>>I'M DIRECTOR OF
MINORITY HEALTH AND HEALTH
DISPARITIES. WELCOME TO THE 60TH
MEETING OF THE NATIONAL COUNCIL
OF MINORITY HEALTH AND HEALTH
DISPARITIES ON TUESDAY MAY 24.
WELCOME EVERYONE WHO IS WATCHING
ON VIDEOCAST AS WELL AS THOSE
WHO ARE IN THE IMMEDIATE ROOM.
THE REST OF THE STAFF WHO ARE ON
VIDEOCAST. SO LET ME TURN IT
OVER TO OUR EXECUTIVE SECRETARY
FOR THIS COUNCIL, DR. MONICA
WEBB HOOPER DEPUTY DIRECTOR OF
NIMHD. MONICA.
>> GOOD MORNING, THANK YOU, DR.
PEREZ-STABLE. WELCOME EVERYONE
TO THE 60TH MEETING OF THE NIMHD
ADVISORY COUNCIL, TODAY'S
SESSION IS OPEN TO THE PUBLIC
AND BEING BROADCAST ON THE NIH
VIDEOCAST NETWORK. 6TH MEETI ME.
COUNCIL MEMBERS I ASK WHEN YOU
SPEAK, ALL PRESENTERS THAT YOU
SPEAK SLOWLY AND DISTINCTLY SO
THAT THE VIDEOCAST OBSERVERS,
TECHNICAL STAFF AND NOTE TAKERS
CAN LISTEN AND NOTE YOUR
COMMENTS. I WILL ADD THERE IS NO
NEED TO ASK IF YOU ARE BEING
HEARD IF YOU ARE RECOGNIZED TO
SPEAK. I WILL PROMPT YOU IF
THERE ARE AUDIO PROBLEMS. AND IN
AN EFFORT TO CONSERVE INTERNET
BANDWIDTH AND MINIMIZE
BACKGROUND NOISE I WILL LEAD THE
ROLL CALL. PLEASE TURN YOUR
CAMERA ON UNMUTE INTRODUCE
YOURSELF AND MAKE A BRIEF
STATEMENT YOUR INSTITUTIONAL
AFFILIATION, YOUR ROLE, AND A
BRIEF STATEMENT ABOUT YOUR
EXPERTISE AND RESEARCH INTEREST
FOLLOWING YOUR INTRODUCTION.
MUTE YOURSELF AND TURN CAMERA
OFF AND MOVE TO THE NEXT PERSON
DR. AGUILA.
>> GOOD MORNING, SO MY NAME IS
EMMA AGUILA, I'M ASSOCIATE
PROFESSOR AT THE SCHOOL OF
PUBLIC POLICY UNIVERSITY OF
SOUTHERN CALIFORNIA. MY RESEARCH
FOCUS ON HOW DIFFERENT DESIGNS
OF SOCIAL INSURANCE PROGRAMS
SUPPLEMENT PROGRAMS HEALTHCARE
SERVICES THAT RACE ECONOMIC
STATUS, IMPROVE THE HEALTH AND
WELL BEING OF MINORITY AND
MIGRANT OLDER ADULTS USING QUASI
EXPERIMENTAL AND EXPERIMENTAL
METHODS. PLEASURE TO BE HERE,
THANK YOU.
>> DR. BARNES.
>> GOOD MORNING, MY NAME IS LISA
BARNES. I AM THE ALLA V AND
SOLOMON JESMER PROFESSOR
GERONTOLOGY AT THE ALZHEIMER'S
DISEASE CENTER AT THE RUSH
UNIVERSITY MEDICAL CENTER. I'M A
COGNITIVE NEUROPSYCHOLOGIST IN
THE DEPARTMENT OF NEUROLOGY AND
MY EXPERTISE IS ON DISPARITIES
IN CHRONIC DISEASE OF AGING,
WITH A PARTICULAR EMPHASIS ON
ALZHEIMER'S DISEASE AND I RUN
COMMUNITY BASED STUDIES OF
AFRICAN AMERICANS TO IDENTIFY
RISK FACTORS FOR ALZHEIMER'S.
HAPPY TO BE HERE.
>> HAPPY TO HAVE YO YO YOU. DR.
CALMAN.
>> GOOD MORNING. MY NAME IS NEIL
CALMAN, FAMILY PHYSICIAN.
PRESIDENT AND CEO OF THE
INSTITUTE FOR FAMILY HEALTH
WHICH IS A NETWORK OF FEDERALLY
QUALIFIED HEALTH CENTERS IN NEW
YORK CITY AND UPSTATE NEW YORK.
I ALSO CHAIR THE DEPARTMENT OF
FAMILY MEDICINE AND COMMUNITY
HEALTH AT MOUNT SINAI. MY
RESEARCH HAVE BEEN IN EQUITY IN
HEALTHCARE ACCESS FOR PEOPLE IN
NEW YORK AND IN RURAL AREAS. AND
MOSTLY IN COMMUNITY INVOLVEMENT
FOR PEOPLE UNDERSTANDING AND
ADVOCATING FOR EQUAL ACCESS TO
CARE. THANK YOU.
>> THANK YOU, GOOD MORNING. DR.
ELLIOT.
>>
>> GOOD MORNING, AMY ELLIOT,
CHIEF CLINICAL RESEARCH OFFICER
AT AVEA HEALTH, A LARGE RURAL
INTEGRATED HEALTH SYSTEM BASED
MANY SOUTH DAKOTA. ALSO
PROFESSOR AND DIVISION CHIEF IN
THE DEPARTMENT OF PEDIATRICS AT
THE UNIVERSITY OF SAN DIEGO
SCHOOL OF MED SEN. RESEARCH
INTERESTS HAVE BEEN IN MATERNAL
CHILD HEALTH PRIMARILY EARLY
CHILDHOOD EXPOSURE PRE-NATAL
EXPOSURES AND EFFECT ON LATER
CHILD DEVELOPMENT. OVER THE PAST
SEVERAL DECADES I HAVE BEEN VERY
INVOLVED IN HELPING HOSPITALS
CLINICS, TRIBES BUILD THEIR INFD
ADVANCE A RESEARCH AGENDA THAT
HELPS WITH RURAL HEALTH AND
AMERICAN INDIAN HEALTH.
>> THANK YOU. MS. ESCALERA.
DR. KEAWE
KAHOLOKULA
>> KEAWE KAHOLOKULA, PROFESSOR
CHAIR OF DEPARTMENT OF NATIVE
HAWAII HEALTH, LEAD PRINCIPAL
INVESTIGATOR FOR PACIFIC
ININVESTIGATIONS KNOWLEDGE AND
OPPORTUNITIES OF CLINICAL
TRANSLATIONAL RESEARCH
INFRASTRUCTURE PROGRAM, ALSO
ACTIVE RESEARCHER DEVELOPING
COMMUNITY BASED INTERVENTIONS TO
ADDRESS ISSUES OF CHRONIC
DISEASE, NATIVE HAWAIIANS AND
PACIFIC ISLANDERS.
>> THANK YOU.
>> DR. MUSTANSKI.
>> GOOD MORNING, EVERYBODY. I'M
DR. BRIAN MUSTANSKI, I'M FACULTY
NORTHWESTERN UNIVERSITY FINEBURG
SCHOOL OF MEDICINE, I DIRECT THE
INSTITUTE FOR SEXUAL AND GENDER
MINORITY HEALTH AND WELL BEING
OR ISJEM, UNIVERSITY WIDE
INSTITUTE FOCUSED ON PROMOTING
LGBT HEALTH RESEARCH AND
CO-DIRECT THE THIRD CO-CENTER
FOR AIDS RESEARCH AND HAPPY TO
SHARE WITH EVERYONE THE NATIONAL
LGBT HEALTH CONFERENCE IS COMING
UP END OF JULY HOTSED BY ISJEM
AND UNIVERSITIES AND COMMUNITY
PARTNERS AND SUPPORTED BY A
CONFERENCE GRANT FROM NIMHD. SO
IF YOU ARE INTERESTED IN THE
FIELD OF LGBT HEALTH PLEASE
CHECK IT OUT.
>> THANK YOU. DR. SIMS.
>> GOOD MORNING, EVERYONE. I'M
MARIO SIMS, PROFESSOR OF
MEDICINE HERE AT THE UNIVERSITY
OF MISSISSIPPI MEDICAL CENTER.
ALSO CHIEF SCIENCE OFFICER FOR
THE JACKSON HART STUDY AND MY
RESEARCH IS ON EXTENT TO WHICH
SOCIAL AND PSYCHOSOCIAL FACTORS
SUCH AS STRESS DISCRIMINATION M
IMPACT CARDIOVASCULAR DISEASE
DISPARITIES. GLAD TO BE HERE.
>> THANK YOU. DR. RESNICOW.
>> THANK YOU, MONICA. I'M KEN
RESNICOW, I'M AT UNIVERSITY OF
MICHIGAN, I SPLIT MY TIME
BETWEEN SO SCHOOL OF PUBLIC
HEALTH AND THE OGLE CANCER
CENTER WHERE I'M ASSOCIATE
HEALTH DISPARITIES RESEARCH, I'M
AN INTERVENTION RESEARCHER SO
MOST OF WHAT I DO INVOLVES SOME
COMBINATION OF MOTIVATIONAL
INTERVIEWING OR EHEALTH TAILORED
INTERVENTION USUALLY IN
UNDER-REPRESENTED OR OTHER
CULTURAL AND RACIAL GROUPS.
>> THANK YOU. DR. REEDE. I'M
SORRY, DR. REEDE IS NOT WITH US
THIS MORNING. DR. SUTHERLAND.
>> I'M PROFESSOR BIOCHEMISTRY AT
THE HOWARD UNIVERSITY COLLEGE OF
MEDICINE ALSO PRINCIPAL
INVESTIGATOR OF RESEARCH CENTER
MINORITY INSTITUTIONS PROGRAM.
RCMI AND MY RESEARCH INTERESTS
IS GENERALLY USING DATA SCIENCE
AS A TOOL TO BETTER UNDERSTAND
CHRONIC DISEASE BURDENS IN THE
WARDS OF WASHINGTON D.C. AND
ANALYSIS OF OMICS TYPE DATA TO
BETTER UNDERSTAND ISSUES RELATED
TO HEALTH DISPARITIES AND
MINORITY HEALTH.
>> THANK YOU. DR. TRINH-SHEVRIN
>> GOOD MORNING, EVERYONE. I'M
CHAU TRINH SHEVRIN PROFESSOR
OKAYAL HEALTH AND MEDICINE,
DIVISION CHIEF OF HEALTH
BEHAVIOR IN DEPARTMENT OF
POPULATION HEALTH NYU SCHOOL OF
MEDICINE. I'M ASSOCIATE
EPIDEMIOLOGIST BY TRAINING AND
MY WORK HAS BEEN FOCUSED ON
UTILIZING A SOCIAL DETERMINANTS
OF HEALTH AND COMMUNITY HEALTH
APPROACHES TO CHRONIC DISEASE
DISPARITIES IN NEW YORK CITY. I
CO-LEAD THE CENTERS INCLUDING
NIMHD CENTER OF EXCELLENCE
FOCUSED ON HEALTH OF ASIAN
AMERICAN COMMUNITIES. I WANT TO
PUT IN A PLUG THAT WE ARE
CO-SPONSORING WITH NATIONAL
COMMUNITY COALITION A CONFERENCE
ON HEALTH OF ASIAN AMERICANS AND
NATIVE HUE I HIGHIANS AND
PACIFIC ISLANDER COMMUNITIES ON
JUNE 7 AND 8TH. THANK YOU.
>> THANK YOU. DR. ZORRILLA.
>> GOOD MORNING. I'M CARMEN
ZORRILLA, I'M APPROXIMATE OBGYN,
IN UNIVERSITY PUERTO RICO SAN
JUAN. I FOCUSED 35 YEARS OF
RESEARCH ON WOMEN LIVING WITH
HIV AND ALSO RECENTLY ON ZIKA
AND COVID. AND PREGNANCY AND IN
WOMEN IN GENERAL. I JUST WANT TO
ALSO THANK FOR THE OPPORTUNITY
TO REPORT THE MISSION OF THE
NATIONAL INSTITUTE OF MINORITY
HEALTH AND HEALTH DISPARITIES
NATIONAL ADVISORY COUNCIL FOR
WHICH TODAY IS MY LAST MEETING.
THIS -- I WANT TO REFLECT IT HAS
BEEN A LEARNING EXPERIENCE AND I
LEAD THIS GROUP FOR -- HEADACHE
THE GROUP SUPPORTING OTHER
INVESTIGATORS TO APPLY AND ALSO
FOCUS ON THE AREAS OF
DISPARITIES. I'M ON THE
OUTSTANDING HEALTH DISPARITIES
WEBSITE, ARE THERE RESEARCH
FRAMEWORK AND OTHER DOCUMENTS
AVAILABLE AND VERY USEFUL FOR
INVESTIGATORS IN THIS AREA.
THANK YOU, DR. PEREZ-STABLE.
>> THANK YOU. AND WE APPRECIATE
YOUR SERVICE. I WILL CERTAINLY
ASK OUR OTHER RETIRING MEMBERS
TO SHARE REFLECTIONS A LITTLE
LATER IN THE MEETING. DROP
JOHNSON.
>> GOOD MORNING, EVERYBODY. I'M
KIMBERLY JOHNSON, PROFESSOR OF
MEDICINE AND THE DUKE UNIVERSITY
SCHOOL OF MEDICINE HERE IN
DURHAM, NORTH CAROLINA. I'M A
GERIATRICIAN PALLIATIVE CARE
CLINICIAN AND ALSO A HEALTH
DISPARITIES INVESTIGATOR. MY
RESEARCH FOCUSES ON IMPROVING
THE QUALITY OF SERIOUS ILLNESS
AND END OF LIFE CARE FOR OLDER
AFRICAN AMERICANS. I ALSO LEAD
OUR HEALTH DISPARITIES IN
MINORITY HEALTH RESEARCH CENTER
OF EXCELLENCE WHICH IS CALLED
REACH EQUITY. REACH EQUITY
FOCUSES ON DEVELOPING AND
TESTING INTERVENTIONS TO ADDRESS
RACIAL ETHNIC DISPARITIES BY
INIMPROVING THE QUALITY OF
PATIENT CENTERED CARE AND THE
CLINICAL ENCOUNTER. THANK YOU.
GLAD TO BE HERE.
>> WONDERFUL TO HAVE YOU. DR.
LONG.
>> HI, I'M JUDITH LONG, I'M THE
CO-DIRECTOR OF THE VA CENTER FOR
HEALTH EQUITY RESEARCH AND
PROMOTION AND I SERVE AS VA
REPRESENTATIVE TO COUNCIL AND I
AM THE DIVISION CHIEF OF GENERAL
INTERNAL MEDICINE AT THE
UNIVERSITY OF PENNSYLVANIA. I
REMY RESEARCH FOCUSES ON
INTERVENTIONS TO ADDRESS SOCIAL
DETERMINANTS OF HEALTH IN AT
RISK POPULATIONS. THANK YOU.
>> THANK YOU. DR. SHELL.
>> GOOD MORNING, EVERYONE. MY
NAME IS DONALD SHELL, ACTING
DIRECTOR OF HEALTH SERVICE
POLICY OVERSIGHT REPRESENTING
DEPARTMENT OF -- EXOFFICIO
MEMBER FAMILY PHYSICIAN AND
DISEASE PREVENTION AND
MANAGEMENT POPULATION HEALTH
OVERSIGHT AND DEPARTMENT OF
DEFENSE INCLUDING WIDE VARIETY
OF DISEASES AND HEALTH EQUITY
AND DISEASE POPULATION OF HEALTH
DEPARTMENT OF DEFENSE. THANK
YOU.
>> THANK YOU. MS. ESCALERA.
HOPEFULLY YOU CAN HEAR ME NOW.
>> WE CAN.
>> THANK YOU. APOLOGIES FOR ALL
THAT AUDIO SNAFU. MY NAME IS
NITZA ESCALERA. I'M ATTORNEY BY
TRAINING. I CURRENTLY TEACH AS
AN ADJUNCT AT JOHN JAY COLLEGE
AND WHEN I WAS PRACTICING I
PRACTICE FOCUS MAINLY ON HIV
AIDS DISCRIMINATION,
REPRODUCTIVE RIGHTS AND ACCESS
TO HEALTHCARE. GOOD MORNING,
EVERYONE.
>> GREAT TO SEE AND HEAR YOU.
HAVE I MISSED ANY OF OUR COUNCIL
MEMBERS IN ATTENDANCE? OKAY. I
ALSO LIKE TO ACKNOWLEDGE THE
NIMHD STAFF WHO ARE WITH US, DR.
STINSON.
>> DIRECTOR OF DIVISION OF
COMMUNITY HEALTH AND POPULATION
SCIENCE IN THE INSTITUTE.
>> THANK YOU, DR. DAS.
>> GOOD MORNING, EVERYBODY.
I'MRYNA DAS, INTEGRATIVE
BIOLOGICAL BEHAVIORAL SCIENCES
DIVISION AT NIMHD.
>> THANK YOU. WE ALSO HAVE
ANOTHER DIVISION DIRECTOR DR.
SANCHEZ WHO IS ON THE VIDEOCAST.
HELLO TO DR. SANTA. WE ALSO HAVE
NEW DIRECTOR OF OF OFFICE OF
EXTRA YOU RECALL MOO RESEARCH
ACTIVITIES. WELCOME TO DR.
POLYCOTTON. KIMBERLY ALAN.
>> GOOD MORNING, I'M KIMBERLY
ALAN EXECUTIVE OFFICER DEPUTY
EXECUTIVE COUNSELOR FOR NIMHD.
>> THANK YOU. I ALSO LIKE TO
ACKNOWLEDGE THE NIMHD STAFF WHO
WORKED MIND THE SCENES TO
PREPARE AND BRING FORTH OUR
COUNCIL MEETING SO THANKS TO ALL
OF YOU. BEFORE WE MOVE ANY
FURTHER, ELISEO, WOULD YOU LIKE
TO ADD COMMENTS OR MAKE ANY
OTHER INTRODUCTIONS YOURSELF?
>> NO, I THINK WE ARE COVERED. I
THINK I NOTICE LINDS SHY
CRISWELL JOINED THE ROOM AND WE
WILL INTRODUCE HER BEFORE SHE
PRESENTS, DIRECTOR OF THE NIAMS
INSTITUTE. REVIEW THE MINUTES.
>> YES WE WILL NOW REVIEW THE
FEBRUARY 2022 COUNCIL MINUTES.
THE CHAT BOX WILL BE USED TO
RECORD THE VOTE ON THE ACTIONS
TODAY. WHEN ASKED ALL IN FAVOR
PLEASE ENTER YES OR Y IN THE
CHAT BOX. WHEN ASKED ANY OPPOSE
PLEASE ENTER NO OR N IN THE CHAT
BOX. THE MINUTES FROM THE
FEBRUARY 2022 COUNCIL MEETINGS
WERE POSTED IN THE ELECTRONIC
COUNCIL BOOK. HAVING REVIEWED
THE MINUTES ARE THERE ANY
QUESTIONS, CONCERNS, OR
CORRECTIONS FOR THESE MINUTES?
IF SO, PLEASE INDICATE THAT IN
THE CHAT BOX. SEEK NONE, MAY I
HAVE A MOTION TO APPROVE THE
MINUTES FROM THE FEBRUARY 2022
COUNCIL?
>> MOTION TO APPROVE.
>> GREAT. MAY I HAVE A SECOND?
>> SECOND.
>> EXCELLENT. ALL IN FAVOR ENTER
Y IN THE CHAT BOX, ANY OPPOSED
ENTER IN THE CHAT BOX OR NO. ANY
ABSTENTIONS ALSO ENTER THAT.
OKAY. AFTER HAVING BEEN MOVED
AND PROPERLY SECONDED THE
MINUTES FROM THE FEBRUARY 2022
ADVISORY COUNCIL MEETING ARE
APPROVED. THANK YOU. NOW WE
WOULD LIKE TO ASK OUR RETIRING
COUNCIL ADVISORY COUNCIL MEMBERS
TO REFLECT MAYBE FOR A FEW
MINUTES ON THEIR EXPERIENCE THUS
FAR OR EXPERIENCE ON THEIR TIME
ON THE ADVISORY COMMITTEE. WE
DID HEAR FROM DR. (INAUDIBLE)
BUT IF YOU WOULD LIKE TO ADD
REFLECTIONS YOU MAY DO SO. DR.
KEAWE KAHOLOKULA, MAY I ASK YOU
TO TAKE THE FLOOR?
>> THANK YOU FOR THAT, EXCUSE
ME, IT IS VERY EARLY IN THE
MORNING HERE SO I'M STILL
GETTING UP. BUT I JUST WANT TO
SAY IT'S BEEN A GREAT PRIVILEGE
AND HONOR TO SERVE ON THIS
COUNCIL AND MAKE SO MANY -- MEET
SO MANY GREAT COLLEAGUES, AND
FRIENDS THAT ARE PASSIONATE
ABOUT IMPROVING THE HEALTH AND
WELL BEING OF OUR MOST
VULNERABLE POPULATIONS IN THE
UNITED STATES. I WOULD LIKE TO
ALLOCATE FOR NATIVE HAWAIIANS
AND PACIFIC ISLANDERS
SPECIFICALLY HAS BEEN A REAL
PRIVILEGE AND HONOR OFTEN WHERE
THEY FEEL OVERLOOKED OFTEN OUR
COMMUNITIES AND TO BE ABLE TO
SIT AT THE TABLE WHERE THESE
DECISIONS ARE MADE ABOUT OUR
POPULATIONS, AND ABOUT THE BEST
WAYS TO ADDRESS THE HEALTH AND
ADVANCE HEALTH EQUITY FOR ALL OF
US. I MADE SOME GREAT CONTACTS
AND RELATIONSHIPS HERE. FORMER
COUNCIL MEMBER NOW SITS ON OUR
EXTERNAL ADVISORY COMMITTEE FOR
INFRASTRUCTURE GRANT AND
CONTRIBUTES SIGNIFICANTLY TO
BUILDING OUR INFRASTRUCTURE HERE
IN HAWAII. BRIAN, DR. MUSTANSKI
AS YOU MAY HAVE HEARD FROM
YESTERDAY BEING ABLE TO LINK A
JUNIOR FACULTY, ACTUALLY NO
LONGER JUNIOR FACULTY, NATIVE
HAWAIIAN DOING VERY WELL AND ON
HER WAY TO BECOMING INDEPENDENT
RESEARCHER BECAUSE OF THE
CONNECTIONS I HAVE BEEN ABLE TO
MAKE HERE BUT MOST OF ALL IT IS
JUST BEEN AGAIN A REAL HONOR TO
BE A PART OF THE PROCESS OF
BEING ABLE TO DEVELOP CONCEPTS
OR DEVELOP IDEAS AROUND THE BEST
STRATEGIES AND WAYS TO ADDRESS
THE CONCERNS OF OUR COMMUNITIES
IN A WAY THAT IS SCIENTIFICALLY
SOUND, CULTURALLY RESPONSIVE,
AND REALLY INVOLVES COMMUNITY
VOICES IN THE PROCESS AS WELL. I
THINK THIS IS ALL INSTITUTES I
HAVE BEEN INVOLVED WITH WHETHER
AS FUNDED INVESTIGATOR OTHERWISE
THIS IS BY FAR THE BEST
INSTITUTE. JUST A LITTLE QUICK
ONE BEFORE I JUMP OFF, I STARTED
MY CAREER WITH A LOAN REPAYMENT,
DIVERSITY SUPPLEMENT SUPPORTED
BY NIMHD MY FIRST R GRANT WAS
FROM NIMHD. SO REALLY BELIEVE IN
A MISSION OF NIMHD AND
DEVELOPING UNDER-REPRESENTED
MINORITIES IN RESEARCH AND I DO
WISH Y'ALL THE BEST INTO THE
FUTURE AND I DO HOPE I CAN BE
ENGAGED IN SOME WAY WITH OTHER
INITIATIVES AND PROJECTS.
