program, 18, 72­75, 73­75, approach, 199­200 103, 202 heart disease, 194 Low birth weight, 21 HIV and AIDS, 195 infant mortality, 194

INDEX 297 mental health, 194­195 Minority Research Fellows, 7 multifactorial basis of health disparities, Mission, to reduce and ultimately eliminate 197­199 health disparities, 205 stroke, 194 Molecular factors, 15 type 2 diabetes, 195 Mortality and morbidity Minority Health and Health Disparities budget, data on, 22, 123 212­213 excessive, 15­16 Minority Health and Health Disparities infant, 129, 194 International Research Training premature, 149 (MHIRT) Program, 75 Moving to Opportunity program, 166 Minority Health and Health Disparities Multifactorial basis of health disparities, 43, Research and Education Act of 2000, 197­199 16­18, 95­111, 125, 178, 185 access and quality of health care, 198 data collection relating to race or ethnicity, biological differences, 198 107­108 cultural issues, 198­199 findings, 95­97 in minority health and health disparities, health disparities research by Agency for 197­199 Healthcare Research and Quality, 105­ racial and ethnic discrimination, 198 107 socioeconomic status/education level, 197­ health professions education, 108­110 198 improving minority health and reducing Multifactorial issues the Strategic Plan should health disparities through the NIH, 97­ include, 38, 42 104 miscellaneous provisions, 111 public awareness and dissemination of N information on health disparities, 110 Narratives, 240 short title, 95 National Academy of Sciences, 107­108, 192 table of contents, 95 National Advisory Council on Minority Health Minority Health Professions Foundation, 116 and Health Disparities, 181 Minority Health Report, 61­62, 255­256, 261­ National African American Youth Initiative in 264 Health and Policy Development basic research, 261 Scholars Program, 203 clinical research, 261­263 National Alliance for Hispanic Health, 118 Final Report, 255­256 National Association for the Advancement of in the Guidelines for Minority Health and Colored People, 244 Health Disparities Reporting, 261­264 National Association of Hispanic Nurses, 244 infrastructure, 263 National Black Nurses Association, 244 non-targeted research, 256 National Cancer Institute (NCI), 19, 48, 66­67, non-targeted research training and career 117, 210 development, 256 Cancer Control Planet, 232 outreach, 264 Cancer PLANET, 232­233 Research Training and Career Development, Community Networks to Reduce Cancer 263­264 Health Disparities through Education, targeted infrastructure, 256 Research and Training Program, 244 targeted outreach, 256 Division of Cancer Control and Population targeted research, 255­256 Sciences, 232 targeted research training and career Health Information National Trends Survey, development, 256 223, 228 Minority individuals, defining, 111 National Center for Health Statistics (NCHS), Minority participation, in non-targeted clinical 22­23, 28 research, determining percent, 262­263

