Health Disparities and Inequities

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<li class='breadcrumb-home'><a href='/'>Home</a></li><li class='breacrumb-break'>/</li><li class='breadcrumb-parent'><a href='/node/80002'><span class='back-to'> < Back To </span>The Science</a></li><li class='breacrumb-break'>/</li><li class='breadcrumb-current'>Health Disparities and Inequities</li></ul></div></div> <article class="node node--type-scientific-focus-area node--view-mode-full" data-title="Health Disparities and Inequities" data-type="scientific_focus_area" data-format="" data-audience="" data-campaign="" > <div class="standard"> <div class="field field--name-field-top-texture-banner field--type-list-string field--label-hidden field__item"> <div class="pageBanner"> <div class="banner-new-light-red"></div> </div> </div> <div class="secondary-grey-background"> <div class="responsive-container responsive-container-constrained"> <div class="content-container page-top"> <div class="rtFlexContainer"> <div class="rtTitleClassification"> <h1> <span>Health Disparities and Inequities</span> </h1> <div class="calloutdescription"> <div class="field field--name-field-definition field--type-string field--label-hidden field__item">Research supported by the National Heart, Lung, and Blood Institute has helped people live longer, healthier lives. However, many groups experience poorer health than the overall population. Differences in health among population groups are called health disparities. Health disparities that are deemed unfair or stemming from some form of injustice are called health inequities. The NHLBI supports research to reduce health disparities and inequities in heart, lung, blood, and sleep disorders.</div> </div> </div> <div class="onThisPage"> <div class="pagenavtitle"> On this page </div> <ul> <li><a href="#makingadifference">Research Making a Difference</a></li> <li><a href="#whyimportant">Why It's Important</a></li> <li><a href="#keyaccomplishments">Key Accomplishments</a></li> <li><a href="#opportunities">Opportunities & Challenges</a></li> <li><a href="#advancingresearch">Advancing the Research</a></li> <li><a href="#relatedreading">Related Reading</a></li> </ul> </div> </div> </div> </div> </div> <div class="responsive-container responsive-container-constrained"> <div class="content-container research-making-a-difference"> <div class="field field--name-field-making-a-difference field--type-entity-reference-revisions field--label-hidden field__item"><div class="flexcontainer paragraph paragraph--type--making-a-difference paragraph--view-mode--default" id="makingadifference"> <h2 class="phone-display" id="makingadifference-phone">Research Making a Difference</h2> <div class="flexItemTextHalf"> <h2 class="desktop-tablet-display" id="makingadifference-desktop">Research Making a Difference</h2> <div class="pullquote"> We’re only scratching the surface of what could be a treasure trove." </div> <div class="bodytext"> <div class="field field--name-field-research-description field--type-string field--label-hidden field__item">In the emerging world of personalized medicine, researchers are furiously looking for disease markers specific to minority populations, and already they have made some promising discoveries. </div> </div> <div class="desktop-display"> <div class="field field--name-field-url field--type-link field--label-hidden field__item"><a href="/news/2018/researchers-search-disease-markers-linked-racially-and-ethnically-diverse-populations">Read more about the search for these biomarkers.</a></div> </div> </div> <div class="flexItemImageHalf"> <div class="image-and-photocredit-container"> <div class="field field--name-field-thumbnail field--type-image field--label-hidden field__item"> <img loading="lazy" src="/modules/custom/nhlbi_blazy/images/clear.png" width="768" height="432" alt="Group of people of different age and backgrounds." data-src="/sites/default/files/styles/16x9_crop/public/2019-04/Diverse_group_stock.jpg?h=c06c8736&itok=pHDsUg0t" class="b-lazy image-style-_6x9-crop" /> </div> </div> </div> </div> <div class="tablet-phone-display"> <div class="field field--name-field-url field--type-link field--label-hidden field__item"><a href="/news/2018/researchers-search-disease-markers-linked-racially-and-ethnically-diverse-populations">Read more about the search for these biomarkers.</a></div> </div> </div> </div> </div> <div class="pale-blue-darker-white-background"> <div class="responsive-container responsive-container-constrained"> <div class="content-container why-its-important storycalloutbox"> <div class="storycallouttitle" id="whyimportant"> <h2 class="why-its-important-header">WHY IT'S IMPORTANT</h2> </div> <div class="storycallouttext"> <div class="bodytext"> <div class="field field--name-field-why-important-description field--type-text-long field--label-hidden field__item"><p>The Nation benefits when everyone has the opportunity to live a long, healthy, productive life. Despite the progress that has been made, many populations experience poorer health outcomes because of their race or ethnic group, religion, financial situation, education, sex, age, or because of where they live, such as in a rural area.</p> <p>Many health concerns within the NHLBI portfolio, including heart disease, asthma, obesity, and diabetes, disproportionately affect certain populations. For example:</p> <ul> <li>High blood pressure, a major risk factor for heart disease, is more common and not as well controlled in African American and Hispanic adults as in white adults.</li> <li>In the United States, rural populations have higher rates of death due to heart disease, chronic lower respiratory disease, and stroke than urban populations.</li> <li>Life expectancies vary by race and sex. For example, among females born in 2015, life expectancy is 84.3 for Hispanic females, 81.1 years for non-Hispanic white females, and 78.1 years for non-Hispanic African American females.