>> THANK YOU, DR. MUSTANSKI, MAY
I ASK YOU TO OFFER SOME THOUGHTS
AND REFLECTIONS?
>> THANK YOU IT IS BEEN A
PLEASURE AND HONOR TO BE PART OF
THE COUNCIL FOR FOUR YEARS,
PARTICULARLY I JOINED SHORTLY
AFTER DR. PEREZ-STABLE HAD
DESIGNATED SEXUAL AND GENDER
MINORITY PEOPLE A HEALTH
DISPARITY POPULATION FOR
RESEARCH PURPOSES AT NIH WHICH
IS A GAME CHANGER IN BRINGING
ATTENTION TO THE DISPARITIES
EXPERIENCED BY OUR COMMUNITY AND
THE ROLE RESEARCH AND SCIENCE
CAN PLAY IN CREATING HEALTH
EQUITY. SO JOINING SHORTLY AFTER
THAT WAS A REAL PRIVILEGE AND TO
BE ABLE TO PROVIDE ADVICE TO
THIS COUNCIL ON SGN HEALTH AND
HIV RESEARCH AS WELL AS ADVOCATE
FOR HOW TO INTEGRATE ISSUES OF
MULTIPLE POPULATIONS AND
MULTIPLE HEALTH ISSUES. ONE OF
THE THINGS THAT IS REALLY
VISIONARY AND UNIQUE ABOUT NIMHD
IS IT REALLY FLIPS THE SCRIPT
FROM THIS TRADITIONAL APPROACH
FOCUSING ON A HEALTH ISSUE AND
GOING TO FIND POPULATIONS THAT
EXPERIENCE HEALTH ISSUES SO YOU
CAN STUDY. AND INSTEAD TO CREATE
A MODEL OF INVESTIGATORS
BUILDING SUSTAIN PARTNERSHIPS
WITH MINORITY HEALTH AND HEALTH
DISPARITY COMMUNITIES AND
FINDING WHAT THEIR NEEDS ARE AND
WORKING TO ADDRESS THEM, IT IS A
POWERFUL MODEL AND ALLOWS US TO
ADVANCE HEALTH IN A REALLY
INNOVATIVE WAY. SO IT'S BEEN A
REAL PLEASURE AS DR. KEAWE
KAHOLOKULA MENTIONED, IT'S BEEN
GREAT TO FORM COLLABORATIONS,
GET TO KNOW OTHERS AND I WANT TO
THANK YOU FOR THE OPPORTUNITY TO
BE PART OF THIS COUNCIL.
>> THANK YOU. WE ALSO HAVE DR.
JOAN REEDE WHO IS ALSO RETIRING
COUNCIL MEMBER, SHE WASN'T ABLE
TO JOIN TODAY BUT DID WANT TO
ACKNOWLEDGE AND THANK HER FOR
HER FANTASTIC SERVICE AS PART OF
NIMHD ADVISORY COMMITTEE.
BEFORE WE MOVE ON, DR. ZORRILLA,
DO YOU HAVE ANY OTHER
REFLECTIONS YOU WOULD LIKE TO
ADD?
>> THANK YOU SO MUCH, I ALREADY
DID.
>> GREAT. OKAY NEXT, FUTURE
MEETING DATES ARE LISTED ON THE
AGENDA. AFTER REVIEWING THE
DATES THIS IS FOR COUNCIL
MEMBERS, PLEASE LET US KNOW IF
THERE IS A DATE YOU CAN'T MAKE,
IT IS VERY IMPORTANT WE HAVE A
QUORUM OF ADVISORY COUNCIL
MEMBERS AT EACH MEETING TO
CONDUCT THE BUSINESS OF THE
INSTITUTE. THE LAST COUNCIL
MEETING IN 202 WILL BE HELD ON
SEPTEMBER 1 AND 2ND. THE 20223
COUNCIL DATES ARE FEBRUARY 6 AND
7 OF 2023. MAY 22ND, AND 23RD
AND AUGUST 3 ISST AND SEPTEMBER
1ST. PLEASE NOTE IT IS AN NIH
POLICY THAT A COUNCIL MEMBER MAY
HAVE ONLY ONE ABSENCE PER
CALENDAR YEAR AND INDIVIDUAL
CANNOT SERVE ON ANY NIH PEER
REVIEW PANELS WHILE SERVING AS A
COUNCIL MEMBER. WE WILL NOW TURN
OVER THE MEETING TO DR.
PEREZ-STABLE FOR THE NIMHD
DIRECTORS REPORT. AFTER HIS
PRESENTATION THE FLOOR WILL BE
OPEN FOR DISCUSSIONS QUESTIONS
AND COMMENTS. YOU MAY TYPE THE
WORD QUESTION, COMMENT OR USE
THE RAISED HAND FEATURE TO FLAG
YOUR INTEREST IN SPEAKING YOU
DON'T HAVE TO TYPE THE ACTUAL
QUESTION OR COMMENT. I WILL BE
MONITORING THE CHAT BOX AND WILL
CALL ON YOU IN THE ORDER
SUBMITTED OR THE OTHER OF HANDS
RAISED. IT IS IMPORTANT THAT
YOUR REMARKS ARE PART OF THE
AUDIO FOR THE NIH VIDEOCAST SO
WHEN YOU ARE CALLED UNMUTE YOUR
SPEAKER, TURN ON YOUR VIDEO AND
ONCE YOU HAVE SPOKEN PLEASE TURN
OFF YOUR CAMERA AND MUTE YOUR
SPEAKER. DR. PEREZ-STABLE.
>> THANK YOU SO MUCH, MONICA. I
WANT TO ESPECIALLY THANK ALL THE
COUNCIL MEMBERS. THIS IS REALLY
A PRIVILEGE FOR ME AS NIMHD
DIRECTOR TO HELP SELECT AND WORK
WITH YOU OVER YOUR FOUR YEAR
APPOINTMENT, ENJOY THE
COMRADERY, INTELLECTUAL
DISCOURSE AND ALL YOUR GREAT
ADVISE WE TAKE YOUR WORD AS
IMPORTANT ADVICE IN THINKING
ABOUT WHERE THE INSTITUTION
DIRECTIONS ARE.
IT'S BEEN AS USUAL AN ACTIVE
LAST ALMOST FOUR MONTHS SO LAST
COUNCIL MEETING IN EARLY
FEBRUARY. SO I WILL PROCEED WITH
SUMMARY WHERE WE HAVE BEEN.
COUPLE OF MAJOR NEW
APPOINTMENTS. AT THE DEPARTMENT
LEVEL ROB CALIFF WAS CONFIRMED
BY THE SENATE AFTER SOMEWHAT
CONTENTIOUS NOMINATION PROCESS.
ROB IS COMING BACK TO BE FDA
COMMISSIONER FOR SECOND TIME. HE
IS A CARDSOLOGIST, REALLY
DISTINGUISHED AND ACCOMPLISHED
CLINICAL INVESTIGATOR IN
INTERVENTIONS IN CLINICAL
CARDIOLOGY PROBABLY DEFINE
MODERN ERA OF INTERVENTIONAL
CARDIOLOGY ALONG WITH OTHERS. I
HAVE THE SHARED FIRST TWO YEARS
OF RESIDENCY TOGETHER AT UCSF SO
WE GO WAY BACK. ROBERT VALDEZ OR
BOB, ROB VALDEZ IS MORE COMMONLY
KNOWN WAS APPOINTED DIRECTOR OF
THE AGENCY FOR HEALTHCARE
RESEARCH AND QUALITY ROB CAME
FROM UNIVERSITY OF NEW MEXICO.
WHERE HE HAD BEEN THE LAST
DECADE OR SO IN PREVIOUSLY IN
THE FEDERAL GOVERNMENT AT HRSA,
HE IS A HEALTH SERVICES
RESEARCHER AND WE WILL WORK
CLOSELY WITH THEM AND WILL BE
PRESENTING TO COUNCIL LATER. DR.
(INDISCERNIBLE) WAS APPOINTED AS
THE CORONA VIRUS RESPONSE
COORDINATOR. AFTER THE INITIAL
APPOINTEE STEPPED DOWN OR
ANNOUNCED HE WAS STEPPING AWAY.
DR. JA (PHONETIC) IS DEAN SCHOOL
OF PUBLIC HEALTH AT BROWN
UNIVERSITY, HE IS A GENERAL
INTERNIST ALSO KNEW HIM FROM MY
TIME AT UCSF WHERE HE WAS A
RESIDENT AND FELLOW IN THE VA
MEDICAL CENTER THERE. DID
RESEARCH AND HAD BEEN EITHER HAD
BEEN IN THE NORTHEAST NOW
HARVARD INITIALLY THEN AT BROWN
SINCE THEN. SO HE IS THE
COORDINATOR FROM THE WHITE
HOUSE. ONE CAVEAT ASHISH TALKED
ABOUT IN ONE OF HIS INTERVIEWS
BEFORE HE WAS APPOINTED WAS THAT
WEARING MASKS IS LIKE AN
UMBRELLA. WHEN CASES ARE HIGH,
WEAR IT, WHEN CASES ARE LOW YOU
CAN RELAX. AND NOT HAVE TO HAVE
AN UMBRELLA SO JUST REMINDER FOR
EVERYONE ON WHAT WE DO FOR
COVID. WE ARE CERTAINLY IN A
PERIOD WE SHOULD BE WEARING
MASKS INDOORSS. DR. COLLINS OUR
NIH DIRECTOR HAS STEPPED DOWN IN
DECEMBER AND WENT BACK TO HIS
LAB TO DO SCIENCE, DIDN'T LAST
LONG IN THAT MODE. HE RESPONDED
TO THE CALL FROM PRESIDENT BIDEN
IN MID FEBRUARY TO TAKE ON THE
ROLE OF ACTING SCIENCE ADVISOR
TO THE PRESIDENT WHICH DOES NOT
REQUIRE CONGRESSIONAL
CONFIRMATION.
ASHISH JHA
APPOINTED AS RESPONSE
COORDINATOR, WHICH IS NOT
REQUIRE SENATE CONFIRMATION. AND
ASHISH (PHONETIC) I MENTIONED
TALKING ABOUT WEARING MASKS WHEN
IT IS RAINING AND WE AND IT IS
RIBBING NOW IN MODERATE
TRANSMISSION MODE. FRANCIS
COLLINS NIH DIRECTOR STEPPED
DOWN IN DECEMBER BUT BY MID
FEBRUARY WAS ASKED BY PRESIDENT
BIDEN TO TAKE OVER THE ROLE OF
ACTING SCIENCE ADVISOR TO THE
PRESIDENT AFTER THE CHANGE IN
THAT OFFICE AND THIS IS NOT A
CABINET LEVEL POSITION AS
OPPOSED TO THE DIRECTOR OF THE
WHITE HOUSE OFFICE OF SCIENCE
AND TECHNOLOGY POLICY WHICH HAS
AN ACTING ROLE NOW WITH THE
FORMER DEPUTY. DR. NED SHARPLESS
ANNOUNCED DECISION TO LEAVE NCI
IN EARLY APRIL AND STEP DOWN AT
THE END OF THE MONTH. HE WAS THE
15TH DIRECTOR OF THE NATIONAL
CANCER INSTITUTE. NED ALSO HAD
SERVED AS ACTING COMMISSIONER
FOR THE FOOD AND DRUG
ADMINISTRATION DOING THE
INTERVAL BETWEEN THE TWO FDA
COMMISSIONERS UNDER FORMER
PRESIDENT TRUMP. DR. DOUG LOWY
WILL SERVE AS NCI ACTING
DIRECTOR, A PRESIDENTIAL
APPOINTMENT WITHOUT SENATE
CONFIRMATION SO WE WILL WAIT FOR
THAT TO HAPPEN. I HAVE TO SAY MY
TIME COINCIDING WITH NED WAS
VERY, VERY POSITIVE. WE WORK
WELL TOGETHER WITH NUMBER OF
INITIATIVES, AS AN NCI DIRECTOR
I FIND HIM APPROACHABLE AND
REALLY UNDERSTOOD THE ISSUES
THAT CONCERNED US AT NIMHD IN
TERMS OF DISPARITIES. I HAD THE
HONOR AND THRILL TO VISIT THE
WHITE HOUSE ON FRIDAY MARCH 18TH
WITH VERY LITTLE ADVICE NOTICE.
DR. TABAK AND I WERE INVITED TO
JOIN THE SECRETARY AND THREE
MEMBERS OF THE CONGRESS FOR THE
SIGNING OF THE JOHN LOUIS NIMHD
RESEARCH ENDOWMENT ACT. THIS IS
A THE NIMHD ENDOWMENT WHICH WE
HAVE BEEN AUTHORIZED TO FUND
SINCE FOUNDING OF THE CENTER
MINORITY HEALTH AND HEALTH
DISPARITIES AND IT WAS A --
SOMEWHAT OF A FIX ON THE
ELIGIBILITY CRITERIA THAT WE HAD
BEEN WORKING ON FOR SOME TIME.
AND IT BECAME VERY HIGH-LEVEL
PRESENTATION AND GAVE ME THE
OPPORTUNITY TO MEET THE
PRESIDENT AND LISTEN TO HIM FOR
A FEW MINUTES WHILE WE WENT
THROUGH THE CEREMONY. WANTED TO
SHARE THAT OPPORTUNITY WITH YO .
LET ME SPEND COUPLE OF MINUTES
TALKING ABOUT ARPAH. SOMETHING
OUR IMMUNITY HAS NOT BEEN AS
PROACTIVE ABOUT AS PERHAPS OTHER
INSTITUTES. THIS IS THE PROPOSED
AGENCY TO BENEFIT ALL AMERICANS
BY CATALYZING BREAKTHROUGHS
MODELED ON THE DARPA MODEL, FROM
THE DEPARTMENT OF DEFENSE, MOST
FAY LOUSE MOUSILY CREDITED WITH
HAVING INVENTED THE INTERNET AND
GPS AMONG OTHERS THINGS, THINGS
THAT CLEARLY AFFECT OUR DAILY
LIVES ACROSS THE GLOBE. THE GOAL
WAS TO SUPPORT HIGH RISK HIGH
REWARD RESEARCH USING A
DIFFERENT MODEL THAN THE NIH HAS
USED. APPLICATIONS AND
IMPLEMENTATION OF BREAKTHROUGHS
REALLY GOING FROM VIEW HERE
PERSPECTIVE WAS TO GO FOR
MOLECULAR WHAT IS THE NEW CURE
FOR ALZHEIMER'S RELATED DEMEN
DEMENTIAS OR DIABETES OR CANCER
TO SOCIETAL ONES MANY THE
IMPLEMENTATION OF HEALTHCARE
INTERVENTIONS AND CARE
POPULATIONS. THAT IS THE
ORIGINAL VISION. IT IS REALLY A
WAY OF LOOKING AT EVERYTHING IN
A FASTER TRACK USING DIFFERENT
MODEL OF MILESTONE -- NOT
MEETING MILESTONES DON'T HAVE
FIVE YEARS TO SEE WHAT YOU CAN
DO. VERY CLOSELY MANAGED BY
STAFF. IT WOULD BE IN IN THE
IDEAL SETTING COMPLIMENTARY TO
NOT DUPLICATIVE OF NIH PROGRAMS
THAT ABLE TO TAKE ADVANTAGE OF
THE NIH EXPERTISE, KNOWLEDGE
INFRASTRUCTURE INCLUDING THE
ADMINISTRATIVE AND
ORGANIZATIONAL INFRASTRUCTURE,
BUT REMAIN DISTINCT WITH ITS OWN
SEPARATE CULTURAL ORGANIZATION.
AT LEAST THAT IS THE CONCEPTUAL
IDEA. THE CURRENT STATUS OF
ARPAH IS IT RECEIVED A BILLION
DOLLARS IN APPROPRIATIONS SINCE
FISCAL YEAR 22 IN MARCH ALONG
WITH THE REST OF OUR BUDGET.
THIS IS THREE YEAR MONEY SO THEY
DON'T HAVE TO SPEND IT BY THE
END OF SEPTEMBER, DIRECTOR OF
ARPAH WILL BE A PRESIDENTIAL
APPOINTMENT SO THAT IS ALSO IN
THE QUEUE. THEY WILL USE A LOT
OF NIH RESOURCES IN TERMS OF
HIRING AND AWARDS AND ERA, ET
CETERA, BUT IT WILL HAVE
DIFFERENT FLEXIBILITIES AND WE
HAVE AT NIH. THERE WAS A
COMMENTARY PUBLISHED LAST YEAR
TO DESCRIBE THE VISION OF WHICH
DR. COLLINS WAS ONE OF THE
AUTHORS. ARPA H ALONG WITH
OTHERS AND ARPA H WAS OFFICIALLY
NOT PLACED ANYWHERE IN THE
OMNIBUS BILL. AND HAD TO BE
DECIDED ON BY THE SECRETARY
WITHIN 30 DAYS, SECRETARY MOVED
IT TO NIH AT THAT TIME. AND ALSO
DECIDED THE ARPA H DIRECTOR
WOULD REPORT TO THE SECRETARY
DIRECTLY. SO THERE WAS A DOTTED
LINE BETWEEN NIH DIRECTOR AND
ARPA H DIRECTOR, LOCATION RIGHT
NOW IS BY DEFAULT IN THE
WASHINGTON MARYLAND VIRGINIA
AREA BUT THAT HAS ALSO NOT BEEN
SETTLED. THERE ARE SENTIMENTS IN
CONGRESS TO BOTH MAKE ARPA H
INDEPENDENT OF NIH AND PUT IT
OUTSIDE OF THE DMV THIS AREA. WE
WILL SEE WHAT WILL HAPPEN.
TURNING TO NIMHD ACTIVITIES OVER
THE LAST SEVERAL MONTHS WE HAD A
SECOND ANNUAL WONDERFUL EVENT
WITH THE SURGEON GENERAL VIVEK
MURTHY, LECTURE SERIES FOR
PUBLIC HEALTH LEADERSHIP, DONE
IN MONTH OF MAY AND OBSERVATION
OF ASIAN AMERICAN HAWAIIAN
PACIFIC ISLANDER MONTH. WE HAD
PRIVILEGE OF LISTENING TO THE
MAYOR OF BOSTON MICHELLE WU WHO
IS REALLY A QUITE A REMARKABLE
INDIVIDUAL AND OUR OWN MONICA
WEBB HOOPER WAS JUST A WONDERFUL
MODERATOR AGAIN IN FIRE SIDE
CHAT FORMAT, DR. MORTI ALSO
PARTICIPATED OF COURSE AND RINA
DAS WAS THE MAIN ORGANIZER. SO
YOU CAN SEE IT ON VIDEO WATCH AT
NIH, VIDEOCAST AT NIH. WE
GRADUATED A 6TH RWANDAN
PHYSICIAN TO PARTICIPATE IN
NIMHD NIDDK HEALTH PROGRAM, THIS
IS A PROGRAM THAT INITIATED IN
2015, 16 WHEN ANN SUMNER
APPROACHED ME AND ASKED WOULD
NIMHD SUPPORT A FELLOW FROM
RWANDA TO HAVE A YEAR EXPERIENCE
AT NIH AS RESEARCHER. DR. SUMNER
IS SENIOR INVESTIGATOR IN THE
NATIONAL INSTITUTE OF DIABETES
AND KIDNEY DIGESTIVE DISEASES,
WHERE SHE HAS A PROGRAM ON
DIABETES IN AFRICAN IMMIGRANTS.
PRETTY MUCH ALL OF THE VISITING
SCHOLARS HAVE BEEN PHYSICIANS,
THEY HAVE RECEIVED TRAINING IN
CLINICAL RESEARCH, HAVE
CONDUCTED RESEARCH AND
CONTRIBUTED TO AND LED
PUBLICATIONS. WE HAD AND IN
PERSON LECTURE THIS YEAR WITH
DR. GOTTESMAN WAS ON VIDEO BUT
DR. COURTHOUSE FROM NIDDK WAS
THERE AND THIS IS ANN SUMNER
HERE, MY CURSOR ISN'T WORKING,
SO I CAN'T SHOW YOU, ANN IS ALSO
A MAJOR ADVOCATE FOR DISABILITY
ACCESS AT NIH. TURNING TO
BUDGET, THE MARCH OMNIBUS BILL
GAVE NIMHD BIGs DISCRETIONARY
INCREASE EVER. WE WENT UP BY $50
MILLION FOR HEALTH DISPARITIES
RESEARCH WITHOUT AN EARMARK
INCLUDED. THERE WERE OTHER
INCREASES RELATED TO THE OVERALL
INCREASE AND FOR SPECIFIC
SPECIFIC INCREASE FOR MY
COORDINATING CENTER. YOU CAN SEE
THE TRACK, WE TRENDED INCREASE
WITHIN NIH INCREASES EACH YEAR
IN FISCAL 21, MULTIPLE CHRONIC
DISEASE RESEARCH CENTERS AND IN
FISCAL 22 WE HAD MAJOR INCREASE.
WE HAD HOPED FOR HIGHER
INCREASE, BUT THAT DIDN'T
MATERIALIZE ALTHOUGH THE
INCREASE OF 200 MILLION IS IN
THE PRESIDENT'S BUDGET FOR 2023
SO WE SHALL SEE WHAT HAPPENS.
THIS SLIDE IS ILLUSTRATIVE OF
WHAT WE HAVE BEEN ABLE TO DO
IMPACTING THE TRAINING AWARDS
PRIMARILY KO 8 K 23 AND KO 1s,
K99s HAVE BEEN PARTS OF
NIMHD'S PORTFOLIO AND THEY HAVE
INCREASED OVER TIME MORE
VARIABLE. IF YOU LOOK AT THE
2021 COLUMN THE GREEN, RED
VIOLET, THOSE ARE ALL K AWARDS
SO, NUMBER OF F GRANTS MORE OR
LESS ARE GOING UP GRADUALLY,
2022 IS TOO EARLY TO HAVE ANY
FINAL WORD ON IT. WE ARE
PARTICULARLY PROUD OF THIS AND
WE LOOK TO INCREASE THIS AS OUR
BUDGET GOES UP. ANOTHER EXAMPLE
OF WHERE WE HAVE BEEN OVER TIME
IS TO LOOK AT THE NUMBER OF RO1
APPLICATIONS WE HAVE RECEIVED.
IN GOING FROM 2016 TO 2021,
WHERE WE HAVE FULL YEAR NUMBER
OF APPLICATIONS YOU CAN SEE THEY
HAVE GONE UP BY ALMOST FOUR FOLD
OVER THIS PERIOD OF TIME.
