>> GOOD DAY, EVERYONE.
WELCOME.
I'M DR. MONICA WEBB HOOPER,
ACTING DIRECTOR OF THE NATIONAL
INSTITUTE ON MINORITY HEALTH AND
HEALTH DISPARITIES.
LET ME WELCOME YOU TO THE 69th
MEETING OF THE NATIONAL ADVISORY
COUNCIL ON MINORITY HEALTH AND
HEALTH DISPARITIES MEETING,
OFFICIALLY HITTING THE GAVEL TO
CALL THE MEETING TO ORDER.
AND I WILL NOW TURN IT OVER TO
DR. PAUL COTTON.
>> THANK YOU VERY MUCH.
GOOD MORNING.
TODAY'S SESSION OF THIS MEETING
IS OPEN TO THE PUBLIC, BEING
BROADCAST ON NIH VIDEOCAST
NETWORK.
COUNCIL MEMBERS, PLEASE SPEAK
SLOWLY AND DISTINCTIVELY WHEN
YOU'RE REQUESTED OR CALLED ON TO
SPEAK.
THE VIDEOCAST OBSERVERS,
TECHNICAL STAFF AND NOTE TAKERS
WILL BE LISTENING TO NOTE YOUR
COMMENT.
NO NEED TO ASK IF YOU'RE BEING
HEARD.
AFTER YOU'RE RECOGNIZED TO
SPEAK, I WILL PROMPT YOU IF
THERE ARE AUDIO PROBLEMS.
IN AN EFFORT TO CONSERVE
INTERNET BANDWIDTH AND MINIMIZE
BACKGROUND NOISE, I WILL LEAD A
ROLL CALL, PLEASE TURN ON YOUR
CAMERAS, UNMUTE, INTRODUCE
YOURSELF
MAKE A BRIEF STATEMENT,
INSTITUTION, ROLL.
FOLLOWING, TURN OFF YOUR CAMERA,
I WILL MOVE TO THE NEXT PERSON.
SO, I WILL AGAIN THE ROLL CALL.
DR. ADUNYAH.
>> GOOD MORNING, SAMUEL ADUNYAH,
PROFESSOR AND CHAIRMAN OF
DEPARTMENT OF BIOCHEMISTRY,
CANCER BIOLOGY, NEUROSCIENCE AND
PHARMACOLOGY AT MEHARRY MEDICAL
COLLEGE, GLAD TO BE HERE.
>> GOOD MORNING, VALARIE BLUE
BIRD JERNIGAN, PROFESSOR AT
OKLAHOMA STATE UNIVERSITY,
CENTER FOR HEALTH SCIENCES,
WHERE I DIRECT CENTER FOR
INDIGENOUS HEALTH RESEARCH AND
POLICY.
>> DR. BAUERMEISTER.
>> GOOD MORNING, PROFESSOR,
UNIVERSITY OF PENNSYLVANIA, GLAD
TO BE HERE.
>> DR. STONE.
DR. STONE, ARE YOU STILL WITH
US?
I SEE YOU.
YOU'RE NOT -- YOU'RE MUTED IF
YOU'RE SPEAKING.
PLEASE UNMUTE YOURSELF.
WE WILL COME BACK TO DR. STONE.
SHE'S IN THE ROOM.
SHE MAY BE HAVING TECHNICAL
DIFFICULTIES.
>> DR. COTTON, I'M PRESENT.
THANK YOU, YES, I'M HAVING
TECHNICAL DIFFICULTIES, I
APPRECIATE IT.
MY APOLOGIES.
>> WE KNOW THINGS DO HAPPEN.
WE'VE DONE THIS A TIME OR TWO.
DID ANYONE LET IN DR. PENEDO?
OKAY.
AND I KNOW THERE ARE SIMONI IS
HERE.
>> I'M IN TRANSIT, I'LL BE ON A
PLANE FORE FOR PART OF THE
MEETING, ASSOCIATE DIRECTOR FOR
BEHAVIORAL AND SOCIAL SCIENCES
AT NIH, DIRECT THE OFFICE FOR
BEHAVIORAL AND SOCIAL SCIENCES.
>> WE'LL CIRCLE BACK FOR AN
INTRODUCTION LATER UPON THE
ARRIVAL OF OUR OTHER EX OFFICIO
AND VOTING COUNCIL MEMBER.
WE'RE GOING TO GO WITH STAFF IN
THE ROOM.
WE'RE GOING TO START.
>> I'M MARISA VILLASANTA, AT
NIMHD, NICE TO BE HERE.
>> DR. DOSS.
>> RENA DOSS, INTEGRATIVE AND
BEHAVIORAL SCIENCES.
>> REBECCA CORELEO, DIRECTOR OF
OFFICE OF SCIENCE POLICY,
PLANNING, EVALUATION AND
REPORTING AT NIMHD.
>> WE ALSO HAVE DR. STIMSON,
WHEN HE STEPS BACK IN WE'LL HAVE
HIM INTRODUCE HIMSELF.
AND HERE HE COMES RIGHT ON CUE.
>> HI, NATHAN STIMSON, DIRECTOR
OF COMMUNITY HEALTH AND
POPULATION SCIENCE AT NIMHD.
>> DID I MISS ANYBODY?
IF I DID, IT'S NOT INTENTIONAL.
AND.
>> I THINK YOU MIGHT HAVE MISSED
ME, I'M PROFESSOR OF POPULATION
HEALTH IN THE DEPARTMENT OF
POPULATION HEALTH AT NYU.
>> RIGHT, I CHECKED YOU OFF
BECAUSE I SAW YOU, I APOLOGIZE
FOR THAT AGAIN.
NEVER MISS YOU ON PURPOSE.
AND WE HAVE COMPLETED OUR --
>> I DON'T KNOW, DR. COTTON, IF
YOU WANT ME TO INTRODUCE MYSELF
MARGARITA ALEGRIA, PART OF THE
PRESENTERS BUT NOT PART OF THE
COUNCIL.
>> AND, YES, YOU CAN.
>> MARGARITA ALEGRIA, CHIEF OF
THE DISPARITIES RESEARCH UNIT AT
MASS GENERAL HOSPITAL.
THANKS FOR HAVING ME HERE.
>> THANK YOU FOR JOINING US FOR
THIS PRESENTATION THAT WE WILL
HAVE MOMENTARILY.
WE'RE FOUR MINUTES AHEAD OF
SCHEDULE, UNUSUAL FOR ME.
MONICA, WOULD YOU LIKE TO GO
INTO THE PRESENTATION?
>> SURE.
HAPPY TO.
THANKS, DR. COTTON.
HAPPY TO HAVE OUR FIRST
PRESENTATION FROM OUR COUNCIL'S
WORKING GROUP, WHICH WAS
ESTABLISHED IN THE BEGINNING OF
2024, AND SPENT THE ENTIRE YEAR
WORKING ON A REVIEW OF OUR
EXTRAMURAL DIVISION OF COMMUNITY
HEALTH AND POPULATION SCIENCES.
AND THIS WORKING GROUP CONSISTS
OF MEMBERS OF THE NIMHD COUNCIL
AS WELL AS EXPERTS IN THE FIELD.
THESE ARE INDIVIDUALS WHO HAVE
BEEN LONG FUNDED BY NIH AND HAVE
DEEP EXPERTISE IN THIS AREA AND
HAVE ALSO RECEIVED FUNDING FROM
NIMHD, AND SO I'M DELIGHTED FOR
THEM TO HAVE THE OPPORTUNITY TO
SHARE THE SUMMARY OF THE WORK
THAT THEY EMBARKED UPON AS A
GROUP, AS A VERY ENGAGED GROUP
FOR THE ENTIRE 2024, AND THE
GOAL OF THIS REVIEW REALLY IS TO
THINK AHEAD, HELP THIS DIVISION
THINK ABOUT ITS WORK AND POINT
TO FUTURE DIRECTIONS WITH AN EYE
ON POTENTIAL OPPORTUNITIES BASED
ON WHAT HAS HAPPENED SO FAR.
THE TWO PRESENTERS FOR THIS
MORNING, YOU'VE BEEN INTRODUCED
TO.
OUR CO-PRESENTERS WILL BE DR.
MARGARITA ALEGRIA, ONE OF THE
CO-CHAIRS OF THIS COMMITTEE.
AND JOSE BAUERMEISTER, WHO IS
ONE OF OUR COUNCIL MEMBERS.
AND ALSO A MEMBER OF THIS
WORKING GROUP.
THE OTHER CO-CHAIR OF THIS
WORKING GROUP IS REVEREND DR.
KENDRICK CURRY, WHO SENDS
REGRETS, UNABLE TO BE HERE, I
SEND A SPECIAL AND HUGE THANK
YOU TO REVEREND CURRY FOR HIS
WORK.
HE'S A MEMBER OF OUR COUNCIL AS
WELL, AND FOR HIS WORK WITH THIS
WORKING GROUP.
SO, I WILL TURN IT OVER THEN TO
THE TWO PRESENTERS.
>> THANK YOU SO VERY MUCH.
I'M GOING TO GO AHEAD AND SHARE
OUR SLIDES.
COULD I GET CONFIRMATION THAT
YOU CAN SEE OUR SLIDES?
>> YES.
>> WONDERFUL.
SO, WE'RE GOING TO TAG TEAM THIS
PRESENTATION.
GOOD MORNING, EVERYONE.
IT'S A PLEASURE TO BE WITH YOU
TODAY.
DR. ALEGRIA AND I WILL BE
CHATTING ABOUT THE FINAL REPORT
OUT OF THE DIVISION.
I WANT TO BEGIN BY ACKNOWLEDGING
OUR CO-CHAIRS AND THE WORKING
GROUP MEMBERS FOR THEIR
COMMITMENT, CRITICAL INSIGHT,
UNWAVERING BELIEF THAT HEALTH
DISPARITIES RESEARCH MUST BE
ACCOUNTABLE TO ALL COMMUNITIES
THAT WE SEEK TO SERVE.
I ALSO WANT TO THANK THE NIH
STAFF WHO PROVIDED DATA AND
INSIGHT TO ACCOMPLISHTY WORK.
THE FUNCTIONAL STATEMENT EXAMINE
PUBLISHED FUNDING OPPORTUNITY
ANNOUNCEMENTS, COOPERATIVE
ALIGNMENTS AND TRAINING AWARDS,
EVALUATED ASSIGNMENT WITH THE
STATE OF THE SCIENCE AND NIMHD
STRATEGIC PLAN FROM 2021-2025,
TASKED WITH COMMITTING A REPORT
SUMMARIZING FINDINGS, RESEARCH
GAPS, PROPOSE RECOMMENDATIONS
REGARDING OPPORTUNITIES TO
ADVANCE STATE OF THE KNOWLEDGE,
INTERVENTIONS, TRANSLATION USING
COMMUNITY HEALTH AND POPULATION
SCIENCE APPROACHES.
AS DR. WEBB HOOPER NOTED, THE
PLEBSHIP INCLUDES SELECT COUNCIL
MEMBERS AS WELL AS EXPERTISE
FROM THE EXTRAMURAL COMMUNITY,
CHARGED WITH ADVISING COUNCIL
AND NIMHD DIRECTOR.
AT THE HEART WAS THE COMMUNITY
HEALTH AND POPULATION SCIENCE
GOALS, THREE-FOLD, TO IDENTIFY
EPIDEMIOLOGIC PATTERNS OF
DISEASE AND DISEASE RISK FACTORS
AND UNDERSTUDIED HEALTH
CONDITIONS IN POPULATIONS WITH
HEALTH DISPARITIES.
SECOND TO UNDERSTAND HOW FAMILY,
COMMUNITY, AND SOCIETAL LEVEL
FACTORS INFLUENCE PATTERNS OF
DISEASE RISK FACTORS, INCIDENCE,
QUALITY OF LIFE, MORBIDITY AND
MORTALITY AND LEVERAGING OF
TOOLS.
THIRD TO DEVELOP AND TEST
INTERVENTIONS DELIVERED IN
COMMUNITY SETTINGS OUTSIDE THE
HEALTHCARE SECTOR TO IMPROVE
HEALTH OF INDIVIDUALS, FAMILIES,
COMMUNITIES, AND POPULATIONS.
TO WHAT EXTENT IS THE DIVISION
ACTIVATING GOALS THROUGH
FUNDING, PARTNERSHIPS,
SCIENTIFIC PRIORITIES.
WE ASSESS ACTIVITIES BETWEEN
FISCAL YEAR 2018 AND 2023,
INCLUDING PROBLEMATIC GROWTH BUT
ALSO MAJOR CONTEXTUAL CHALLENGES
INCLUDING COVID PANDEMIC,
HEIGHTENED AWARENESS OF HEALTH
DISPARITIES, INCREASING CALL FOR
NEEDS OF SCIENCE TO BENEFIT ALL
POPULATIONS.
THE REPORT WAS GUIDED BY AN
IMPACT ASSESSMENT FRAMEWORK,
WHICH COVERED THE FOLLOWING
AREAS, WHICH WE'LL SPEAK OF
TODAY.
THOSE INCLUDE SCIENTIFIC
PRIORITIES AND FOCUS, RESEARCH
ALLOCATION, SCIENTIFIC IMPACT,
BREADTH OF THE PORTFOLIO ITSELF,
COLLABORATIONS AND PARTNERSHIPS,
OUTREACH AND COMMUNICATIONS,
CHALLENGES AND FUTURE
DIRECTIONS.
THIS WAS AN AMBITIOUS
UNDERTAKING, 13 MONTHS, BRINGING
PERSPECTIVES FROM MULTIPLE
INSTITUTIONS TO ASSESS
PERFORMANCE AND FUTURE
DIRECTION, WE REQUESTED
SUPPLEMENTAL DATA ON OUTREACH
AND PERFORMANCE MATRIX AND
CONDUCTED FIVE LISTENING
SESSIONS WITH INVESTIGATORS AND
PROGRAMMERS IS, SESSIONS WERE AN
HOUR, TRANSCRIBED AND ANALYZED
PROVIDING CONTEXT FOR THE
WORKING GROUP REVIEW.
IN TOTAL, THE WORKING GROUP
CONVENED OVER 17 VIRTUAL
MEETINGS OF THE FULL GROUP, 15
PLANNING SESSIONS BETWEEN THE
CO-CHAIRS, SYNTHESIZED COMPLEX
INFORMATION, CHALLENGING
ASSUMPTION, REFINED FRAMEWORK.
SUBGROUPS CONTINUED TO INTEGRATE
ASSESSMENTS IN INTEGRATED
FASHION.
ACROSS A 291 COMPETING RESEARCH
PROJECTS FUNDED BETWEEN FISCAL
YEARS 18 AND 23, THE DIVISION
CONTRIBUTED EXTENSIVELY TO SIX
OF THE NINE STRATEGIC PLAN
GROWLS BY BY FOLK -- GOALS BY
FOCUSING ON COMMUNITY
ENGAGEMENT.
THE DIVISION WAS FOCUSED ON
PROGRAMS EXPECTING AND REQUIRING
DIRECT ENGAGEMENT TO ENSURE
RESEARCH WAS CULTURALLY ALIGNED
AND COMMUNITY DIRECTED.
THAT COMMUNITY PARTNERS WERE
ENGAGED IN ALL PHASES OF
RESEARCH TO ENSURE FINDINGS AND
INTERVENTIONS WERE RELEVANT AND
SUSTAINABLE ACROSS OBJECTIVES.
WE WERE DEVELOPING INTERVENTIONS
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH, AND THERE WAS A
FOSTERING OF RESEARCH AND
INTERVENTIONS THAT ADDRESS
VARIOUS LEVELS OF INFLUENCE,
WHETHER INDIVIDUAL,
INTERPERSONAL, COMMUNITY, AND/OR
STRUCTURAL.