298 INDEX National Center for Research Resources National Human Genome Research Institute (NCRR), 17, 75, 78, 210 (NHGRI), 209 National Center on Minority Health and Health National Institute of Allergy and Infectious Disparities (NCMHD), 1­14, 17­20, Diseases (NIAID), 19, 34, 66­67, 115, 33­34, 50, 58­59, 61, 64, 72­77, 85­ 209­210, 241 87, 113­114, 188­189, 219, 235­249, National Institute of Child Health and Human 278­279 Development (NICHD), 19, 64, 67­68, Advisory Council, 11, 19, 76­77 113, 210 as a center, 72­76 National Institute of Dental and Craniofacial Centers of Excellence program, 18, 101­ Research (NIDCR), 68 103, 202, 274­276 National Institute of Diabetes and Digestive Project EXPORT, 73, 76 and Kidney Diseases (NIDDK), 19, 67, for research education and training, 101­ 82, 117, 209­210 103 National Institute of Mental Health (NIMH), 209 efforts to reduce and ultimately eliminate National Institute of Nursing Research (NINR), health disparities, 202­204 64, 68, 209­210 establishment of, 97­104 National Institute on Aging (NIA), 68 Extramural Loan Repayment Program for National Institute on Deafness and Other Minority Health Disparities Research, Communication Disorders (NIDCD), 103 68 general provisions regarding the Center, National Institute on Drug Abuse (NIDA), 209, 103­104 211 Health Disparities Ambassadors, 202 National Institutes of Health (NIH), 1­14, 43, Loan Repayment Program, 18, 72­75, 103, 54, 78­87, 113, 186, 217, 278­279. 202 See also Committee on Minority Office of Community-Based Participatory Health and Health Disparities Research Research and Outreach, 76 Definitions and Application purpose of, 97­101 Methodology; National Center for Research Endowment Program, 18, 72­73, Research Resources; Strategic Plans 202, 277 Annual Reports, 10, 60, 71 Research Infrastructure in Minority budget allocations for health disparities, 64­ Institutions Program, 202 71 responsibilities for the Minority Health and Budget Office, 11, 64 Health Disparities Research program Computer Retrieval of Information on and the Strategic Plan, 76­77 Scientific Projects (CRISP), 61, 268­ role of, 188­189 269 National Children's Study, 166 Council of Public Representatives, 83 National Conference on Health Professions efforts to reduce and ultimately eliminate Education and Health Disparities, 109 health disparities, 201­204 National Council of La Raza, Institute for Health Disparities Strategic Plan Fiscal Hispanic Health, 244 Years 2004-2008, Volume I (draft), National Eye Institute (NEI), 67 176­214 National Health Interview, data from, 130 Hispanic Communications Initiative, 244 National Healthcare Disparities Report, 28, Institutes and Centers, 3­4, 9, 13­14, 17­19, 144 32­34, 47, 54­56, 61, 64­71, 77­80, National Heart, Lung, and Blood Institute 181, 187­188, 199, 212­214, 235­237, (NHLBI), 19, 82, 116, 209­211 249, 254, 270 National Hispanic Medical Association, 244 independence of, 14 National Hispanic Youth Initiative in Health, Institutions of Emerging Excellence, 17 Biomedical Research and Policy Minority Health and Health Disparities Development, 203 budget, 212­213

INDEX 299 Neuroscience Blueprint, 82­83 Neuroendocrine responses, 155 New Definitions and Methodology, 61 Neuroscience Blueprint, 82­83 Obesity Research Task Force, 82 New Definitions and Methodology, 61 Office of Minority Health Research, 16 New Pathways, 83 Office of the Director, 2, 5, 20, 64, 181, NHGRI. See National Human Genome 187­189, 194, 214 Research Institute organization and function, 79­80 NHLBI. See National Heart, Lung, and Blood organizational structure, 188 Institute report regarding resources of NIH dedicated NIA. See National Institute on Aging to minority and other health disparities NIAID. See National Institute of Allergy and research, 104 Infectious Diseases Research Agenda NICHD. See National Institute of Child Health implications of analysis for, 168­169 and Human Development implications of health disparities, 31­33 NIDA. See National Institute on Drug Abuse Research Career (K) Awards, 45, 47, 263 NIDCD. See National Institute on Deafness and Research Definitions and Application Other Communication Disorders Methodology, 61 NIDCR. See National Institute of Dental and Research Fellowship (F) Awards, 46, 263 Craniofacial Research Research Training Grant (T) Awards, 45, 48, NIDDK. See National Institute of Diabetes and 263 Digestive and Kidney Diseases Revitalization Act of 1993, 81 Nielsen Media Research, 242 Roadmap, 83 NIH. See National Institutes of Health Special Population Networks, 242 NIMH. See National Institute of Mental Health Strategic Research Plan and Budget to NINR. See National Institute of Nursing Reduce and Ultimately Eliminate Research Health Disparities, 1, 3, 18, 35 NLM. See National Library of Medicine Strategic Research Plan and Budget to NMA. See National Medical Association Reduce and Ultimately Eliminate Non-targeted activities, in the Minority Health Health Disparities, Fiscal Years 2002- Report, 264 2006, 182, 191 Non-targeted clinical research, 262­263, 266 Working Group, 34 determining percent minority participation, National Library of Medicine (NLM), 78, 211 262­263 National Longitudinal Mortality Study, 132 reporting non-targeted clinical research, 262 National Medical Association (NMA), 116, Non-targeted research 203, 242, 244 in the Health Disparities Report, 257 National Science and Technology Council, 45 in the Minority Health Report, 256 National Science Board, 45 Non-targeted research training and career National Vital Statistics Reports, 195 development, in the Minority Health National Youth Anti-Drug Campaign, 241, 243 Report, 256 Native American. See American Indian/Alaska Native Native Hawaiians. See Asian/Pacific Islanders O NCHS. See National Center for Health OAR. See Office of AIDS Research Statistics Obesity, in understanding causes of health NCI. See National Cancer Institute disparities, 150­151 NCMHD. See National Center on Minority Obesity Research Task Force, 82 Health and Health Disparities OBSSR. See Office of Behavioral and Social NCRR. See National Center for Research Sciences Research Resources Occupational level, 122, 132, 157 NEI. See National Eye Institute ODP. See Office of Disease Prevention Neoplasms, malignant, 22

