This year, as the National Institute on Minority Health and Health Disparities (NIMHD) recognizes its 5th anniversary, we reflect on the evolution of the Institute’s role in public health achievements and the future improvements in minority health and health disparities.
The Report of the Secretary’s Task Force on Black and Minority Health (published in 1985 and also known as the Heckler Report) played a seminal role in creating what is today the NIMHD. Among its many groundbreaking recommendations, the report cited a pressing need for scientific research to address striking but previously unrecognized racial disparities in population health. NIH responded by establishing the Office of Minority Programs in 1990 and convening unprecedented town hall meetings across the country to gather community input for the agency’s first-ever Minority Health Initiative.
Recognizing those efforts, Congress established the Office of Research on Minority Health (ORMH) at NIH in 1993. Through its D.C. Infant Mortality Initiative, which addressed disparities in the nation’s capital, ORMH helped reduce the African American infant mortality rate in D.C. by 28 percent compared to a 21 percent decline nationwide over the same period. Building on OMRH’s successes, Congress passed the Minority Health and Health Disparities Research and Education Act of 2000, creating the National Center on Minority Health and Health Disparities (NCMHD). The new Center developed the first NIH Health Disparities Strategic Plan and Budget and launched Congressionally-mandated programs to support health disparities research and encourage the recruitment and retention of scientists from diverse backgrounds. In 2010, Congress elevated NCMHD to Institute status through the Patient Protection and Affordable Care Act.
Since 2010, NIMHD has awarded more than 1,000 grants and contracts dedicated to advancing health equity and enhancing the diversity of the scientific workforce. From its early beginnings in 1985 to today, NIMHD has maintained an unsurpassed commitment to meaningful community engagement in its flagship programs. Diverse teams working together, capitalizing on innovative ideas and distinct perspectives, outperform homogenous teams. Moreover, involving community members in needs assessment, research planning and design, project implementation, as well as data analysis and dissemination enhances participation of disadvantaged populations and facilitates development of workable interventions.
For example, the Collaborative Research Center for American Indian Health (CRCAIH), based in Sioux Falls, South Dakota, collaborates with tribes across South Dakota, North Dakota and Minnesota to address a range of health priorities. Historically, tribal communities have often had negative experiences participating in research, including lack of community involvement in setting priorities and designing studies, inadequate informed consent and a perceived unauthorized use of biospecimens. To change that pattern, the Turtle Mountain Band of Chippewa Indians and its newly formed Tribal Nations Research Group are working with CRCAIH to develop a model tribal research infrastructure to promote collaborations based on mutual respect, equity, and empowerment. Through this partnership, the tribe is establishing a tribal research code, its own research review board, a community advisory board, and a tribal data repository.
In addition, in 2015, NIMHD partnered with the National Hispanic Medical Association to host the Consensus Summit on Building Diversity in Medicine and Research. The summit brought together a diverse group of thought leaders to share lessons learned, discuss best practices, and establish innovative strategies and recommendations for next steps toward enhancing workforce diversity in medicine and biomedical and behavioral research.
It is collaborations such as these that show that, in the 30 years since the publication of the Heckler Report, NIMHD has substantially contributed to scientific research devoted to advancing health equity. The focus on health equity remains as vital today as it was when the report was established in 1985. NIMHD is committed to carrying on the legacy of the Heckler Report to improve the health of all Americans.
Dr. Yvonne T. Maddox is the Acting Director at the National Institute on Minority Health and Health Disparities