OVER THIS PERIOD, THE DIVISION
BUILT A RESEARCH PORTFOLIO
THAT'S NOT JUST SCIENTIFICALLY
ROBUST BUT DEEPLY RESPONSIVE TO
THE CAUSES OF HEALTH
DISPARITIES, DIVISION
PRIORITIZED COMMUNITY ENGAGED
RESEARCH, EPIDEMIOLOGY, REAL
WORLD INTERVENTIONS DESIGNED TO
SCALE AND SUSTAIN IMPACT.
THE MAJORITY OF FUNDED PROJECTS
TACKLED HELD AT THE INDIVIDUAL
AND COMMUNITY LEVELS, WITH 94%
ADDRESSING INDIVIDUAL FACTORS
AND 69% ON COMMUNITY INFLUENCES.
IMPORTANTLY, A GROWING SUBSET OF
WORK IS TURNING UPSTREAM
TARGETING BROADER SOCIAL
DETERMINANTS OF HEALTH INCLUDING
POLICY AND SYSTEM LEVEL DRIVERS.
IN TERMS OF DOMAINS, 85% OF THE
PORTFOLIO EXPLORED BEHAVIORAL
INFLUENCES, TWO-THIRDS ADDRESSED
SOCIAL AND CULTURAL FACTORS.
THE DYE DIVERSITY REFLECTED IN
THE DIVISION'S COMMITMENT TO
TACKLING DISPARITIES WAS NOTED
AS HIGHLIGHT BY THE WORKING
GROUP, ACKNOWLEDGING DIMENSIONS.
IN SHORT THE WORKING GROUP FINDS
THE PORTFOLIO WAS ASSIGNED TO
STUDY DISPARITIES AND ADDRESS
THEM HEAD ON.
OVER FIVE YEARS UNDER REVIEW
DIVISION REVIEWED MORE THAN
2,000 APPLICATIONS, MADE 291
AWARDS, WITH TOTAL INVESTMENT OF
$386 MILLION, THAT FUNDING
BREAKS DOWN TO INCLUDE $319
MILLION TO R01 AND U01
MECHANISM, $2 MILLION TO SMALLER
RESEARCH GRANTS LIKE R03 AND
R21, $17 MILLION TO CAREER
DEVELOPMENT AWARDS, AND $22
MILLION TO SBIRs AND STTRs.
OVER THE PAST FIVE YEARS, THE
DIVISION WAS THOUGHT TO HAVE
FIRMLY ESTABLISHED ITSELF AS A
NATIONAL LEADER IN ADVANCING
MINORITY HEALTH, REDUCING HEALTH
DISPARITIES THROUGH COMMUNITY
ENGAGED SCIENCE.
DIVISION WORK DOESN'T JUST
BENEFIT COMMUNITIES, IT
STRENGTHENS THE ENTIRE SYSTEM,
EVERY TIME WE LEARN FROM A
PROJECT, WE IMPROVE THE NATION'S
ABILITY TO RESPOND TO PANDEMIC,
CHRONIC ILLNESS, FUTURE HEALTH
THREATS.
THAT'S AN INVESTMENT IN ALL OF
US.
CRITICALLY, THE WORKING GROUP
FOUND THE DIVISION HAS
PRIORITIZED TRANSLATIONAL
IMPACTS.
LEADERSHIP DURING THE PANDEMIC,
VIA RADx AND CEAL DEMONSTRATED
AGILITY AND COMMUNITY TRUST.
COMPETING RESEARCH PROJECTS AND
SUBPROJECTS FOCUSED ON PROJECTS
EXPERIENCING HEALTH DISPARITIES
FOUND TO BE BROAD AND INCLUSIVE,
THAT INCLUDES STUDIES ON
DISPARITIES EXPERIENCED BY
RACIAL AND ETHNIC MINORITY
POPULATIONS, POPULATIONS WITH
LOW SOCIOECONOMIC STATUS AND
RURAL POPULATIONS.
AMONG THE R01 EQUIVALENT
APPLICATIONS, 25% FOCUSED ON LOW
SES COMMUNITIES, 18% ON RURAL
POPULATIONS, 89% ON RACIAL AND
ETHNIC MINORITY POPULATIONS.
THE WORKING GROUP ACKNOWLEDGE
THE COMPLEXITY AND RICHNESS OF
ONGOING WORK.
SCIENTIFIC IMPACT ISN'T ALWAYS
IMMEDIATE, ISN'T ALWAYS VISIBLE.
SOMETIMES THE MOST POWERFUL
EFFECTS ARE HAPPENING QUIETLY
LIKE HELPING LEADERS BUILD
HEALTHIER ENVIRONMENTS AND
CHANGE LIVES.
SCIENTISTS AND PROGRAM OFFICERS
ACKNOWLEDGED THAT SCIENTIFIC
IMPACT IS DIFFICULT TO MEASURE,
ESPECIALLY WHEN THE WORK IS
UNFOLDING ACROSS MULTIPLE
STUDIES, OUTCOMES, TIMEFRAMES.
AS NOTED IN THIS QUOTE, THE
CUMULATIVE IMPACT OF THE BODY OF
RESEARCH RATHER THAN A SINGLE
PUBLICATION OR PROJECT IS WHAT
SHIFTS PARADIGMS AND FORMS
POLICY AND TRANSFORMS LIVES.
WE HEARD THROUGH THE LISTENING
SESSIONS OUR CURRENT SYSTEMS
DON'T ALWAYS CAPTURE THE
COMPLEXITY WHEN PEOPLE REPORT
BACK ON THEIR PROJECTS.
STANDARD REPORTING MECHANISMS
OFTEN FALL SHORT IN BEING ABLE
TO PROVIDE SUFFICIENT
INFORMATION AROUND THE RICH
COMMUNITY ENGAGED WORK HAPPENING
AND OFTEN WE'VE ASKED TO
DEMONSTRATE OUTCOMES.
THE WORKING GROUP RECOMMENDS
ADDITIONAL EFFORTS BE UNDERTAKEN
TO BROADER DEFINITION OF IMPACT
ACROSS SCIENCE.
THAT INCLUDES DEVELOPMENT OF NEW
EVIDENCE-BASED INTERVENTIONS
CULTURALLY GROUNDED, INCLUDES
HOW COMMUNITIES PERCEIVE
RELEVANCE AND IMPORTANCE OF THE
WORK SO COMMUNITY PERCEPTION
ISN'T A PERIPHERAL BUT CORE TO
IMPACT.
WE DID HEAR CONTINUED CALL TO
ELEVATE COMMUNITY BASED
PARTICIPATORY RESEARCH, AND TO
RECOGNIZE THAT CBPR APPROACHES
ARE RIGOROUS AS A SCIENCE.
SO IF WE ARE SERIOUS ABOUT
HEALTH DISPARITIES RESEARCH OUR
MEASURES OF IMPACT MUST REFLECT
THESE APPROACHES AND VALUES.
FROM A PORTFOLIO PERSPECTIVE 40%
OF AWARDS FOCUSED ON COMMUNITY
BASED PREVENTION OR HEALTH
PROMOTION, 32% EPIDEMIOLOGIC,
16% EXAMINED POPULATION PATHWAYS
AND DETERMINANTS.
72% OF ALL AWARDS SOUGHT TO
ADVANCE SCIENTIFIC UNDERSTANDING
OF DISPARITIES AND 46% TESTED
INTERVENTIONS.
THIS SIGNALS ALIGNMENT BUT WE
CONTINUE TO SEE UNDERINVESTMENT
IN ENVIRONMENTAL POLICY AND
SYSTEMS RESEARCH.
THE DIVISION DESERVES HUGE
CREDIT FOR EXTENSIVE
COLLABORATIVE INFRASTRUCTURE, 30
NOTICE OF OPPORTUNITIES
CO-DEVELOPED WITH INSTITUTES AND
FEDERAL AGENCIES.
STAFF PARTICIPATED IN MULTIPLE
NIH-WIDE WORK GROUPS AND CO-LED
MAJOR INITIATIVES OVER THE
PERIOD.
ONE OF THE MOST INNOVATIVE
APPROACHES AS OBSERVED BY THE
WORKING GROUP WAS RECOGNIZING
SCIENCE DOESN'T LIVE ONLY IN
LABS.
IT LIVES IN COMMUNITIES.
BY PARTNERING WITH PEOPLE MOST
AFFECTED BY HEALTH DISPARITIES,
WE FOUND EVIDENCE OF CREATING
SOLUTIONS THAT ARE EFFECTIVE,
TRUSTED, ADOPTED, SUSTAINABLE.
IF YOU OR SOMEONE YOU LOVE FACED
BARRIERS TO CARRY BECAUSE OF
POVERTY, GEOGRAPHY, IDENTITY,
THIS DIVISION IS FUNDING
SCIENTIFIC CHALLENGES AND
CHANGES THOSE CONDITIONS.
DIVISION-LED WORKSHOPS WERE WIDE
RANGING, OVER 20 FORUMS ACROSS
TOPICS WERE OBSERVED.
WE ALSO WANT TO COMMEND THE
DIVISION GROWTH AND DIGITAL
OUTREACH WITH WEB TRAFFIC AND
SOCIAL MEDIA ENGAGED INCREASING
SINCE 2022.
INTERESTINGLY, WHEN WE THINK
ABOUT DISSEMINATION OF
SCIENTIFIC WORK WE FOUND THAT
PROJECTS SUPPORTED BY THE
DIVISION PRODUCED 1400
PEER-REVIEWED PUBLICATIONS, AND
TO NOTE THAT'S NOT JUST
PRODUCTIVITY, IT'S INFLUENCE.
FOR EXAMPLE, STUDIES FUNDED
THROUGH R01 EQUIVALENT GRANTS
AVERAGED 18 CITATIONS EACH, WELL
ABOVE THE NORM.
AND STRONG SIGNAL THESE FINDINGS
ARE BEING USED BY OTHER
RESEARCHERS.
NOTABLY CAREER DEVELOPE AND
SMALL BUSINESS GRANTEES
CONTRIBUTED HELPING GROWING
LEADERS AND INNOVATORS BUT THE
WORKING GROUP ACKNOWLEDGED THAT
WHAT MATTERS MOST ISN'T JUST
NUMBERS; IT'S THE SCIENCE THAT
IT REPRESENTS.
THESE ARE NOT THEORETICAL
EXERCISES.
THESE ARE EVIDENCE-BASED WORK
SCIENTISTS MAKE HEALTH CARE MORE
ACCESSIBLE, INTERVENTIONS MORE
GROUNDED AND OUTCOMES MORE
EQUIVALENT.
THIS IS THE KIND OF SCIENCE THAT
MOVES THE NEEDLE.
AND WE'RE PLEASED TO SEE IT.
I'M GROPING -- GOING TO PASS TO
DR. ALEGRIA TO ADDRESS
CHALLENGES AND RECOMMENDATIONS.
MAGGIE?
>> THANK YOU.
THIS IS THE WORK OF, AGAIN, A
WHOLE TEAM THAT WORKED ON THIS
FOR 13 MONTHS, SO I'M VERY
HONORED TO BE PRESENTING IT.
WE FOUND SOME CHALLENGES AND
ALSO WANTED TO TALK A LITTLE BIT
ABOUT FUTURE DIRECTIONS IN THE
SPIRIT OF HOW TO EVEN DO MORE
WITH A DIVISION THAT HAS BEEN,
AS YOU SAW, STELLAR WORK IN THE
PAST.
I THINK STILL THE DIVISION WE
FOUND FACES MANY CHALLENGES AND
BARRIERS.
ONE OF THE THINGS THAT WE
MENTIONED HERE IS THE LOCAL AND
INSTITUTIONAL BARRIERS TO DATA
SHARING THAT CAN REALLY IMPACT
HOW EFFICACIOUS IS THE
CROSS-SECTOR COLLABORATION AND
THE ABILITY TO ENSURE
CONFIDENTIALITY OF PARTICIPANT
DATA.
SO TRYING TO SEE WAYS OF SHARING
DATA STILL REPRESENTS AN
OBSTACLE.
WE FOUND DISPARITIES IN
PARTICIPATION OF INSTITUTIONS
WITH FEWER RESEARCH RESOURCES,
ESPECIALLY LESS RESOURCED
INSTITUTIONS, SO WE FOUND THAT
THERE IS MORE NEED TO TRY TO
BRING UP, YOU KNOW, INSTITUTIONS
THAT HAVE NOT HAD AN OPPORTUNITY
TO BE FUNDED, MAYBE THROUGH
OTHER MECHANISMS.
THERE'S A NEED FOR ALSO GREATER
UNDERSTANDING AND ACCEPTANCE OF
COMMUNITY-ENGAGED RESEARCH,
PARTICULARLY AT THE LEVEL OF
INSTITUTIONS, PROMOTIONS FOR
FACULTY, BECAUSE IT'S ONE OF THE
FUNDAMENTAL METHODOLOGIES THAT'S
NEEDED WITHIN OUR COMMUNITIES.
ALSO MAKING SURE THAT WE HAVE
REPRESENTATION OF MOST RELEVANT
SCIENTIFIC DISCIPLINES.
FOR EXAMPLE, MORE REPRESENTATION
OF PUBLIC HEALTH, MORE
REPRESENTATION OF ENVIRONMENTAL
SCIENCES, ECONOMICS, SOCIOLOGY,
AND DEMOGRAPHY TO ALSO RAMP UP
THE TYPES OF RESEARCH THAT COULD
BENEFIT.
NEXT.
AREAS OF FUTURE FOCUS FOR THE
DIVISION, WE'RE GOING TO MENTION
SOME OF THE ONES THAT WERE
GENERATED BASED ON THE LISTENING
SESSIONS AND ALSO ON THE REVIEW
OF THE DOCUMENTS.
IT WOULD BE BENEFICIAL TO
BROADEN THE RANGE OF
INSTITUTIONS LIKE WE SAID
BEFORE.
PARTICULARLY GRANTS FOCUSING --
OOPS.
SORRY, I LOST THE SIGNAL.
ON COMMUNITY HEALTH AND
POPULATION SCIENCE IN THESE
INSTITUTIONS.
SO MORE SUPPORT FOR LOW RESOURCE
INSTITUTIONED TO BE ABLE TO DO
THIS WORK.
WE THINK ABOUT THE DEVELOPMENT
OF HUMAN CAPITAL ENSURING THE
FIELD REFLECTS AND RESPONDS TO
THE POPULATION IT AIMS TO SERVE,
THAT WE WOULD WANT TO MAKE SURE
THAT WE'RE REPRESENTATIVE OF ALL
OF THOSE THAT WE WANT TO SERVE
AT THE COMMUNITY AND
INSTITUTIONAL LEVEL.
MAKING SURE THAT WE HAVE A
DEEPER UNDERSTANDING AND BROADER
ACCEPTANCE OF COMMUNITY-ENGAGED
RESEARCH IS SOMETHING WE HEARD
OVER AND OVER AGAIN ABOUT THE
IMPORTANCE OF MAKING SURE THAT
PEOPLE UNDERSTAND THAT THIS A
METHODOLOGY THAT IS VITAL TO
REALLY BE ABLE TO PROVIDE
RESOURCES AND PROVIDE, YOU KNOW,
MORE INFORMATION TO LOCAL
COMMUNITIES AND INSTITUTIONAL
SETTINGS.
AND THEN UNDERSTANDING THE
BENEFITS AND RISKS ASSOCIATED
WITH MACHINE LEARNING AND
ARTIFICIAL INTELLIGENCE WHILE
IMPROVING POPULATION HEALTH AND
REDUCING DISPARITIES.
WE NEED TO UNDERSTAND BETTER HOW
THEY CAN BE A BENEFIT OR RISK TO
OUR COMMUNITIES.
NEXT.
IN TERMS OF RESEARCH
REPRESENTATION, THERE WAS
DISCUSSION AND IMPORTANCE HOW WE
SHOULD BE DISAGGREGATING THE
DATA WITHIN HETEROGENEOUS
GROUPS, FOR EXAMPLE ASIAN
AMERICAN SUBGROUPS OR INDIGENOS
COMMUNITIES, PEOPLE FELT THIS
WAS A MISSED OPPORTUNITY TO
BETTER UNDERSTAND WHAT'S
HAPPENING IN TERMS OF MECHANISMS
OF DISPARITIES.