300 INDEX Office of AIDS Research (OAR), 19, 34, 55, current approaches to disparity groups, 127­ 79, 81, 190 139 Advisory Council, 81 defining health disparity groups, 125­127 Office of Behavioral and Social Sciences an empirical view, 123­125 Research (OBSSR), 34, 55, 79, 190 gender, 143 Office of Community-Based Participatory interaction among factors associated with Research and Outreach, 76 disparities, 139­143 Office of Disease Prevention (ODP), 34, 79, moving beyond documentation to 190 understanding health disparities, 143­ Office of Extramural Research, Education, and 152 Priority Populations, 19, 271 Overview of NIH programs to reduce and Office of Intramural Research (OIR), 190 ultimately eliminate health disparities, Office of Management and Budget (OMB), 48­ 208­211 49 community outreach, information Office of Minority Health Research, 16 dissemination, and public health Office of Portfolio Analysis and Strategic education, 211 Initiatives (OPASI), 83 research, 209­210 Office of Public Health and Science, 203 research capacity, 210­211 Office of Rare Diseases Research (ORD), 190 Office of Research on Minority Health (ORMH). See National Center on P Minority Health and Health Disparities Pacific Islanders. See Asian/Pacific Office of Research on Women's Health Islanders (ORWH), 19, 34, 51, 79, 81­82, 117, Partners, 241­242 190 Pathogens, 29, 146 Office of the Director (OD), 2, 5, 20, 64, 181, Pathophysiological factors, 15 187­189, 194, 214 "Percent relevancy," 57, 265 OIR. See Office of Intramural Research Perry Preschool, 166 OMB. See Office of Management and Budget Physical disability, 36 OPASI. See Office of Portfolio Analysis and Physical environment, in understanding health Strategic Initiatives disparities, 29­30 Open meeting agendas, 112­118 Physicians for Human Rights, 116 Committee on the Review and Assessment Plan for HIV-Related Research, 81 of NIH's Strategic Research Plan to Planning matrix to advance public Reduce and Ultimately Eliminate communication and outreach, 235­245 Health Disparities, 113 the audience, 237­239 OPORTUNIDADES, 166 channel selection, 242­245 ORD. See Office of Rare Diseases Research the message, 239­241 Organization message effects, 239­241 of the Committee's report, 20 message theories, 239 of the Strategic Plan, 190 partners, 241­242 Orphan diseases, 36 sponsors, 235­237 ORWH. See Office of Research on Women's strategy and tactics, 242 Health POP tracking. See IMPAC II Population Outreach Tracking database in the Health Disparities Report, 267­268 Population research, in the 2002 and 2004 in the Minority Health Report, 264 Strategic Plans, 42 Overview of health disparities, 121­174 Poverty. See Socioeconomic status conceptual approaches to mechanisms Preclinical indicators, of disease states, 169 underlying disparities, 152­169 Prevention, 16, 234