</li> <li>Children from low-income families are more likely to have asthma.</li> <li>African Americans are almost three times more likely to die from asthma-related causes than white Americans.</li> </ul> <p>The NHLBI is working to better understand the unique risk factors in different populations.</p></div> </div> </div> </div> </div> </div> <div class="tertiaryBlueBackground"> <div class="responsive-container responsive-container-constrained"> <div class="content-container key-accomplishments storycalloutbox"> <div class="storycallouttitle" id="keyaccomplishments"> <h2 class="key-accomplishments-header">KEY ACCOMPLISHMENTS</h2> </div> <div class="storycallouttext storycalloutlist"> <div class="field field--name-field-key-accomplishments field--type-string field--label-hidden field__items"> <ul> <li><div class="field__item calloutdata font-size-xl">A study linked residential segregation to higher blood pressure in African Americans, suggesting that policies to reduce segregation may have health benefits.</div></li> <li><div class="field__item calloutdata font-size-xl">The Jackson Heart Study is the largest study of causes of cardiovascular disease in African Americans, involving more than 5,300 men and women.</div></li> <li><div class="field__item calloutdata font-size-xl">The Strong Heart Study, the largest epidemiologic study of American Indians, examines cardiovascular disease and its risk factors in that population.</div></li> <li><div class="field__item calloutdata font-size-xl">The Hispanic Community Health Study/Study of Latinos is the most comprehensive study of Hispanic/Latino health and disease in the United States.</div></li> <li><div class="field__item calloutdata font-size-xl">The Multi-Ethnic Study of Atherosclerosis looks at early atherosclerosis in a diverse, population-based sample of more than 6,800 men and women.</div></li> </ul> </div> </div> </div> </div> </div> <div class="responsive-container responsive-container-constrained"> <div class="content-container opportunities-and-challenges storycalloutbox"> <div class="storycallouttitle" id="opportunities"> <h2 class="opportunities-and-challenges-header">OPPORTUNITIES & CHALLENGES</h2> </div> <div class="storycallouttext"> <div class="field field--name-field-opportunities-description field--type-text-long field--label-hidden field__item"><p>In 2016, the NHLBI released its <a href="/about/strategic-vision">Strategic Vision</a>, which will guide the Institute’s research activities for the coming decade. Many of the objectives, compelling questions, and critical challenges identified in the plan focus on understanding the causes of population health differences and identifying strategies to address these differences. The NHLBI supports late-stage translational research to promote the rapid adoption and sustained use of proven-effective interventions to reduce and eliminate disparities in heart, lung, blood, and sleep disorders. Training the next generation of diverse scientists and clinicians to help address health disparities and inequities is also a high priority for the NHLBI.</p></div> <div class="supplemental-accordion"> <div class="field field--name-field-opportunities-accordion field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <h3 class="graysubaccordionheading" id="more-information-11175"> <div class="field field--name-field-panel-title field--type-string field--label-hidden field__item">More Information</div> <span class="ui-helper-hidden-accessible"> - Health Disparities and Inequities </span> </h3> <div class="ui-accordion ui-widget ui-helper-reset paragraph paragraph--type--standard-accordion-panelparagraph--view-mode--default" > <div class="bodytext"> <div class="field field--name-field-accordion-body field--type-text-long field--label-hidden field__item"><ul><li><strong>Supporting research in communities. </strong>The NHLBI continues to support research that includes patients, health care providers, policy makers, and their communities to learn how to better support the needs of these communities.</li><li><strong>Partnering to conduct more research studies. </strong>The NHLBI will partner with other federal agencies and NIH institutes such as the <a href="https://www.nimhd.nih.gov/" rel="noreferrer">National Institute of Minority Health and Health Disparities</a> to support more research that can be used to reduce health disparities.</li><li>I<strong>mproving care to populations with health disparities.</strong> The NHLBI is working to ensure evidence-based guidelines are adopted and implemented in health care settings to improve clinical care for all.</li><li><strong>Addressing asthma disparities in children.</strong> The NHLBI is supporting clinical trials to evaluate asthma programs that provide comprehensive care for children at high risk of poor asthma outcomes. This includes children in rural areas.</li><li><strong>Studying sleep deficiency and sleep disorders to reduce health disparities. </strong>Researchers are working to better understand disparities in sleep health and how they might be contributing to health disparities in other diseases, such as cardiovascular disease, obesity, and diabetes.