OUTREACH AND ENGAGEMENT OF LESS
RESOURCED INSTITUTIONS WAS AGAIN
A TOPIC, AS YOU SEE.
TRYING TO ADDRESS UNDERSTUDIED
AREAS IN RESEARCH, ONE AREA WE
FOUND LITTLE IN THE PORTFOLIO
WAS DISABILITY-FOCUSED RESEARCH,
STUDYING HEALTH OF PEOPLE WITH
MULTIPLE IDENTITIES.
IN TERMS OF CONTINUING TO INVEST
IN MECHANISMS AND STRATEGIES
THAT ACCELERATE SCIENTIFIC
IMPACT, WE WANTED TO SEE IF
THERE COULD BE MORE ON CREATING
PATHWAYS FOR TRANSING
INVESTIGATORS FROM SMALL
FEASIBILITY GRANTS LIKE R21s
TO LARGER COMPETITIVE GRANTS
LIKE R01s BECAUSE WE SAW SOME
GROUPS THAT ONLY WENT TO THE
R21s BUT THEN WE NEEDED TO
PROVIDE MORE SUPPORT FOR THE
R01s.
DEVELOPING FUNDING MECHANISMS
FOR LONG-TERM MAINTENANCE AND
ADOPTION OF SUCCESSFUL
INTERVENTIONS, ONE OF THE AREAS
WE WANT TO LOOK FOR MORE IS THE
IDEA TO MAKE SURE THAT PEOPLE
ARE NOT ONLY TESTING
INTERVENTIONS BUT ACTUALLY
ADOPTING THEM AND SUSTAINING
THEM AFTER THE RESEARCH HAS BEEN
GONE.
SO MORE APPROACHES AS
IMPLEMENTATION SCIENCE AND
SYSTEM SCIENCE IS NECESSARY.
ALSO TO ENCOURAGE NEW FUNDING
MECHANISMS TO PROMOTE THE
ADAPTATIONS OF EVIDENCE-BASED
INTERVENTIONS TO MEET THE UNIQUE
NEEDS OF POPULATIONS WITH HEALTH
DISPARITIES.
THERE NEEDS TO BE ADAPTATIONS OF
EVIDENCE-BASED INTERVENTIONS TO
MAKE SURE THEY WORK IN DIFFERENT
TYPES OF COMMUNITIES, DIFFERENT
ENVIRONMENTS, WITH DIFFERENT
POPULATIONS.
NEXT.
WE WANT TO ALSO STRENGTHEN
SCIENTIFIC COMMUNITY
PARTNERSHIPS, WE THINK THESE ARE
A STRONG WAY TO BRING EVIDENCE
TO COMMUNITIES.
ONE WAY TO SIMPLIFY THE SUBAWARD
PROCESS IS FOR COMMUNITY-BASED
ORGANIZATIONS TO REDUCE
ADMINISTRATIVE CHALLENGES,
PEOPLE COMPLAIN HOW DIFFICULT IT
WAS TO BILL, DO THE
ACCOUNTABILITY, SO WE NEED TO
PROVIDE FOR SUPPORT FOR
COMMUNITY PARTNERS.
WE NEED TO INCORPORATE
SUSTAINABILITY IN THE FUNDING
MODELS BECAUSE ONE OF THE
CONCERNS COMMUNITIES HAVE ARE
THE ISSUE OF JUST DOING THE
INTERVENTION, LEAVING, AND NOT
BEING ABLE TO SUSTAIN THE
INTERVENTION, ONCE THE RESEARCH
IS GONE.
WE ALSO WANT TO ENSURE BUDGET
TRANSPARENCY AND FLEXIBILITY,
AND MAKING SURE THAT WE GIVE
OPPORTUNITIES FOR COMMUNITY
PARTNERS IN FUNDED PROJECTS, SO
THEY HAVE THEIR VOICE BE
ELEVATED IN TERMS OF THE
RESEARCH THAT'S DONE.
INCREASING ALLOWABLE FUNDS FOR
PRE-DISSEMINATION ACTIVITIES
LIKE RELATIONSHIP BUILDING AND
COMMUNITY MOBILIZATION, GIVING
THAT IT'S IMPORTANT FOR OUR
COMMUNITIES TO REALLY HAVE THE
RESOURCES TO BUILD THE
INFRASTRUCTURE AND TO MOBILIZE
AND BE PART OF THE NOT ONLY
DECISION MAKING BUT ALSO THE
SOLUTION.
ENABLE COMMUNITY PARTNERS TO
LEAD SCALING AND DISSEMINATION
EFFORTS OF SUCCESSFUL
INTERVENTIONS.
THE SUPPORT FOR EARLY-STAGE
INVESTIGATORS, THERE WAS A LOT
OF DISCUSSION ABOUT MAKING SURE
THAT WE PROVIDE MENTORING
PROGRAMS AND ENHANCED SUPPORT
MECHANISMS TO MAKE SURE THAT OUR
EARLY-STAGE INVESTIGATORS ARE
SUPPORTED THROUGHOUT THE CASCADE
OF THEIR TRAJECTORY OF BECOMING
INDEPENDENT INVESTIGATORS.
THIS MEANS BUILDING PATHWAYS FOR
EARLY CAREER RESEARCHERS TO
MENTORSHIP PROGRAMS AND MAKING
SURE THAT WE DEVELOP INTENSIVE
OUTCOME-BASED TRAINING PROGRAMS
FOR THIS RESEARCH AT
LESS-RESOURCED INSTITUTIONS.
NEXT.
I THINK THIS IS MY LAST
RECOMMENDATION.
A KEY RECOMMENDATION FOCUSES ON
ENHANCING RESEARCH FOCUS,
FOSTERING COMMUNITY PARTNERSHIPS
AS WE DISCUSSED IN OUR PREVIOUS
SLIDE, ENSURING THE SCALABILITY
AND SUSTAINABILITY OF IMPACTFUL
INTERVENTIONS.
SO, ONE OF THE THINGS THAT WE
FELT IS AN UNDERSTUDIED AREA
BASED ON THE EXAMINATION OF THE
PORTFOLIO IS DATA SCIENCE AND
HEALTH DISPARITIES, BUT MORE
LOOKING AT THE DATA SCIENCES,
PRIORITIZING RESEARCH THAT IS
BASED ON COMMUNITY STRENGTH AND
ASSETS, NOT SO MUCH ON DEFICIT
MODELS.
SO THAT WE CAN LOOK AT LONG-TERM
SOLUTIONS, AND ALSO UNDERSTAND
WHERE THE COMMUNITY EFFECTS OF
ADVERSE SOCIAL DETERMINANTS,
MAKING SURE THAT WE IMPLEMENT
INTERVENTIONS TO ADDRESS
MULTI-MORBIDITY AND ADDRESSING
OVERLAPPING HEALTH AND SOCIAL
ISSUES THROUGH INTERDISCIPLINARY
STRATEGIES, LEVERAGE INNOVATIVE
METHODOLOGIES LIKE
IMPLEMENTATION SCIENCE, DIGITAL
PHENOTYPING, TO MAKE SURE THAT
-- AND SYSTEM SCIENCE TO MAKE
SURE THAT WE CAN BE CUTTING EDGE
IN TERMS OF IMPROVING THE
OUTCOMES.
AND THEN EMPHASIZING AGAIN CBPR
AS ONE OF OUR MAIN MECHANISMS TO
MAKE SURE THAT THE INFORMATION
STAYS AT THE LEVEL OF THE
COMMUNITY.
NEXT, LET ME SEE, THERE'S ONE
LAST ONE.
OKAY, WE NEED TO EXPAND FOCUS ON
REACHING, IMPLEMENTING, AND
DISSEMINATING THE SCIENCE.
ONE OF THE AREAS THAT WE WANTED
TO EMPHASIZE WAS HOW IMPORTANT
IT IS TO DO THE OUTREACH TO MAKE
SURE THAT THE INFORMATION THAT'S
GENERATED IS EFFECTIVELY
INTEGRATED INTO THE REAL WORLD
SETTINGS.
AND HOW TO HARNESS TECHNOLOGY
AND INNOVATION BY PARTNERING
WITH COMPANIES AND DATA
SCIENTISTS TO MAKE SURE THAT WE
ARE UP TO THE LATEST, APPLYING
ARTIFICIAL INTELLIGENCE, AND
MACHINE LEARNING, TO MAKE SURE
WE CAN UNCOVER HEALTH STRENGTHS,
PREDICT OUTCOMES, AND DEVELOP
CULTURALLY SENSITIVE TOOLS THAT
REDUCE DISPARITIES.
WE ALSO NEED TO COLLABORATE WITH
GENOMIC RESEARCH INSTITUTIONS
AND TELEHEALTH PROVIDERS TO MAKE
SURE THAT WE INTEGRATE PRECISION
MEDICINE AND DIGITAL HEALTH
SOLUTIONS.
AND FINALLY WE NEED TO INVEST IN
LONG-TERM, MULTI-GENERATIONAL,
AND CROSS-SECTOR APPROACHES TO
ADDRESS THE ROOT CAUSES OF
HEALTH DISPARITIES, WHILE
RECOGNIZING COMMUNITY STRENGTHS
AND ASSETS AS CORE TO THE
LONG-TERM HEALTH OUTCOMES.
LET ME SEE THERE'S ONE MORE.
NO THIS IS IT.
THANK YOU FOR THE OPPORTUNITY TO
PRESENT RESULTS, AND THANKS TO
THE DIVISION FOR BEING SUCH A
PARTNER IN BEING ABLE TO EXAMINE
ALL OF THE WORK THEY HAVE BEEN
DOING DURING THIS TIME.
THANK YOU.
>> THANK YOU SO MUCH.
JUMPING IN QUICKLY BEFORE YOU
OPEN IT UP, I WANT TO SAY TO THE
WORKING GROUP BEFORE YOU START
TAKING QUESTIONS AND THERE'S
DISCUSSION, JUST REALLY
EXPRESSING A HUGE THANK YOU.
I MEAN, VERY APPRECIATIVE OF THE
WORK.
AND THAT YOU WORKED ON FOR SO
LONG.
AND THIS IS REALLY AN IMPORTANT
OUTCOME.
YOU CAN SEE JUST BY -- THE
SLIDES ONLY CAPTURE PART OF IT,
COULDN'T CAPTURE EVERYTHING YOU
CAPTURED IN THE FULL REPORT BUT
THIS IS GOING TO BE SO
BENEFICIAL FOR NIMHD AS WE THINK
ABOUT NOT ONLY THIS DIVISION BUT
NIMHD OVERALL.
WE HAVE A LOT TO THINK ABOUT
BASED ON YOUR REVIEW AND YOUR
RECOMMENDATIONS SO I WANT TO
START WITH APPRECIATING THAT.
PAUL?
>> THANK YOU VERY MUCH.
WHAT WE'RE GOING TO DO NOW,
WE'RE GOING TO OPEN THE FLOOR TO
COUNCIL MEMBERS THAT MAY HAVE
QUESTIONS.
TURN YOUR CAMERA ON AND RAISE
YOUR HAND, OR PUT YOUR NAME IN
THE CHAT BOX.
THAT WAY I'LL KNOW THAT WE ARE
RESPONDING.
FIRST WITH THE HAND UP.
>> THANK YOU.
FIRST OFF, I WANT TO THANK DR.
ALEGRIA FOR BEING HERE.
LOVELY TO SEE HER TODAY, THIS
MORNING, AS PART OF THE
COMMITTEE TO PRESENT THE REPORT.
I WANT TO ECHO DR. HOOPERS'S
COMES, THANK THE COMMITTEE FOR
MAKING THIS EXTENSIVE REVIEW AND
ASSESSMENT.
CLEARLY THE DIVISION MADE A
TREMENDOUS IMPACT IN
ACCELERATING SCIENCE AND
RESEARCH TO REDUCE HEALTH
DISAPPEARANCE, DEVELOPING
EVIDENCE-BASED ACROSS
COMMUNITIES INCLUDING LOW INCOME
AND RURAL POPULATIONS AND OTHER
POPULATIONS EXPERIENCING HEALTH
DISPARITIES.
I THINK ONE DIFFICULT ASPECT OF
MEASURING BUT REALLY A TANGIBLE
IMPACT OF SUPPORTED RESEARCH IS
BUILDING TRUST IN SCIENCE, AND
ENSURING RELEVANCE OF END REACH
OF SCIENTIFIC BREAKTHROUGHS FOR
ALL COMMUNITIES ACROSS THE
COUNTRY.
I ALSO WANT TO UNDERSCORE THE
RECOMMENDATION IN TERMS OF NEED
TO STRENGTHEN AND EXPAND
OPPORTUNITIES FOR EARLY-STAGE
INVESTIGATORS TO CONDUCT
RIGOROUS COMMUNITY ENGAGED
RESEARCH, REAL CHALLENGES FOR
JUNIOR SCIENTISTS.
SO THINKING THROUGH WITH NIMHD
AND REALLY THE LARGER NIH ABOUT
WAYS TO CREATE INCENTIVES AT THE
INSTITUTIONAL LEVEL AT ACADEMIC
INSTITUTIONS TO ADVANCE THIS
RESEARCH AND SUPPORT
INVESTIGATORS, CAREERS IN
POPULATION HEALTH AND HEALTH
DISPARITIES RESEARCH IS VITAL TO
ENSURE WE HAVE A STRONG AND
SOLID WORKFORCE.
ONE ADDITIONAL RECOMMENDATION
WAS TOUCHED UPON, TO EXPAND THE
TIMELINE FOR THESE RESEARCH
GRANTS.
I THINK COMMUNITY ENGAGED
RESEARCH IS CHALLENGING.
YOU KNOW, WE'RE BOTH DEVELOPING,
MAINTAINING, SUSTAINING THOSE
RELATIONSHIPS WHILE WORKING IN
PARTNERSHIP WITH COMMUNITY
PARTNERS TO THINK THROUGH HOW TO
ENSURE THAT THE RESEARCH IS
COMMUNITY DRIVEN, THAT THE
FINDINGS HAVE RELEVANCE AND CAN
BE SUSTAINED OVER THE LONG TERM.
AND SO I KNOW THERE HAVE BEEN
STUDENTS TO EXPAND RESEARCH
TIMELINES BEYOND A THREE OR
FIVE-YEAR PERIOD, I WANT TO
UNDERSCORE THAT AS A KEY
RECOMMENDATION THINKING ABOUT
NEW OPPORTUNITIES AND NEW
RESEARCH AND UNDERSCORING NEED
FOR TRAINING PROGRAMS TO HELP
THE COMMUNITY AND TO HELP THE
DEVELOPMENT OF COMMUNITY ENGAGED
RESEARCH.
I WANT TO APPLAUD THE COMMITTEE
IN TERMS OF RECOGNIZING THE NEED
FOR APPLYING SYSTEMS SCIENCE,
ARTIFICIAL INTELLIGENCE, CAUSAL
INFERENCE AND OTHER DATA SCIENCE
METHODS AS PART OF THE PACKAGE
OF HOW DO WE, YOU KNOW, DO
HEALTH DISPARITIES RESEARCH
PARTICULARLY RESEARCH THAT
INTERSECT AT MULTIPLE LEVELS OF
INFLUENCE.
A SERIES OF COMMENTS, I WANT TO
THANK THE COMMITTEE FOR
RECOMMENDATIONS AND REVIEW AND
ALSO WANT TO ADD A FEW PLUGS IN
TERMS OF THE TIMELINE FOR DOING
GRANTS, WORKING WITH COMMUNITIES
IN DEVELOPING THE RESEARCH AND
NEED FOR MORE TRAINING PROGRAMS
TO HELP THE NEXT GENERATION OF
RESEARCHERS IN THIS FIELD.
THANK YOU.
>> THANK YOU, CHAU.
>> THANK YOU.
>> CAN'T HEAR YOU.