UNFORTUNATELY OUR AWARD RATE HAS
ALSO DECREASED BY ABOUT HALF.
ALTHOUGH HOPEFULLY WE BOTTOMED
OUT IN 2020 AND WILL BE BEGIN TO
SEE INCREASE FROM YEAR-TO-YEAR,
I'M OPTIMISTIC OUR SUCCESS RATE
FOR 2022 WILL BE AT LEAST 13% IF
NOT HIGHER THAN 2021 IT IS FAR
FROM OVER. THIS IS ONE OF THE
MAIN AREAS WE WOULD EXPAND IF WE
INCREASE OUR BUDGET. AS WE
INCREASE OUR BUDGETS. IN
COMPARISON OF EARLY STAGE TO
ESTABLISHED INVESTIGATOR
SUCCESS, YOU CAN SEE THAT FISCAL
21, 18.4% OF OUR EARLY STAGE
INVESTIGATORS WERE SUCCESSFULLY
AWARDED FOR RO1 APPLICATION
COMPARED TO 21% ESTABLISHED
INVESTIGATORS SHOWING YOU ALL
THE DATA HERE TO SEE IN BETWEEN
INVESTIGATORS, BUT YOU GET A
SENSE THAT WE ARE GETTING
APPLICATIONS FROM OUR FUTURE
EARLY STAGE INVESTIGATORS BUILD
GREAT ERICA DRER, CADRE OF LEGIE
FUNDING. ON THE LEGISLATIVE
FRONT HAVE BEEN ACTIVE. THERE
WAS IN BRIEFING WITH THE FOUR
CORNERS OR THE FOUR
APPROPRIATIONS COMMITTEES, THE
STAFFERS. WHICH RUN THE
COMMITTEES. TO BROADEN UPDATE ON
ONGOING COVID WORK WAS NUMBER OF
IC DIRECTORS PRESENTED INCLUDING
DR. TROMBURG AND GIB BONNES AND
I PRESENTED ON RADX FOR
UNDERSERVED POPULATIONS AND GARY
GIBBONS PRESENTED ON CO 2
PROGRAMS WE ARE VERY MUCH
INVOLVED WITH IT I BRIEFED THE
SENATE FINANCE COMMITTEE
MAJORITY STAFF ON DATA ANALYTICS
AND RESEARCH ON HEALTH
DISPARITIES RESEARCH. ALTHOUGH
NOT NOT SHOWN HERE I ALSO
BRIEFED A MINORITY STAFFER
ANOTHER COMMITTEE ON INCLUSIVE
PARTICIPATION IN CLINICAL
RESEARCH. DR. STINSON BRIEFED
DAVID PRICE STAFFER ON THE COE
PROGRAM AND DUKE UNIVERSITY COE
PROGRAM IN PARTICULAR. WE
BRIEFED THE -- THERE IT IS.
ENERGY AND COMMERCE MINORITY
COMMITTEE ON DIVERSITY IN THE
WORK FORCE. LOT OF INTEREST IN
THE LATTER ASPECT, SOME OF IT
WAS THE DATA FROM NIH PROVIDED
BY OFFICE OF EXTRAMURAL RESEARCH
FROM MIKE LAUER OFFICE AND ALSO
EXPERIENCE WE HAD WITH THE
MODERNA VACCINE TRIA TRIAL. WE E
DELIGHTED TO WELCOME PAUL COTTON
TO THE NIMHD LEADERSHIP, PAUL
COMES TO US WITH 20 YEARS OF
FEDERAL SERVICE MOST RECENTLY AT
THE NATIONAL HEART LUNG BLOOD
INSTITUTE WHERE HE WAS PROGRAM
OFFICER, THE LEAD PROGRAM
OFFICER FOR THE DECIPHER
PROGRAM. HE ALSO SPENT TIME AT
THE NATIONAL INSTITUTE OF
NURSING RESEARCH AND NUMBER OF
YEARS AT THE U.S. DEPARTMENT OF
AGRICULTURE WHERE HE ACTUALLY
WAS IN THE LEAD OF THEIR
RESEARCH PROGRAM. THAT HAS A
BUDGET OVER $100 MILLION. DR.
COTTON HAS A BACKGROUND IN
NUTRITIONAL SCIENCES. HE IS A
GRADUATE OF HOWARD UNIVERSITY,
VERY PROUD AND I THINK MIGHT
STILL BE A WRESTLING COACH
THOUGH MAY HAVE HAD TO GIVE THAT
UP. WE WILL BE DELIGHTED TO HAVE
HIM JOIN AND BE THE FUTURE
EXECUTIVE SECRETARY OF THIS
COUNCIL, SO YOU WILL GET MORE,
BETTER IN THE NEXT COUNCIL
MEMBER. NEW MEMBERS OF NIMHD,
STAFF MEMBERS I SHOULD SAY
(INDISCERNIBLE) JOINED THE
DIVISION OF CLINICAL HEALTH
SERVICES RESEARCH, SIDONIA
BRINGS RICH EXPERIENCING
CLINICAL CARE AS A SOCIAL WORKER
AND SHE IS GOING TO BE WORKING
UNDER AVILA SANTA, OFFICE OF
DIRECTOR GINA TRANSITIONED FROM
CONTRACTOR TO EMPLOYEE, AS
ADVISOR DIRECTLY WORKING WITH
DR. WEBB HOOPER AND I AS WE TAKE
ON DIFFERENT ASPECTS OF PROJECTS
WITHIN THE INSTITUTE. FINALLY
NEW ADMINISTRATIVE OFFICER
CRYSTAL LIONS JOINED THE OFFICE
OF ADMINISTRATIVE MANAGEMENT. WE
CERTAINLY CONTINUE TO RECRUIT
MORE STAFF THAN ARE NEEDED. SOME
INTERESTING ACTIVITIES, BLOGS
AND POSTS, MOST PROUD OF THE ONE
I DID WITH NED SHARPLESS ON THE
FIRST PROGRAM. STRENGTHENING
INCLUSIVE EXCELLENCE IN
BIOMEDICAL RESEARCH WILL
HOPEFULLY HEAR MORE ABOUT THIS
PROGRAM OVER TIME. NOT
NECESSARILY TODAY. AS THE SECOND
AND THIRD COHORT WILL BE AWARDED
OVER THE NEXT YEAR OR SO. I HAD
THE HONOR BEING INTERVIEWED BY
KOBE SMITH, FOR HER PODCAST BLOG
POST ON DIFFERENT KIND OF
LEADER. IT WAS FUN AND ENJOYED
THE TIME AND IT IS ACTUALLY NOW
POSTED. MANY OF OUR STAFF WERE
RECOGNIZED IN DIFFERENT AWARD
SETTINGS THIS PAST YEAR.
PARTICULARLY CALL THIS OUT,
BECAUSE IT WAS A DEPARTMENTAL
AWARD FOR THE WORK ON RADX
INITIATIVE. IN OUR CASE THE RADX
UNDERSERVED POPULATION
INITIATIVE. YOU CAN SEE ALL THE
NAMES HERE OF ALL DIFFERENT
STAFF WHO WORK SO MUCH TO GET
THIS STARTED IN REVIEWED AND
GOING. AND OF COURSE CONTINUE
WITH MUCH EFFORT COMING FROM A
NUMBER OF STAFF EXCEPT FOR OF
COURSE THE THREE WHO HAVE
RETIRED. JUST TO MENTIONED
WHEREX BRIEFLY, THE EXCITEMENT
OF GETTING IT STARTED AND MAKING
THE INITIAL AWARDS IS OVER. WE
ARE NOW IN A DIFFERENT PHASE.
DUKE UNC COORDINATING CENTER
NIMHD STAFF MEET EVERY OTHER
WEEK. WE HAVE FUNDED 127 UNIQUE
PROJECTS, ACROSS THE COUNTRY
FROM HAWAII TO PUERTO RICO. IN
DIFFERENT FORMATS. MENTIONED
COORDINATION -- COORDINATING
CENTER. 112,000 UNIQUE
PARTICIPANTS HAVE BEEN CONSENTED
SO FAR AS OF EARLY MAY. WITH
OVER 222,000 UNIQUE TESTS DONE,
SOME OF THEM ARE NOT IN PEOPLE
WHO HAVE CONSENT AND COMPLETED
SURVEYS. THEY ALSO ABSTRACTED
ALMOST 1.7 MILLION INDIVIDUAL
TESTS FROM THE ELECTRONIC HEALTH
RECORDS. NUMBER OF GRANTS HAVE
BEEN GIVEN TO COMMUNITIES AS
WELL AS RAPID RESEARCH PILOT
AWARDS, AND OVER 75 PROJECTS ARE
SHARING DATA WITH THE CDCC
ACTIVELY NOW. THE SCIENTIFIC
SYMPOSIUM ON MAY 3RD HAD SIX
PRESENTATIONS VERY DIFFERENT
VERY EXCITING WITH PRELIMINARY
DATA OUTCOME RESULTS, MANY OF
THEM. THERE ARE 50 PUBLICATIONS
AT LEAST THAT HAVE COME FROM
RADX UP PROGRAM SO FAR. WE LOOK
FORWARD TO CONTINUING THIS
EFFORT TO BUILD THIS DATABASE
THAT CAN BE USED BIOVAR
INVESTIGATORS TO EVALUATE. I
HAVE THE HONOR OF BEING
CORRESPONDING AUTHOR ON THIS
VIEWPOINT THAT WAS TAKEN BY JAMA
AND PUBLISHED THIS LAST MONTH,
IT WAS AN EFFORT GENERATED BY
THE OFFICE OF NUTRITIONAL
RESEARCH, DIRECTED BY CHRIS
LYNCH AND NOW OFFICE OF DIRECTOR
IN WORKING WITH OUR STAFF IN
MANY COMMUNICATIONS, SHANNON
ZINK AND LARRY TABAK AND I,
PUBLISHED THIS VIEWPOINT ON THE
IMPORTANCE OF ADDRESSING
NUTRITION AND SECURITY. SO I
ENCOURAGE YOU TO LOOK AT THAT.
MONICA WEBB HOOPER PUBLISHED A
PAPER, COMMENTARY ON COVID-19
AND SOCIAL DETERMINANTS OF
HEALTH. I WAS ALSO PRIVILEGED TO
BE PART OF THIS. AND HIGHLIGHTS
ALL THE FACTORS RELATED TO
HEALTH AND HEALTHCARE
SOCIOECONOMICS AND ENVIRONMENTAL
DETERMINANTS IN A STRUCTURAL
RACISM AND DISCRIMINATION
PERSPECTIVE. THIS WAS IN
BEHAVIORAL MEDICINE COUPLE OF
MONTHS AGO. THE JOURNAL
PSYCHIATRY HAD A SPECIAL ISSUE
ON STRUCTURAL RACISM AND MENTAL
HEALTH DISPARITIES BUILDING ON A
WORKSHOP THAT WAS CO-SPONSORED
BY NIMH AND NIMHD. CRYSTAL
BARKSDALE WAS LEAD ON PUSHING
THIS, I CO-AUTHORED THE
COMMENTARY ALONG WITH JOSH
GORDON AND CRYSTAL IN THIS
ISSUE. THIS WAS JUST PUBLISHED
YESTERDAY I BELIEVE, AND I THINK
WE ARE NOW APPRECIATING THE
EFFECTS OF THE PANDEMIC, MILLION
PEOPLE HAVE DIED IN THIS
COUNTRY, WE HAVE HAD OVER 500
MILLION CASES WORLDWIDE, THE
BURDEN ON MEDICAL SIDE IS
ENORMOUS BUT THE CONSEQUENCES ON
MENTAL HEALTH PARTICULARLY AMONG
OUR YOUTH I THINK ARE GOING TO
BE WITH US FOR A LONG TIME. THIS
IS AN AREA THAT WILL NEED
INTENSIVE RESEARCH BOTH ON A
UNDERSTANDING MECHANISMS AND
INTERVENING TO MEDIATE,
ALLEVIATE THESE. TURNING TO SOME
SCIENTIFIC ADVANCES, OVER THE
COURSE OF THE LAST SEVERAL
MONTHS, THIS MAY HAVE BEEN ONE
OF THE MOST IMPORTANT PAPERS
PUBLISHED RECENTLY. IT WAS IN
NEW ENGLAND JOURNAL FOCUSED ON
MINORITY HEALTH HEALTH
DISPARITIES. IT WAS TREATMENT
OF WHAT THE AUTHORS CALLED MILD
CHRONIC HYPERTENSION, A THROW
BACK TO TERMINOLOGY WE USED TO
USEUSE. THIS IS SYSTOLIC BLOOD
PRESSURE LESS THAN 160 BUT OVER
140. AND DIASTOLIC BETWEEN 90 TO
104. THAT'S MILD HYPERTENSION
AND CHRONIC IN THAT IT WASN'T
NEW WITH PREGNANCY. SO THE WOMEN
WERE ALREADY KNOWN TO HAVE HIGH
BLOOD PRESSURE. WHY IS THIS
IMPORTANT? ONE IS HYPERTENSION
DISPROPORTIONATELY AFFECTS
AFRICAN AMERICANS. LATINA WOMEN
AND WHITE WOMEN HAVE SIMILAR
RACE OF HYPERTENSION AND IT IS A
RISK FACTOR THAT CAN BE MODIFIED
VERY EASILY WITH MEDICATIONS TO
PREVENT COMPLICATIONS. PREGNANT
WOMEN WITH HYPERTENSION EVEN
MILD HYPERTENSION HAVE A HIGHER
RATE OF SIGNIFICANT MATERNAL
MORBIDITY, A PROBLEM THAT HAS
CHALLENGED THE U.S. HEALTH
SYSTEM AND INVESTIGATORS. SO THE
ACTIVE TREATMENT GROUP RECEIVED
MUCH MORE AGGRESSIVE OR
INTENSIVE ANTI-HYPERTENSIVE
MEDICATION TO LOWER TO A GOAL OF
UNDER 140 OVER 90 WHILE CONTROL
GROUP WOULD NOT RECEIVE AS
ACTIVE MEDICATIONS UNLESS THEY
WENT ABOVE 160 OVER 105. KEEP IN
MIND THAT THE NORMAL PHYSIOLOGY
OF PREGNANCY LEADS TO A LOWERING
OF BLOOD PRESSURE AND MOST WOMEN
WHO ARE PREGNANT BLOOD PRESSURE
IS MORE LIKE 110 OVER 70 IN THAT
RANGE. YOU CAN SEE THE RESULTS
IN THIS CHART, THE ACTIVE
TREATMENT GROUP HAD AN ABSOLUTE
REDUCTION OF 7% IN THE PRIMARY
OUTCOME. THE OUTCOME WAS A
COMPOSITE OF SEVERE
PRE-ECLAMPSIA. PRE-TERM BIRTH
BEFORE 35 WEEKS, PLACENTAL
ABRUPTION OR FETAL OR NEONATAL
DEATH WHICH IS THE MOST UNCOMMON
E COLLIELY PERHAPS THE MOST
IMPORTANT. THIS IS THE KIND OF
RESEARCH THAT WOULD POINT TO
WHAT WE NEED TO DO IF WE WILL
BEGIN TO DENT THE
DISPROPORTIONATE BURDEN OF
SEVERE MORBIDITY AND MORTALITY
PARTICULARLY EFFECTING NOT JUST
AFRICAN AMERICAN WOMEN AND
AMERICAN INDIAN WOMEN BUT ON THE
MORBIDITY SIDE ALL WOMEN OF
COLOR. IN THIS STUDY THAT DR.
WEBB HOOPER IS A COLLABORATOR
EXAMINATION OF EFFECTS OF
AEROBIC AND RESISTANT EXERCISE
ON FUNCTIONAL OUTCOMES AMONG
OLDER WOMEN, MEAN AGE OF 72, WHO
ARE BREAST CANCER SURVIVORS AND
STRATIFIED BY SOCIOECONOMIC
STATUS, THIS IS A YEAR LONG
RANDOMIZE TRIAL GROUP EXERCISE
INTERVENTION VERSUS SUPPORT
GROUP PLUS A FIT BIT TO MONITOR
YOUR ACTIVITY. OVER 213 WOMEN
WERE RANDOMIZED AFRICAN
AMERICAN, NOT QUITE HALF WERE
AFRICAN AMERICAN AND WHITE
BREAST CANCER SURVIVORS AND
STRATIFIED BY OCS'S ADVANTAGE.
OVERALL THE EXERCISE IS MORE
INTENSIVE INTERVENTION, IMPROVE
PHYSICAL PERFORMANCE IS ONE MAY
EXPECT. THE INTERESTING
OBSERVATION WAS THE EXERCISE
EFFECT MAYBE MODERATED BY RACE,
WITH AFRICAN AMERICAN WOMEN
APPEARING TO PROVIDE LARGER
BENEFIT THAN COMPARISON THE
WHITE WOMEN. WE MENTIONED THE
NOTION OF FINANCIAL INCENTIVES
AND THIS STUDY BY DR.
(INDISCERNIBLE) SHOWED YOU CAN
LOWER HEMOGLOBIN A 1C IN NOT
WELL CONTROLLED AFRICAN AMERICAN
PATIENTS WITH TYPE 2 DIABETES
OVER COURSE OF ONLY THREE MONTHS
BY PROVIDING FINANCIAL
INCENTIVES. THIS WAS A
RANDOMIZED TO THREE CONDITIONS,
ONE TIME PAYMENT, TWO PARTS
PAYMENT AND GLUCOSE MEASUREMENT
UPLOAD AND THE HIGH
MULTI-COMPONENTS, MULTIPLE
FINANCIAL INCENTIVES WITH
EDUCATION SESSION ATTENDANCE
BEING PARTS OF IT. YOU CAN SEE A
GRADIENT DECREASE IN A 1C. THIS
ABSOLUTE REDUCTION OF 1.74%,
KEEP IN MIND THESE WERE ALL
PATIENTS THAT WERE ABOVE 8%.
WHICH FOR CLINICIANS THAT IS
SORT OF THE HALLMARK OF CUT
POINTS, IDEALLY YOU WANT PEOPLE
TO BE NORMALIZED WITHOUT DOING
HARM. UP B DEER 8% YOU ARE
USUALLY OKAY OVER 9 YOU ARE NOT
SO THESE WERE NOT WELL
CONTROLLED TYPE 2 DIABETES. SO
GETTING A DENT THIS MAGNITUDE,
ONE AND A QUARTER TO ALMOST ONE
THREE QUARTER% IS LEVEL OF
MAGNITUDE OF CHANGE IN RANDOMIZE
THERAPY IN INSULIN THERAPY IN
TYPE 1 DIABETES 20, 25 YEARS AGO
FIRST STUDY SHOWS GLUCOSE
CONTROL DID LOWER COMPLICATIONS
FROM DIABETES. THIS IS THE KIND
OF RESEARCH WE ARE GOING TO SEE
MORE FUNDED BY NIMHD. THIS WAS
AN OBSERVATIONAL STUDY LOOKING
AT ASSOCIATION OF NEIGHBORHOOD
COMPLAINTS OF EXCESSIVE POLICE
FORCE AND WHAT HAPPENED WITH
PRE-TERM DELIVERY IN
CARDIOVASCULAR DISEASE AMONG
BLACK WOMEN, IT IS EXTRACTED
FROM THE ELECTRONIC HEALTH
RECORD IN OUTCOMES IN PREGNANCY,
YOU CAN SEE THE SAMPLE SIZE, OF
67,000, CARDIOVASCULAR DISEASE
COHORT OF ALMOST 7,000. BLACK
WOMEN WHO WERE EXPOSED TO POLICE
VIOLENCE OR COMPLAINTS OF
EXCESSIVE POLICE FORCE MANY
THEIR NEIGHBORHOOD WERE 1.2
TIMES MORE LIKELY TO EXPERIENCE
PRE-TERM DELIVERY. 1.4 TIMES
MORE LIKELY TO DEVELOP
CARDIOVASCULAR DISEASE IN FOLLOW
SO IT IS AN INDICATION AGAIN OF
WHERE EXCESSIVE POLICE FORCE MAY
BE ADVERSELY AFFECTING HEALTH IN
ADDITION TO WHAT WE KNOW HAPPENS
WITH THE USE OF FIREARMS
EXCESSIVELY BY POLICE. BREAST
FEEDING HAS BEEN KNOWN TO BE
BENEFICIAL TO THE INFANT TO THE
CHILD AS WELL A Z MOTHER FOR
DECADES LITERALLY. WE HAVE NOT
BEEN ABLE TO GET THE MEETING THE
GOALS OF EVERY CHILD BEING
BREAST FED FOR A YEAR, NOW THERE
ARE LOGISTICAL SOMETIMES MEDICAL
BARRIERS OR OPERATIONAL
BARRIERS, IT IS HARD, WOMEN HAVE
TO PUMP IF THEY ARE WORKING.
THERE ARE VARIETY -- BUT WILL IS
ANOTHER BIT OF EVIDENCE IN A
SMALL STUDY THAT YOU CAN SEE
CARDIOVASCULAR BENEFIT FOR THE
MOM RELATED TO BREAST FEEDING
FOR AT LEAST 12 MONTHS. THIS IS
THE RECOMMENDATION, THERE IS
BENEFICIAL EFFECTS ON DEVELOPING
BREAST CANCER, THERE ARE
MULTIPLE BENEFICIAL EFFECTS ON
INFANT. AGAIN, IT IS SOMETHING
WE DON'T SEE AS MUCH IN
POPULATIONS WITH HEALTH
DISPARITIES LOW INCOME AND
AFRICAN AMERICAN WOMEN HAVE LESS
LIKELIHOOD OF SUSTAINING BREAST
FEEDING FOR 12 MONTHS AND IT IS
AN AREA AGAIN OF ACTIVE
INTERVENTION THAT COULD WORK.
THIS IS A STUDY THAT RECEIVED
MEDIA ATTENTION AS WELL. IT IS
FROM THE ELECTRONIC HEALTH
RECORDS LOOKING AT 18 STATES
EHRs AND COMMUNITY HEALTH
CENTERS, OVER 40,000 CHILDREN
AND ADOLESCENTS AGE 3 TO 17 WITH
ASTHMA DIAGNOSIS BASED ON THE
ELECTRONIC RECORD. AND SAW
SPANISH -- THEY REPORTED SPANISH
PREFERRING CHILDREN HAD HIGHER
ODDS OF CLINIC VISITS EVEN FOR
MASS EXACERBATIONS SO THEY WERE
COMING TO THE PRIMARY CARE
SETTING WHEN THEY HAD ASTHMA
EXACERBATION. FOR ACUTE
MANAGEMENT. AFRICAN AMERICAN
CHILDREN HAD LOWER USE OF
PRIMARY CARE SETTING AND HIGHER
ODDS GOING TO THE THE EMERGENCY
DEPARTMENT AND THIS WAS IN A SUB
ANALYSIS OF THE ORGAN MEDICAID.