INDEX 301 Primary emphasis "P," in the CRISP emphasis Q codes, 265, 268­269 Prisoners, 36 Quality of health care, a basis of health PROGRESA project, 166 disparities, 198 Progress, in measuring health disparities, Quality-of-life measures, 26, 122 recent, 28­29 Public comment, 36, 187­188 Public communication, outreach, and R communication inequalities, 110, 221­ Race/ethnicity, 16, 21, 124, 157­158, 243­244 230 as an approach to disparity groups, 127­131 communication inequality, 222 data on health disparities based in, 26, 48­49 functions of health communication, 221­222 defining, 17 SES, race discrimination as a basis of health and ethnicity and their relation to disparities, 198 inequalities in access to and use of Racial and Ethnic Approaches to Community information, 223­226 Health, 203 and ethnicity and their relation to Recommendations, 4­14 inequalities in attention to and developing the science of communication processing of health information, 226­ and dissemination, 247­248 227 to help NCMHD achieve its outreach and ethnicity and their relation to objectives, 246­248 inequalities in the comprehension of summary of, 278­279 and action on health information, 227­ surveillance system for public 230 communications, 246­247 Public communications and its role in reducing Re-engineering the Clinical Research and eliminating health disparities, 215­ Enterprise, 83 253 Report of the Secretary's Task Force on Black concluding remarks, 248­249 and Minority Health, 15 impact sought and timetable, 245 Reporting knowledge transfer, 220­221 non-targeted clinical research, 262 NCMHD Strategic Plan public information principles for, in the Guidelines for Minority and outreach objectives, 219 Health and Health Disparities planning matrix to advance public Reporting, 260­261 communication and outreach, 235­245 regarding resources of NIH dedicated to recommendations to help NCMHD achieve minority and other health disparities its outreach objectives, 246­248 research, 104 research dissemination and health disparities, Research 230­235 in the 2002 and 2004 Strategic Plans, 38­39 tracking and evaluation, 245­246 in the charge to the Committee, 3, 18 Public health education in the 2002 and 2004 to reduce and ultimately eliminate health Strategic Plans, 52­55 disparities, 206, 209­210 Public Health Service Act, 17, 58 Research capacity Public information and community outreach in the 2002 and 2004 Strategic Plans, 39, in the 2002 and 2004 Strategic Plans, 39 43­52 in the charge to the Committee, 3, 18 clinical trials, 46­49 objectives, 219 community-based participatory research, Public Law 106-525, November 22, 2000 49­50 ("Minority Health and Health effects of various research infrastructure Disparities Research and Education and capacity programs, 51 Act of 2000"), 95­111 scientific workforce, 43­46 Push-pull process, 221 valid and reliable data, 50­51

302 INDEX building, 75­76 S to reduce and ultimately eliminate health disparities, 207, 210­211 School curricula, professional, 55 Research Career (K) Awards, 7, 45, 47, 263 Science leadership and presence within the Research Definitions and Application NCMHD, responsibility for the Methodology, 61 Minority Health and Health Disparities Research diffusion, 220 Research program and the Strategic Research dissemination, 220­221 Plan, 77 and health disparities, 230­235 Science of communication and dissemination, Research Endowment Program, 18, 72­73, 202, developing, 247­248 277 Scientific workforce, in the 2002 and 2004 Research Fellowship (F) Awards, 46, 263 Strategic Plans, 43­46 Research infrastructure Seat belt use, 230 in the 2002 and 2004 Strategic Plans, 39 Secondary emphasis "S," in the CRISP in the charge to the Committee, 3, 18 emphasis codes, 265, 269 Research Infrastructure in Minority Institutions Segregation, residential, 146 (RIMI) Program, 75, 202 Sensation seeking, 239­240 Research objectives SES. See Socioeconomic status in the 2002 and 2004 Strategic Plans, 3 SF=36, 168 8­43 Smoking effects, in understanding causes of disparities in health care, 42­43 health disparities, 21, 149­151, 230 population research, 42 Social capital, 148, 154, 162­163 social factors, 38, 41 Social control function, of health Research Teams of the Future, 83 communication, 221 Research Training and Career Development Social disadvantage, 151 in the Health Disparities Report, 267 Social environment in the Minority Health Report, 263­264 in understanding causes of health disparities, non-targeted activities, 264 147­149 targeted activities, 263­264 in understanding health disparities, 30 Research Training Grant (T) Awards, 7, 45, 48, Social factors, in the 2002 and 2004 Strategic 263 Plans, 38, 41 Residential segregation, 146 Social isolation, 147 Respiratory diseases, chronic, 22 Social support, 147­148, 154 Responsibilities for the Minority Health and Sociodemographic factors associated with Health Disparities Research program disparities, interactions among in and the Strategic Plan, 76­77 measuring health disparities, 27­28 resources and capacity of the NCMHD, 76­ Socioeconomic status (SES), 15­16, 21, 58, 77 223, 228­229 science leadership and presence within the in access to and use of information, 223­226 NCMHD, 77 approach to disparity groups, 132­136 RIMI. See Research Infrastructure in Minority in attention to and processing of health Institutions Program information, 226­227 Risk, chain of, 163­164 a basis of health disparities, 123­124, 132, Roadmap, 83 139, 148, 155­158, 165­169, 197­198 New Pathways, 83 in the comprehension of and action on health Re-engineering the Clinical Research information, 227­230 Enterprise, 83 data on, 26­27 Research Teams of the Future, 83 Speaking of Health, 235 Rural health disparities, 28, 58, 124, 136­139 Special Population Networks, 242 data on, 27 Sponsors, 235­237

