Office of the Scientific Director

美国健康差异负担项目。在2019财年，NIMHD启动了一项具有里程碑意义的合作研究，名为“全球疾病负担美国健康差异”，并继续与承包商健康评估与评估研究所合作，以产生按种族/民族，SES，性别和年龄分层的美国县级疾病负担估计值。NIMHD致力于编制一份关于美国疾病负担状况的综合报告，按种族/民族、性别、教育、年龄和地点对健康状况指标和风险因素的模式进行详细评估，并提供一个公共平台供下载数据和数据可视化。NIMHD和美国健康差异负担工作组（来自多个NIH研究所和中心的代表）一直在指导承包商的工作。 在2023财年，NIMHD开始更新和建立综合数据库，以研究美国20年来的县级发病率和死亡率，并评估年龄、性别、种族和民族之间的差异。目前的合同将允许IHME产生疾病发病率的措施（例如，由于残疾而失去的健康寿命年数），继续更新新发布的数据和方法，将亚洲人和夏威夷土著人/太平洋岛民分为单独的种族群体，并将多种族群体添加到所有分析中。IHME还将生成和分析健康的社会决定因素的个人和社区措施（例如，教育程度、环境暴露）和其他风险因素（例如，肥胖症），以确定导致发病率和死亡率的种族-民族差异的机制。对SDOH的地理差异和差异的评估将有助于确定可作为干预目标的社区和地区。 该项目还旨在按种族、民族和教育程度估计美国县一级至少四项其他健康指标。研究人员正在努力计算寿命损失年数（YLLs，或因过早死亡而损失的年数），残疾生活年数（YLDs，或未完全健康的年数），残疾调整寿命年数（DALs，或YLLs和YLDs之和）和健康预期寿命（黑尔，或考虑死亡率和非致命性结果的预期寿命指标）。我们还估计了某些疾病的患病率和发病率;暴露于高空腹血糖、高收缩压和高体重指数等风险;以及这些风险因素的人群归因分数。由于该项目结果的规模和维度的增加，研究人员必须修改现有计算框架的关键组件，以在县一级生成这些汇总指标。 NLM在MeSH上的协作。NIMHD继续建设其能力，并利用NIH范围内的设施和合作，以推进对NIH健康差异和少数民族健康的研究。该机构与美国国家医学图书馆（NLM）合作，批准增加80个术语和概念，以及24个与健康的社会决定因素（SDOH）相关的新医学主题词（MeSH），并于2021年11月上市。在2023财年，我们最终确定了NLM在MeSH系统中实施的种族、民族、原籍国和人口组的描述符列表。 人员的在2023财年，我们聘请了一位新的工作人员助理肯尼迪·鲍恩。她监督项目活动，确定优先事项，并提供援助，协调和后续行动，以确保该司朝着NIMHD使命的进展。她还在校内研究部门内制定了NIMHD政策的SOP以及流程和程序。 NIH健康差异兴趣小组和NIMHD研讨会。NIMHD为健康差异利益集团提供财政和行政支持。在2023财年，NIMHD在每个月的第二个星期二举办了4次健康差异兴趣小组研讨会和6次健康差异研讨会。研讨会可通过NIH视频广播，以增加内部和外部感兴趣的团体对研讨会系列的访问。演示者的例子如下。 标题：怀孕：解决整个生命过程中健康不平等问题的窗口 介绍者：Claire E. Margerison，博士，副教授，流行病学与生物统计学系，密歇根州立大学 优势，社区和框架，以促进美国印第安人和阿拉斯加原住民健康公平 演讲者：Katie Schultz，博士，MSW，社会工作副教授，密歇根大学 标题：“在肥胖预防框架（GTE）中实现公平"：早期经验和潜在的下一步 演讲者：Shiriki Kumanyika，博士，公共卫生硕士，宾夕法尼亚大学佩雷尔曼医学院流行病学名誉教授

U.S. Burden of Health Disparities Project. In FY 19, NIMHD DIR launched a landmark collaborative study called the Global Burden of Disease U.S.Health Disparities and continues to work collaboratively with the Contractor, Institute of Health Metrics and Evaluation, to produce U.S. county-level estimates of the burden of disease stratified by race/ethnicity, SES, sex, and age. NIMHD DIR seeks to produce a comprehensive report on the state of the U.S. burden of disease, providing detailed assessments of patterns of health status indicators and risk factors by race/ethnicity, sex, education, age, and location, with a public platform for downloading the data and data visualizations. NIMHD DIR and the U.S. Burden of Health Disparities Working Group (with representation from multiple NIH Institutes and Centers) have been guiding the work of the Contractor. During FY23, NIMHD began updating and building upon comprehensive database to study county level morbidity and mortality in the United States over a 20-year period, and assess differences across age, sex, and race and ethnicity. The current contract will allow IHME to generate measures of disease morbidity (e.g., years of healthy life lost due to disability), continue to update with newly released data and methodology, separate Asian and Native Hawaiian/Pacific Islander into separate racial groups and add multiracial group to all analyses. IHME will also generate and analyze individual and neighborhood measures of social determinants of health (e.g., educational attainment, environmental exposures) and other risk factors (e.g., obesity) to identify mechanisms that lead to racial-ethnic disparities