</li></ul></div> </div> <div class="readMoreContainer"> </div> </div> </div> </div> </div> </div> </div> </div> <div class="pale-blue-darker-white-background"> <div class="responsive-container responsive-container-constrained"> <div class="content-container advancing-the-research"> <h2 id="advancingresearch">Advancing the Research</h2> <div class="field field--name-field-sub-category field--type-entity-reference-revisions field--label-hidden field__items"> <div class="paragraph paragraph--type--sfa-sub-category paragraph--view-mode--default"> <div class="field field--name-field-sfa-card field--type-entity-reference-revisions field--label-hidden field__items"> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-branch-lab"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">We Perform Research</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>NHLBI’s <a href="/about/scienfic-divisions/division-intramural-research">Division of Intramural Research (DIR)</a> focuses on health disparities by using basic science findings to develop community-based approaches to help prevent obesity, heart attacks, and strokes in racially diverse populations. DIR researchers in <a href="/science/social-determinants-obesity-and-cardiovascular-risk">Social Determinants of Obesity and Cardiovascular Risk Laboratory</a> are exploring inequities among different populations.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-branch-lab"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">We Fund Research</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The research we fund today will help reduce the Nation’s health disparities and inequities. The NHLBI’s <a href="/about/scienfic-divisions/center-translation-research-and-implementation-science">Center for Translation Research and Implementation Science (CTRIS)</a> plans, fosters, and supports research to identify the best strategies to implement evidence-based interventions in the United States and abroad. CTRIS’s <a href="/node/80009">Health Inequities and Global Health Branch</a> is the NHLBI’s main source for guidance on domestic and global health inequities implementation research. Other <a href="/about/scientific-divisions">NHLBI Divisions</a> also support research to address health disparities.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-programs"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">The Promise of Precision Medicine </div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>Through NHLBI’s <a href="/science/trans-omics-precision-medicine-topmed-program">Trans-Omics for Precision Medicine (TOPMed)</a> program, researchers will use data from studies focused on heart, lung, blood and sleep disorders to better predict, prevent, diagnose, and treat diseases based on a patient’s unique genes, environment, and molecular signatures, which can help address health disparities. Learn more about NHLBI <a href="/science/precision-medicine-activities">precision medicine activities</a>.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-pivotal-trial"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Improving the Heart Health of African Americans</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The <a href="/science/jackson-heart-study-jhs">Jackson Heart Study</a> is the largest investigation of causes of cardiovascular disease in African Americans, involving more than 5,300 men and women in Jackson, Mississippi. The goal of the study is to investigate genetic and environmental factors to understand how African Americans are disproportionately affected by cardiovascular diseases, especially high blood pressure, coronary heart disease, heart failure, stroke, and peripheral arterial disease.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-pivotal-trial"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Learning about the Health of American Indians</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The <a href="/science/strong-heart-study-shs">Strong Heart Study</a> is a study of cardiovascular disease and its risk factors among American Indian men and women and is one of the largest epidemiological studies of American Indians ever undertaken. The study has identified several risk factors that may account for the high rates of heart disease in the American Indian population, including having type 2 diabetes, high blood pressure, or high cholesterol, as well as engaging in smoking.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-pivotal-trial"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Identifying Strategies to Enhance Hispanic and Latino Health</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The <a href="/science/hispanic-community-health-studystudy-latinos-hchssol">Hispanic Community Health Study/Study of Latinos (HCHS/SOL)</a><span> is the most comprehensive study of Hispanic/Latino health and disease in the United States. The goals of the study are to describe the prevalence of selected chronic diseases, especially heart and lung conditions; the risk and protective factors associated with these conditions; and the relationship between the initial health profiles and future health events in a diverse cohort of Hispanics and Latinos.</span></p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-pivotal-trial"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Studying Diverse Populations to Prevent Cardiovascular Disease</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The <a href="/science/multi-ethnic-study-atherosclerosis-mesa">Multi-Ethnic Study of Atherosclerosis (MESA)</a> is a medical research study that looks at early, or subclinical, atherosclerosis, a disease in which plaque builds up inside the arteries. <span>Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. MESA researchers study a diverse, population-based sample of more than 6,800 men and women who had no signs of cardiovascular disease at enrollment and were aged 45 to 84.</span></p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-consortium"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Reducing Asthma Disparities</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The goals of the <a href="https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001123.v2.p1" rel="noreferrer">Consortium on Asthma among African-Ancestry Populations in the Americas (CAAPA)</a> are to discover genes that confer asthma risk among individuals of African ancestry and to study genetic diversity in populations of African descent. Among people with asthma, people of African descent tend to have more severe asthma than people of European descent. The CAAPA project has sequenced over 1,000 genomes from a population of African-ancestry individuals living in North and South America, the Caribbean, and Africa.