>> PAUL, YOUR VOLUME SEEMED A
LITTLE LOW.
>> IS THAT BETTER?
OKAY.
>> THIS IS SAMUEL ADUNYAH.
I WANT TO ADD MY VOICE AND
COMMENDING THE COMMITTEE
MEMBERS, OBVIOUSLY FOR STRONG
EVIDENCE OF COLLABORATIVE WORK
WHICH HAS PRODUCED THESE
RESULTS, AND THANK THE SPEAKERS
OR THE PRESENTERS FOR A
WONDERFUL JOB.
AND TO ALSO MENTION THE
COMMITTEE OBVIOUSLY LOOKS AT THE
HBCUS AND MINORITY-SERVING
INSTITUTIONS BECAUSE AS YOU KNOW
NOT EVERY -- IF YOU LOOK AT, FOR
EXAMPLE, THE UNIVERSITY FOCUSING
ON GRADUATE STUDENTS, IT'S VERY
IMPORTANT THAT THIS COMMITTEE
THEN PUTS ALL THOSE INTO
CONSIDERATION AND OBVIOUSLY ALSO
MAKING SURE THAT HEALTH
DISPARITIES CONTINUES.
AND THANK YOU VERY MUCH FOR THE
WONDERFUL JOB.
>> DR. STONE.
>> PAUL, WE CAN BARELY HEAR YOU.
>> DR. STONE?
>> THANK YOU, DR. COTTON.
I WANT TO COMMEND DR. ALEGRIA,
ALWAYS A PLEASURE TO HAVE YOU
LEAD AND DR. REVEREND CURRY AS
WELL.
AND JOSE, DR. JOSE BAUERMEISTER,
THANK YOU FOR JUMPING IN.
I REALLY APPRECIATE, I WANT TO
SAY YOUR COMMENT ON THE SCIENCE
DOESN'T ALWAYS LIVE IN LABS, BUT
IN COMMUNITIES, IS REALLY
TELLING.
I THINK THE FINDINGS CAME AT A
REALLY INSTRUMENTAL MOMENT FOR
US, AND THE INSIGHTS ON HOW FAR
WE HAVE COME IN THE ROLE OF
POPULATION HEALTH, COMMUNITY
HEALTH, POPULATION SCIENCE HAS
TAKEN OVER MANY DECADES, SPEAKS
TO, AS A COMMITTEE MEMBER
SERVING ON THIS, LISTENING
SESSIONS THERE WAS DEEPER
INSIGHT AND ALIGNMENT BETWEEN
THE NIH PROGRAM OFFICERS, EARLY
STAGE INVESTIGATORS AND LATER
STAGE SENIOR SCHOLARS.
IN TERMS OF AGREEING MORE TIME
IS NEEDED TO GENERATE THIS TYPE
OF WORK, TO MAKE TRUE IMPACT ON
REDUCING HEALTH DISPARITIES AS
YOU SAID, JOSE, MOVING THE
NEEDLE NOT JUST ON WORKFORCE
DEVELOPMENT, THE STATE OF
SCIENCE AND HEALTH DISPARITIES
AROUND THE ETIOLOGY AS WELL OF
THE SOLUTIONS.
I THINK BUILDING ON COMMUNITY
ASSETS.
ONE THING THAT WASN'T MENTIONED
BUT WORTH CONSIDERING THAT
I'M -- THAT'S BEING DISCOVERED
IN OUR COMMUNITY ENGAGEMENT
ALLIANCE WORK, WITH THE 21
STATES, IS IMPACT OF BUILDING
SCIENCE AND SCHOLARS WITH
COMMUNITY PARTNERS AS
CO-INVESTIGATORS AND PRINCIPAL
INVESTIGATORS.
THERE'S BEEN REALLY AN
UNCOVERING OF I WOULD CALL THE
BEAUTIFICATION OF SCHOLARS
UNFOLDING WITH PROMONTORAS,
PRINCIPAL INVESTIGATORS WHO
LAUNCHED MINORITY SERVING
CBOs, IN COMMUNITIES RURAL
FRONTIER AND TRIBAL WHERE
COMMUNITY-BASED ORGANIZATIONS
ARE NOT FLOURISHING BUT MOVING
TO LAUNCH LLCs AND
NON-PROFITS, FOR EXAMPLE THE AND
--
THE NAVAJO NATION, THE OTHER
IMPACT THAT GOES UNTOLD.
I JUST WANT TO MENTION THAT AS
POTENTIAL FUTURE DIRECTIONS.
AGAIN, I COMMEND, I'M SO
IMPRESSED WITH HOW THE FINDINGS
AND TAKEAWAYS YOU PRESENTED CAME
TOGETHER.
I'M GOING TO SAVOR THIS BECAUSE
I THINK IT SPEAKS TO POSITIVE
FUTURE OUTLOOKS AND DIRECTIONS,
AND THE FACT THAT WE HAVE BUILT
SO MANY DECADES OF WORK HERE
THAT CANNOT BE OVERSHADOWED
REGARDLESS OF ANY FUNDING
DIRECTIONS OR POLICY CHANGES.
THANK YOU.
>> THANK YOU.
>> ARE THERE ADDITIONAL
QUESTIONS??
>> I HAVE ONE, JUST IF YOU
MIGHT REFLECT, YOU KNOW,
MARGARITA, JOSE, AND OTHER
WORKING GROUP MEMBERS WHO ARE
PRESENT, ONE OF THE AREAS THAT
YOU SPENT A LOT OF TIME THINKING
ABOUT AND STRUGGLING WITH HOW TO
PRESENT, HOW TO REVIEW, WAS THE
IMPACT OF THE SCIENCE AND THE
DIVISION BECAUSE THE -- YOU
KNOW, WHEN YOU FUND A PROJECT,
IF IT'S A FIVE-YEAR PROJECT, IT
WILL BE YEARS, AT LEAST FIVE,
SIX, SEVEN YEARS, BEFORE YOU SEE
FOR EXAMPLE INTERVENTION STUDY
IN PRINT OR EVEN STUDIES THAT
MIGHT BE OBSERVATIONAL.
SO CAN YOU TALK ABOUT -- I THINK
IT WILL BE INFORMATIVE AS WE GO
FORWARD WITH REVIEWS FOR FUTURE
DIVISION HOW WE MIGHT THINK
ABOUT OUR IMPACT.
>> YEAH, ABSOLUTELY, VERY GLAD,
DR. HOOPER, THAT YOU ASKED THAT
BECAUSE ONE OF THE THINGS WE
DEFINITELY WOULD RECOMMEND IS
THAT THE FORMS THAT PEOPLE
REPORT ON BE BROADER THAN JUST
PUBLICATIONS AND GRANTS THAT
PEOPLE DO BUT ARE ACTUALLY, YOU
KNOW, RELATIONSHIPS WITH THE
COMMUNITY THAT THEY WOULD ADD ON
WITH THE IMPACT THAT'S BEEN DONE
ON THE IN THE COMMUNITY BECAUSE
WE HEARD IN THE LISTENING
SESSIONS HOW PEOPLE ACTUALLY --
LISA CACARI STONE MENTIONED
SOME, THERE ARE A LOT OF IMPACTS
PEOPLE TALK ABOUT HAVING THE
RESEARCH BEING PARTNERSHIP WITH
COMMUNITY SO I WOULD ADD MORE
INFORMATION ABOUT THAT.
I ALSO THINK IT WOULD BE IDEAL
TO COLLECT DATA, NOT ONLY AT THE
END OF THE FIVE OR SIX YEARS
THAT THIS STUDY IS RUN BUT MAYBE
ALSO ASKED TO COLLECT DATA AT A
LATER PERIOD OF TIME, IN SOME
INSTITUTIONS FOR EXAMPLE THEY
HAVE ACTUALLY BY ARTIFICIAL
INTELLIGENCE THEY ACTUALLY LOOK
AT THE PORTFOLIO OF
INVESTIGATORS AND THEN THEY
BRING UP ALL THE PUBLICATIONS
THAT HAVE BEEN DONE, AND I THINK
WE NEED TO DO MORE OF THAT, NOT
ONLY AT THE FIVE-YEAR END PERIOD
BUT ACTUALLY AT THE TEN-YEAR END
PERIOD BECAUSE A LOT OF THE
PAPERS COME OUT AFTER THE REPORT
HAS BEEN DONE AND WE MESS UP ON
THAT.
I THINK JOSE MENTIONED 17
PUBLICATIONS.
I THINK WOULD YOU HAVE A LOT
MORE OF THE PUBLICATIONS, AND A
LOT OF THE -- IT TAKES A YEAR AT
LEAST TO GET A GOOD PUBLICATION
OUT SO I THINK WE WOULD SEE A
LOT MORE PRODUCTIVITY.
AND FINALLY I THINK THERE'S A
LOT THAT COULD BE ALSO
COLLECTED, BASED ON PEOPLE'S
CAREER TRAJECTORIES.
I THINK WE DON'T HAVE ENOUGH
DATA COLLECTED AFTER PEOPLE HAVE
GONE THROUGH THE PROCESS ABOUT
THEIR CAREER TRAJECTORY BECAUSE
I MEAN WHEN I WAS IN COUNCIL I
SAW PEOPLE GO ALL THE WAY FROM,
YOU KNOW, OUR VERY R21s THAT
MOVED TO BECOME REALLY SENIOR
INVESTIGATORS, VERY SUCCESSFUL
AND WE DON'T CAPTURE THAT SO I
THINK WE NEED MORE OF THAT TO
SHOW THIS IS VERY WORTH THE
INVESTMENT.
>> THANK YOU.
THAT'S VERY HELPFUL.
>> I WILL JUMP IN AND JUST SAY
THAT ONE OF THE THINGS I TAKE
AWAY FROM LISTENING SESSIONS,
VERY RICH, NOT NIMHD SPECIFIC
BUT NIH SPECIFIC IN REPORTING,
IS THAT WE NOW HAVE A SECTION
FOR TECHNOLOGY BEING DEVELOPED
AS PART OF SPONSORED RESEARCH,
AND WHAT WE HEARD FROM BOTH
EARLY STAGE INVESTIGATORS AND
SEASONED INVESTIGATORS IS COULD
THERE BE A COMMUNITY IMPACT
SECTION FOR INVESTIGATORS TO
WRITE ON.
ARE SMALL BUSINESSES BEING
DEVELOPED, ARE THERE NEW
TECHNOLOGIES OR PROGRAMS BEING
DEVELOPED BY COMMUNITIES OWNED
BY THEM AND NOT -- KIND OF
ANCILLARY TO THE SCIENCE THAT'S
BEING DONE BUT IT EVOKES NEW
THINKING, NO PARTNERSHIPS, SO
HOW DO WE REALLY CAPTURE THE
FACT THE INVESTMENTS WE'RE DOING
THROUGH SCIENCE HAS SPILLOVER
EFFECTS TO BETTER ALL SORTS OF
COMMUNITIES THROUGHOUT THE
COUNTRY.
I'M TRYING TO THINK AS AN
INVESTIGATOR HOW I WOULD WRITE
THAT IN MY PROGRESS REPORTS
RIGHT NOW.
AS WE THINK ABOUT IMPACT THERE
ARE NON-SCIENTIFIC TANGIBLES
THAT HAPPEN WHEN WE INVEST IN
COMMUNITIES WE CAN DO A BETTER
JOB AT CAPTURING.
>> GREAT, THANK YOU.
SINCE I DON'T SEE ANYONE ELSE
I'LL JUMP IN WITH ANOTHER
THOUGHT.
I WANTED TO COMMEND YOU ON THE
APPROACH THAT YOU TOOK WITH THIS
REVIEW IN TERMS OF IT BEING VERY
MIXED METHOD.
SO YOU DID RECEIVE A LOT OF
INFORMATION IN TERMS OF NUMBERS
AND DATA FROM NIMHD AND NIMHD
STAFF AND OFFICES, BUT IT WAS
VERY IMPORTANT TO YOU, AND I
KNOW MAGGIE WAS A MAJOR CHAMPION
TO SAY WE NEED TO HEAR FROM
INVESTIGATORS WHO HAVE NIMHD
PROJECTS, TO HEAR ABOUT THEIR
PROJECTS, WHAT THEIR CHALLENGES
ARE, WHAT KIND OF WORK THEY ARE
FOCUSED ON, ITS IMPORTANCE AND
IMPACT, AND THEN YOU ALSO
LISTENED TO NIMHD STAFF IN THE
DIVISION.
SO I THINK THAT WAS A REALLY
IMPORTANT PART OF THE PROCESS,
AND SO I COMMEND YOU FOR
THINKING OF IT, AND WE WERE
HAPPY TO SUPPORT IT BECAUSE I
THINK THAT AS YOU MENTIONED,
JOSE, VERY RICH DISCUSSION THAT
ADDED CONTEXT, WHEN WE TALK
ABOUT MIXED METHODS RESEARCH
THESE ARE THE METHODS YOU APPLY
THROUGH THIS PROCESS AS WELL.
>> THANKS, MONICA.
IT WAS A REAL PLEASURE AND I
COULDN'T SAY HOW EXCITED THE
RESEARCHERS WERE THAT WE WERE
ASKED TO HEAR WHAT THEY HAD TO
SAY IN THOSE PRESENTING
SESSIONS.
SO PEOPLE WERE TAKING TIME OFF
AND SPENDING ENORMOUS AMOUNTS OF
TIME PARTICIPATING IN LISTENING
SESSIONS BECAUSE THEY
APPRECIATED WE WANTED TO HEAR
WHAT THEY HAD TO SAY.
>> ONE MORE AND I'LL STOP AND WE
CAN MOVE FOR THE COUNCIL TO VOTE
ON THE REPORT.
YOU GATHERED SO MUCH
INFORMATION.
IF YOU HAD TO MAKE -- IF YOU HAD
TO THINK ABOUT THE PRIORITY OF
THE RECOMMENDATIONS THAT YOU HAD
AND WHERE WE MIGHT START, WHERE
WE MIGHT THINK ABOUT BASED ON
THE MULTIPLE TYPES OF
RECOMMENDATIONS THAT YOU
OFFERED, COULD YOU THINK ABOUT
WHAT YOU MIGHT PRIORITIZE, WHAT
WE MIGHT PRIORITIZE AS THE FIRST
THING BASED ON YOUR REVIEW?
THAT'S A TOUGH QUESTION, I
REALIZE.
>> IT'S A REALLY TOUGH
QUESTIONS, IT'S LIKE WHICH OF
YOUR CHILDREN DO YOU LIKE THE
MOST.
BUT I WOULD SAY I WOULD INVEST
IN THE EARLY CAREER
INVESTIGATORS.
I THINK IT'S AN AREA THAT IS
SUFFERING BECAUSE OF SO MANY
THINGS, AND I THINK WE NEED TO
MAKE SURE THAT THE -- THAT WE
DON'T LOSE THE CADRE OF
INVESTIGATORS THAT ARE POISED TO
BE THE INHERITORS OF ALL OF THIS
WEALTH OF -- INTELLECTUAL
WEALTH, THAT WE DON'T LET THEM
FALL THROUGH THE CRACKS SO I
WOULD INVEST IN EARLY-CAREER
INVESTIGATORS, THAT WOULD BE MY
NUMBER ONE TOP CHOICE.
>> I WILL SECOND THAT, WITH AN
ADDENDUM, WHICH IS I THINK OF
EARLY STAGE INVESTIGATORS AS
INNOVATORS, AND SO MUCH OF WHAT
WE HEARD AROUND DATA SCIENCE,
ARTIFICIAL INTELLIGENCE, WILL
REQUIRE NEW VOICES AND
PERSPECTIVES, HOW TO MAKE SURE
WE'RE BRINGING COMMUNITY VOICE
INTO THE TECH SECTOR.