INDEX 303 State health departments, 241 Sudden Infant Death Syndrome, 230 Strategic planning model for reducing and Suicide, 136, 195 ultimately eliminating health Surveillance system, 8 disparities, 205­211 for public communications, 246­247 goals and objectives, 206­208 mission, 205 overview of NIH programs, 208­211 T vision, 205 Targeted activities Strategic Plans, 2­3, 17, 60­61, 69­71, 77, 86­ in the Health Disparities Report, 257, 266 87, 164, 278­279 in the Minority Health Report, 255­256, for 2002-2006, 10­11, 36, 86, 219, 230 262­264 for 2004-2008, 10, 36­37, 86 Targeted infrastructure budget, 6­8, 10­11 in the Health Disparities Report, 257 community outreach, information in the Minority Health Report, 256 dissemination, and public health Targeted research training and career education, 7­8, 52­55 development consideration of additional research in the Health Disparities Report, 257 objectives, 38­43 in the Minority Health Report, 256 development and availability of, 34­59 Tertiary emphasis "T," in the CRISP emphasis Executive Summary, 37 codes, 265, 269 feasibility of, 19 36-Item Short-Form Health Survey (SF-36), goals and objectives, 38, 182 168 health disparities as defined by, 9­10, 56­59 Toxins, 29, 146 of the ICs, 9, 55­56 Trans-agency approaches, 4 and minority and health disparities research, Trans-NIH initiatives, 2, 12­13, 18­19, 32­33, management and coordination of, 12­ 55­56, 71, 77, 80­84, 189, 191, 199, 14, 78­87 278­279 public information and outreach objectives, NIH Neuroscience Blueprint, 82­83 219 NIH Obesity Research Task Force, 82 research capacity, 7, 43­52 NIH Roadmap, 83 research plan, 6­8, 38, 43 OAR, 81 and tactics, 242 OPASI, 83 updated, 9 ORWH, 81­82 Strategic Research Plan and Budget to Reduce Trends in Racial and Ethnic-Specific Rates for and Ultimately Eliminate Health the Health Status Indicators, 195 Disparities, 1, 3, 18, 35 Tribal Epidemiology Centers program, 203 Stress Type 2 diabetes, 21­22 acute, 151 in minority health and health disparities, chronic, 151 129, 195 in understanding health disparities, 30­31, 147, 151­152, 160 Stroke, in minority health and health U disparities, 194 Strong Heart Study, 22 Unequal Burden of Cancer, The, 48, 57, 254 Structure of trans-NIH Health Disparities Unequal Treatment: Confronting Racial and Research Program and Strategic Plan, Ethnic Disparities in Healthcare, 25, 78­84 29, 144­145 NIH's organization and function, 79­80 Urban and Rural Health Chartbook, 136 research on health disparities, 78­79 U.S. culture, unhealthful aspects of, 131 trans-NIH initiatives, 80­84 U.S. Department of Education, 16

304 INDEX U.S. Department of Health, Education, and V Welfare, 15 Health Status of Minorities and Low-Income Very low birth weight, 21 Groups, The, 15 U.S. Department of Health and Human Services (DHHS), 32, 41, 85, 116, 201, W 203, 235 Whitehall Study, 132 Acting Deputy Assistant Secretary for Workforce. See Scientific workforce Minority Health, 19 Working Group, 34 efforts to reduce and ultimately eliminate World Health Organization, 122­123, 168 health disparities, 201­204 Office of the Secretary, 16 U.S. Department of Justice, 16

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In the United States, health among racial and ethnic minorities, as well as poor people, is significantly worse than the overall U.S. population. Health disparities are reflected by indices such as excess mortality and morbidity and shorter life expectancy. Examining the Health Disparities Research Plan of the National Institutes of Health is an assessment of the National Institutes of Health (NIH) Strategic Research Plan and Budget to Reduce and Ultimately Eliminate Health Disparities. It focuses on practical solutions to remedy the state of the current health disparity crisis.

The NIH has played the leading role in conducting extensive research on minority health and health disparities for more than two decades. Although additional research is critical to facilitating a better understanding of the overarching social, economic, educational, and environmental factors that predispose groups to specific diseases and conditions, there is also a great need to translate the existing and new information into best care practices. This means increasing communication with affected populations and their communities. Examining the Health Disparities Research Plan of the National Institutes of Health presents solutions to improving the health disparities nationwide and evaluates the NIH strategy plan designed to actively correct and combat the ongoing health disparities dilemma.

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