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-consortium"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Increasing the Diversity of Our Scientific Workforce</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>The <a href="/node-general/programs-increase-diversity-among-individuals-engaged-health-related-research-pride">Programs to Increase Diversity among Individuals Engaged in Health-Related Research (PRIDE)</a> is an all-expense-paid Summer Institute that seeks to address new researchers’ difficulties in establishing academic research careers. The program seeks to increase the number of scientists from backgrounds currently underrepresented in the biomedical sciences and those with disabilities by preparing them to compete for research funding in heart, lung, blood, and sleep disorders.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-consortium"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Resources to Reduce Health Disparities</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>NHLBI developed science-based, culturally appropriate <a href="https://www.nhlbi.nih.gov/education/heart-truth/CHW" rel="noreferrer">community health worker health education materials</a> to reduce health disparities in heart disease among underserved and minority communities. Available resources include community health worker manuals, tip sheets, picture cards, and more.</p></div> </div> </div> </div> <div class="field__item"> <div class="science-instance-card"> <div class="field field--name-field-icon field--type-list-string field--label-hidden field__item"> <div class="card-icon"> <div class="card-icon-programs"></div> </div> </div> <h3> <div class="field field--name-field-card-title field--type-string field--label-hidden field__item">Global Research on HIV</div> </h3> <div class="bodytext"> <div class="field field--name-field-description field--type-text-long field--label-hidden field__item"><p>Researchers from African and American universities are working together with governments, community partners, and health facilities on cardiovascular disease initiatives for people living with HIV in six African countries through the <a href="https://www.hlbsimple.org/" rel="noreferrer">HLB-SIMPLe</a> (<strong>H</strong>eart, <strong>L</strong>ung, and <strong>B</strong>lood Co-morbiditie<strong>S Imple</strong>mentation Models in People Living with HIV) global research alliance.</p></div> </div> </div> </div> </div> </div> </div> <a class="viewmorebutton" href = "/science/all-science?field_related_sfas_target_id=80046" >View all science about Health Disparities and Inequities </a> </div> </div> </div> <a id="relatedreading"></a> <div class="responsive-container responsive-container-constrained"> <div class="content-container-margin"> <div class="related-ht-press-container"> <div class="card"> <h2>Related Health Topics</h2> <div class="related-topics"> <div class="field field--name-field-related-health-topics field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/health/asthma" hreflang="en">What Is Asthma?</a></div> <div class="field__item"><a href="/health/copd" hreflang="en">What Is COPD?</a></div> <div class="field__item"><a href="/node/92320" hreflang="en">High Blood Pressure</a></div> <div class="field__item"><a href="/health/overweight-and-obesity" hreflang="en">What Are Overweight and Obesity?</a></div> <div class="field__item"><a href="/health/sleep-deprivation" hreflang="en">What Are Sleep Deprivation and Deficiency?</a></div> <div class="field__item"><a href="/health/stroke" hreflang="en">What Is a Stroke?</a></div> </div> </div> </div> </div> </div> </div> <div class="tertiaryBlueBackground"> <div class="responsive-container responsive-container-constrained"> <div class="content-container-margin"> <div class="field field--name-field-related-news-single field--type-entity-reference field--label-hidden field__item"> <h2><div class="whitesubhead font-size-l"> RELATED NEWS </div></h2> <article class="featured-science-instance-teaser-container node node--type-press-release node--view-mode-featured-science-instance-teaser"> <div class="flexItemImageThird"> <div class="image-and-photocredit-container"> <div class="field field--name-field-hero-image field--type-image field--label-hidden field__item"> <img loading="lazy" src="/modules/custom/nhlbi_blazy/images/clear.png" width="768" height="432" alt="Diagram illustration of Peripheral arterial disease" data-src="/sites/default/files/styles/16x9_crop/public/2019-01/PAD.jpg?h=b389e315&itok=NOzdkumU" class="b-lazy image-style-_6x9-crop" /> </div> </div> </div> <div class="flexTextWithImage flexItemText"> <div class="font-size-l bannerdate"> <time datetime="2019-01-23T11:00:00Z" class="datetime"><span>January 23, 2019</span></time> <div class="paddedBar"> | </div> <div class="field field--name-field-article-type field--type-entity-reference field--label-hidden field__item">News Release</div> </div> <div class="herobannertitle" > <a href="/news/2019/smoking-linked-higher-risk-peripheral-artery-disease-african-americans" rel="bookmark"> <span>Smoking linked to higher risk of peripheral artery disease in African-Americans</span> </a> </div> <div class="bodytext"> <div class="field field--name-field-additional-introduction field--type-text-long field--label-hidden field__item"> <p><span><span><span><span>African-Americans who smoke appear to be at greater risk for peripheral artery disease, or PAD, new research has found. 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