THAT BRIDGING OF MAKING SURE
THAT THERE ARE -- EVERYBODY IS
AROUND THE TABLE AS WE THINKING
ABOUT HUGE DATA STREAMS AND
WE'RE MAKING SENSE OF THESE NEW
ALGORITHMS WILL BE REALLY
IMPORTANT, SO FULLY AGREE WITH
DR. ALEGRIA BUT PLUGGING IN
TECHNICAL EXPERTISE ALSO ON DATA
SCIENCE AS A PRIORITY FOR ME.
>> AND I MEAN, I WOULD ADD MY
ADDENDUM WOULD BE TO MAKE SURE
THAT WE ARE EXPANSIVE ON THE
DISCIPLINES.
I THINK WE NEED TO BRING
BUSINESS PEOPLE WITH BUSINESS
ACUMEN.
I THINK WE NEED TO BRING PEOPLE
OF DEMOGRAPHY BECAUSE SO MUCH OF
THE DATA ON GEOGRAPHY IS SO
CENTRAL, SO I THINK WE NEED TO
EXPAND THE DISCIPLINES THAT HAVE
BEEN FUNDED AT NIMHD.
>> THANK YOU.
THANK YOU FOR THOSE SUGGESTIONS.
APPRECIATE THAT.
>> THANK YOU VERY MUCH FOR THE
PRESENTATIONS.
WE'RE GOING TO REQUEST THAT DR.
BAUERMEISTER THAT THE COUNCIL
ACCEPT THE REPORT OF THE WORKING
GROUP.
>> SO MOVED.
>> CAN I GET A COUNCIL MEMBER TO
SECOND?
>> SECOND IT.
>> THANK YOU VERY MUCH.
NOW, COUNCIL MEMBERS, IN YOUR
INFINITE WISDOM, IF YOU AGREE TO
THIS PLEASE TYPE Y OR YES IN THE
CHAT BOX.
AND OF COURSE YOU HAVE THE
OPPORTUNITY TO TYPE NO IF YOU DO
NOT ACCEPT THE REPORT.
SO, WE'LL GIVE YOU A FEW SECONDS
TO ENTER YOUR --
OKAY.
WE HAVE 100% AGREEMENT THAT THIS
WONDERFUL REPORT WILL BE
ACCEPTED BY THE COUNCIL, SO THE
WORK OF THIS PARTICULAR WORKING
GROUP IS DONE.
THANK YOU VERY MUCH.
WE'RE AHEAD OF TIME.
WHAT I WANT TO DO IS MAKE SURE
THAT COUNCIL MEMBERS KNOW ABOUT
OUR FUTURE DATES FOR COUNCIL
MEETINGS.
SEPTEMBER 5, 2025.
FEBRUARY 6, 2026.
MAY 19, 2026.
AND AUGUST 11, 2026.
AND AS YOU'RE AWARE, WE'D LIKE
YOU TO REVIEW THE DATES, MAKE
SURE YOU HAVE THEM AVAILABLE IF
AT ALL POSSIBLE AND COUNCIL
MEMBERS ARE ALLOWED TO HAVE ONE
ABSENCE PER CALENDAR YEAR, AND
AN INDIVIDUAL CANNOT SERVE ON
PEER REVIEW PANEL WHILE SERVING
AS A MEMBER OF COUNCIL.
WITH THAT, WE'RE ACTUALLY AT
11:00 A.M., WE'RE ABOUT 15
MINUTES AHEAD OF OUR NEXT
PRESENTER.
WE COULD EITHER JUMP RIGHT IN OR
WE CAN TAKE A 15-MINUTE BREAK.
I WILL LET THE PRESENTER MAKE
THAT DECISION.
>> I'M THE NEXT PRESENTER.
I AM READY OR WE CAN TAKE A
BREAK.
IT'S UP TO THE COUNCIL IF YOU
NEED A BREAK.
OTHERWISE WE CAN GO INTO -- I
CAN TELL YOU MY REPORT AND
DISCUSSION WILL NOT BE AN HOUR.
>> DO WE NEED A BREAK OR READY
TO MOVE FORWARD?
>> MOVE ON.
>> YEAH, MOVE FORWARD.
>> OKAY.
SO LET'S GET THE SLIDES UP.
>> GREAT.
SO THANK YOU, DR. COTTON.
AGAIN, THANKS TO THE WORKING
GROUP FOR THAT AMAZING WORK.
I ALSO WANT TO THANK EVERYONE
AGAIN FOR ATTENDING OUR MAY 2025
COUNCIL MEETING.
SO, FOR THE NEXT 20, 30 MINUTES
I WILL HIGHLIGHT A SELECT SET OF
ACTIVITIES AT NIH AND NIMHD OVER
THE PAST FEW MONTHS.
NEXT SLIDE.
THIS IS A BRIEF HISTORY OF
NIMHD.
I SHARE THIS TO MAKE TWO
OVERARCHING POINTS.
FIRST, WE RECENTLY ACHIEVED A
MILESTONE OF 15 YEARS AS AN NIH
INSTITUTE.
NIMHD STARTED AS AN OFFICE IN
1990, BECAME A CENTER IN 2000,
AND WAS ESTABLISHED AS AN
INSTITUTE IN 2010.
I THINK IT'S IMPORTANT TO
ACKNOWLEDGE THIS MILESTONE.
BUT REALLY 15 YEARS IS NOT A
LONG TIME.
MY OLDEST CHILD TURNED 14,
SEEMED LIKE HE GOT HERE
YESTERDAY.
RESEARCH INVESTMENTS HAVE
INCREASED OVER THE TIME IN THIS
AREA BUT THERE ARE BROAD
QUESTIONS THAT NEED TO BE
INVESTIGATED, MORE TO LEARN TO
UNDERSTAND MULTI FACETED NATURE
OF WHY HEALTH DISPARITIES
PERSIST ACROSS GENERATIONS AND
POPULATIONS, MOVING TO THE NEXT
PHASE WITH URGENCY, DETERMINING
WHAT WE CAN DO TO ADDRESS THEM
IN SUSTAINABLE WAYS.
NEXT SLIDE.
AND WITH THAT, OUR MISSION
REMAINS STRONG AND THAT IS TO
LEAD SCIENTIFIC RESEARCH AIMED
AT IMPROVING HEALTH AND REDUCIG
HEALTH DISPARITIES, COORDINATE
WITH THE ULTIMATE GOAL OF
ENSURING GOOD HEALTH FOR ALL
POPULATIONS.
OUR INSTITUTION CONDUCTS AND
SUPPORTS MULTI-DISCIPLINARY
RESEARCH SPANNING INTEGRATIVE
BIOLOGICAL AND BEHAVIORAL
SCIENCES, CLINICAL AND HEALTH
SERVICES RESEARCH, AS YOU HEARD
COMMUNITY HEALTH AND POPULATION
SCIENCE.
OUR SCIENCE IS DEDICATED TO
ADDRESSING CRITICAL RESEARCH
GAPS BY APPLYING RIGOROUS
SCIENTIFIC METHODS TO GENERATE
KNOWLEDGE NEEDED AND TO PROVIDE
ESSENTIAL EVIDENCE AROUND THE
UNDERLYING CONTRIBUTORS TO
HEALTH DISPARITIES.
WE DO THIS THINKING ABOUT ACROSS
POPULATIONS, ACROSS DISEASES,
ACROSS CONDITIONS.
WE ARE ALSO RESPONDING TO
POPULATION NEEDS AND ADVANCING
EVIDENCE-BASED CLINICAL AND
COMMUNITY INTERVENTIONS, I WANT
TO PAUSE HERE JUST TO EXPRESS MY
DEEP GRATITUDE TO STAFF MEMBERS
AT NIH, NIMHD, AND THE SCIENCE
TEAMS INCLUDING COMMUNITY
PARTNERS ACROSS THE COUNTRY
WORKING TO REDUCE DISPARITIES, I
APPLAUD YOUR UNWAVERING
DEDICATION TO SCIENCE OF HEALTH
DISPARITIES, HEALTH PROMOTION,
SAVING LIVES THROUGH THIS
RESEARCH.
NEXT SLIDE PLEASE.
NEXT I HAVE TWO IMPORTANT NIH
UPDATES.
NEXT SLIDE.
FIRST NIH HAS A NEW DIRECTOR, HE
BEGAN HIS TENURE ON APRIL 1, WAS
CONFIRMED BY THE U.S. SENATE ON
MARCH 25, BACHELOR AND MASTER'S
DEGREES FROM STANFORD, MEDICAL
SCHOOL, AND Ph.D. IN ECONOMICS
AT STANFORD UNIVERSITY, HE IS A
SCIENTIST AND HEALTH ECONOMIST
WHO HELD TENURED PROFESSOR AT
STANFORD, RESEARCH HAS FOCUSED
ON POPULATION AGING AND CHRONIC
DISEASES, PARTICULARLY ON THE
HEALTH OF AND WELL-BEING OF
VULNERABLE POPULATIONS.
SO WE WELCOME HIM.
NEXT SLIDE.
AND HERE ARE HIS INITIAL
PRIORITIES WHICH HE HAS
DISCUSSED PUBLICLY, FIRST IS
FOCUS ON IMPROVING POPULATION
HEALTH, WHETHER THROUGH BASIC
RESEARCH OR APPLIED STUDIES, THE
WORK OF NIH IS HERE TO ADDRESS
THE REAL AND PRESSING HEALTH
CHALLENGES OF OUR NATION,
PARTICULARLY THE CHRONIC
DISEASES THAT AFFECT MILLIONS OF
LIVES.
SO, THE RESEARCH MUST BE
PURPOSEFUL, ENSURING DISCOVERIES
TRANSLATE INTO BETTER CARE,
PREVENTION, AND TREATMENTS FOR
ALL.
NEXT IS REPRODUCIBILITY AND
RIGOR, SCIENCE MUST BE RIGOROUS
AND HE EMPHASIZES RESPONSIBILITY
TO INCREASE REPRODUCIBILITY IN
THE BIOMEDICAL SCIENCES AND
ENSURE THAT THE FINDINGS WE
PRODUCE STAND THE TEST OF TIME
AND SCRUTINY.
THE OTHER PIECE OF THIS IS
INNOVATION AND COLLABORATION, IN
TERMS OF HIS PRIORITIES, HE
STATED WE MUST EMBRACE NEW
TECHNOLOGIES, FRESH IDEAS,
AROUND PIONEERING APPROACHES TO
OUR OLD CHALLENGES AND THIS
PROGRESS WOULD COME WHEN WE
BREAK BARRIERS AND PUSH
BOUNDARIES AND WORK TOGETHER
ACROSS DISCIPLINES.
RESEARCH SAFETY AND
TRANSPARENCY, DIRECTOR WANTS TO
ENSURE THAT EXPERIMENTS
SUPPORTED BY NIH POSE NO RISK OF
HARM TO HUMAN POPULATIONS AS
WELL AS MEET THE HIGHEST ETHICAL
STANDARDS.
FINALLY WITH RESPECT TO ACADEMIC
FREEDOM HE IS SEEKING TO
CULTIVATE AT NIH AND BROADER
SCIENTIFIC COMMUNITY AN
ENVIRONMENT WHERE DIFFERENT
PERSPECTIVES ARE NOT JUST
WELCOMED BUT ENCOURAGED, AND HE
TALKS ABOUT THAT THE IMPORTANCE
OF HAVING BOLD IDEAS AND HOW WE
CAN THRIVE WHEN SCIENTISTS ARE
FREE TO ASK HARD QUESTIONS AND
CHALLENGE ASSUMPTIONS.
THESE ARE HIS STARTING POINTS.
THEY SEEM TO BE FORMING THE
BACKBONES OF HIS INITIAL
PRIORITIES, WE MAY SEE THEM
EVOLVE OVER TIME.
I WANTED TO SHARE THAT WITH YOU.
NEXT SLIDE.
NIH IS CURRENTLY ACCEPTING
APPLICATIONS.
PLEASE NOTE THAT SOME FUNDING
OPPORTUNITIES HAVE CLOSED AND
OTHERS HAVE BEEN UPDATED TO
ALIGN WITH AGENCY PRIORITIES.
SO I WOULD ENCOURAGE APPLICANTS,
POTENTIAL APPLICANTS TO CAREFUL
REVIEW FUNDING OPPORTUNITIES FOR
CHANGES, TO PRIOR SUBMISSIONS,
AND TO ADJUST APPLICATIONS
ACCORDINGLY.
I ALSO ENCOURAGE POTENTIAL
APPLICANTS TO REVIEW THE NIH
POLICIES AND COMPLIANCE WEB PAGE
FOR CHANGES, A WEB PAGE YOU CAN
GOOGLE AND GO TO AND CHECK FOR
KEY CHANGES TO POLICY
STATEMENTS, REQUIREMENTS, AND
REPORTING.
I ENCOURAGE YOU TO DO THAT AND
CHECK BACK AS NEEDED.
NEXT SLIDE.
THOSE ARE THE TWO MAJOR UPDATES
AT THE NIH LEVEL.
NOW I'LL TURN TO A FEW NIMHD
SCIENCE ADVANCES BECAUSE IT'S
VERY IMPORTANT WE CONTINUE
TALKING ABOUT SCIENCE AND
CONDUCTING THE SCIENCE NEEDED TO
ADVANCE THE NIH MISSION WITH
CONTRIBUTIONS FROM NIMHD.
I HAVE SELECTED SIX OF MANY
RECENT NIMHD-SUPPORTED
PUBLICATIONS TO SHARE.
NEXT SLIDE.
BEFORE I REALLY GET INTO THESE
ADVANCES I WANT TO HIGHLIGHT
SOMETHING WE JUST HEARD A BIT
ABOUT, THAT IS THE ROLE OF
INTERDISCIPLINARY RESEARCH, AT
THE HEART OF OUR RESEARCH
EFFORTS AT NIMHD TO UNDERSTAND
AND ELIMINATE HEALTH
DISPARITIES.
HEALTH DISPARITIES ARE RARELY
THE RESULT OF A SINGLE FACTOR;
THEY ARE INFLUENCED BY THE
INTERPLAY OF BIOLOGICAL
BEHAVIORAL, SOCIAL AND
ENVIRONMENTAL FACTORS, AND SO
ADDRESSING THESE ISSUES
EFFECTIVELY REQUIRES INTEGRATING
KNOWLEDGE AND METHODS FROM
MULTIPLE DISCIPLINES, PLACING
EMPHASIS ON INTERDISCIPLINARY
RESEARCH, DR. BAUERMEISTER WAS
TALKING ABOUT CROSS-SECTOR
PARTNERSHIPS IN THE A.I., ML,
AND TEST SPACE.
AS AN EXAMPLE WE CAN CREATE MORE
TARGETED HOLISTIC AND IMPACTFUL
HEALTH INTERVENTIONS.
WE ALSO KNOW INTERDISCIPLINARY
TEAMS ARE PRIMED TO DEVELOP
INNOVATIVE INTERVENTIONS AND
POLICIES BRINGING THEIR VARIED
PERSPECTIVES.
WHEN THE RESEARCH WE'RE
CONDUCTING HAS IMPLICATIONS FOR
PROMISING OR BEST PRACTICES WE
SHOULD ALSO BE THINKING ABOUT
THE TRANSLATION OF RESEARCH INTO
PRACTICE, INTO EVIDENCE-BASED
COMMUNITY PROGRAMS, IN HEALTH
SETTINGS, RELATED POLICIES.
SO, AS I GO THROUGH THE ADVANCES
YOU WILL SEE CLEAR EXAMPLES OF
BOTH MULTI-DISCIPLINARY AND
INTERDISCIPLINARY SCIENCE AND
GREAT EXAMPLES OF TEAM SCIENCE
AND RESEARCH METHODS THAT
INCLUDE COMMUNITY ENGAGED
PRINCIPLES.
NEXT SLIDE.
SO YOU WILL HEAR ABOUT THIS
STUDY LATER DURING DR. CHOI'S
PRESENTATION BUT I DID WANT TO
TALK ABOUT IT BECAUSE OF HOW
INTERDISCIPLINARY AND HOW
IMPACTFUL THIS PROJECT CONTINUES
TO BE.