in morbidity and mortality. Assessments of geographic variation in SDOHs and disparities will allow for the identification of communities and areas that could be targeted for intervention. The project also aims to estimate at least four other summary measures of health at the US county level by race and ethnicity and education. Researchers are hard at work computing years of life lost (YLLs, or years lost due to premature mortality), years lived with disability (YLDs, or years lived in less than full health), disability-adjusted life years (DALYs, or the sum of YLLs and YLDs), and healthy life expectancy (HALE, or a measure of life expectancy that considers mortality and nonfatal outcomes). We are also estimating prevalence and incidence of select diseases; exposure to risks like high fasting plasma glucose, high systolic blood pressure, and high body mass index; and the population attributable fractions for those risk factors. Due to the increased scale and dimensions of results for this project, researchers must modify key components of the existing computational framework to produce these summary metrics at the county level. NLM Collaboration on MeSH. NIMHD DIR continues to build its capacity and leverage NIH-wide facilities and collaborations to advance research on health disparities and minority health at NIH. DIR worked with the National Library of Medicine (NLM) to obtain approval to add 80 terms and concepts, and 24 new Medical Subject Headings (MeSH) related to social determinants of health (SDOH), which became available November 2021. During FY23, we finalized the list of descriptors for race, ethnicity, country of origin, and population groups for NLM to implement into the MeSH system. Personnel. During FY 23, we hired a new staff assistant, Kennedy Bowen. She monitors program activities, sets priorities, and provides assistance, coordination, and follow-up to ensure the Division's progress toward the NIMHD mission. She also worked on developing the SOPs and process and procedure of the NIMHD policy within the division of intramural research. NIH Health Disparities Interest Group and NIMHD DIR Seminars. NIMHD DIR provides financial and administrative support to Health Disparities Interest Group. During FY23, NIMHD DIR hosted 4 Health Disparities Interest Group Seminar and 6 DIR seminars on every 2nd Tuesday of each month. The seminars are available via NIH video cast to increase access to the seminar series for both internal and external interested group. Examples of presenters are below. Title: Pregnancy: A Window to Address Health Inequities Across the Lifecourse Presenter: Claire E. Margerison, PhD, Associate Professor, Department of Epidemiology & Biostatistics, Michigan State University Title: Strengths, Community, and Frameworks to Advance American Indian and Alaska Native Health Equity Presenter: Katie Schultz, PhD, MSW, Associate Professor of Social Work, University of Michigan Title: The "Getting-to-Equity in Obesity Prevention Framework (GTE)": Early Experience and Potential Next Steps Presenter: Shiriki Kumanyika, PhD, MPH, Professor Emerita of Epidemiology, University of Pennsylvania Perelman School of Medicine