THERE WERE NO INPATIENT
ADMISSION DIFFERENCES BY RACE
ETHNICITY IN THIS STUDY. THERE
ARE MULTIPLE OTHER FACTORS THAT
WOULD BE AFFECTING THIS. THIS IS
AN AREA OF DATA AS SCIENCE OR
ANALYSIS COMBINING ELECTRONIC
HEALTH RECORDS WE WILL SEE MORE
OF ACROSS THE BOARD IN HEALTH
CLINICAL RESEARCH, IN THIS
PARTICULAR SETTING. THIS IS AN
INTERESTING STUDY THAT LOOKED
HOW WE INTERVENE TO IMPROVE CARE
IN CLINICAL TRIAL PARTICIPATION
P ON LOW INCOME MINORITY ADULTS
WITH CANCER, THESE WERE 66
PATIENTS IN THE INTERVENTION
GROUP, 72 IN COMPARISON GROUP
AND NOT RANDOMIZED SO NOT
CONTROL GROUP. THEY WERE SICK.
15 OF THE 66 AND 22 OF THE 72
DIED WITHIN SIX MONTHS. THE IDEA
HERE IS THAT QUALITY OF CARE
PEOPLE WHO INCURABLE CONDITION,
PUT IT THAT WAY, WHERE OUR GOALS
OF THERAPY ARE HEALTH RELATED
QUALITY OF LIFE, GOAL, NOT CURE,
WILL DEPEND ON INTERVENTIONS
SUCH AS ENGAGING COMMUNITY,
ORGANIZATIONS IN ENGAGING
COMMUNITY HEALTH WORKERS AND
IMPROVING SUPPORTIVE CARE
DELIVERY THROUGH SERVICES IN
HOUSE HOSPICE WHICH ARE VERY
UNDERUTILIZED ACROSS THE COUNTRY
PARTICULARLY FOR POPULATIONS
WITH HEALTH DISPARITIES. AN
EXAMPLE OF HOW THESE CAN IMPROVE
AS AN ADDITIONAL BENEFIT,
PARTICIPATE POTENTIALLY IN
CLINICAL TRIALS THAT ARE
AVAILABLE. STUDY COMING FROM A K
AWARDEE, LOOKING AT VACCINE
HESITANCY AMONG AFRICAN
AMERICANS LIVING IN THE SOUTH,
SAMPLE OF CENTRAL SAVANNAH AREA,
ANY ADULT OVER AGE OF 18 WAS
STUDIED AND WE NOTICE THAT THE
HESITANCY AND RESISTANCE TO
RECEIVING COVID-19 VACCINE WAS
MORE LIKELY AMONG YOUNGER ADULTS
UNDER THE AGE OF 30,
PARTICULARLY THOSE WHO
EXPERIENCED ANY HOUSING
INSECURITY. SO FURTHER
EVALUATION OF THESE FACTORS THAT
CONTRIBUTE TO VACCINE HESITANCY,
LACK OF UPTAKE AMONG YOUNG
AFRICAN AMERICANS IS IMPORTANT.
CLEARLY, THE BENEFIT OF THE
COVID-19 VACCINE IN THIS
POPULATION IS IN ACTUAL TERMS
LESS CLEAR THAN IT IS FOR OLDER
ADULTS, BUT BENEFICIAL IN TERMS
OF INTERRUPTING AND DIMINISHING
NOT TO SAY ELIMINATE EXTENSIVE
COMMUNITY TRANSMISSION. AND
ENHANCING GENERAL IMMUNITY AND
COMMUNITY. OUR INTRAMURAL
PROGRAM, THIS IS FROM THE
(INDISCERNIBLE) LAB, WHERE E
WHAT'S BEEN USING THE UK BIOBANK
TO LOOK AT GENETIC ANCESTRY
COMPARISON TO INFLAMMATION IN
THIS CASE REFLECTED BY C
REACTIVE PROTEIN. CONCLUDING IN
THE UK BIOBANK DATA LAWS OF
IMPORTANCE OF AFRICAN ANCESTRY
AND ENVIRONMENTAL FACTORS REALLY
ACCOUNTING FOR MUCH MORE HIGHER
LEVEL C REACTIVE PROTEIN THAN
GENETIC ANCESTRY. IN ANOTHER
ANALYSIS USING A CANCER COHORT
CHANGES IN GENE EXPRESSION
MEDIATED BY EPIGENETIC
MECHANISMS WITH GREATER
CONTRIBUTION TO CANCER SURVIVAL.
HIS LAB IS LEVERAGING
AVAILABILITY OF LARGE DATA SETS,
WE LOOK FORWARD TO HIS WORK NOT
JUST NOW IN THE UK BIOBANK BUT
THE ALL OF US COHORT THAT HAS
RECENTLY RELEASED ALMOST 100,000
WHOLE GENOME SEQUENCES ON THE
PARTICIPANTS IN ALL OF US NUMBER
CLOSE TO HALF A MILLION. THESE
SIGNIFICANT EFFECTS OF
INTERACTION OF METHYLATION
ANCESTRY, IN MANY CASES WE ARE
GOING TO SEE LOOK AT THINGS LIKE
ANCESTRY AS PROXIES FOR OTHER
THINGS, WE DON'T HAVE DATA ON
THE SOCIAL DETERMINANTS OF
INDIVIDUAL LIFE EXPERIENCE. THIS
IS -- THESE ARE THE KIND OF
INVESTIGATIONS THAT WILL HELP US
FURTHER UNDERSTAND MECHANISMS.
THIS IS FROM CALVIN TROY'S LAB
LOOKING AT SCAR SMOKING. I'M
ORIGINALLY FROM CUBA WHERE CIGAR
SMOKING WAS A TRADITION, IS A
TRADITION. NOTICE LATINOS HAVE
NO CHANGE IN PAGE OF CIGAR
SMOKING INITIATION BUT AFRICAN
AMERICANS WITH COLLEGE DEGREE
INTERESTINGLY INITIATING CIGAR
SMOKING AT OLDER AGE BUT NO
CHANGE IN THOSE WITH LESS THAN A
COLLEGE DEGREE. CALVIN'S GROUP
HAS BEEN WORKING DILIGENTLY ON
THE BEHAVIOR AROUND SMOKING
CIGARETTES COMBUSTIBLE
CIGARETTES ELECTRONIC OR IN THIS
CASE CIGARS. OVER THE YEARS. HOW
THIS INFLUENCES POLICY AND HOW
IT INTERACTS WITH POLICY AND ALL
CIGARS MAKE UP A SMALL
PROPORTION COMBUSTIBLE
CIGARETTES, IT IS A NICHE THAT
IS GAINED SOME POPULARITY IN
SOME YOUNGER ADULT GROUPS
PARTICULARLY YOUNG ADULTS OF
COLOR. FROM (INAUDIBLE) WILLIAMS
LAB WE SEE EFFORT ON LOOKING AT
THE NIEHS SISTER STUDY, NATIONAL
INSTITUTE ON ENVIRONMENTAL
HEALTH STUDY SISTER STUDY
LOOKING AT BREAST CANCER
SCREENING IN WOMEN BORN IN THE
U.S. VERSUS FOREIGN BORN WOME W.
THE PRIMARY IMPORTANT FINDING
HERE IS FOREIGN BORN LATINA
HISPANIC WOMEN ARE MORE LIKELY
TO HAVE NEVER BEEN SCREENED.
BREAST CANCER PERHAPS ONE
SCREENING HELPS BUT IS NOT
SUFFICIENT. IT IS INTENDED TO BE
OVER TIME, THERE IS NO LIMIT ON
YOU THINK 50 TO AGE 80, MAYBE 15
SCREENINGS OVER LIFETIME IS WHAT
WE KNOW RIGHT NOW WITH SCREENING
MAMMOGRAPHY, THERE ARE OTHER
METHODS THAT ARE BEING
CONSIDERED AND OTHER METRICS
BEING USED TO EVALUATE BUT
CLEARLY ONE OF THE CHALLENGES IN
NON-U.S. BORN PERSONS COMING THE
U.S. IS THEY ARE NOT USED TO
NECESSARILY HAVING ACCESS TO OR
BEING ASKED TO BE SCREENED.
WHETHER IT BE BREAST CANCER
SCREENING OR PAP SMEARS OR
COLORECTAL CANCER SCREENING.
RECENTLY WE WERE PRIVILEGED TO
SEE OUR NIH POST BACCALAUREATE
POSTER DAY. THESE ARE THE YOUNG
FACES OF OUR POST BACKS. ONE --
FIRST PERSON PHOTS TOE ON THE
UPPER LEFT THERE WAS FROM MY
LAB, THE REST ARE NIMHD LABS.
THE THREE BOTTOM ROW HIGHLIGHTED
IN YELLOW STEPHANIE, AND
GABRIELLE ZUCKERMAN WERE
RECOGNIZED FOR HAVING THE TOP
20% POSTERS BY THE RATERS. IT
WAS A VIRTUAL EVENT WITH THE
PEOPLE COMING IN TO THE ROOM AND
ASKING TO HAVE THE POSTER
PRESENTED. I PARTICIPATED IN IT
WITH CHELSEA OUR POSTBACK AND IT
WAS REALLY EXCITING AND DOESN'T
QUITE HAVE THE BECAUSE OF HAVING
THE IN PERSON EVENT. WITH
POSTERS AND PEOPLE TALKING, BUT
MAYBE NEXT YEAR WE WILL GET BACK
TO THAT. THERE WERE HONORS
ACCORDING TO THESE INTRAMURAL
FELLOWS FROM THE SOCIETY OF
BEHAVIORAL MEDICINE, FROM THE
ACADEMY HEALTH AND FROM THE
AMERICAN PUBLIC HEALTH
ASSOCIATION AS WELL. THAT BRINGS
AN END TO MY PRESENTATION. I
ENCOURAGE EVERYONE TO CONSIDER
APPLYING FOR A POSITION, WE ARE
IN CONTINUOUS RECRUITMENT MODE
AT NIMHD. BOTH ADDRESS OUR
HOPEFULLY INCREASING BUDGET OVER
TIME AS WELL AS TO CONTINUE TO
ADDRESS MOVEMENT OF STAFF WITHIN
NIH. THANK YOU VERY MUCH FOR
YOUR ATTENTION AND WE HAVE TIME
FOR SOME QUESTIONS. GET ME --
>> WE DO. THANK YOU VERY MUCH
FOR AN EXCELLENT OVERVIEW. I
INVITE OUR COUNCIL MEMBERS TO
INDICATE IN THE CHAT BOX IF YOU
HAVE QUESTION OR COMMENT YOU
WOULD LIKE TO MAKE. DR. BARNES,
PLEASE.
>> DR. PEREZ-STABLE, VERY NICE
PRESENTATION AS USUAL. I WAS
REALLY INTRIGUED BY THE STUDY
THAT YOU TALKED ABOUT, WITH
CIGAR SMOKING. AND I WAS
WONDERING TWO QUESTIONS. DID
THE PAPER GO INTO SOCIAL
CULTURAL DIFFERENCES BETWEEN
LATINOS AND AFRICAN AMERICANS
WITH AGE DIFFERENCE WITH AFRICAN
AMERICANS STARTING LATER COLLEGE
EDUCATED AFRICAN AMERICANS
STARTING LATER AND ALSO IS THERE
A DIFFERENCE IN ADVERSE OUTCOMES
BASED ON WHEN YOU START THE
CIGAR SMOKING? ?
>> THANK YOU FOR THAT QUESTION,
LISA. I DON'T KNOW THE DETAIL
BUT THIS IS FROM THE NATIONAL
SURVEY ON DRUG USE AN HEALTH SO
ALL THOSE USUAL VARIABLES
DEMOGRAPHIC SOCIAL VARIABLES
WERE ADJUSTED FOR IN ANALYSIS.
I CAN SAY THIS ABOUT CIGARS, IT
MAKES UP MAYBE 2% COME BUSTABLE
TOBACCO CONSUMED IS MUCH MORE
COMMON FORESI TOWARD USE SMOKERS
TO BE MEN THAN WOMEN. TOBACCO
PUT INTO CIGAR IS INTENDED TO BE
ABSORBED IN THE ORAL MUCOSA.
NICOTINE, SO IT ISN 'T REALLY
DESIGNED FOR INHALATION INTO THE
LUNGS LIKE CIGARETTES ARE. SO
THEORETICALLY THERE SHOULD BE
MUCH LESS OF A RISK OF
RESPIRATORY TRACK LOWER
RESPIRATORY TRACK DISEASE Z AND
CANCER. THE REASON ASSOCIATION
WITH INCREASE RISK OF CART OWE
VASCULAR EVENTS WITH SECOND HAND
SMOKE AND THERE IS INCREASE RISK
OF ORAL PHARYNGEAL CANCERS. VERY
SLIGHT UNCREASE IN LUNG CANCER
MAYBE ASSOCIATED BUT HARD TO --
IT IS NOT AS COMMON A PROBLEM AS
COMBUSTIBLE CIGARETTES. THE
PATTERN WE SEE IN THE CARIBBEAN
LET'S SAY AMONG MEN WHO SMOKE
CIGARS WOULD BE THEY SMOKE TEN
CIGARS A DAY, BUT I DON'T THINK
WE ARE LOOKING AT THAT LEVEL OF
SMOKING IN THIS POPULATION.
>> THANK YOU, DR. SOUTHERLAND,
>> ELISEO, GREAT PRESENTATION. I
HAD A QUESTION ABOUT ONE OF THE
IS THE DIS YOU PRESENCE
INVOLVING BREAST CANCER
SCREENING VERSUS U.S. VERSUS
FOREIGN BORN. DID AUTHORS
INVESTIGATORS HAVE ANY SIMILAR
CORRESPONDING DATA WITH BLACK OR
AFRICAN AMERICAN WOMEN, U.S.
BORN VERSUS FOREIGN BORN?
>>
>> AGAIN, I DON'T KNOW THE
ANSWER. THIS IS FROM THE SISTER
STUDY, WHICH IS A COHORT STUDY
THAT IS IN FOLLOWING WOMEN WHO
HAVE A FIRST DEGREE RELATIVE
WITH BREAST CANCER, MAJORITY OF
THEM DO. AND MOST OF THE SAMPLE,
THOUGH IT IS A LARGE STUDY,
44,000 PLUS, ARE U.S. BORN WHITE
WOMEN. SO THE NUMBER OF MINORITY
WOMEN IN THIS COHORT STUDY IS
LIMITED. SO I DON'T THINK THAT
THERE WAS SUFFICIENT I'M GOING
TO GUESS SUFFICIENT AFRICAN
AMERICAN WOMEN WHO WERE BORN
OUTSIDE THE U.S. THAT THEY COULD
LOOK AT THIS.
>> THANK YOU.
>> DR. CALMAN.
>> GREAT PRESENTATION. I LOVE
THIS PART OF THE MEETINGS
BECAUSE THERE IS A PO POTPOURRIF
INCENTIVES. THE ONE THAT STRUCK
ME WAS UNSENTIVES AND REDUCTION
OF A 1C. THAT IS A SIGNIFICANT
REDUCTION IN A 1C AMONG PEOPLE
WITH DIABETES. THAT WE GOT FOR
$300. THE QUESTION I HAVE IS DO
WE KNOW ANYTHING ABOUT WHAT THE
MONEY DID? DID IT PAY FOR
TRANSPORTATION TO THE CLINIC FOR
MEDICATIONS DID IT HELP IMPROVE
DIET OR WAS IT PURELY BRIBERY
SITUATION WHERE PEOPLE WERE
WORKING FOR THE DOLLARS? WE KNOW
ANYTHING ABOUT WHAT DID WE ASK
WHAT PEOPLE DID IN ORDER TO
ACHEF THEIR IMPROVEMENT. WHAT
ELSE DO WE KNOW ABOUT IT?
>> NEIL I WILL SEND YOU THE
PAPER. IT IS IN PLUS ONE BUT MY
UNDERSTANDING IS THEY ARE LOW
ONE TIME WAS BASICALLY BRIBERY
OF FINANCIAL INCENTIVE WHILE THE
OTHER MODERATE, HIGH DID INCLUDE
MORE SPECIFIC INTERVENTIONS
RELATED TO UPLOADING GLUCOSE
MEASUREMENTS, BEING ABLE TO
SHARE THOSE, ALSO USING GETTING
ATTENDING EDUCATIONAL SESSIONS.
KEEP IN MIND THIS WAS QUITE A
SMALL SAMPLE SIZE. SO THERE
ISN'T A QUOTE UNQUOTE USUAL CARE
COMPARISON CONTINUE TO HAVE YOUR
DIABETES CONTROLLED. WHICH 3 TO
6 MONTHS WOULDN'T BE UNETHICAL
THOUGH YOU COULD ARGUE THAT THAT
WAS WHAT DROVE THEM NOT TO DO
THAT. I DON'T HAVE ENOUGH
RETENTION OF THE DETAILS OF THE
PAPER TO ANXIOUS YOUR QUESTIONS
-- ANSWER YOUR QUESTIONS.
>> SEND IT. SEND IT.
>> THANK YOU.
>> DR. ELLIOT.
>> THANK YOU FOR THAT
PRESENTATION. I LISTENED TO MANY
DIRECTORS REPORTS OVER THE
YEARS. SOMETHING THAT REALLY
STRUCK ME ABOUT THIS IS THE
QUALITY AND RIGOR OF THE
SCIENCE, THAT YOU PRESENTED AND
THE IMPACT OF JOURNALS GETTING
IN SO TWO QUESTIONS, FIRST WOULD
YOU AGREE WITH THAT OBSERVATION
AND IF YOU DO WHAT WOULD YOU
ATTRIBUTE THAT INCREASE IN
QUALITY AND RIGOR.
>> THANK YOU FOR THAT AMY. I
WASN'T NECESSARILY TRYING TO
COMPARE TO ANYTHING ELSE. I
LEARNED THIS FROM MY TIME ON
NATIONAL INSTITUTE ON AGING
COUNCIL THAT IT WAS ALWAYS GOOD
TO FEATURE SOME OF THE SCIENCE
AND THAT IS WHAT DROVE ME HERE
AT NIH IS SCIENCE. I DO ENJOY
LOOKING AT THIS. STAFF FROM EACH
DIVISION SELECT OR NOMINATE
PAPERS BASED ON THAT WE HAVE
FUNDED SO THOSE ARE THE ONES
THAT COME TO ME, I ESPECIALLY
ASK FOR MORE INTERVENTIONS,
ECHOING DR. RESNICOW'S PLEA FROM
LAST COUNCIL. I DON'T PRESENT
ALL THAT ARE NOMINATED BUT I DO
MAKE A SELECTION. I DO -- DID
EMPHASIZE MORE THE INTRAMURAL
THIS TIME. AS IT WAS PRESENTED,
NOT ALL WERE THERE. I WILL ALSO
LOOK AT OR RYE TO SELECT PAPERS
PUBLISHED THAT STUDIES THAT ARE
PUBLISHED THAT ARE PARTICULARLY
RELEVANT TO NIMHD ON THE
MINORITY HEALTH, HEALTH
DISPARITIES, THESE ARE FROM
THINGS I SEE COME MAYMY WAY, AS
OPPOSED TO NECESSARILY
HYPERTENSIVE STUDY FUNDED BY
NHLBI AND I THINK IT IS A VERY
CURRENT TOPIC. MATERNAL
MORBIDITY MORTALITY, WE ARE
WORKING ON THAT SO I THOUGHT IT
WAS PARTICULARLY RELEVANT WHAT
WE MAY WANT TO BE FUNDING IN
THAT AREA. THANKS FOR THAT.
>> DR. ZORRILLA.
>> THANKS FOR MENTIONING THAT
STUDY EVEN THOUGH IT WAS OPEN
LABEL RANDOMIZE, I CHECK
INFORMATION I WASN'T AWARE OF
THAT RECENT PUBLICATIONS. I
THINK IT ALSO BRINGS MAKES US
AWARE THERE IS ANODE FOR
RESEARCH IN PREGNANCY, THAT IS
BEYOND PHASE 1 AND 2 BUT ALSO
PARTICIPATION IN VACCINE TRIALS
IN TREATMENT TRIALS CERTAINLY
BECAUSE SOMETIMES WE END UP
PRESCRIBING MEDICATIONS AND
PROVIDING TREATMENT STRATEGIES
THAT HAVE NOT BEEN PROPERLY
STUDIED IN PREGNANCY OR IN THAT
PERSON SO THANKS FOR BRINGING US
THAT TOPIC AND MAKING US AWARE
OF THE NEED FOR THAT PARTICULAR
BEAUTIFUL PEOPLE THAT NEED
RESEARCH.
>> THANK YOU, CARMEN. THE
INCLUSION ACROSS THE LIFE SPAN
EFFORTS PARTICULARLY AROUND THE
VACCINE COVID-19 VACCINE AND
THERAPIES EMPHASIZING THE
IMPORTANCE OF INCLUDING PREGNANT
PEOPLE AND IN STUDIES. THERE IS
A NATURAL RESISTANCE ON THE PART
OF INDIVIDUALS SAYING WELL WHY
SHOULD I VOLUNTEER TO STUDY, I
KNOW WHAT EFFECTS ARE GOING TO
BE. BUT I THINK YOU DONE KNOW
WHAT YOU DON'T KNOW. SO I THINK
IT IS IMPORTANT. NOTED THAT IN
BOTH PFIZER AND MODERNA VACCINE
TRIALS THAT WERE QUITE A FEW
RANDOMIZE PARTICIPANTS WHO NOT
KNOWINGLY WERE PREGNANT AT THE
TIME OF RANDOMIZATION. THERE ARE
DATA ON THOSE ORIGINAL TRIALS
THAT WHERE IT IS NOT DESIGNED
THAT WAY BUT THAT IS HOW IT
TURNED OUT.
>> THAT WAS ONE OF THE
PRIESTESSESSORS TO LACK OF --
PREDECESSORS TO LACK OF PARTS
OPERATION AN ENROLLMENT OF WOMEN
IN PARTICULARLY IN THE VACCINE
COVID VACCINE TRIALS WHERE THERE
WERE ALL KINDS OF LEGAL
ASSURANCES PROTECTED FROM
LIABILITY. THIS IS I THINK AN
ONGOING DISCUSSION THAT WE NEED
MORE PROFOUND DISCUSSION.
>> ABSOLUTELY.
>> THANK YOU. DR. JOHNSON.
>> THANK YOU, DR. PEREZ-STABLE
FOR A REALLY OUTSTANDING
PRESENTATION. I ALSO LOOK
FORWARD TO YOUR DIRECTOR'S
REPORT. I HAVE A QUESTION ABOUT
SOME OF THE DATA YOU PRESENTED
REGARDING FINDINGS, IT IS GREAT
THERE WAS A BUDGET INCREASE WHAT
YOU EXPECT AND YOU SHOW K AWARDS
AND THEN RO1s FIRST TIME
ESTABLISHED INVESTIGATORS. AS
YOU THINK ABOUT THE ADDITIONAL
FUNDING THAT'S NOW AVAILABLE FOR
THIS FISCAL YEAR, DID YOU SPEAK
SOME TO HOW YOU THINK ABOUT
PRIORITIES REGARDING
DISTRIBUTION OF FUNDING FOR MORE
Ks OR MORE Rs OR OTHER NIMHD
PROGRAMS?
>> GLOBALLY I CAN SHARE.