THIS IS THE GLOBAL BURDEN OF
DISEASE PROJECT, LED BY THE
INSTITUTE FOR HEALTH METRICS AND
EVALUATION, IHME, AT THE
UNIVERSITY OF WASHINGTON SCHOOL
OF MEDICINE.
THIS IS A LARGE SCALE
COLLABORATIVE EFFORT INVOLVING
RESEARCHERS FROM OVER 150
COUNTRIES WITHIN THE U.S., THE
U.S. HEALTH DISPARITIES
COLLABORATORS AT NIH ARE KEY
COMPONENT WORKING IN PARTNERSHIP
WITH IHME TO INVESTIGATE AND
QUANTIFY HEALTH DISPARITIES
ACROSS DIFFERENT POPULATIONS AND
GEOGRAPHIC AREAS IN THE U.S.
SO, THIS NEW PUBLICATION IS ONE
PART OF AN ONGOING SERIES OF
U.S. COUNTY-LEVEL ANALYSES OVER
TIME BY RACE AND ETHNICITY.
I THINK IT'S IMPORTANT BECAUSE
LOCAL LEVEL GEOGRAPHIC DATA ARE
NEEDED TO UNCOVER WHAT WE SEE AT
THE NATIONAL LEVEL.
AND ALSO TO ADDRESS SORT OF THE
ROOT CAUSES OF HEALTH
DISPARITIES AMONG DIFFERENT
POPULATION GROUPS IN THE U.S.
SO YOU'LL HEAR ABOUT, REALLY
WHAT I WANT TO POINT TO THAT
THIS STUDY WAS LOOKING AT
EDUCATIONAL DISPARITIES AND LIFE
EXPECTANCY ACROSS U.S. COUNTIES,
HIGHLIGHTING HOW THESE
DIFFERENCES IN EDUCATION LEVELS
IMPACT OUR LIFESPAN.
AND WE'VE SEEN NATIONAL TRENDS
ABOUT THE RELATIONSHIP BETWEEN
EDUCATION AND LIFE EXPECTANCY
BUT HERE THESE RESEARCHERS AIM
TO PROVIDE A MORE DETAILED
COUNTY-LEVEL ANALYSIS TO LOOK AT
POPULATIONS THAT MAY BENEFIT
FROM THINGS LIKE IMPROVED ACCESS
TO HEALTH CARE IN CERTAIN AREAS.
SO, I WANT TO POINT OUT IT'S SO
IMPORTANT THAT WHEN WE THINK
ABOUT LIFE EXPECTANCY OVER TIME,
THIS STUDY LOOKS AT BETWEEN 2000
AND 2019 FINDING WIDESPREAD AND
INCREASING EDUCATION
DISPARITIES, VARIATION ACROSS
TIME AND LOCATION BUT OVERALL
LIFE EXPECTANCY AMONG PEOPLE WHO
DIDN'T COMPLETE HIGH SCHOOL WAS
MARKEDLY LOWER THAN AMONG PEOPLE
WHO COMPLETED LEDGE. -- COLLEGE.
WHEN WE THINK ABOUT AN 8-YEAR
LIFE EXPECTANCY DIFFERENCE FROM
2000, 11 YEARS IN 2019, OVER A
DECADE IN TERMS OF YEARS OF
LIFE.
SO, WHY IS THIS IMPORTANT TO
KNOW ABOUT?
ONE REASON IS THAT THIS RESEARCH
TELLS THAT COMPELLING AND
LONGITUDINAL STORY ABOUT
EDUCATION BASED DISPARITIES, WE
OFTEN THINK ABOUT AND STUDY
HEALTH DISPARITIES USING A
RACIAL AND/OR ETHNIC LENS BUT
HOW EDUCATION IS IMPORTANT AS A
VARIABLE, AS WE MOVE FORWARD A
GREATER FOCUS ON EDUCATION AS
RELIABLE SES INDICATOR IS
WARRANTED AND ADDRESSING GAPS
MAY HELP CLOSE THEM.
THIS IS A STUDY IN THE PRIMARY
CARE SETTING.
WE KNOW THAT EXPERIENCING
POVERTY AS A CHILD IS RELATED TO
ADVERSE DEVELOPMENTAL AND HEALTH
OUTCOMES.
THERE'S EVIDENCE HAVING A
POSITIVE PARENT-CHILD
RELATIONSHIP CAN BE A PROTECTIVE
FACTOR FOR CHILD DEVELOPMENT.
SO, VIDEO INTERACTION PROJECT,
VIP PROGRAM, WAS OFFERED THROUGH
PEDIATRIC HEALTH CARE SETTINGS
THAT HELP PARENTS SUPPORT YOUNG
CHILDREN'S DEVELOPMENT.
THEY USED SHORT VIDEOS OF
PARENTS PLAYING OR READING WITH
THEIR CHILDREN, KIDS UP TO 3
YEARS OF AGE, TO GIVE FAMILIES
HELPFUL REALTIME FEEDBACK.
AND THIS RESEARCH CONTROLS --
WAS A RESEARCH CONTROLLED STUDY
AND SHOWED BASICALLY THAT VIP
IMPROVED POSITIVE PARENTING
BEHAVIOR.
AND OTHER STUDIES HAVE SHOWN
THAT BUT UNCLEAR HOW MANY
SESSIONS ARE NEEDED TO MAKE A
DIFFERENCE WHEN USED IN EVERYDAY
HEALTHCARE SETTINGS.
SO HERE THESE RESEARCHERS
FOLLOWED THESE PARENT-CHILD
PAIRS, 183 PAIRS, AT A PUBLIC
HOSPITAL THAT MOSTLY SERVED LOW
INCOME FAMILIES OR FAMILIES WHO
WERE UNDERINSURED OR DID NOT
HAVE INSURANCE AND MEASURED
PARENTING BEHAVIORS DURING PLAY,
DURING READING, THEY DID THAT AT
THE START OF THE STUDY AND THEN
AFTER ONE OR TWO OF THESE VIP
SESSIONS.
AND THE RESULTS FOUND THAT EVEN
JUST ONE VIP SESSION LED TO THIS
NOTICEABLE IMPROVEMENT IN
RESPONSIVE PARENTING.
SO THAT'S HOW WELL THE PARENT
NOTICES AND RESPONDS TO THEIR
CHILD'S SIGNAL, AND EFFECT GREW
EVEN STRONGER AFTER THE SECOND
SESSION.
THIS MEANS PARENTS BECAME MORE
ENGAGED AND MORE SUPPORTIVE
DURING PLAYING AND READING WITH
THEIR CHILD AFTER ONLY ONE OR
TWO VISITS.
I THINK THIS IS IMPORTANT
BECAUSE IT DEMONSTRATES THAT
JUST ONE OF THE VIDEO
INTERACTION PROJECT SESSIONS
DELIVERED DURING A REGULAR WELL
CHILD VISIT CAN MAKE A
MEANINGFUL DIFFERENCE IN
PARENTING AND HAS IMPLICATIONS
FOR FACILITATING TYPICAL
DEVELOPMENT IN THEIR CHILDREN.
AND THIS WORK ALSO SUPPORTS
MAKING THE PROGRAM AVAILABLE TO
MORE FAMILIES, EVEN IF THEY
CAN'T ATTEND EVERY SESSION.
NEXT SLIDE.
THIS STUDY EXPLORED A NEW MENTAL
HEALTH RISK SCREENING TOOL.
THIS IS ALSO IN THE HEALTH CARE
SETTING, IT'S DESIGNED FOR
PATIENTS HOSPITALIZED AFTER
EMERGENCY CARE WHO ARE AT
HEIGHTENED RISK FOR ANXIETY,
DEPRESSION, PTSD.
SO GIVEN NATIONAL GUIDELINES
REQUIRING TRAUMA CENTERS TO
SCREEN HIGH RISK PATIENTS, THESE
RESEARCHERS SOUGHT TO DEVELOP A
TOOL THAT HOPEFULLY WOULD
GENERALIZE ACROSS POPULATIONS SO
THEY INCLUDED ALL FIVE RACIAL
AND/OR ETHNIC POPULATIONS IN THE
STUDY, INCLUDED OVER 1300
PATIENTS WORKING AT THREE
HOSPITALS THAT SERVE COMMUNITIES
WITH RESIDENTS OF VARIOUS
RACIAL, ETHNIC, SOCIOECONOMIC
BACKGROUNDS AND IDENTIFIED RISK
FACTORS AND LATER MEASURED
MENTAL HEALTH SYMPTOMS.
SO AFTER TESTING PREDICTORS
FOUND THAT 10 SCREENS ITEMS
IDENTIFIED 75% OF PATIENTS WHO
WOULD BE LIKELY TO DEVELOP
MENTAL HEALTH SYMPTOMS LATER ON,
WHILE COMPLETELY RULING OUT
CORRECTLY 71% OF OTHERS, HIGH
SENSITIVITY, AND HIGH
SPECIFICITY OF THIS SCREENER.
IMPORTANTLY THE SCREENER
PERFORMED WELL ACROSS ALL FIVE
RACIAL AND ETHNIC SUBGROUPS
DEMONSTRATING BROAD
EFFECTIVENESS AND
GENERALIZABILITY.
ANY IS CALLED THE HOSPITAL
MENTAL HEALTH RISK SCREEN,
EFFECTIVELY PREDICTED RISKS
ACROSS POPULATIONS THAT MAKES IT
A PROMISING TOOL FOR TRAUMA
CENTERS AND VALIDATED IN FUTURE
STUDIES THE IDEA IS THAT THIS
SCREENING METHOD COULD BE WIDELY
USED TO REDUCE DISPARITIES IN
REFERRALS AS WELL AS ACCESS TO
MENTAL HEALTH CARE, COULD ALSO
IMPROVE OUTCOMES AND SUPPORT
PREVENTIVE CARE, AND ALSO THINGS
LIKE ENHANCING EARLY
INTERVENTION EFFECT FOR PATIENTS
RECOVERING FROM EMERGENCY CARE.
NEXT SLIDE.
I WANT TO START HERE BY
CREDITING FOR THIS PHOTO A
PROGRAM OFFICIAL AT NIMHD FOR
THE COOL PHOTO EXAMINING A
FAMILY-BASED COMMUNITY-DRIVEN
INTERVENTION, AIMED AT
ADDRESSING HEALTH DISPARITIES
AMONG NATIVE HAWAIIANS WITH A
SOPHISTICATED FOOD SYSTEM
FACILITATING LOCAL FOOD
PRODUCTION.
CURRENTLY FACE DISPARITIES DUE
TO LIMITED ACCESS TO HEALTHY
FOOD THAT USED TO BE PRESENT.
SO THIS TEACHES FAMILIES HOW TO
BUILD AND USE BACK YARD
AQUAPONICS TO GROW THEIR OWN
FOOD FOR HEALTHIER EAT BE
HABITS.
THERE WERE 21 PARTICIPANTS, 10
FAMILIES, COMPLETED THIS
THREE.MONTH CURRICULUM, HANDS
ON, WORKSHOPS FOCUSED ON
AQUAPONICS AND NUTRITION, AND
FOUND ENGAGEMENT WAS HIGH, NO
PARTICIPANTS DROPPED OUT OF THE
INTERVENTION PROGRAM.
RESULTS WERE POSITIVE, THIS IS A
PILOT STUDY BUT DID FIND THAT
FRUIT CONSUMPTION SIGNIFICANTLY
INCREASED FROM TWO SERVES BEFORE
THE INTERVENTION TO THREE
SERVINGS AFTERWARD AND DID
MEASURE BMI, WAIST TO HIP RATIO,
DIDN'T FIND SIGNIFICANT CHANGES
THERE WHICH WASN'T REALLY
EXPECTED WITH A SMALL SAMPLE BUT
DID SEE POSITIVE TRENDS IN BLOOD
PRESSURE, MANAGEMENT REDUCTION,
FISH CONSUMPTION, VEGETABLE
INTAKE, NOTEWORTHY THAT
PARTICIPANTS IN THIS
INTERVENTION FUND IT TO BE
HIGHLY CULTURALLY ACCEPTABLE AND
RECOGNIZE MULTIPLE BENEFITS FROM
THIS TYPE OF PROGRAM.
SO, THIS IS AN EXAMPLE OF
COMMUNITY DRIVEN SOLUTIONS THAT
CAN OFFER A PROMISING APPROACH
TO IMPROVING HEALTH AND REDUCING
DISPARITIES IN THIS POPULATION.
CLEARLY A LARGER STUDY OF FULLY
POWERED DESIGN WOULD BE NEEDED
TO CAN NUTRITION OVER TIME AND
HEALTH OUTCOMES BY THESE KINDS
OF INTERVENTIONS CAN HELP TO
COMBAT NUTRITIONAL DISPARITIES
AND PROMOTE SUSTAINABLE AND
CULTURALLY RELEVANT
INTERVENTIONS.
NEXT SLIDE.
THIS IS GOING A LITTLE DIFFERENT
DIRECTION.
EMERGING RESEARCH AREA THAT I
THINK IS REALLY IMPORTANT, WE
KNOW FROM PREVIOUS RESEARCH THAT
PERCEIVED DISCRIMINATION
SIGNIFICANTLY IMPACTS HEALTH
LEADING TO BOTH MENTAL AND
PHYSICAL HEALTH DISPARITIES,
BROADLY DISCRIMINATION FOR A
NUMBER OF REASONS BUT PERCEPTION
OF INTERPERSONAL DISCRIMINATION
IS LINKED, ASSOCIATED WITH
PHYSICAL HEALTH OUTCOMES LIKE
HYPERTENSION, AND CARDIOVASCULAR
DISEASE.
SO, THIS PUBLICATION EXAMINED
HOW EXPERIENCING PERCEIVED
DISCRIMINATION MIGHT AFFECT A
PERSON'S GUT HEALTH BY EXAMINING
THE GUT MICROBIOME AND CHANGES.
THE GUT MICROBIOME IS THE
COMMUNITY OF TRILLIONS OF
BACTERIA AND OTHER
MICROORGANISMS THAT LIVE IN THE
DIGESTIVE SYSTEM, AND THEY PLAY
KEY ROLE IN DIGESTION, IMMUNE
FUNCTION, EVEN MENTAL HEALTH.
SO CHANGES IN THE MICROBIOME
HAVE BEEN LINKED TO STRESS AND A
VARIETY OF CHRONIC CONDITIONS.
THESE RESEARCHERS STUDIED ADULTS
AND DIVIDED THEM INTO GROUPS
BASED ON HOW THEY REPORTED
PERCEPTIONS OF DISCRIMINATION
USING A STANDARD QUESTIONNAIRE
AND ASSESSED PERCEIVED STRESS,
DIET, EMOTIONAL HEALTH,
PARTICIPANTS PROVIDED STOOL
SAMPLES FOR GUT MICROBIOME
ANALYSIS AND GENE EXPRESSION
TESTING.
RESULTS SHOWED PEOPLE WHO
REPORTED HIGH LEVELS OF
PERCEIVED DISCRIMINATION HAD
MORE TYPES OF GUT MICROBES
OVERALL, GREATER SPECIES
RICHNESS BUT OVERALL GUT
COMMUNITY WAS DIFFERENT FROM
THOSE WHO REPORTED LOW
DISCRIMINATION, AND SPECIFICALLY
TWO IMPORTANT TYPES OF GUT
BACTERIA, ONE AFFECT ENERGY
PRODUCTION, INFLAMMATION, IMMUNE
REGULATION FOUND IN LOWER
AMOUNTS IN PEOPLE WHO
EXPERIENCED MORE DISCRIMINATION.
THESE INDIVIDUALS ALSO REPORTED
HIGHER LEVELS OF DEPRESSION,
ANXIETY, STRESS, SENSITIVITY IN
THE BODY.
THEY ALSO CONDUCTED GENE
EXPRESSION ANALYSES AND FOUND
THEIR BIOLOGICAL DIFFERENCES IN
THE WAY CELLS FUNCTIONED
INCLUDING GENES RELATED TO
SENSING THE ENVIRONMENT AND
METABOLISM, APPLIED A MACHINE
LEARNING MODEL, RANDOM FOREST,
COMBINED ALL OF THE BIOLOGICAL
MARKERS TO ACCURATELY IDENTIFY
PEOPLE WHO HAD EXPERIENCED LOW
VERSUS HIGH DISCRIMINATION AND
FOUND VERY HIGH ACCURACY WITH
THIS MODEL.
I THINK THIS RESEARCH IS NOVEL,
INNOVATIVE, SHOWS AND THIS IS
ALSO CRITICAL THAT
DISCRIMINATION IS NOT JUST A
SOCIAL OR PSYCHOLOGICAL ISSUE
BUT HAS EFFECT, MAY CONTRIBUTE
TO LONG-TERM HEALTH PROBLEMS.
SO UNDERSTANDING THESE
CONNECTIONS CAN HELP RESEARCHERS
DEVELOP NEW WAYS TO PREVENT OR
REDUCE HARMFUL EFFECTS OF JUST
PERCEIVED DISCRIMINATION,
ESPECIALLY IN COMMUNITIES WHO
REPORT THESE EXPERIENCES MOST
OFTEN.
NEXT.
THE FINAL THAT I WANT TO MENTION
HERE IN TERMS OF ADVANCES, THIS
IS A STUDY CONDUCTED BY PROGRAM
OFFICIALS IN OUR DIVISION OF
CLINICAL HEALTH SERVICES
RESEARCH, WE'RE EXCITED ABOUT
THIS REVIEW, A SCOPING REVIEW.
NEARLY HALF OF ADULTS IN THE
U.S. LIVE WITH MULTIPLE CHRONIC
HEALTH CONDITIONS, SUCH AS
DIABETES, HEART DISEASE,
DEPRESSION.
THESE CONDITIONS ARE ESPECIALLY
COMMON AMONG MIDDLE AGED ADULTS,
FROM RACIAL AND ETHNIC MINORITY
GROUPS.
HOWEVER, THERE IS LITTLE
RESEARCH ON WHICH HEALTH CARE
DELIVERY MODELS WORK BEST FOR
HELPING MANAGE THESE POPULATIONS
TO MANAGE THEIR MULTIPLE CHRONIC
CONDITIONS EFFECTIVELY.
SO WITH THAT THIS STUDY REVIEWED
RESEARCH LOOKING FROM 2016
THROUGH 2023 TO BETTER
UNDERSTAND WHAT HEALTH CARE
MODELS HAVE BEEN TESTED IN THE
UNITED STATES FOR ADULTS WITH
2004 OR MORE -- TWO OR MORE
CHRONIC CONDITIONS, THEY
REVIEWED OVER 9500 RECORDS AND
FOUND ONLY 17 STUDIES MET ALL OF
THE CRITERIA FOR INCLUSION, AND
OF THOSE JUST 5 WERE RIGOROUS
RANDOMIZED CONTROLLED TRIALS.
MOST FOCUSED ON TREATING MENTAL
HEALTH AND PHYSICAL HEALTH
CONDITIONS TOGETHER.
THEY ALSO FOUND THAT THE MOST
FREQUENTLY USED CARE MODEL WAS
THE PATIENT CENTERED MEDICAL
HOME THAT EMPHASIZE TEAM BASED
COORDINATED CARE CENTERED ON THE
PATIENT'S NEEDS.
MOST OF THE RESEARCH TOOK PLACE
IN CLINICAL SETTINGS, PRIMARY
CARE, SPECIALTY CARE, BEHAVIORAL
HEALTH CLINICS, ALL STUDIED
REPORTED POSITIVE OUTCOMES FOR
PATIENTS.
AND THESE OUTCOMES INCLUDED
BETTER USE OF HEALTH CARE
SERVICE, IMPROVEMENT IN HEALTH
MEASUREMENTS LIKE BLOOD
PRESSURE, BLOOD SUGAR, AND ALSO
SOME REDUCTIONS IN HEALTHCARE
COST.
HOWEVER, WE WILL NOTE THE REVIEW
FOUND EVEN THOUGH THE CHRONIC
CARE MODEL IS WELL KNOWN
FRAMEWORK EXISTED FOR DECADES,
VERY FEW STUDIES HAD TESTED USE
SPECIFICALLY AMONG POPULATIONS
WHO EXPERIENCED HEALTH
DISPARITIES AND HAD MULTIPLE
CHRONIC CONDITIONS.
SO I THINK THIS KIND OF STUDY IS
IMPORTANT TO HIGHLIGHT, BECAUSE
THIS IS REVIEW AND SHOWS THERE'S
A MAJOR GAP IN RESEARCH ON
EFFECTIVE CARE MODELS FOR PEOPLE
WHO HAVE MULTIPLE CHRONIC
ILLNESSES AND FACE SYSTEMIC
HEALTH DISPARITIES.
AND SO TO IMPROVE OUTCOMES FOR
THESE INDIVIDUALS, AND
POPULATIONS, MORE WORK IS NEEDED
TO CREATE AS WELL AS TEST HEALTH
CARE STRATEGIES THAT ARE
EVIDENCE-BASED, THAT ARE
PATIENT-CENTERED AND THAT ARE
DESIGNED WITH ADDRESSING HEALTH
DISPARITIES.
LET'S GO TO THE NEXT SLIDE.
SO, I THINK NIMHD IS A VERY
IMPORTANT INSTITUTE, HAS MADE
SIGNIFICANT PROGRESS OVER THE
PAST 15 YEARS, STARTED 35 YEARS
AGO TO BE EXACT BUT THERE'S MOE
TO LEARN.
THERE WERE MANY MORE RECENT
STUDIES I COULD HAVE HIGHLIGHTED
BUT DECIDED TO GO WITH BREVITY.
STUDIES SUMMARIZED HERE TODAY
REPRESENT INTERDISCIPLINARY
SCIENCE, ASKING A RANGE, RIGHT,
OF EMPIRICAL QUESTIONS FROM A
RANGE OF PERSPECTIVES AND
METHODOLOGIES CONDUCTED IN
VARIOUS PARTS OF THE COUNTRY,
AND WITH PEOPLE FROM DIFFERENT
BACKGROUNDS, ALL WHO ARE SEEKING
TO OPTIMIZE THEIR HEALTH AND
WELL-BEING.
AND THAT'S WHY WE DO THIS WORK
EVERY DAY.
THIS IS THE SCIENCE THAT SERVES
COMMUNITIES, TO UNDERSTAND AND
ADDRESS THESE LARGELY
PREVENTIBLE AND MODIFIABLE
DIFFERENCES IN POPULATION
HEALTH, WHAT WE REFER TO AS
HEALTH DISPARITIES.
SO WE ENCOURAGE INVESTIGATORS TO
SHARE YOUR PUBLICATIONS, WE
INVITE YOU TO SHARE RECENT
PUBLICATIONS WITH OUR PROGRAM
OFFICIALS.
WE'RE DELIGHTED TO RECEIVE NIMHD
SUPPORTED PUBLICATIONS FOR OUR
IMPACT.
I'LL STOP THERE.
I'M HAPPY TO TAKE QUESTIONS,
I'LL HOPEFULLY BE ABLE TO ANSWER
THEM.
>> WE'LL USE THE SAME PROCEDURE.
TURN YOUR CAMERA ON, COUNCIL
MEMBERS, IF YOU WANT TO MAKE A
COMMENT OR ASK A QUESTION.
RAISE YOUR HAND.
OR PUT YOUR -- WE HAVE OUR FIRST
QUESTION.
>> OR COMMENT.
WE'LL SEE.
>> OR COMMENT.
>> THANK YOU SO MUCH, DR.
HOOPER.
A COMMENT AND QUESTION.
TERRIFIC PRESENTATION OVERALL,
GREAT TO SEE NOT ONLY THE
HISTORY, BUT ALSO THE WORK
THAT'S BEEN DONE OVER THE COURSE
OF THIS PERIOD.
IT'S REALLY -- IT'S REALLY
APPRECIATED HIGHLIGHTS,
EMPHASIZING FAMILY CENTERED
INTERVENTIONS IN THE CONTEXT OF
INDIVIDUAL BUT ALSO AT THE
COMMUNITY LEVEL.
REGARDING THE VIP PARENTING
INTERVENTION, CAN YOU SHARE A
LITTLE BIT MORE ABOUT THE MENTAL
HEALTH AND PHYSICAL HEALTH
OUTCOMES ASSESSED IN THERE'S
EVIDENCE IMPROVING PARENTS CAN
IMPROVE CHILDREN'S MENTAL
HEALTH, IN MANY WAYS PARENTING
INTERVENTIONS HAVE POTENTIAL TO
NOT ONLY BUFFER AND PARTICULARLY
FOR LOW INCOME AND POOR
FAMILIES, BUT ALSO TO STRENGTHEN
NOT ONLY THE PARENT AND FAMILY
OUTCOMES BUT ALSO THE LONGER
TERM OUTCOMES FOR CHILDREN.
SO JUST I DIDN'T KNOW IF YOU --
HOW VERSED YOU WERE IN TERMS OF
THAT STUDY, BUT ALSO JUST MAYBE
EVEN LESS SO IN TERMS OF
THINKING THROUGH BUT JUST SORT
OF IMPLICATIONS OF EXPANDING
THAT KIND OF WORK IN THE CONTEXT
OF OTHER AREAS.
>> YEAH, GOOD QUESTION.
SO, WHAT THEY USED IN THIS
STUDY, THEIR PRIMARY MEASURES
WERE KIND OF COACH COMPLETED
OBSERVATIONAL PARENTING BEHAVIOR
CHECK LIST, AND SO THE
CHECKLISTS WERE USED IN REAL
TIME SO AS THEY WENT THROUGH THE
COACHES FOR VIP WHILE THEY
COMPLETED THE CHECKLIST WHILE
PARENT INTERACTIONS WERE BEING
RECORDED, I THINK UP TO 20
BEHAVIORS THAT THEY WERE RATING
LIKE WHETHER OR NOT THE -- HOW
THE PARENT RESPONDED TO THE
CHILD'S VOCALIZATION, THEIR
WORDS.
THEY LOOKED AT WHETHER OR NOT
THE CHILD WAS GIVEN THE
OPPORTUNITY TO ACTIVELY -- FOR
THE BOOKS AND THINGS THEY WERE
PLAYING WITH, SO THAT WAS HOW
THEY KIND OF MEASURED THE
BEHAVIORS THAT WERE GOING ON IN
THE CONTEXT OF THIS STUDY.
I COULD LOOK BACK AND SEE OTHER
MEASURES BUT IT WAS POSITIVE
PARENTING BEHAVIORS THEY MOSTLY
FOCUSED ON.
>> VERY HELPFUL AND INTERESTING
TO SEE THAT EVEN JUST ONE DOSE
OF THAT COULD HAVE AN IMPACT ON
IMPROVING PARENTING OUTCOMES.
THANK YOU.
>> ANY ADDITIONAL COMMENTS OR
QUESTIONS FROM COUNCIL MEMBERS?
I DON'T SEE ANY.
OH, HERE WE GO.
DR. CACARI STONE.
>> YES, THANK YOU, DR. HOOPER.
I
I THINK YOUR FOCUSED AND
COMPREHENSIVE PRESENTATION
FOCUSED ACROSS GEOGRAPHIES, AND
ALSO REPRESENTS AND DEMONSTRATES
ROBUST PORTFOLIO OF NIMHD AT ANY
GIVEN TIME AND ALIGNS WITH THE
NIH DIRECTOR'S PRIORITY
REFLECTING RIGOROUS SCIENTIFIC
METHODS THAT SPANS
MULTI-DISCIPLINES, I WANT TO
APPRECIATE WHAT YOU PRESENTED.
THANK YOU.
>> THANK YOU.
I APPRECIATE THAT.
>> AT THIS MOMENT THAT APPEARS
TO BE THE LAST COMMENT OR
QUESTION REGARDING YOUR
PRESENTATION.
AND OUR NEXT SCHEDULED PRESENTER
IS SCHEDULED FOR 12:15.
SO, WE HAVE A WONDERFUL
OPPORTUNITY FOR LUNCH.
I WOULD RECOMMEND LOGGING BACK
IN IF YOU'RE LOGGING OUT OR YOU
DON'T HAVE TO LOG IN, JUST TURN
OFF -- YOU DON'T HAVE TO LOG
OUT, JUST TURN OFF YOUR CAMERA
AND MIC, IF YOU THINK THERE MAY
BE A PROBLEM GETTING BACK IN.
AND WE WILL RECOMMEND THAT YOU
COME BACK ONLINE AT 12:10.
I DON'T EXPECT YOU TO READ
EVERYTHING THAT I'M GOING TO
SHOW YOU, JUST GOING TO PREFACE
ON THAT.
WE PUT THESE FACTORS NAMED BY
COMMUNITY PARTNERS AND ACADEMIC
PARTNERS INTO A CAUSAL LOOP
DIAGRAM TO DRIVE DISPARITY IN
HEALTH OUTCOMES, FACTORS ARE
INTERRELATED AND THAT SUSTAIN
THIS PERSISTENT WORSE HEALTH
OUTCOME IN THE AREA.
THAT'S ALSO WHY SOMETIMES WHEN
WE INTERVENE ON A SYSTEM LIKE
THEY WE DON'T ALWAYS SEE RESULTS
AND DECLINE IN DISPARITY BECAUSE
SYSTEM IS TRYING TO RESIST
CHANGES WE PUT IN PLACE.
WE'VE ALSO IDENTIFIED WITH
COMMUNITY PARTNERS WHAT ARE
POTENTIAL INTERVENTIONS THAT
THEY WOULD LIKE TO SEE
IMPLEMENTED IN THE COMMUNITY.
WE'RE GOING BACK TO NORFOLK NEXT
WEEK TO FIGURE OUT WHAT WOULD BE
THE INTERVENTIONS THAT THEY
WOULD LIKE TO SEE IMPLEMENTED,
HOW WE ADVANCE IN INTERVENTION
AND IMPLEMENT IN THE LOCAL
SETTING AND EVALUATE THE IMPACT
OF THESE INTERVENTIONS ON HEALTH
DISPARITIES.
THIS ALSO INVOLVES SPEARHEADING
THE PROMOTING HEALTH DISPARITY
RESEARCH AT THE NIH THROUGH ITS
SUPPORT ON THE HEALTH DISPARITY
INTEREST GROUP.
ON THE INTRAMURAL SIDE OF NIH WE
HAVE THESE SCIENTIFIC INTEREST
GROUPS THAT FOCUS ON DIFFERENT
SCIENTIFIC AREAS, AND THIS IS
THE ONE THAT WE FOUNDED IN 2014,
WHICH AIMS TO FACILITATE
DISCUSSION TO ADVANCE
BIOLOGICAL, CLINICAL,
BEHAVIORAL, SOCIAL, AND
POPULATION SCIENCES RESEARCH TO
UNDERSTAND MECHANISMS OF HEALTH
DISPARITIES AND DEVELOP
INTERVENTIONS TO ELIMINATE THEM.
WE HAVE THREE TO FOUR SEMINARS
EVERY YEAR AND ALSO CONDUCT A
WORKSHOP DURING THE NIH RESEARCH
FESTIVAL AND WE ACTUALLY HAVE
ONE COMING UP THAT FOCUSES ON
RURAL HEALTH DISPARITY.
IN TERMS OF MEASURING THE NEXT
GENERATION OF HEALTH DISPARITY
RESEARCHERS, WE HAVE ESTABLISHED
THE COLEMAN RESEARCH AWARD NAMED
AFTER OUR FIRST PERMANENT
SCIENTIFIC DIRECTOR, DR.
COLLMAN, A COMPETITIVE INTERNAL
FUNDING MECHANISM FOR JUNIOR
SCIENTISTS SLOWING POSTDOCTORAL
FELLOWS, SCIENTISTS, CLINICIANS
NOT JUST WIN THE NIMHD BUT
ACROSS THE NIH INTRAMURAL
PROGRAM.