SPECIFICS ARE INTERNAL. SO ONE
OF MY GOALS WAS THAT WE WOULD BE
ABLE TO FUND MORE OF THE RO1s
EVERY CYCLE WERE LEAVING ON THE
TABLE. THESE WERE WELL REVIEWED,
FUNDABLE SCORES, NOT NECESSARILY
JUST EARLY STAGE INVESTIGATORS
BUT IN GENERAL. AND I THINK THAT
THIS ADDED FUNDING WILL BRING US
AT LEAST CLOSER TO OUR GOAL.
12%, 13% AWARD RATE IS NOT THE
WORST BUT IT IS NOT WHERE WE
WOULD LIKE TO BE. WE WOULD LIKE
TO BE AT 25% WHERE SOME OF THE
INSTITUTES ARE. AND NOT HURT
OTHER PROGRAMS. SHORT TERM
INCREASING SUPPORT FOR THE LOAN
REPAYMENT PROGRAM IS AN EASY
ANSWER. WE ALSO WILL PARTNER
WITH NATIONAL HEART LUNG BLOOD
INSTITUTE ON THE SEAL INITIATIVE
WHICH NEEDS FUNDING. AND WAS
ALSO NOT -- DID NOT RECEIVE
FUNDING WE EXPECTED IN THE
APPROPRIATIONS. AND GOING
FORWARD WILL LOOK FOR MORE
STRUCTURAL RESOLVE ON THAT. THEN
CONTINUE OUR PROGRAMS, SOME OF
THE THINGS WE LAUNCHED YOU DID
OVER PUBLIC WE HAVE AN RFA OUT
FOR CLINICAL RESEARCH NETWORK
WITHIN THE RCMI, I WOULD LIKE TO
SEE THAT EXPAND IN THE FUTURE IF
WE HAVE THE FUNDING. WE
CURRENTLY HAVE GRANTS FOR
COMMUNITY LEVEL INTERVENTIONS,
THIS IS AN AREA WE HAVE ALWAYS
BEEN VERY UP FRONT ON COMMUNITY
INTERVENTIONS AND WE WANT TO
CONTINUE THAT, THE STRUCTURAL
RACISM RFA WAS ONE TIME RFA BUT
WE HOPE AN EXPECT THAT THAT WILL
CONTINUE TO FOSTER RESPONSES
ALONG THIS LINE TO BE
SYNERGISTIC WITH A COMMON FUND
PROGRAM. AND FOR EXAMPLE, THE
MATERNAL MORBIDITY MORTALITY WE
HAD A ONE TIME RFA BACK IN 2020
WE FUNDED TOTAL OF FIVE RO1s
AND NHLBI FUNDED ONE OR TWO. WE
HAVE NOW BEEN RECEIVING MORE RO1
APPLICATIONS IN THAT SPACE SO
HAVING PROGRAM ANNOUNCEMENT WILL
THEN FOSTER MORE APPLICATIONS
AFTER THE INITIAL EFFORT. I
THINK WE LOOK FORWARD FOR THOSE
EFFORTS AS WELL. WE CONTINUE TO
GROW OUR INTRAMURAL PROGRAM,
THOUGH I WILL GO AHEAD AND
EMPHASIZE THAT WE HAVE THE
SMALLEST INTRAMURAL PROGRAM
PROPORTIONAL IN TERMS OF BUDGET
ALLOCATED. TO THE ONE OF THE
INSTITUTES DOES NOT HAVE AN
INTRAMURAL PROGRAM SO WE --
THOSE THAT DO, WE HAVE THE
SMALLEST BY BUDGET. THAT GROATS
IS PROJECTED TO CONTINUE. WE
CONTINUE TO HAVE INVESTIGATORS
RECRUITED. WE EXPECT ONE NEW
TENURE TRACK INVESTIGATOR THIS
YEAR, AND SHE WILL START LATER
THIS YEAR. THOSE ARE SOME IDEAS.
YOU MIGHT BE PARTICULARLY
INTERESTED IN THE CENTERS OF
EXCELLENCE I THINK. AND YES THAT
WILL CONTINUE, WE ARE
CONGRESSIONALLY MANDATED TO HAVE
CENTERS OF EXCELLENCE PROGRAM
AND THERE WILL BE A CALL FOR
APPLICATIONS IN FOR FISCAL 23.
>> THANK YOU.
>> THANK YOU. SO I THINK THAT
CONCLUDES THE QUESTIONS AND
COMMENTS INDICATE MISDEMEANOR
THE CHAT BOX. THE TIMING IS
ACTUALLY PERFECT. BECAUSE IT IS
TIME FOR OUR FIRST BREAK. SO WE
HAVE NOW COME TO THE END OF OUR
FIRST THIRD OF OUR COUNCIL
MEETING. WE WILL START AGAIN
PROMPTLY AT 1 P.M. WITH TWO
PRESENTATIONS THEN THE FINAL
THIRD WILL BE DISCUSSION AND
APPROVAL OF NEW NIMHD CONCEPTS.
SO SEE YOU BACK AT 1 P.M.
EASTERN.
>>THANK YOU, MONICA.
>>IT IS MY HONOR
AND PLEASURE TO INTRODUCE A
INSTITUTE DIRECTOR COLLEAGUE WHO
WILL PRESENT TO US NOW. DR.
LINDSEY CRISWELL, SHE BECAME
DIRECTOR OF NATIONAL INSTITUTE
ON NEPHRITIS MUSCULOSKELETAL
DISEASE IN FEBRUARY OF 2021. SO
WELL INTO THE PANDEMIC. SHE IS I
THINK REFERRED TO THE PANDEMIC
FIVE, NEW IC DIRECTORS WHO
JOINED THE NIH AFTER MARCH OF
2020. PRIOR TO THAT SHE WAS VICE
CHANCELLOR RESEARCH UNIVERSITY
OF CALIFORNIA SAN FRANCISCO
WHERE RENEW HER AND SHE WAS
PROFESSOR OF MEDICINE IN THE
DIVISION OF RHEUMATOLOGY CHIEF
OF THE DIVISION RHEUMATOLOGY FOR
TIME AND PROFESSOR OF OR ROW
FACIAL SCIENCE. HER RESEARCH IS
FOCUSED ON GENETICS AND
EPIDEMIOLOGY OF HUMAN AUTOIMMUNE
DISEASE, PARTICULARLY ARTHRITIS
AND SYSTEMIC LUPUS. WHICH IS A
PARTICULARLY RELEVANT BECAUSE IT
DISPROPORTIONATELY AFFECTS WOMEN
OF COLOR. SHE ALSO MENTORED MANY
STUDENTS JUNIOR FACULTY TO
INDEPENDENT RESEARCH CAREERS.
SHE GOT BACHELORS DEGREE IN
GENETICS AND MASTERS IN PUBLIC
HEALTH FROM THE UNIVERSITY
CALIFORNIA BERKELEY, GENETIC
EPIDEMIOLOGY DOCTOR IN SCIENCES
AND GENETIC EPIDEMIOLOGY FROM
NETHERLANDS AND MOST IMPORTANTLY
SHE GRADUATED FROM THE UCSF
MEDICAL SCHOOL. I FIRST MET
LINDSEY WHEN SHE WAS A FOURTH
YEAR MEDICAL STUDENT. I WAS
ASSISTANT PROFESSOR AND STARTED
ON THE WARD WE OVERLAPPED FOR A
WEEK AND AT THAT TIME LITTLE DID
I KNOW OUR CIRCLES WOULD BRING
US TOGETHER MULTIPLE TIMES. SO
LINDSEY, YOU CAN SHARE THE
SCREEN.
>> THANK YOU SO MUCH, I WILL
SHARE MY SCREEN.
>> CAN YOU SEE MY SCREEN OKAY?
>> ALL GOOD.
>> GREAT. SO YES, IT IS REALLY A
PLEASURE TO BE HERE IN PART
BECAUSE OF MY RELATIONSHIP WITH
ELISEO, GOES BACK MANY, MANY
YEARS AND I NEVER WOULD HAVE
GUESSED WE WOULD BE WORKING
TOGETHER LIKE THIS AT NIH AND
IT'S A PRIVILEGE TO WORK WITH
ELISEO AND THE OTHER INSTITUTE
AND CENTER DIRECTORS. SO I
APPRECIATE THE OPPORTUNITY TO
FOCUS ON SOME OF THE WORK WE
HAVE BEEN DOING AT NIAMS TO
ELIMINATE HEALTH DISPARITIES
THROUGH RESEARCH WORKFORCE AND
ENGAGEMENT. I'M GOING TO ADJUST
THE VIEW HERE A MINUTE. I WILL
BEGIN WITH A REVIEW NIAMS
INCLUDING THE CURRENT STEGE
PLAN. THE INSTITUTE WAS
ESTABLISHED IN IS IT 86 BUT
PREVIOUSLY PART OF THE NATIONAL
INSTITUTE OF ARTHRITIS,
DIABETES, AND DIGESTIVE AND
KIDNEY DISEASE. WHICH IS MOW
THE NIDDK. AND OUR MISSION OF
COURSE IS TO SUPPORT AND CONDUCT
RESEARCH IN TO THE CAUSES
TREATMENT AND PREVENTION OF
ARTHRITIS AND MUSCULOSKELETAL
AND SKIN DISEASE. TO TRAIN THE
NEXT GENERATION OF SCIENTISTS
CARRY OUT THIS RESEARCH, AND
PROVIDE INFORMATION TO THE
PUBLIC ABOUT RESEARCH PROGRESS
IN OUR MISSION AREAS AND HOW IT
CAN BE APPLIED TO IMPROVE
HEALTH. OUR CURRENT BUDGETS IS
656 MILLION. WHICH REPRESENTS A
3.4% INCREASE COMPARED TO LAST
YEAR. NIAMS SUPPORTS INTRAMURAL
RESEARCH AND EXTRAMURAL RESEARCH
PROGRAMS. SO THIS SLIDE SHOWS
THE BREAK DOWN OF OUR BUDGET
INTO THE MAJOR CATEGORIES NIAMS
ON THE RIGHT COMPARED TO THE NIH
OVERALL ON THE LEV. SIMILAR TO
THE REST OF NIH MOST OF OUR
FUNDING GOES TO THE EXTRAMURAL
RESEARCH COMMUNITY, 84%, WITH 10
1/2 PERCENT GOING TO OUR
INTRAMURAL RESEARCH PROGRAM. RMS
OPT SLIDE STANDS FOR RESEARCH
MANAGEMENT SUPPORT BUT YOU CAN
THINK OF AS OUR OVERHEAD. SO
OUR CURRENT STREAM PLAN GOES TO
2024 AND IT WAS DEVELOPED WITH
INPUT FROM THE NIAMS ADVISORY
COUNCIL AND PUBLIC. THE ULTIMATE
GOAL DEVELOP PATIENT CENTERED
PERSONALIZED WAYS TO IMPROVE
HEALTH OUTCOMES AND ARE FIVE
CORE AREAS ON THE RIGHT OF THE
SLIDE, SYSTEMIC AUTOMATIC AND
AUTOIMMUNE DISEASE, SKIN BIOLOGY
AND DISEASE. BONE BIOLOGY AN
DISEASES, MUSCLE BIOLOGY AN
DISEASE, AND JOINT BIOLOGY
DISEASES AND ORTHOPEDICS
RESEARCH. SO THE PLAN INCLUDES
DEDICATED SECTION FOR EACH AREAS
INCLUDING SOME BROAD RESEARCH
DIRECTIONS. IMPORTANTLY THOUGH
ARTHRITIS AND MUSCULOSKELETAL
SKIN CONDITIONS AFFECT PEOPLE
AWFUL AGES RACIAL AND ETHNIC
BACKGROUNDS, INFECT TENS OF
MILLIONS OF AMERICANS THEY CAUSE
TREMENDOUS SUFFERING AND THEY
HAVE A MAJOR IMPACT OF U.S.
ECONOMY DUE TO HEALTHCARE COSTS
AND LOST PRODUCTIVITY. ALSO MOST
OF THESE ARE KRONIG, MANY ARE
ASSOCIATED WITH CHRONIC PAIN AN
DISABILITY MANY COMMON AND RARE
AFFECT WOMEN AND MINORITY, BOTH
TERMS OF RISK OF DISEASE AS WELL
AS DISEASE SEVERITY. SO THE
CURRENT STRATEGIC PLAN ALSO
HIGHLIGHTS SEVERAL SCIENTIFIC
THEMES THAT CUT ACROSS THE FIVE
DISEASE AREAS. THESE ARE LISTED
ON THE SLIDE INCLUDING NEW
TECHNOLOGIES TO IDENTIFY SHARED
MECHANISMS OF HEALTH AMONG
DISEASE, ADVANCING PATIENT
CENTERED APPROACHES, ENABLING
PRECISION MEDICINE TO TAILOR
CARE FOR EACH PATIENT. AND
ADDRESSING THE HEALTH NEEDS OF
DIVERSE POPULATIONS. THESE
CROSS CUTTING THEMES EMERGE FROM
THE NIAMS LISTENING SESSION THAT
WE HELD WITH THOUGHT LEADERS OF
EACH -- IN EACH FIVE DISEASE
AREAS. IT WAS REALLY CLEAR FROM
THE LISTENING SESSIONS AND AS
REFLECTED IN OUR STRATEGIC PLAN
OUR COMMUNITY CLEARLY RECOGNIZES
THAT NIAMS FUNDED RESEARCH MUST
BE APPLICABLE TO HEALTH AND
DISEASE AND DIVERSE POPULATIONS
TO ACHIEVE THE GOAL IN IMPROVING
HEALTH OF ALL AMERICANS. IN THIS
NEXT SECTION I WILL HIGHLIGHT
DISPROPORTIONAL IMPACTS ON
UNDER-REPRESENTED MINORITY
POPULATIONS. I WILL START WITH
OSTEOARTHRITIS, THE MOST COMMON
TYPE OF ARTHRITIS AND LEADING
CAUSE OF DISABILITY IN THE U.S.
AND WORLD WIDE. THE
OSTEOARTHRITIS INSTITUTE OR OAI
ALSO IS AN EXAMPLE OF NIAMS
PARTNERING WITH NIMHD. NIMHD HAS
SPONSORED THIS EFFORT SINCE THE
BEGINNING OF 2001 AND CONTINUES
THROUGH EIGHT YEARS FOLLOWING.
IT IS AN EXTRAORDINARY EFFORT
WITH ALMOST 4800 PARTICIPANTS
WHO ARE BETWEEN AGE 45 AND 79,
ONE OF THE LARGEST MOST
IMPORTANT DATA SETS IN THE
HISTORY OF RESEARCH, INCLUDES
CLINICAL GENOMIC PATIENT
REPORTED AND FUNCTIONAL DATA AS
WELL AS BIOLOGICAL SPECIMENS AND
X-RAY AND IMAGING DATA. THE DATA
ARE FREELY AVAILABLE AT
OAI.NIH.GOV TO SUPPORT STUDIES
OF NATURAL HISTORY, BIOMARKERS
AND RISK FACTORS FOR OA RISK AS
WELL AS PROGRESSION. IT IS ALSO
A NICE RESOURCE FOR
INVESTIGATORS WITH COMPUTATIONAL
AND MACHINE LEARNING EXPERTISE
TO APPLY THOSE BIG DATA METHODS
TO SOME OF THESE PROBLEMS. ALSO
HIGHLY PRODUCTIVE WITH 680 PEER
REVIEWED PAPERS USING THE
RESOURCES FROM THIS INITIATIVE.
HEALTH DISPARITIES INST OWE
ARTHRITIS TREATMENT OUTCOMES AND
ACCESS TO CARE ARE WELL
DOCUMENTED. COUPLE OF EXAMPLES
ON THIS SLIDE, AFRICAN AMERICANS
WHO UNDERGO TOTAL KNEE
REPLACEMENT FOR VEER OA ARE TWO
AND A HALF TO FIVE TIMES MORE
LIKELY THAN WHITES TO BE
DISCHARGED TO IN PATIENT
REHABILITATION FACILITY OR
SKILLED NURSING FACILITY RATHER
THAN TO HOME HEALTHCARE OR HOME
SELF CARE. ANOTHER STUDY
DEMONSTRATED AFRICAN AMERICANS
WERE MORE LIKELY TO DELAY TOTAL
KNEE REPLACEMENT AND THUS ENTER
SURGERY WITH MORE SEVERE DISEASE
COMPARED TO WHITE PATIENTS. AS
RESULT OF SOME OF THESE CONCERNS
NIAMS NIA AND NIMHD WILL BE
HOSTING A VIRTUAL TWO DAY
WORKSHOP TO BETTER UNDERSTAND OA
HEALTH DISPARITIES, HOW AND WHY
THEY DEVELOP AND HOW THEY CAN BE
ADDRESSED AND THE OVERALL GOAL
TO IDENTIFY RESEARCH GAPS AND
NEEDS THAT COULD BE ADDRESSED IN
FUTURE ACTIVITIES BY BRINGING
TOGETHER OSTEOARTHRITIS
INVESTIGATORS WITH OTHERS WHO
ARE HEALTH DISPARITIES RESEARCH
EXPERTISE. LISTED ON THIS SLIDE
IS DATE THE REGISTRATION OPENS
AND HOPE TO ENCOURAGE YOUR
COMMUNITY TO PARTICIPATE. NIMHD
PARTNERED WITH NIAMS NIA AND THE
NIH OFFICE OF DISEASE PREVENTION
ON THE 2018 PATHWAYS TO
PREVENTION WORKSHOP ON THE
APPROPRIATE USE OF DRUG
THERAPIES FOR OSTEO PRODUCT
PLAQUE PREVENTION. A COMMON
MISPERCEPTION THAT IT IS
EXCLUSIVELY ELDERLY FRAIL WHITE
WOMEN, WHO ARE AT RISK FOR
OSTEOPOROSIS. CLEAR EVIDENCE
INDICATES WOMEN OF OTHER RACES
AN MEN ARE AFFECTED BY
OSTEOPOROSIS. THERE ARE ALREADY
WELL DOCUMENTED DISPARITIES IN
SCREENING DIAGNOSIS AND
TREATMENT OF OSTEOPOROSIS. ONCE
AGAIN I HUE I LIGHT AD FEW
STUDIES ON THIS SLIDE
INSHREWDING A 2020 STUDY USING
MEDICARE DATA THAT SHOW IN THE
YEAR FOLLOWING AN OSTEOPOROSIS
RELATED FERTILITY FRACTURE POST
MENOPAUSAL BLACK WOMEN WERE MORE
LIKELY TO DIE, PLACED IN LONG
TERM NURSING FACILITY OR BECOME
NEWLY ELIGIBLE FOR MEDICAID
COMPARED TO WHITE PATIENTS. IN
ANOTHER STUDY AFRICAN AMERICAN
WOMEN OVER AGE 65 HAD LESS
KNOWLEDGE OF OSTEOPOROSIS THAN
WHITE AND DEEMED A LOWER
PRIORITY RELATIVE TO THEIR OTHER
HEALTH PROBLEMS. FURTHER, MOST
GENETIC STUDIES OF OSTEOPOROSIS
HAVE FOCUSED ON POPULATIONS OF
EUROPEAN DESCENT. THERE WAS A
LARGE META ANALYSIS THAT
EXAMINED SIX INDEPENDENT
POPULATION OF AFRICAN DESCENT,
THEY FOUND OF THOSE 56
ASSOCIATED GENETIC MARKERS
IDENTIFIED IN EUROPEANS ONLY 3
WERE PRESENT IN THESE STUDY
POPULATIONS OF AFRICAN ANCESTRY
AND IDENTIFIED SOME NOVEL
GENETIC PARKER IN THE AFRICAN
AMERICAN ANCESTRY POPULATIONS SO
HOPEFULLY THESE RESEARCH
FINDINGS INDICATE SOME GENETIC
DIFFERENCES THAT MAY IMPACT
FUTURE DEVELOPMENT OF TARGETED
THERAPIES, OR BE INFORMATIVE FOR
RISK PREDICTION. AS ELISEO
MENTIONED LUPUS PREDOMINANTLY
AFFECTS WOMEN AND IN PARTICULAR
WOMEN FROM NON-EUROPEAN ANCESTRY
POPULATIONS, STRIKING
DISPROPORTIONATE IMPACT IN THESE
POPULATIONS. OF A DNA AMERICANS
AND HISPANICS DEVELOP AT YOUNGER
AGE AND HAVE MORE SEVERE
DISEASE. I HIGHLIGHTED A COUPLE
OF RESEARCH FINDINGS HERE ON THE
RIGHT SIDE OF THE SLIDE BY
(INDISCERNIBLE) A PIONEER IN
THIS AREA, SHE HAPPENS TO BE
FROM UCSF. SHE HAS SHOWN THAT
RACIAL ETHNIC MINORITIES AND
INDIVIDUALS FROM LOW
SOCIOECONOMIC STATUS BACKGROUNDS
ARE MUCH HIGHER RISK FOR POOR
ACCESS TO SPECIALTY CARE AND
EXPERIENCE LOWER QUALITY OF
CARE. ALSO IN RECENT
PUBLICATION FROM JUST THIS YEAR,
HISPANIC AND ASIAN PATIENTS HAVE
HIGHER INCIDENTS OF RENAL,
HEMOTHE LOGIC AND ORGAN DISEASE.
ONE OF OUR FEW P 30 CLINICAL
RESEARCH CENTERS LED BY GARY
(INAUDIBLE) AT MEDICAL
UNIVERSITY OF SOUTH CAROLINA
FOCUSES ON LUPUS AND SCLERODERMA
PATIENTS. I ALSO WANT TO LIGHT
INTRAMURAL RESEARCH PROGRAMS
THAT FOCUS ON SCLERODERMA AND IN
FACT SPECIFICALLY AFRICAN
AMERICAN SCLERODERMA PATIENTS.
RESEARCH IS LED BY DR.
(INAUDIBLE) WHO DEVELOPED
RESEARCH PROGRAM WITH STRONG
SUPPORT OF HIS MENTOR DAN
KASLER, A VERY WIDELY RECOGNIZED
AND PRODUCTIVE SCIENTIST AT THE
NIH AND WAS THE DIRECTOR OF THE
SCIENTIFIC DIRECTOR OF NHGRI
UNTIL HE STEPPED DOWN THIS PAST
YEAR. BECAUSE OF THE VERY
IMPORTANT IMPACT OF SCLERODERMA
ON AFRICAN AMERICANS THEY
DEVELOPED AN IMPORTANT RESEARCH
RESOURCE FOR GENETICS STUDIES OF
AFRICAN AMERICANS CALLED GRASP,
ON THE RIGHT HAND SIDE OF THE
SLIDE THAT INCLUDES 25 CENTERS
AROUND THE UNITED STATES
EXPLORING ANCESTOR SPECIFIC
GENETIC VARIANTS THAT CONTRIBUTE
NOT ONLY TO INCREASE RISK IN
THESE POPULATIONS BUT ALSO TO
MORE SEVERE DISEASE OUTCOMES.