THE AIM OF THIS AWARD AS IN THE
NAME IS TO SUPPORT INNOVATIVE
RESEARCH TO UNDERSTAND AND
REDUCE HEALTH DISPARITY, AND
WITH THESE SMALL INVESTMENT WHAT
WE HOPE TO ALSO ACHIEVE IS TO
GENERATE PILOT DATA FOR
LONGITUDINAL STUDIES AND CAREER
PROGRESSION OF THESE JUNIOR
SCIENTISTS.
SINCE 2017, WE ESTABLISHED THE
AWARD, WE HAVE MADE 54 AWARDS,
TOTAL OF OVER $800,000
INVESTMENT.
SO THIS IS A VERY SUCCESSFUL
INITIATIVE THAT HAS PUT
RESOURCES IN THE HANDS OF JUNIOR
INVESTIGATORS FOR THEM TO
DEVELOP THEIR RESEARCH PORTFOLIO
AND CAREER.
HERE ARE SOME EXAMPLES OF THE
PREVIOUSLY AWARDED COLEMAN
RESEARCH INNOVATION AWARD.
THE TOPICS COVER NEIGHBORHOOD
DISADVANTAGE, PREGNANCY, AWARDED
TO A POSTDOC AT NIEHS, WE ALSO
HAVE AWARDED A PROJECT LOOKING
AT MODIFYING ROLE OF CHRONIC
PSYCHOSOCIAL AND ENVIRONMENTAL
STRESS ON NATURAL KILLER CELL
FUNCTION, AWARDED TO A POSTDOC
IN NHLBI, AND A MITOCHONDRIAL
DNA HAPLOGROUPS, MITOCHONDRIAL
FUNCTION, HOW IT'S RELATED TO
OXIDATIVE STRESS, INFLAMMATION,
HYPERTENSION.
OR COURSE WE SUPPORTED OUR OWN
POSTDOC AT NIMH THROUGH THIS
AWARD.
THESE ARE ALL REVIEWED BY
INVESTIGATORS, REVIEWED AND
SCORE WELL TO RECEIVE THESE
AWARDS.
THE ONE BY THE POSTDOC IN NIMHD
FOCUSES ON FACTORS INFLUENCING
PHYSICAL ACTIVITY AMONG
MEDICALLY UNDERSERVED AND
UNDERREPRESENTED FEMALE BREAST
CANCER SURVIVORS IN THE UNITED
STATES.
IN ADDITION TO THE COLEMAN AWARD
WE HAVE A FELLOWSHIP PROGRAM TO
SUPPORT THE YOUNG INVESTIGATOR
OR YOUNG SCIENTISTS AT DIFFERENT
STAGES OF THEIR CAREER.
WE HAVE POSTDOCTORAL AND
PRE-DOCTORAL FELLOWSHIP, A
FOUR-YEAR MENTORED RESEARCH BY
INVESTIGATOR FOR POSTDOCTORAL
STUDENT.
WE SUPPORT MEDICAL RESEARCH
SCHOLAR PROGRAM, WHICH IS RUN BY
THE CLINICAL CENTER, MEDICAL
STUDENTS TAKE ONE YEAR OFF, COME
TO NIH TO CONDUCT RESEARCH WITH
VARIOUS INSTITUTES, INTRAMURAL
PROGRAM.
WE HAVE A POST BACCALAUREATE
FELLOWSHIP PROGRAM WHICH SUPPORT
PEOPLE OF RECENTLY GRADUATED
WITH BACHELOR'S DEGREE AND
INTERESTED IN BIOMEDICAL
RESEARCH, PROVIDE TWO YEARS OF
MENTORED RESEARCH OPPORTUNITY BY
INVESTIGATORS AND THEY GET A
SENSE OF WHETHER THEY ARE
INTERESTED IN DOING RESEARCH AS
THEIR FUTURE CAREER AND WHAT
KIND OF RESEARCH THEY ARE
INTERESTED IN PURSUING AS THEIR
CAREER IN BIOMEDICAL RESEARCH.
LASTLY, A SUMMER 8 WEEK
INTERNSHIP PROGRAM, BRINGING IN
8 TO 10, SOMETIMES 12 SUMMER
INTERNS EVERY YEAR, AND GIVE
THEM OPPORTUNITY TO HAVE A TASTE
OF DOING BIOMEDICAL RESEARCH AT
THE NIH.
SO SINCE 2017, OUR DIVISION
PROVIDED FELLOWSHIP TO 129
TRAINEES AND MANY, MANY OF THESE
TRAINEES AFTER THEY GRADUATED
FROM THE FELLOWSHIP THEY BECAME
FACULTY MEMBERS AT A UNIVERSITY,
THEY BECAME GRADUATE STUDENTS,
OR MEDICAL STUDENTS, IN
PRESTIGIOUS MEDICAL SCHOOL AND
GRADUATE SCHOOL, AND PURSUING
RESEARCH CAREER THAT WAY.
WE'RE PROUD OF TRAINEES THAT
GRADUATED FROM THE PROGRAM.
SO, IN CONCLUSION, I WANT TO
REITERATE THE NIMHD DIVISION OF
INTRAMURAL RESEARCH CONDUCTS
RESEARCH TO UNDERSTAND HEALTH
DISPARITY, PARTNER WITH
COMMUNITIES AND ACADEMIC
INSTITUTIONS TO REDUCE HEALTH
DISPARITY, AND TRAIN THE NEXT
GENERATION OF RESEARCHERS
FOCUSED ON HEALTH DISPARITY AND
WANT TO ACHIEVE THE GOALS OF
NIMHD WHICH IS TO ENSURE THAT
EVERYONE IN THE UNITED STATES
CAN ACHIEVE THEIR OPTIMAL
HEALTH.
THANK YOU.
AND I WILL STOP AND TAKE
QUESTIONS.
>> THANK YOU VERY MUCH FOR THE
PRESENTATION ABOUT DIR
SPECIFICALLY.
IT'S IMPORTANT FOR THE COMMUNITY
TO HEAR ABOUT OUR DIVISION OF
INTRAMURAL RESEARCH BECAUSE I
DON'T KNOW IF EVERYONE KNOWS,
IT'S LIKE A WELL-KEPT SECRET.
I THINK THE INTRAMURAL PROGRAM
AT NIH OVERALL IS SORT OF A
REALLY WELL-KEPT SECRET BUT THEN
SPECIFICALLY WHAT WE HAVE.
CAN YOU TALK ABOUT SOME OF THE
OTHER PROJECTS THAT ARE
HAPPENING WITHIN DIR FROM SOME
OF THE INVESTIGATORS?
>> YEAH, CERTAINLY.
SO WE HAVE RIGHT NOW SIX
INVESTIGATORS IN OUR DIVISION, I
TALKED IN MY PRESENTATION, MY
WORK ON TOBACCO YOUTH DISPARITY
AND TOBACCO CONTROL.
WE HAVE INVESTIGATORS THAT LOOK
AT FOR EXAMPLE DIABETES
DISPARITY, SPECIFIC INVESTIGATOR
THAT LOOK AT HOW PERCEIVED
NEIGHBORHOOD DRIVE PSYCHOLOGICAL
STRESS AND THEN IN TURN
INFERENCE INFLAMMATORY MARKER IN
THE BODY, PAVING WAY TO
DEVELOPMENT OF DIABETES.
WHAT YOU CALL THE ENVIRONMENTAL
CYCLE, PHYSIOLOGICAL PATHWAY TO
DIABETES.
WE ALSO HAVE ANOTHER
INVESTIGATOR LOOKING AT HOW
LIVED EXPERIENCE INFERENCE
HYPERTENSION DISPARITY, AND THEN
WE HAVE ANOTHER INVESTIGATOR
LOOKING AT MENTAL HEALTH
DISPARITY WITHIN THE POPULATION
WITH ANOTHER INVESTIGATOR
LOOKING AT DIGITAL HEALTH AND
THINKING ABOUT HOW PEOPLE
INTERACT WITH THE, FOR EXAMPLE,
HEALTH PORTAL THAT WE USE, SOME
OF US USE, SOME OF US DON'T.
AND DISPARITY IN ACCESSING AND
USING AND HOW THAT ACTUALLY CAN
HELP PEOPLE BETTER MANAGE AND
KEEP TRACK OF THEIR HEALTH.
ALSO DEVELOPING SOME OF THE
JUST-IN-TIME MOBILE-BASED
INTERVENTION TO HELP PEOPLE, YOU
KNOW, ACHIEVE BETTER HEALTH
THROUGH, YOU KNOW, REDUCING THE
BEHAVIOR, FOR EXAMPLE, AND
ANOTHER INVESTIGATOR LOOKING AT
BREAST CANCER SURVIVORSHIP
DISPARITY, PARTICULARLY
UNDERSTANDING HOW WE CAN
ACTUALLY IMPROVE SURVIVORSHIP IN
POPULATION THAT HAVE KNOWN TO
HAVE SHORTER SURVIVORSHIP AFTER
THE CANCER DIAGNOSIS AND
TREATMENT.
AND SHE'S DEVELOPING SIMULATION
MODELS TO REALLY GIVE PEOPLE THE
PRECISE INFORMATION BASED ON THE
CLINICAL CAREERS, IF THEY ENGAGE
IN CERTAIN ACTIVITIES THIS WOULD
INCREASE THEIR LIFE EXPECTANCY
BY SO MANY YEARS.
SO I THINK THOSE INFORMATION
GIVEN TO PATIENTS THROUGH THEIR
CONVERSATION WITH PRACTITIONER
CAN MOTIVATE THEM TO ACHIEVE A
BETTER ADHERENCE TO GUIDELINES
AND IMPROVE THEIR HEALTH
OUTCOMES.
>> GREAT.
EXCELLENT PRESENTATION.
COUNCIL MEMBERS, I INVITE YOU TO
TURN YOUR CAMERA ON AND ENGAGE
WITH DR. CHOI.
>> I HAVE A QUICK QUESTION AND
COMMENT.
DR. CHOI, THANK YOU SO MUCH.
TERRIFIC PRESENTATION.
ALSO, CONGRATULATIONS ON YOUR
APPOINTMENT.
WE'RE VERY FORTUNATE TO HAVE YOU
IN THIS ROLE.
YOU PRESENT COMPELLING EVIDENCE
TO DOCUMENT HEALTH DISPARITY
ACROSS COMMUNITIES AND
GEOGRAPHY, HOW IMPORTANT TO
UNDERSTAND IMPACT OF LOCAL
CONTEXT SHAPING RISKS OR
DIFFERENCES IN VARIOUS OUTCOMES.
I'M JUST CURIOUS IS IT POSSIBLE
TO OVERLAY THE DATA THAT YOU
SHARED AND EXAMINED HOW
DIFFERENT SOCIAL AND HEALTH
POLICIES ARE ASSOCIATED WITH
REGIONAL AND GEOGRAPHIC
DIFFERENCES?
AND SECONDLY, HOW MIGHT OTHER
EARLY CAREER INVESTIGATORS BE
ABLE TO DO SIMILAR STUDIES LIKE
THAT?
SHOULD THEY BE CONNECTED OR TRY
TO CONNECT WITH I THINK IT WAS
INSTITUTES OF HEALTH METRICS
EVALUATION OR WITH YOU OR OTHERS
AT NIH TO DO SOMETHING SIMILAR?
>> SO, THANK YOU FOR THE
QUESTIONS.
SO, AS I MENTIONED, I DID
TOBACCO RESEARCH, POLICY, ONE OF
THE THINGS WE LOOK AT QUITE A
BIT.
AND THAT IS SOMETHING THAT WE
LOOK FORWARD TO DO.
IT'S IMPORTANT TO SEE WHAT ARE
THE THINGS THAT WE HAVE DONE IN
TERMS OF POLICY OR EVEN
NON-POLICY BUT LOCAL
INTERVENTIONS THAT MIGHT HAVE
CONTRIBUTED TO REDUCING
DISPARITIES ACROSS DIFFERENT
COMMUNITIES.
AND SO I THINK THE EFFORT MOVING
FORWARD IS TO FIGURE OUT HOW TO
COLLECT THAT INFORMATION AT
THE -- EITHER THE NATIONAL SCALE
OR EVEN THE LOCAL, STATE LEVEL,
THERE STILL MAY BE VARIATION IN
SOME IMPLEMENTATION OF THESE
DIFFERENT POLICIES AND PROGRAMS
THAT WE CAN OVERLAY THAT
INFORMATION ON THE DATA THAT WE
HAVE BY COUNTY AND THEN WE CAN
SEE, OH, MAYBE WITH THIS SET OF
PARTICULAR INTERVENTIONS WE DO
SEE IN SOME PLACES WHERE
DISPARITIES IS DECREASING OVER
TIME.
I THINK THAT WOULD BE SOMETHING
VERY, VERY INTERESTING TO DO.
FOR THE SECOND QUESTION ABOUT,
YOU KNOW, EARLY STAGE
INVESTIGATE -- INVESTIGATORS GT
INVOLVED, THE DATA WILL BE MADE
PUBLICLY AVAILABLE LATER AS WE
FINALIZE THE DATA AND ALL THAT.
BUT IF ANYBODY IS INTERESTED IN,
YOU KNOW, TAKING A PEEK AND
WORKING ON THE PROJECT, THEY ARE
MORE THAN WELCOME TO JUST E-MAIL
ME AND THEY CAN CERTAINLY FIND
ME ON THE NIMHD WEBSITE AND I'M
MORE THAN HAPPY TO TALK TO
EARLY-STAGE INVESTIGATORS WILL
THIS.
ANY INVESTIGATOR FOR THAT
MATTER.
>> THAT'S TERRIFIC.
THANK YOU.
>> OTHER COMMENTS OR QUESTIONS?
PAUL, YOUR VOLUME IS KIND OF
LOW.
>> I DO NOT SEE ANY ADDITIONAL
HANDS OR ANYTHING IN THE CHAT.
SO WE WILL VOTE AGAIN, TWICE,
THREE TIMES, AND WE'LL MOVE ON.
THANK YOU VERY MUCH.
EXCELLENT AND INFORMATIVE
PRESENTATION.
>> THANK YOU FOR THE
OPPORTUNITY.
LOOKING FORWARD TO WORKING WITH
ALL OF YOU.
>> THANK YOU, KELVIN.
>> WE WILL NEXT MOVE TO DR.
MONICA WEBB HOOPER'S CLOSING
REMARKS TO THE OPEN SESSION AND
ADJOURN.
>> WELL, I WANT TO THANK
EVERYONE FOR A SUCCESSFUL MAY
COUNCIL.
THANK YOU FOR YOUR FLEXIBILITY
IN SCHEDULING AND MAKING SURE
THAT YOU WERE ABLE TO BE HERE.
WE REALLY APPRECIATE THAT.
AND THANKS TO THE COUNCIL
WORKING GROUP FOR THE REVIEW OF
OUR DIVISION OF COMMUNITY HEALTH
AND POPULATION SCIENCE, REALLY
STELLAR WORK, THAT WILL BE VERY
HELPFUL TO NIMHD SO WE'LL TAKE
THE RECOMMENDATION FROM COUNCIL
WHO ACCEPTED THE REPORT AND
WE'LL BEGIN TO DELVE IN AND TAKE
A LOOK AT WHAT SOME OF THE
PRIORITY AREAS MIGHT BE THAT
MIGHT BE ACTIONABLE.
SO THANK YOU FOR THAT.
AND AS ALWAYS, THANK YOU FOR
YOUR SUPPORT OF NIMHD AND SO WE
WILL HEREBY CLOSE THIS MEETING.
HERE IS THE GAVEL.
IT'S STRANGE HITTING THE GAVEL
ON A DESK WITH NOBODY HERE BUT
IT'S FINE.
THERE'S THE GAVEL.
THE MEETING IS ADJOURNED.
THANK YOU, EVERYONE.
>> PLEASE HOLD ON FOR THE CLOSED
SESSION.