ATOPIC DERMATITIS, ALSO KNOWN AS
ECZEMA USUALLY BEGINS IN
CHILDHOOD, MORE COMMON IN BLACK
CHILDREN. FURTHER THE RASH IS
MORE LIKELY TO BE RAISED AND IN
TO FALL IN EFFECTED AREAS AROUND
THE JOINTS IN BLACKS THAN
WHITES. RECENT VERGE GIVES
CLUES TO MECHANISTIC DIFFERENCES
BETWEEN POPULATION GROUPS THAT
EXPLAIN DIFFERENCES IN MANY
PREVALENCE. ALSO LISTED HERE
ARE SOME OF THE MANY STUDIES
NIAMS SUPPORTS RELATED TO ATOPIC
DERMATITIS INCLUDING COUPLE THAT
FOCUS ON SOME OF THE HEALTH
DISPARITIES WITHIN THIS
CONDITION. (INAUDIBLE) IS THE
LOSS OF NATURAL COLOR OR PIG.
WHICH MAKES THE DISEASE MORE
APPARENT ON DARKER SKIN.
CURRENTLY THE CONDITION IS TREAT
WITH BLEW CO-CORTICOIDS, BROAD
RANGE IMMUNOSUPPRESSANTS AND
PHOTOTHERAPY WITH INADEQUATE
RESULTSES AND LONG TERM TOXICITY
SO THERE INTEREST IN TRYING TO
UNDERSTAND BETTER THE
MECHANISTIC UNDERPINNINGS OF THE
DISEASE SO TARGETED THERAPIES
CAN BE DEVELOPED. OF PARTICULAR
INTEREST IS RECENT WORK IN AN
ANIMAL MODEL THAT SHOWS SKIN
RESIDENT MEMORY T-CELLS AS WELL
AS CIRCULATING T-CELLS COOPERATE
TO ESTABLISH LESIONS IN THE
SKIN. SO OUR HOPE IS THIS WORK
WILL CONTINUE IN TRANSLATIONAL
STUDIES IN HUMAN SKIN SAMPLES.
NIAMS IS PARTNERING WITH NIMHD
AND OTHER INSTITUTES AN CENTERS
ON A FUNDING DONE ANNOUNCEMENT
TO SUPPORT INNOVATIVE
COLLABORATIVE AND
MULTI-DISCIPLINARY RESEARCH THAT
IS DESIGNED TO STUDY EFFECTIVE
ADAPTATION INTEGRATION AND
IMPLEMENTATION OF RECOMMENDED
GUIDELINES FOR CARE OF PERSONS
WITH MULTIPLE CHRONIC CONDITIONS
FROM POPULATIONS THAT EXPERIENCE
HEALTH DISPARITIES. I HAVE
LISTED THE NIAMS FOCUS AREAS ON
THE BOTTOM OF THE SLIDE BUT AS
YOU CAN SEE THEY INCLUDE THE
SPAN OF CONDITIONS WITHIN THE
NIAMS PORTFOLIO. WE ALSO
PARTICIPATE IN A NUMBER OF
TRANS-NIH ACTIVITIES RELATED TO
DEVELOPING A MORE BALANCED AND
EQUITABLE WORK FORCE. I ASSUME
YOU ARE FAMILIAR WITH THE
CORNERSTONE OF THESE ACTIVITIES
WITHIN THE NIH WHICH IS UNITE
INITIATIVE WHICH INCLUDES FIVE
DISTINCT COMMITTEES THAT TACKLE
DIFFERENT ASPECT OF THIS REALLY
COMPLEX CHALLENGING ISSUE. I
ALSO WANT TO HIGHLIGHT SOME OF
THE NIAMS EFFORTS IN THIS AREA,
THESE WERE DEVELOPED BEFORE I
ARRIVED BUT I FEEL PROUD OUR
INSTITUTE HAS BEEN SO ACTIVE IN
THIS AREA. AS I HAVE ALREADY
MENTIONED OUR CURRENT STRATEGIC
PLAN RECOGNIZES THAT MANY
CONDITIONS WITHIN OUR MISSION
DISPROPORTIONATELY AFFECT PEOPLE
IN UNDERSERVED DEMOGRAPHIC
GROUPS. SEVERAL YEARS AGO WE
CREATED THE NIAMS CULTURE
COMMITTEE TO PROMOTE AN
ORGANIZATIONAL CLIMATE
CHARACTERIZED BY INCLUSIVITY,
CIVILITY AND DIVERSITY. AND THIS
GROUP ALSO ADVISES INSTITUTE
LEADERSHIP ON RECRUITING
RETAINING AND PROET NOING
EMPLOYEES FROM UNDER-REPRESENTED
BACKGROUNDS. WE HAVE A NUMBER OF
OTHER ACTIVITIES WITHIN OUR
INTRAMURAL AND EXTRAMURAL
ACTIVITIES AND HIGHLIGHT A
COUPLE OF THOSE ON THE NEXT FEW
SLIDES. OUR INTRAMURAL RESEARCH
PROGRAM CAREER DEVELOPMENT
OUTREACH BRANCH HAS BEEN VERY
ACTIVE IN DEVELOPING AND
IMPLEMENTING PROGRAMS TO ENHANCE
DIVERSITY IN THE NIAMS WORK
FORCE AND TO ADDRESS STRUCTURAL
RACISM IN BIOMEDICAL SCIENCE.
DURING THE PAST YEAR IN RESPONSE
TO THE COVID-19 PANDEMIC WHEN IT
BECAME IMPOSSIBLE TO HOST
UNDERGRADUATE STUDENTS WITHIN
OUR LABORATORIES THE BRANCH
DEVELOPED HIGHLIGHTED PILOTED
INTRAMURAL VIRTUAL TRAINING AND
RESEARCH CALLED IN VITRO. THIS
WAS A HIGHLY COMPETITIVE PROGRAM
INVOLVING APPLICANTS FROM AROUND
THE COUNTRY AND PUERTO RICO AND
SUCCESSFUL CANDIDATES
PARTICIPATED IN EIGHT WEEK
VIRTUAL ONLINE INTERACTIVE
PLATFORPLATFORM. OF PROFESSIONL
CAREER DEVELOPMENT AND TRAINING
OPPORTUNITIES, IT WAS SUCCESSFUL
AND APPRECIATED. WE HAVE ALSO
POSTED SERIES OF VIDEOS ON NIAMS
YOUTUBE CHANNEL THAT HIGHLIGHTS
DIVERSITY AND INCLUSION WITHIN
OUR NIAMS RESEARCH WORK FORCE.
COUPLE LISTED HERE ARE FROM
(INAUDIBLE) CHIEF OF THE
SYSTEMIC BRANCH AND NATASHA HILL
ONE UNDERPEN DEN RESEARCH
SCHOLARS WITHIN THE NIAMS IRP.
ON THE EXTRAMURAL SIDE NIAMS
SUPPORTS THE NIH ADMINISTRATIVE
SUPPLEMENTS PROGRAM, TO ENHANCE
DIVERSITY OF THE RESEARCH WORK
FORCE AT THE STUDENT POST DOC
AND JUNIOR INVESTIGATOR LEVELS.
WE HAVE BEEN STRONGLY SUPPORTIVE
OF THIS PROGRAM FOR MANY, MANY
YEARS, WIKI PENDING UPON CAREER
LEVEL CAN PROVIDE DIRECT COST
FROM 5,000 TO $100,000. AND
RELATED TO THIS PROGRAM IN 2021
WE LAUNCHED A NEW PROGRAM
CALLING THE NIAMS DIVERSITY
SCHOLARS PROGRAM IN WHICH WE
ESTABLISH COHORT OF SCHOLARS AND
MENTORS EACH YEAR AND BRING THEM
TOGETHER IN THE FORM OF A
WEBINAR FOR NETWORKING AND
REALLY TO SUPPORT THE COHORT
THESE INDIVIDUALS AN PROVIDE
THEM WITH ADDITIONAL
PROFESSIONAL TRAINING AND
OUTREACH OPPORTUNITIES, WE HOLD
PROFESSIONAL DEVELOPMENT
ACTIVITIES THAT ARE LED BY
FORMER SUCCESSFUL DIVERSITY
SUPPLEMENT SCHOLARS, COUPLE OF
ONES WE HELD THIS YEAR THAT WERE
POPULAR INCLUDE ONE CALLED MY
JOURNEY TOWARD CAREER IN
RESEARCH, CAREER PATHS AND
INDUSTRY AT THE NIH. I WAS ABLE
TO PARTICIPATE IN THE MOST
RECENT ONE OF THESE PROGRAMS AND
IT IS FUN AND BE VERY HELPFUL
FOR THESE VERY EARLY STAGE
INVESTIGATORS. RECENTLY I WAS
INTERVIEWED BY DR. DAVID WILSON,
WHO IS DIRECTOR OF THE TRIBAL
HEALTH RESEARCH OFFICE. THAT
WAS IN RECOGNITION OF THE FACT
THAT NIAMS IS A VERY LONG
HISTORY OF SUPPORTING TRIBAL
HEALTH INCLUDING FORMATION OF
THE NIH AMERICAN INDIAN ALASKA
NATIVE HEALTH COMMUNICATION
INFORMATION WORKING GROUP. THE
PRIMARY OUTPUT OF THAT WORKING
GROUP WAS AN E NEWS LETTER
ENTITLED HONORING HEALTH WHICH
WAS SUCCESSFULLY TRANSITIONED TO
THE TRHO THIS PAST YEAR. IN
ADDITION OUR SCIENCE
COMMUNICATION OUTREACH BRANCH
POSTED A SERIES OF VIDEOS IN
ENGLISH AND SPANISH TO INCREASE
AWARENESS AND ENHANCE INCLUSION
OF UNDER-REPRESENTED RACIALETH
IN THIS GROUPS IN CLINICAL
RESEARCH. IN THESE VIDEOS
PATIENTS TELL PERSONAL STORIES
ABOUT LIVING WITH DISEASE AND
PARTICIPATING IN STUDIES AT THE
NIH CLINICAL CENTER IN AN EFFORT
TO INCREASE PARTICIPATION FROM
UNDER-REPRESENTED INDIVIDUALS
ACROSS THE COMMUNITY. WE ALSO
POSED FREE HEALTH INFORMATION ON
VARIETY OF AUTOIMMUNE
MUSCULOSKELETAL AND SKIN
CONDITIONS IN CHINESE, KOREAN,
VIETNAMESE AND SPANISH. AND OUR
ENTIRE HEALTH INFORMATION WEBB
PRESENCE IS TRANSLATED TO HELP
SPANISH LANGUAGE SPEAKERS FIND
RESOURCES THEY ARE LOOKING FOR.
THIS SLIDE SHOWS SOME OF THE
TRANSLATED MATERIALS, THESE
FOCUSING ON BACK PAIN ARTHRITIS
AND LUPUS. WHICH HAVE BEEN VERY
POPULAR, INCLUDE HOW TO MANAGE
THE CONDITIONS AND THEY HAVE
TEAR OUT TOOLS SUCH AS SYMPTOM,
DATA REACTIVE AND MEDICATION
TRACKERS THAT HAVE BEEN POPULAR
SO I JUST WANTED TO CONCLUDE
WITH THIS SLIDE THAT SHOWS SOME
OF THE OTHER WAYS TO CONNECT
WITH US FOR THOSE THAT AREN'T
FAMILIAR WITH THE NIAMS
COMMUNITY, WE SHARE A LOT OF
INTEREST WITH NIMHD AND LOOK
FORWARD TO HEARING IDEAS ABOUT
WAYS WE CAN PARTNER TOGETHER.
ON THAT NOTE I AM HAPPY TO TAKE
ANY QUESTIONS. I WILL STOP
SHARING NOW.
>> THANK YOU SO SO MUCH LINDSEY,
I DON'T THINK I APPRECIATE THE
OVERLAPS WE HAVE HAD OR HISTORY
OF YOUR INSTITUTE HAVING BEEN
PART OF NIDDK PRIOR TO 1986, I
GUESS AT THAT TIME I WAS JUST
STARTING MANY PI RESEARCH CAREER
SO WOULDN'T HAVE KNOWN ANY BEAR
QUESTIONS FOR CRISWELL? FROM
COUNCIL MEMBERS? OR STAFF WHO
ARE IN THE ROOM? YOU DID MENTION
THE ECONOMIC BURDEN OF
OSTEOARTHRITIS, IT IS A
CONDITION THAT I THINK
HISTORICALLY HAS HAD LITTLE
SCIENTIFIC INTEREST IN MANY
WAYS, DEGENERATIVE JOINT DISEASE
IT IS INEVITABLE WITH AGING I
GUESS YET ISSUES AROUND BACK
PAIN OR PATIENTS RELATED TO
ARTHRITIS AT THE SPINE I THINK
IS STILL NUMBER 1 TICKET ITEM ON
THE MEDICARE BUDGET BETWEEN ALL
THE MEDICAL CARE AND THE
SURGICAL CARE. WE ARE VERY
EXCITED ABOUT THE UPCOMING
WORKSHOP THAT WE ARE SPONSORING
WITH YOU AND IT IS A GOOD TIMING
TO ADDRESS THIS. AS A COMMON
CLINICAL PROBLEM THAT EXTENDS
BEYOND THE SPECIALTY
PERSPECTIVE. SO WE HAVE A COUPLE
OF QUESTIONS I THINK BILL YOU
ARE FIRST.
>> THE GREAT PRESENTATION, THANK
YOU SO MUCH. I WANTED TO ASK CAN
YOU SAY SOMETHING ABOUT
MAGNITUDE OF THE DIVERSITY YOU
SEE IN SCLERODERMA? AND CAN YOU
SAY ANYTHING ABOUT GENETICS THAT
MIGHT BE DRIVING THAT DISPARITY
>> YEAH. THANK YOU FOR THAT
QUESTION. AS IS THE CASE FOR
MANY CONDITIONS THAT KISS
PROPORTIONATELY AFFECT
INDIVIDUALS IN THE UNITED
STATES, WE DON'T HAVE GREAT
POPULATION BASED DATA THAT CAN
SPEAK TO THAT SPECIFICALLY.
EXCEPT ALL OF THE STUDIES THAT
HAVE ATTEMPTED TO COMPARE RATES
OF DISEASE AND SEVERITY OF
DISEASE AMONG AFRICAN AMERICANS
WITH SCLERODERMA AND EUROPEAN
ANCESTRY SHOW INCREASE RISK IN
INCREASE DISEASE SEVERITY. NOW
SOME OF THAT MAY BE ATTRIBUTABLE
OR AT LEAST ASSOCIATED WITH
INCREASE FREQUENCY OF SPECIFIC
AUTOANTIBODIES AMONG INDIVIDUALS
AFRICAN AMERICAN ANCESTRY AND
INTERESTINGLY CONSIDER ACROSS
MULTIPLE AUTOIMMUNE DISEASE,
OFTEN GENETIC ASSOCIATION WITH
SPECIFIC AUTOANTIBODIES STRONGER
THAN GENETIC ASSOCIATION WITH
THE DISEASE THEMSELVES. SO
PROBABLY GENETIC RISK FACTORS IF
YOU WANT TO THINK THAT WAY, THAT
PRE-DISPOSE TO SPECIFIC
AUTOANTIBODY PROFILES ARE
DRIVING DISEASE, IT IS
INTERESTING TO SPECULATE WHY THE
DIFFERENCES IN THOSE
AUTOANTIBODIES. THERE IS
INTERESTING RESEARCH IN
AUTOIMMUNE DISEASE TRYING TO
RELATE INCREASE FREQUENCY OF
VARIANTS TO DIFFERENT PRESSURE
RELATED TO INFECTIOUS DISEAS
DISEASE.MENT IN DIFFERENT PARTS
OF THE WORLD. SO INPICACHOS
DISEASE EXPOSURE TRIGGERS IMMUNE
RESPONSE AND WITH ONGOING
EXPOSURE OVER TIME THERE IS
SELECTION FOR CERTAIN GENERAL
TECH VARIANTS TO PROTECT AGAINST
THAT INPICACHOS AGENT, MALARIA
IS A COMMON EXAMPLE --
INFECTIOUS AGEN AGENT. THE PLAG.
IMPACT OF PLAGUE IN WESTERN
EUROPE AND HOW IT SELECTED
CERTAIN GENETIC VARIANTS THAT
PRE-DISPOSES NOW TO AUTOIMMUNE
DISEASE ARE GOOD EXAMPLES. IT S
DRIVEN BY GENETIC RISK VARIANTS
THAT MIGHT BE HISTORICAL REASONS
FOR DIFFERENT POPULATIONS AND
FREQUENCY.
>> THANK YOU. LISA.
>> THANK YOU FOR YOUR
PRESENTATPRESENTATPRESENTATION.Y
THE SLIDE WHERE YOU SHOWED
OSTEOPOROSIS AND RACIAL
DIFFERENCES. I THOUGHT FOR MANY
YEARS THAT AFRICAN AMERICAN
WOMEN HAD LOWER RISK AND YOU
SAID IT WAS A MYTH. SO I WAS
JUST CURIOUS WHAT PLAYS INTO
THAT MYTH? WHY IS IT SO --
WIDESPREAD THAT PEOPLE THINK
THAT IS LOWER IN AFRICAN
AMERICAN WOMEN?
>> ONCE AGAIN WE LACKED GREAT
EPIDEMIOLOGIC DATA TO HAVE
SPECIFIC NUMBERS FOR SOME OF
THOSE ASSOCIATIONS BUT PART OF
IT MIGHT HAVE BEEN IN THE OTHER
STUDY THAT I HAD ON THAT SLIDE
WHICH TALKS ABOUT PRIORITIZATION
OF HEALTH PROBLEMS. SO IF YOU
THINK ABOUT INDIVIDUALS FROM
LOWER SOCIOECONOMIC STATUS
GROUPS OR ETHNIC MINORITY
POPULATIONS THAT EXPERIENCE A
HIGHER BURDEN OF HYPERTENSION
AND DIABETES AND ET CETERA, ET
CETERA, ET CETERA, THE NOTION
CONCERNS ABOUT OSTEOPOROSIS
WHICH TYPICALLY LEAD TO
FRACTURES LATE IN LIFE, MIGHT BE
NOT AS MUCH IN THE FOR FRONT OF
THEIR MINDS OR CONCERNS FOR
THOSE OTHER REASONS. I THINK IT
IS ALSO GOOD TO KEEP IN MIND
THAT MAYBE OTHER CO-MORE BITTIES
THAT MIGHT HAVE TO HELP EXPLAIN
THESE ASSOCIATIONS OSTEOPOROSIS
IS MORE COMMON IN THIN
INDIVIDUALS AND TO EXTENT
OBESITY IS ASSOCIATED WITH
AFRICAN AMERICAN OR LATINO
BACKGROUNDS THAT MIGHT BE
PROTECTING THEM FROM
OSTEOPOROSIS. SO ON THE OTHER
HAND THERE IS ALSO SOME DATA
THAT SUGGESTS TYPE 2 DIABETES
MIGHT INCREASE RISK OF
OSTEOPOROSIS SO THERE IS A LOT
WE DON'T UNDERSTAND. BUT
PROBABLY PART OF WHAT IS
HAPPENED IS THAT OSTEOPOROSIS
HASN'T BEEN FRONT OF MIND FOR
MANY INDIVIDUALS FROM AFRICAN
AMERICAN HISPANIC BACKGROUNDS
BECAUSE OF THE HEALTH PROBLEMS
THEY FACE THAT MIGHT HAVE MORE
IMMEDIATE IMPACT ON HEALTH AND
WELL BEING.
>> THANK YOU.
>> I WOULD ADD ONE OF THE
REASONS I THINK ALSO PLAYED IN
THE ORIGINAL STUDY OF
OSTEOPOROSIS FRACTURE
COORDINATED UCSF BY STEVE
CUMMINGS, THE INCLUSION CRITERIA
WERE ONLY WHITE WOMEN. AND THE
RATIONALE AT THE TIME, IT WAS
DESIGNED IN 1980s, THE RATES
OF FRACTURE IS GREATER. THEY
WANT TO MAXIMIZE NUMBER OF
EVENTS IN ORDER TO MAKE
SOMETHING OF THE EPIDEMIOLOGICAL
STUDY. THE ANSWER IS THESE
DISEASES ARE NOT ABSENT IN BY
RACE ETHNICITY OR GENDER OR SEX.
THEY JUST LESS -- GET LESS
OUTCOMES. FEWER OUTCOMES. AND
BUT IT DOESN'T MEAN IT IS ABSENT
SO THAT WAS RETROSPECTIVELY
PROBABLY PARROTED DIFFERENTLY OR
INCLUDED AT LEAST BLACK WOMEN,
AND THEN I THINK THE OTHER
CHALLENGE IS MEN ALSO GET
OSTEOPOROSIS AND DEVELOP
FRACTURES AND WILL IS NOT A
CLINICAL CONSENSUS I'M AWARE OF
UNLESS YOU KNOW THAT MEN SHOULD
BE SCREENED. NUMBER OF YEARS AGO
STILL ACTIVE CLINICALLY, I
THOUGHT THAT DATA WERE ALREADY
GOOD, THAT THERE WASN'T
CONSENSUS ON THAT.
>> THERE IS A BIOMARKERS F NIH
BIOMARKERS CONSORTIUM PROJECT
FOCUSING ON BIOMARKERS FOR
OSTEOPOROSIS. I HEARD AN UPDATE
OF THAT A FEW DAYS AGO AND SOME
OF THE STATISTICS SHARED IN THAT
SETTING WERE THAT 50% OF WOMEN
OVER THAT ARE LIFETIME
EXPERIENCE OSTEOPOROTIC FRACTURE
AND 25% MEN. SO YES, IT IS LESS
COMMON IN MEN BUT 25% LATER AGE,
SO I THINK YOU ARE RIGHT. ONE
OF THE CHALLENGES HAS BEEN THAT
TO IF LOOKING FOR OUTCOME OF
FRACTURE IN CLINICAL TRIAL THE
NUMBER OF NEW AGENTS TO TEST FOR
IS MIND BOGGLING. SO THIS EFFORT
IS TRYING TO GET BONE MINERAL
DENSITY VALIDATED AS VALID
BIOMARKER IN THESE CLINICAL
TRIALS SO THEY CAN BE PERFORMED
AT ONE-TENTH THE COST OF STUDIES
IN THE PAST SO WE FORTUNATELY
WILL LIKELY SEE MUCH MORE
PROGRESS RELATED TO OSTEOPOROSIS
ONCE FDA APPROVES THAT IMPORTANT
BIOMARKER FOR OSTEOPOROTIC
FRACTURES. ELISEO IF I CAN
SPEAK TO THE BACK PAIN ISSUE, I
WANT TO SHARE, I SHARE THE
OBSERVATION YOU MADE WHICH IS AS
A MEDICAL STUDENT OR TRAINEE,
BACK MAYBE AND OSTEOARTHRITIS
ARE NOT GLAMOROUS, THEY DON'T
ARACKET THE GREAT MINDS OF
MEDICINE AND IT IS UNFORTUNATE
BECAUSE OF THE BURDEN AND IMPACT
ON QUALITY OF LIFE. I HOPE WE
ARE ENTERING AN ERA WE DON'T
FOCUS EXCLUSIVELY ON DISEASES
THAT WILL KILL YOU AND THINK
ABOUT QUALITY OF LIFE IN CON UK
DISEASE SUCH AS LOW BACK AND
OSTEOARTHRITIS AND THINKING
ABOUT OKAY THIS IS NOT AN
INEVITABLE CONSEQUENCE OF AGING
BUT MAYBE WE CAN PREVENT THIS
AND INTERVENE TO CHANGE THAT
ASSUMPTION, IT IS KIND OF THE
PARADIGM OR MIND SET THAT WE ARE
HOPING TO ADDRESS AND YOU MAY BE
AWARE OF LARGE EFFORT BEING
FUNDED THROUGH HEAL, HELPING END
ADDICTION LOW BACK PAIN,
CONSIDER SOCIO BEHAVIORAL
FACTORS, ENVIRONMENTAL FACTORS,
GENETIC RISK FACTORS, OTHER
CLINICAL PREDICTORS AND RYE TO
UNDERSTAND MUCH MORE
COMPREHENSIVE APPROACH MUCH MORE
COMPREHENSIVE THEORETICAL
FRAMEWORK HOW TO ADDRESS CHRONIC
LOW BACK PAIN SO LOOK FORWARD TO
SEEING THE RESULTS OF THAT
EFFORT.
>> ABSOLUTELY. WE HAVE ENTERED A
NEW ERA THINKING ABOUT THESE FOR
SOME TIME AND HEAL IS AN
EXAMPLE. PEOPLE FOCUS ON,
QUALITY OF LIFE NOT JUST THE
QUANTITY. OSTEOARTHRITIS
PARTICULARLY BECAUSE SO COMMON
HAS BIG IMPAC IMPACT. YOU MENTID
STUDY OVERMERRY PLACEMENT. KNEE
REPLACEMENT IS A TERRIFIC
INTERVENTION, IT IS SAFE, IT IS
CAN BE DONE IN MANY PLACE, YOU
DON'T NEED TO GO TO HIGH END
MEDICAL CENTER TO GET IT DONE.
IT CHANGES PEOPLE'S LIVES IN A
DRAMATIC WAY. 30 YEARS AGO THAT
WASN'T THE CASE. THERE WERE
STILL -- AND YET IT IS PROBABLY
I DON'T WANT THE SAY
UNDERUTILIZED BUT FREQUENTLY
PEOPLE ARE AVERSE TO THINKING OF
GETTING IT DONE AND AN IMPORTANT
QUALITY OF LIFE, WE ARE NOT
SAVING LIVES WE ARE IMPROVING
QUALITY OF LIFE IN SOMEONE WITH
SEVERE KNEE OSTEOARTHRITIS. SO
QUESTION FROM KEN.
>> DR. CRISWELL, THANKS FOR THE
WONDERFUL PRESENTATION. CURIOUS
IF THE INSTITUTE EVER HAS OR
PLANS TO OFFER FOA SPECIFICALLY
AROUND DISPARITIES, OBVIOUSLY
YOU HAVE SCIENTIST WHOSE ARE
FUNDED TO DO DISPARITY RESEARCH
BUT HAVE YOU SOUGHT PROPOSALS
WITH THAT AS ONE OF THE
EXCLUSIVE THEME?
>> THIS IS FOR HEALTH
DISPARITIES IN PATIENTS OR
UNDER-REPRESENTED WORK FORCE,
WANT TO MAKE SURE I UNDERSTAND.
>> AMONG PATIENTS, SORRY.
>> AFRAID I CAN'T SPEAK ABOUT
HISTORICALLY. BUT AT THE MOMENT
JUST TRYING TO THINK, I DON'T
BELIEVE WE HAVE FOA THAT
INVOLVES FUNDS SET ASIDE
SPECIFICALLY FOR THAT THOUGH I
WOULD HIGHLIGHT THAT MANY OF THE
DISEASES IN OUR MISSION AREAS
AFFECT INDIVIDUALS OF ETHNIC
MINORITY SO IT DOES FOCUS ON
THOSE POPULATIONS. WE HOPED
OVER COUPLE OF YEARS TO HAVE
OPPORTUNITIES FOR FUNDING TO
DIRECT FUNDING TO THIS IMPORTANT
AREA. OUR -- WE HAVE NOT HAD
ADDITIONAL FUNDS BEYOND THE 3%
OR SO ANNUAL INCREASE FOR MANY,
MANY YEARS. AND OUR PAY LINE IS
VERY TIGHT. AND OUR COSTS OF
GRANTS THAT COME INTO OUR
INSTITUTE EACH YEAR ARE MORE
EXPENSIVE THAN THE INCREASE IN
OUR BUDGETS SO IT IS REALLY
CHALLENGING TIMES FOR US TO
CONTINUE TO SUPPORT THE WORK
FORCE. THIS IS AN AREA IMPORTANT
TO US BECAUSE OF DISEASE WITHIN
OUR MISSION AREA AND I HOPE WE
HAVE AN OPPORTUNITY TO DO MORE
AND CERTAINLY COLLABORATING WITH
NIMHD MOVING FORWARD WILL BE A
GREAT OPPORTUNITY TO LOOK OUT
FOR. ELISEO, MAYBE YOU CAN SAY
MORE ABOUT YOUR CHRONIC DISEASE
INITIATIVE THAT I THINK HAS BEEN
AN OPPORTUNITY OR SOMETHING YOU
MAY HAVE AN OPPORTUNITY TO FOCUS
ON AT THE NIH. GREAT OPPORTUNITY
TO JOIN FORCES WITH YOU.
>> ABSOLUTELY. SO LARISSA LED
THE EFFORT TO PUBLISH THAT
PROGRAM ANNOUNCEMENT. WE ARE NOT
SETTING AD SIDE MONEY BUT DOING
SEE WHAT PEOPLE COME IN. IT IS
INTENDED LARGER THAN STANDARD
RO1 SO WE ARE LOOKING MORE THAN
A MILLION DOLLARS IN SIZE SIZE.U
HAVE HAVE TWO OR MORE INNOVATIVE
MODELS OF CARE, COUNCIL FAMILIAR
WITH CONCEPTS LAST SEPTEMBER,
AND FOA, IS OUT. SO YOU SCIAENID
UP, THAT IS WHAT YOU SHOWED IN
YOUR PRESENTATION. Z IT MAKES
PERFECT SENSE WE HAVEN'T
ENTERTAINED APPLICATIONS YET BUT
LOOK FORWARD TO GETTING SOME
ALMOST EVERY PATIENT I SAW UCSF
HAD OSTEOARTHRITIS. HEART PAIL
YOUR DIABETES OR OR DISORDER TO
PARTNER WITH NIAMS AND OTHER
INSTITUTES ON THIS AND SEE WHAT
COMES IN. THE OTHER ONE IS WE
DID FUND 11 CENTERS FOCUS ON
MULTIPLE CHRONIC DISEASE. WE I
CAN SITESSED THEM TO
PARTICIPATE, AROUND THE TIME WE
WERE BUSY WRITING THE FOA BUT
NONE OF THE FUNDED ONES
HIGHLIGHTED DISEASE AS THEIR
TARGET. DIABETES HEART DISEASE,
LIVER DISEASE KIDNEY DISEASE BUT
AND IT WAS ONE FOCUSED ON
CHILDREN SO THAT IS AREA WE CAN
THINK ABOUT ADDING COMPONENT TO
OR FIGURING WHAT TO DO ABOUT IT.
IT WAS A CONGRESSIONAL SET ASIDE
SO THAT WAS DONE THROUGH RFA. SO
BUT THAT IS AN AREA WE HOPE TO
LEVERAGE INTO MORE.
>> I SHOULD HAVE CLARIFIED I WAS
SPEAKING ABOUT A SET ASIDE THAT
CERTAINLY ANY OPPORTUNITY LIKE
YOU MENTIONED WHERE WE CAN PART
NEAR USING NORMAL MECHANISM
WOULD BE GREAT INTEREST BUT LOVE
TO SET ASIDE MONEY SPECIFICALLY
FOR THIS BUT NOT HAD THE
OPPORTUNITY YET.
>> THANK YOU. ALL UNDERSTOOD IN
THE CONTEXT OF DIMINISHING OUR
SMALL INCREASES IN BUDGETS.
>> OTHER COMMENTS OR QUESTIONS
FOR DR. CRISWELL? IF NONE
>> ONE MORE.
>> I WANTED TO FOLLOW-UP ON THE
HEALTHCARE MODELS PROGRAM
ANNOUNCEMENT. I HAVEN'T LOOKED
AT IT, I'M CURIOUS IN THAT FOA,
WHAT ARE -- ARE THERE
OPPORTUNITIES TO CONSIDER
ALTERNATIVE MODELS, FOR EXAMPLE
INTEGRATING COMMUNITY HEALTH
WORKERS JUST GET AN -- I'M
THINKING ABOUT LIKE THE
DISPARITIES THAT WERE NOTED NOR
ASIAN AND LATINX COMMUNITIES.
AND OFTENTIMES THE WORK THAT WE
HAVE SEEN IN NEW YORK CITY,
COMMUNITY HEALTH WORKERS WHO ARE
PART OF THAT TEAM BASED CARE
CONSIDER EFFECTIVE IN TERMS OF
SUPPORTING ENGAGEMENT ADHERENCE
AND REDUCING STIGMA ASSOCIATED
WITH CERTAIN DISPARITIES. SO
JUST A THOUGHT AND A PLOT FOR
INTEGRATING COMMUNITY HEALTH
WORKERS IN THOSE TYPE OF MODELS
>> I WOULD ASSUME THOSE WOULD BE
ENCOURAGED. ABSOLUTELY.
>> I DON'T THINK THAT IT IS UP
TO THE INDIVIDUAL INVESTIGATORS
TO SEE WHAT THEY WOULD PROPOSE.
OBVIOUSLY IN THINKING ABOUT
INNOVATIVE MODELS OF CHRONIC
CARE, WE ARE NOT SAYING --
THERE'S THE LIMITATIONS ARE NOT
STANDARD. SO LARISSA IS NOT ON
THE ZOOM SO I CAN'T CALL HER TO
ANSWER YOU BUT TAKE A LOOK, THE
IDEA IS TO GET THE COMMUNITY TO
THIS SCIENTIFIC COMMUNITY TO
THINK OUT OF THE BOX AND HOW WE
CAN DEMONSTRATE IMPROVEMENT IN
HOW WE ARE DOING IT. THANK YOU
FOR CONSIDERING THAT.
>> ELISEO, SHE HAS JOINED THE
ZOOM IF YOU WANT TO INVITE HER
TO COMMENT.
>> DO YOU WANT TO COMMENT ON THE
QUESTION? IF YOU ARE THERE? NOTE
SEEING HER.
>> IF YOU ARE SPEAKING YOU ARE
MUTED. MAYBE SHE'S NOT THERE, I
SEE HER MUTED.
>> ALL RIGHT.
>> WE WILL FOLLOWUP.
>> THANK YOU AGAIN LINDSEY. IT
IS WONDERFUL TO HAVE YOU AT THE
DIRECTOR'S TABLE. GLAD FRANCIS
WAS ABLE TO RECRUIT YOU AND
SELECTED YOU TO BE THE DIRECTOR
OF NIAMS. YOU FOLLOWED A LEGEND
IN STEVE KATZ WHO WAS LOVED BY
ALL WHO KNEW HIM, AND BOB CARTER
WHO WAS ACTING FOR TWO YEARS AND
WE LOOK FORWARD TO MORE
COLLABORATION AND SYNERGY IN
WORK WITH NIAMS IN THE COMING
YEARS. THANKS AGAIN FOR TAKING
THE TIME.
>> THANK YOU SO MUCH FOR YOUR
SUPPORT. PLEASURE TO MEET
Y'ALL.
>> BYE-BYE.
>> WE HAVE BOB BACK. DR. VALDEZ.
CALL YOU FIVE NAMES TODAY P. IS
IT THAT LONG? YOU ARE COUNTING
NOT ME. OUR SECOND PRESENTER
TODAY IS THE NEW DIRECTOR FOR
THE AGENCY FOR HEALTHCARE
RESEARCH AND QUALITY. ROBERT
VALDEZ IS APPOINTED DIRECTOR IN
FEBRUARY, I KNEW HE WAS PLANNING
TO COME TO WASHINGTON BECAUSE HE
HAD TOLD ME BUT I THOUGHT IT WAS
FOR DIFFERENT JOBS. WHEN HE SAID
OH, I CAN'T DO THIS, I CAN'T DO
THAT. WEEK LATER I SEE THE
ANNOUNCEMENT, IT WAS LIKE WOW,
SO IT WAS A GREAT WONDERFUL
SURPRISE. AHRQ HAD BEEN WITH
OTHER PERMANENT DIRECTORS WITHIN
THE NEW ADMINISTRATION. REALLY
IS AGENCY THAT NIMHD SEES IN
MANY WAYS SHAREING A LOT OF
COMMON DIRECTION AND COMMON
EFFORTS, AT LEAST WITHIN PART OF
OUR AGENDA. USE PREVIOUSLY
ROBERT WOOD JOHNSON FOUNDATION
PROFESSOR EMERITUS OF FAMILY AND
COMMUNITY MEDICINE IN ECONOMICS
AT UNIVERSITY OF NEW MEXICO
WHERE I VISITED IN SEPTEMBER OF
2019 AND SPENT TIME WITH DR.
VALDEZ, IT WAS REALLY A PLEASURE
TO BE THERE AND SEE THE
INSTITUTION AND VISIT THE
AMERICAN INDIAN COMMUNITY. IN
THE SUNY RESERVATION. HE
RECEIVED HIS Ph.D. FROM THE
RAND GRADUATE SCHOOL FOR PUBLIC
POLICY STUDIES. SPECIALIZING IN
STUDIES OF HEALTHCARE FINANCING
QUALITY OF MEDICAL CARE SO VERY
WELL SUITED FOR AHRQ DIRECTOR.
AT UNIVERSITY OF MICHIGAN SCHOOL
OF PUBLIC HEALTH HE WAS AWARDED
A MASTERS DEGREE IN HEALTH
POLICY ADMINISTRATION AND GONE
PREVIOUSLY TO HARVARD WHERE HE
STUDIED DEPARTMENT OF HISTORY
AND SCIENCE SPECIALIZING IN
LATIN AMERICAN HISTORY AND
BIOCHEMISTRY. THOSE ARE A LITTLE
DIFFERENT. HE WAS THE FOUNDING
EXECUTIVE DIRECTOR OF RWJ CENTER
FOR HEALTH POLICY IN NEW MEXICO
AN HAD A LONG CAREER WORKING IN
ACADEMIC AND SOME TIME IN
GOVERNMENT AND UCLA AT DREXEL
AND VARY OF OTHER SETTINGS. I
HAVE KNOWN BOB MOSTLY BECAUSE
THEY ARE JUST NOT THAT MANY
LATINO SCIENTISTS THAT HAD BEEN
KNOWN AROUND THE COUNTRY THAT
WORK IN THE AREA OF CLINICAL OR
POPULATION SCIENCE OR HEALTH
SERVICES SCIENCE SO OUR PATHS
INTERSECTED A NUMBER OF TIMES
AROUND DIFFERENT PROGRAMS AND IT
IS REALLY WONDERFUL TO HOST HIM
HERE AT OUR COUNCIL SINCE IT
WILL BE WORKING TOGETHER MORE
NOW THAT HE IS DIRECTOR OF AHRQ
AND WE SHARED A LOT OF COMMON
GROUND. DR. VALDEZ.
>> THANKS VERY MUCH. I REMEMBER
OUR ANNUAL MEETINGS IN SAN
ANTONIO MY HOMETOWN FOR THE
CANCER PROGRAM. (INAUDIBLE) NEAR
AND DEAR ACTIVITY AS PART OF OUR
WORK TOGETHER. MAY I HAVE MY
SLIDES UP? THANK YOU. I WANT TO
TALK ABOUT AND REMIND EVERYBODY
THE 20TH ANNIVERSARY OF IOM
REPORT CALLED UNEQUAL TREATMENT.
TO TALK A LITTLE BIT ABOUT WHAT
HAVE WE DONE THE LAST 20 YEARS
WITH REGARD TO CONFRONTING
RACIAL ETHNIC DISPARITIES IN
HEALTHCARE WHICH IS WHAT THE
FOCUS OF UNEQUAL TREATMENT WAS
ABOUT, MUCH OF WHAT YOUR
INSTITUTE DOES IS FOCUS ON
DISPARITIES IN HEALTH WHICH IS
THE IMPORTANT OUTCOME OF THAT
CARE. NEXT SLIDE PLEASE. AHRQ
FOR THOSE WHO DON'T KNOW BECAUSE
WE ARE A SMALL AGENCY MOST
PEOPLE DON'T REALLY KNOW WHO --
WHAT AHRQ IS AMONG THE SCIENCE
ORGANIZATIONS WITHIN THE
DEPARTMENT OF HEALTH AND HUMAN
SERVICES. WE ARE ONE OF THE FOUR
SCIENCE BASED ORGANIZATIONS THAT
HAS CONGRESSIONAL
RESPONSIBILITIES TO PRODUCE
SCIENTIFIC EVIDENCE THAT MAKES
HEALTHCARE ALWAYS AMAZING THINGS
WE GOT TO GET IT DONE YESTERDAY.
THE ACA ADDED ALSO A SPECIAL
FOCUS ON PRIMARY CARE RESEARCH
AND PRIMARY CARE IMPROVEMENT. SO
YOU CAN ADD THAT ON TO THAT LIST
OF SCIENTIFIC EVIDENCE. WHAT IS
MET BY SCIENTIFIC EVIDENCE IS
REALLY TAKING ALL THE MANY
STUDIES YOU HEARD ABOUT DESCRIBE
TODAY BY DR. PEREZ-STABLE IN ALL
THE WORK THAT GETS DONE AT NIH
AND ELSEWHERE. AND SIFTS THROUGH
ALL THOSE MANY STUDIES IN FLANKS
THAT COLONEL OF EVIDENCE OR WHAT
WE CAN SAY WHAT OUR KNOWLEDGE IS
TODAY AND OUR MIGHT IS REALLY TO
TAKE THAT KNOWLEDGE AND
TRANSPORT BACK INTO THE CLINIC.
SO THAT PATIENTS AND HEALTH
PROFESSIONALS AND HAIR
INTERACTIONS TAKE ADVANTAGE OF
MOST RECENT INFORMATION AND
THERAPIES. WE CAN'T DO THIS
BECAUSE WE ARE SMALL AGENCY WITH
OUR OWN PROGRAMS, SO WE RELY
TREMENDOUSLY ON OUR PARTNERSHIPS
WITH OTHER FEDERAL AGENCIES,
SUCH AS THIS ONE. BUT ALSO
TRIBAL STATE AND LOCAL HEALTH
DEPARTMENTS AND AGENCIES AND
UNIVERSITIES ACROSS THE COUNTRY
AS WELL AS OUR EFFORTS TO WORK
MORE DIRECTLY WITH THE
HEALTHCARE DELIVERY
ORGANIZATIONS AND HEALTHCARE
SYSTEMS ACROSS THE COUNTRY. SO
HERE IS THE FOUR BIG SCIENCE
AGENCIES OF THE DEPARTMENT. NIH,
FDA, CDC. THE FOUR OF US
TOGETHER ARE TRYING TO MOVE
TOWARD THAT GOAL THAT THE
PRESIDENT PUT FORWARD, MAKING
21ST CENTURY CARE A REALITY FOR
EVERYONE IN OUR COUNTRY. PRIME
MEDICAL SCIENCE IS NECESSARY BUT
INSUFFICIENT SO WHAT AHRQ TRIES
TO DO FOCUS ON HEALTHCARE
IMPROVEMENT USING THE SCIENCES,
SOCIAL BEHAVIORAL AND CLINICAL
SCIENCES AS WELL AS
IMPLEMENTATION SCIENCE NECESSARY
FOR UNDERSTANDING HOW TO BETTER
ADOPT AND DELIVER INNOVATIVE
THERAPIES THAT ARE INITIATIVE
REQUIRES. NEXT SLIDE PLEASE.
UNEQUAL TREATMENT IS AN
INTERESTING READ IF YOU HAVEN'T
SEEN IT MANY THE LAST 20 YEARS,
I RECOMMEND YOU PICK IT UP
AGAIN. BECAUSE IT HAD SOME
REALLY INSIGHTFUL AND
CHALLENGING IDEAS. SOME WHICH
WE PICKED UP OVER THE LAST 20
YEARS AND SOME WHICH WE LET LIE
FALLOW. IN THAT PARTICULAR BOOK,
AM TOOTING OUR OWN HORN AT AHRQ
WE WERE RECOGNIZED FOR THE WORK
WE ALREADY STARTED TO UNDERSTAND
HOW TO ELIMINATE HEALTH
DISPARITIES IN THE CARE THAT IS
PROVIDED IN OUR COMMUNITIES.
THE COMMITTEE MADE A GREAT URGE
IN THAT BOOK FOR GREATER SUPPORT
FOR THIS KIND OF WORK TO
ELIMINATE DISPARITIES IN
HEALTHCARE. AND ALSO REALLY
PUSHED US TO CREATE A MORE
AMBITIOUS AGENDA THAT
DISENTANGLE THE PROCESS
STRUCTURE AND OUTCOMES WHICH IS
THE FRAMEWORK THAT MICHIGAN PUT
FORWARD SO MANY YEARS AGO. IS
THE BASIS FOR MUCH OF THE
QUALITY OF CARE AWARD, STILL
GOES ON TODAY. NEXT SLIDE
PLEASE. THE UNEQUAL TREATMENT
DID A NICE JOB TAKING ALL
STUDIES AVAILABLE AT THE TIME
DOCUMENTED HOW PERSONS OF COLOR
REALLY EXPERIENCE THE HEALTHCARE
SYSTEM. THEY WANTED TO TRY TO
UNDERSTAND HOW THESE DISPARITIES
IN TREATMENT AROSE AND WHAT
ASPECT OF THE CLINICAL ENCOUNTER
MADE THEMSELVES AVAILABLE FOR
INTERVENTION. AND MODIFICATION.
THESE ARE AREAS I THINK UNEQUAL
TREATMENT TRY TO GET US TO PAY
ATTENTION TO, THAT WAS MEDICAL
CARE AND FINANCING, THE ACTUAL
ALLOCATION OF HEALTHCARE IS MADE
TODAY I DON'T THINK PEOPLE ARE
TALKING ABOUT THE FACT THAT WE
CREATED OVER THE LAST 20, 25
YEARS, A SEGREGATED CARE
DELIVERY SYSTEM. IN OUR COUNTRY
SEGREGATED NOT NECESSARILY BY
RACE AND ETHNICITY BUT CERTAINLY
CLASS AND INCOME. THEY ALSO
RAISED THE ISSUE OF AVAILABILITY
OF LANGUAGE TRANSLATION.
SERVICES. CREATED MANDATES FOR
LANGUAGE TRANSLATION SERVICES
SINCE THE LAST 20 YEARS. AMONG
NON-PROFIT HOSPITALS, TWO-THIRDS
OF THEM PROVIDE LANGUAGE
TRANSLATION SERVICES. AMONG FOR
PROFIT HOSPITALS SITUATION IS
WORSE. ONLY 18% PROVIDE THESE
MANDATED SERVICESS. WE HAVE YET
ENFORCE THOSE MANDATES IN
MEANINGFUL WAY TO MAKE LANGUAGE
TRANSLATION THE NORM RATHER THAN
EXCEPTION THE RESEARCH SPECIFIC
RECOMMENDATIONS WERE QUITE
INTERESTING TO REREAD BECAUSE IT
REALLY RECOMMENDED WE FOCUS ON
PROMISING INTERVENTION
STRATEGIES. I HEARD EARLIER
TODAY THAT THERE WAS INTEREST IN
REALLY UNDERSTANDING
INTERVENTIONS AND INTERVENTION
STRATEGIES. AMONG THIS GROUP. I
ENCOURAGE YOU TO RETHINK HOW WE
MIGHT DO THAT. THERE IS ANOTHER
SET OF ISSUE, AND THAT IS TO
CONDUCT RESEARCH ON ETHICAL
ISSUES AND OTHER BARRIERS ON
ELIMINATING DISPARITIES IN CARE
I DON'T THINK WE HAVE DONE MUCH
IN THE WAY OF LOOKING AT ETHICAL
ISSUES. WE CLEARLY ARE LOOKING
AT BARRIER ISSUES CLEARLY NOT
ENOUGH UNDERSTANDING WHAT
SPECIFICALLY ARE THE BARRIERS
BEYOND THE ISSUES OF RESOURCE
ALLOCATION THAT AFFECT IN
IMMUNITIES. NEXT SLIDE PLEASE.
AT AHRQ WE TRY TO ADDRESS THESE
ISSUES IN THIS RESEARCH BY
HAVING A GOAL. I REALLY CHANGED
THE FOCUS OF AHRQ SINCE
ARRIVING, AWAY FROM SIMPLY BEING
PATIENT FOCUSED TO UNDERSTANDING
WE NEED TO RECOGNIZE THAT
RELATIONSHIP OF THE PATIENT AND
HEALTH PROFESSIONAL SO THE WELL
BEING OF THE HEALTH PROFESSIONAL
IS EXTREMELY IMPORTANT IF IN
FACT WE PROVIDE OPTIMAL CARE FOR
PATIENTS. I THINK THE PANDEMIC
HAS MADE THAT EXCEEDINGLY CLEAR
AT LEAST EXCEEDINGLY CLAIRE
CLEAR TO ME MANY MY PERSONAL
EXPERIENCE NEW MEXICO, AND
WORKING WITH MY COLLEAGUES
DURING COURSE OF THE PANDEMIC.
MANY WHOM HADN'T BEEN MT.
HOSPITAL IN AGES AND FOUND
THEMSELVES BECOME HOSPITALLISTS
WHILE THOSE WHO DIDN'T HAVE
CLINICAL RESPONSIBILITIES OR WHO
HAD OTHER RESPONSIBILITIES TAKE
UP TEACHING RESPONSIBILITIES AND
ADMINISTRATIVE GOALS. BUT IT WAS
CLEAR THAT THE -- THEIR WORKING
EXPERIENCE TAKEN INTO ACCOUNT IN
ORDER FOR THEM TO PROVIDES HIGH
QUALITY CARE AS WAS EXPECTD BY
THE PATIENTS AND BY MY
COLLEAGUES. AT AHRQ WE GO ABOUT
OUR WORK THROUGH AN EFFORT TO
LOOK AT HEALTH SYSTEMS RESEARCH
ISSUES AROUND PRACTICE
IMPROVEMENT AND COLLECTION OF
DATA AND DEVELOPMENT OF NEW
ANALYTICS FOR UNDERSTANDING
THOSE DATA AND TURNING THAT DATA
INTO INFORMATION. NEXT SLIDE
PLEASE. COUPLE OF ILLUSTRATIONS
DONE AT AHRQ TRYING TO RESPOND
TO THIS IOM REPORT. SOME OF THE
FINDINGS THAT DRIVE US TO
CONTINUE TO DO MORE OF THIS WORK
NOT ONLY ON THEIR OWN BUT IN
PARTNERSHIP WITH NIH AND CDC AND
OTHER AGENCIES IN THE FEDERAL
GOVERNMENT. OTHER DEPARTMENTS
HONESTLY. TODAY ONE OF THE
BIGGEST INVESTORS IN RURAL
HEALTHCARE IS DEPARTMENT OF
AGRICULTURE WHO HAS SECRETARY
WHO DECIDED THE RESPONSE TO
PANDEMIC REQUIRES REAL
INVESTMENT IN RURAL HEALTHCARE.
AND HEALTHCARE SYSTEMS. NEXT
SLIDE PLEASE. THESE ARE OUR
FUNDING ANNOUNCEMENTS ON THE
RESEARCH SIDE AND ONE OF THE
REASONS PEOPLE DON'T KNOW AHRQ
EXISTS IS MANY FUNDING
ANNOUNCEMENTS COME OUTLOOKING AS
IF THEY ARE NIH GRANTS SO MANY
OF OUR GRANTEES HAVE NO CLUE
FUNDED BY AHRQ IN LARGE PART WE
PURCHASE THE FUNDING
ANNOUNCEMENT FUNDING PROCESS
THAT NIH DOES SO WELL. SOME OF
THE WORK WE ARE DOING IN
RESPONSE TO THE PRESIDENT
INITIATIVE AND PARTICULARLY
FOCUS ON CLIMATE CHANGE, LOOKING
AT THE STRESSES AND STRAINS OUR
HEALTH SYSTEMS EXPERIENCE AS A
RESULT OF CLIMATE CHANGE ISSUES
AND THIS ONE EXAMPLE OF A REPORT
WE PUT OUTLOOKING AT CHIEF
RELATED EMERGENCY DEPARTMENT
VISITS. MUCH OF THE WORK THAT
WE DO AT AHRQ IS CONSOLIDATING
SIFTING THROUGH MANY STUDIES
THAT ARE DONE ACROSS THE COUNTRY
AND AROUND THE GLOBE AROUND
PARTICULAR SETS OF ISSUES AND
CONCERNS. THIS PARTICULAR
KNOWLEDGE PIECE COMPARATIVE
EFFECTIVENESS REVIEW IS FOCUSED
ON PREVENTIVE SERVICES FOR
ADULTS. AND NEEDLESS TO SAY MANY
OF OUR COMMUNITY MEMBERS DO NOT
GET ALL THE RECOMMENDED
PREVENTIVE SERVICES THAT
PREVENTIVE TASK FORCE HAS MADE
MANNEDTORY AND COVERED UNDER
HEALTH INSURANCE PROGRAMS AS A
RESULT OF AFFORDABLE CARE ACT.
NEXT SLIDE PLEASE. AS I SAID WE
FOCUS ON PRACTICE RECRUITMENT
AND -- WE HAVE BEEN LOOKING AT
DIAGNOSTIC AREA IN PARTICULAR,
AND THIS PARTICULAR STUDY IS AN
EXAMPLE OF AN AREA THAT HAS
CAUGHT A LOT OF ATTENTION, WE
HAVE ASP DNA AMERICAN MATERNAL
MORTALITY AT UNBELIEVABLY HIGH
RATES AND IN MY TRAINING, AND IN
PUBLIC HEALTH WAY BACK MANY THE
DAY. THAT SIGNAL SYSTEMS
PROBLEMS. MANY FOLKS LOOK AT THE
INDIVIDUAL AS MAYBE THE
INDIVIDUAL HAS AN ISSUE OR
PROBLEM. AT LEAST IN MY
EXPERIENCE NATIONALLY ABOUT NOW,
IT IS CLEARLY A SIGNAL THAT OUR
HEALTHCARE SYSTEMS ARE FAILING.
WE DO COMPARATIVE EFFECTIVENESS
REVIEWS, IN THIS PARTICULAR
REVIEW WHICH WE DID DEPARTMENT
OF AGRICULTURE WE ILLUSTRATED
THE IMPORTANCE OF WIC FOR
NUTRITION OF WOMEN AND CHILDREN.
NOT ONLY DOES WIC SUPPORT THE
WELL BEING OF CHILDREN AS
EXPECTED TO DO BUT ALSO HAS A
GREAT EFFECT ON MATERNAL HEALTH
OUTCOMES. WE HAVE BEEN LOOKING
AT ALSO ISSUES AROUND CANCER AS
A RESULT OF THE PRESIDENT'S
CANCER MOON SHOT INITIATIVES AND
THIS IS AN EFFORT TO LOOK AT
CHILD KAREN SURVIVORSHIP. IT IS
CLEAR THAT THOSE CHILDREN WHO
SURVIVE CANCER DON'T DO AS WELL
AND VARIETY OF OTHER DIMENSIONS
THAT WE WANT OR EXPECT CHILDREN
TO SUCCEED IN SO GREAT
OPPORTUNITIES FOR US TO IMPROVE
LIVES CHILDREN SURVIVE CANCER.
NEXT SLIDE PLEASE. THIS IS
SOMETHING WAS EXCITING. I WAS
DEALING WITH WHEN I JOINED AHRQ
THREE MONTHS AGO I WAS DEALING
WITH MY MOTHERS CANCER. I USED
TO TAKE HER TO ONCOLOGIST EVERY
TIME BEFORE WE WENT TO HER
ONCOLOGY VISIT WE SIT DOWN AT
KITCHEN TABLE AND JOT DOWN ON
PIECE OF PAPER SOMEWHERE WHAT
WERE THOSE QUESTIONS WHAT WERE
ISSUES THAT MY MOM WANTED TO ASK
HER ONCOLOGIST. WHAT IS IT SHE
NEEDED TO KNOW TO FEEL BETTER
ABOUT THE TREATMENT SHE WAS
RECEIVING ABOUT PROCEDURES SHE
SHOULD BE FOLLOWING AT HOME. I
WASN'T HOME WITH HER MOST OF THE
TIME, I WAS IN ALBUQUERQUE AND
SHE LIVED IN SAN ANTONIO SO I
WOULD DRIVE DOWN A 12 HOUR
DRIVE, TO TAKE HER TO HER
ONCOLOGY VISITS. AND SO WE WOULD
WRITE THESE THINGS DOWN BUT
SOMETIMES WE WOULD BE DOING IT
ON THE TELEPHONE THE WEEKEND
BEFORE, BEFORE I WAS DRIVING
OFF, AND MY MOM WOULD FIND
LITTLE PIECES OF PAPER WHEN I
GOT THERE. THIS PARTICULAR
LITTLE DEVICE WHICH GOES ON YOUR
SMART PHONE WAS GREAT WAY OF
BUILDING THE QUESTIONS THE
PATIENTS NEED ANSWERED AIDS AS
THEY GO CLINICIANS. IT IS A
GREAT REMINDER, GREAT TOOL. ONE
OF THE HOTTEST TOOLS ON APPLE
APPS ONE OF THE TOP DOWNLOADS
NEXT SLIDE PLEASE. MUCH OF OUR
WORK IS DONE ALSO COLLECTING
DATA AND ANALYZING IT AND MAKING
AVAILABLE FOR DECISION MAKERS
AND CLINICIANS TO USE AS WELL AS
OTHERS. WE PUT OUT THE NATIONAL
HEALTHCARE QUALITY AND
DISPARITIES REPORT ON AN ANNUAL
BASIS IN ORDER TO KEEP TRACK OF
THE KIND OF HEALTHCARE
EXPERIENCE AND OUTCOMES THE
AMERICAN PUBLIC EXPERIENCES,
WITH A SPECIAL FOCUS ON HOW
RACIAL ETHNIC MINORITIES GROUPS
EXPERIENCE THE HEALTHCARE
SYSTEM. NEEDLESS TO SAY MORE
THAN HALF OF THE QUALITY
INDICATORS HAVEN'T MOVED AN INCH
FOR RACIAL ETHNIC COMMUNITIES,
IN FACT SOME HAVE IMPROVE BUD
THE VAST MAJORITY STAYED THE
SAME OR GOTTEN WORSE
PARTICULARLY DURING THE COURSE
OF THE PANDEMIC. NEXT SLIDE
PLEASE. WE USE A NUMBER OF
ANALYTIC TOOLS TO LOOK AT THE
EXPERIENCE AMERICAN PUBLIC. THIS
IS A STUDY THAT WAS DONE
INTERNALLY LOOKING AT
HOSPITALIZATIONS AND HOSPITAL
DEATHS BY RACE AND ETHNICITY
BOTH BEFORE PANDEMIC AND AFTER
THE PANDEMIC. WHAT YOU CAN SEE
IS THAT THE THERE IS A GREAT
CHANGE IN HOSPITALIZATIONS AND
AS WELL AS MORTALITY WITH A
GREATER MORTALITY AMONG RACIAL
ETHNIC COMMUNITIES, THAT IS NOT
A SURPRISE BUT IT IS ANOTHER
INDICATION OF THE -- OF THE
EXPERIENCE OUR COMMUNITIES HAD
DURING THE COURSE OF THE
PANDEMIC. NEXT SLIDE PLEASE.
THIS IS AGAIN ANOTHER LOOK USING
A DIFFERENT DATA SET LOOKING AT
MEPS RESEARCH THAT LOOKS AT THE
IMPORTANCE OF SOCIAL
DETERMINANTS OF HEALTH. FOR
THOSE WHO WERE ENGAGED IN
RESEARCH AND NEED ACCESS TO
SOCIAL DETERMINANTS OF HEALTH
DATA AHRQ IS RELEASING A SOCIAL
DETERMINANTS OF HEALTH DATA SET
LINKABLE TO MOST DATA SETS
AVAILABLE STATE AND NATIONAL
LEVEL DATA ON HEALTH AND
HEALTHCARE USE SO THE SOCIAL
DETERMINANTS OF HEALTH DATA IS
AN ATTEMPT TO TRY TO POOL IN A
SYSTEMATIC KIND OF WAY THE
INFORMATION THAT IS NEEDED AT
THE LOCAL AND INSTITUTE LEVEL TO
DO THIS RESEARCH. NEXT SLIDE
PLEASE. THIS IS ANOTHER AREA
GREAT IMPORTANCE TO THE -- THE
OPIOID CRISIS, THIS IS WORK DONE
TO LOOK AT NON-ELDERLY ADULTS
FILL PRESCRIPTIONS AND WHO THEY
HAPPEN TO BE. THIS IS A CLEAR
SIGNAL OF WHAT WE HAVE KNOWN FOR
SOME YEARS THE OPIOID CRISIS IS
LARGELY NOT BEEN A CRISIS OF
ETHNIC MINORITIES AS WAS ASSUMED
BY THE MEDIA AND BY MANY
DECISION MAKERS EARLY ON CRISIS.
NEXT SLIDE PLEASE. THIS
PANDEMIC IS REALLY UNDERSCORED
THE URGENCY OF THE WORK AHRQ IS
DOING AROUND MAKING HEALTHCARE
SAFER AND HIGHER QUALITY, IN
FACT ON THE QUALITY SIDE PATIENT
SAFETY DECLINED TREMENDOUSLY.
SINCE IT BEGAN ALL THE SUCCESS
WE HAD IN THE FIVE PREVIOUS
YEARS ON PATIENT SAFETY HAVE
BEEN ERASED IN THE LAST TWO
YEARS AS A RESULT OF THE
PANDEMIC SO WE FIND OURSELVES IN
A HEALTHCARE SYSTEM THAT IS TA
TEARED AND ATTORNEY AND -- AT
THAT TIME TEARED AND ATTORNEY
AND NEEDS OUR ATTENTION.
COLLABORATION IN BOTH HEALTHCARE
SPHERE TO SUCCEED IN ELIMINATING
BOTH HEALTHCARE DISPARITIES AND
HEALTH DISPARITIES IS SOMETHING
THAT I HAVE BEEN LOOKING FORWARD
TO BECAUSE HAVING DR.
PEREZ-STABLE AT NIMH, A NATURAL
PARTNERSHIP WITH AHRQ AND YOUR
AGENCY, I LOOK FORWARD TO TRYING
TO WORK TO END STRUCTURAL RACISM
THAT AFFECTS THE HEALTHCARE
PEOPLE RECEIVE, TO IMPROVE NOT
ONLY HEALTHCARE BUT THE HEALTH
OF ALL OUR COMMUNITIES. SO THANK
YOU VERY MUCH FOR GIVING ME THE
TIME TO REMIND YOU OF 20TH
ANNIVERSARY OF UNEQUAL TREATMENT
AND ENCOURAGE YOU TO READ IT, IT
WILL ALSO PROVIDE YOU WITH THE
KINDS OF RECOGNITION OF THE KIND
OF WORK YOU HAVE DONE THE LAST
20 YEARS TO ELIMINATE THOSE
DISPARITIES. THANK YOU.
>> THANK YOU SO MUCH, BOB. I
THINK APROPOS TO THE 20TH
ANNIVERSARY I HIGHLIGHT THE
REPORT AT THE TIME HAD LIMITED
DATA ON NON-AFRICAN AMERICAN
DISPARITIES. WAY BACK WHEN I DID
READ THE REPORT OR WENT THROUGH
IT FAIRLY THOROUGHLY I FOUND ALL
THE LATINO DATA IN A
SUPPLEMENTAL CD THAT WAS WITH
THE BOOK. . THAT WAS SORT OF
REFLECTION OF THE TIME, I
SUPPOSE NOW BE DOWNLOADABLE AS
SUPPLEMENT FROM PDF. LET ME ASK
YOU TWO QUESTIONS CONSTANTLY
BEING BROUGHT UP AT NIH THAT WE
ARE IN THE MIDDLE OF, ONE IS --
WHAT IS THE DIVERSITY RACE
ETHNIC DISABILITY SOCIOECONOMIC
STATUS OF THE WORK FORCE YOU
FUND? PRINCIPLE INVESTIGATORS OF
THE GRANTS AHRQ FUNDS? YOU SAID
YOU ARE SMALL AND I CERTAINLY
KNOW ABOUT AHRQ, FROM ITS
BEGINNING, THEY FUNDED A CENTER
AT UCSF ON DISPARITIES BEFORE IT
WAS AHRQ WHEN IT WAS CALLED
H,CPR. -- HCPR. THAT IS ONE
QUESTION, THE PARALLEL QUESTION
IS HOW MANY -- WHAT DOES AHRQ DO
TO FUND THE LESS RESOURCE
INSTITUTIONS, PARTICULARLY
MINORITY SERVING OR HBCUs BUT
NOT THE GORILLAS IN THE -- THE
BIG INSTITUTIONS GET BULK OF NIH
FUNDING.
>> I THINK WE HAVE THE SAME
EXPERIENCE AT NIH HAS, THAT IS
TOO FEW RACIAL -- HISTORICALLY
MINORITY RESEARCHERS FUNDED AT
AHRQ AND WE ALSO HAVE VAST
MAJORITY OF FUNDING DOMINATED BY
BIGGER ORGANIZATIONS THOUGH AHRQ
HAS DONE A NICE JOB OF REACHING
THE MIDDLE OF THE COUNTRY MUCH
MORE SO THAN MUCH -- MANY OF THE
NIH INSTITUTES. THERE IS A
CONSCIOUS EFFORT PARTICULARLY
OVER THE LAST DECADE, WITH NOT
ONLY RESEARCH PROGRAMS BUT ALSO
SOME OF ITS PROGRAMMATIC
ACTIVITIES. TO REACH INTO THE
MIDDLE OF THE COUNTRY. AM I
SATISFIED? I CAN TELL YOU I
SIGNED OFF ON A DOCUMENT FOR
MEMBERS OF COMMITTEE WHERE THERE
CLEARLY WASN'T ENOUGH DIVERSITY
IN THAT COMMITTEE. I'M PUTTING
IN PLACE SOME EFFORTS TO TRY TO
MAKE OUR RESEARCHERS MORE
VISIBLE MORE ACTIVE WE HAVE A
NEW PCORI INITIATIVE WHICH IS
JUST GETTING UNDERWAY THIS JUNE.
THAT AS A RESULT OF COMING ON
BOARD IN FEBRUARY, I WAS ABLE TO
CHANGE COMPOSITION OF THE GROUPS
THAT WE HAVE NOW MUCH MORE
REPRESENTATIVE GROUP OF SCHOLARS
HELPING LEAD STRATEGIC PLANNING
AROUND THAT PCORI WORK.
>> THERE ARE NUMBER OF QUESTIONS
LINED UP. I WILL START WITH DON
SHELL.
>> THANK YOU, SIR. COME OFF
MUTE. GREAT PRESENTATION, I
APPRECIATE THE WEALTH OF
INFORMATION AND YOU ARE
PRESENTATION MADE ME THINK ABOUT
ARE YOU AWAR OF COMPARISONS
BETWEEN SIMILARITIES RACE AND/OR
ETHNIC SIMILARITIES OF PROVIDERS
WITH YOUR PATIENTS? THUS HAVE
ANY IMPACT ON OUTCOMES?
SPARSE DISPARITIES THAT I HAVE
SEEN? INTERESTING THOUGHTS ON
THAT. WHETHER OR NOT ANY
COMPARISONS ON IF YOU ARE AWARE
OF SIMILARITY THRENE BETWEEN
PROKPROVIDER, AND RACIAL ETHNIC
(INAUDIBLE)
>> CERTAINLY OVER THE YEARS WE
HAVE SEEN CONSIDERABLE
LITERATURE ON CONCURRENCE THAT
IS HOW PATIENTS AND THEIR
PROVIDERS WHO COME FROM SAME OR
SIMILAR RACIAL ETHNIC BACK
GROUNDS. I DON'T KNOW IF AHRQ
DID THAT WORK BUT CERTAINLY LOOK
AT IT SUGGESTS THAT WHEN YOU DO
HAVE CONCURRENCE YOU ARE ABLE TO
GET BETTER ADHERENCE TO
TREATMENT REGIMENS AND
COMMUNICATION ISSUES, THAT
UNEQUAL TREATMENT TRIED TO POINT
OUT, IN ITS REPORT F THAT PLAY
OUT THAT IS, WHAT ARE THE ISSUES
ONE OF THE WAYS UNEQUAL
TREATMENT WAS RECOMMENDING WAS
THAT MINORITY POSITIONS IN
PARTICULAR IN OTHER HEALTHCARE
PROFESSIONALS GET CULTURE AND
LINGUISTIC TRAINING TO BETTER
SERVE AND UNDERSTAND PATIENTS, I
DON'T KNOW THAT WE HAVE DONE
THAT GOOD A JOB, IT WAS A
RECOGNITION THAT THERE IS NO WAY
IN HELL WE CAN INCREASE THE
NUMBER OF HEALTH CARE
PROFESSIONALS PARTICULARLY
PHYSICIANS, WHO COME FROM
MINORITY COMMUNITIES GIVEN THE
RATE OF GROWTH OF THE
POPULATION. AND THE LENGTH OF
PIPELINE IT TAKES TO GET PEOPLE
TO THE CLINICAL SETTING.
CERTAINLY THE PEOPLE HAVE DONE
MOST WORK IN THIS AREA ARE
PSYCHOLOGISTS. WHO LOOKED AT
THE MENTAL HEALTH ISSUE US,
WHERE COMMUNICATIONS IN MANY
WHATEVER LANGUAGE PREFERENCE
THERE IS AND RACE AND CULTURAL
RELATIONSHIPS ARE KEY TO
UNDERSTANDING BOTH CONCEPTS AND
CONCERNS DEMONSTRATED
CONSIDERABLE EFFECTIVENESS WHEN
YOU HAVE CONCURRENCE.
>> THANK YOU, APPRECIATE THAT.
>> THANK YOU, SIR. APPRECIATE
THE PRESENTATION.
>> SORRY I'M COUGHING ALL THE
TIME BUT JUST RECOVERING FROM
COVICOVID.
>> THANK YOU THANK YOU FOR BEING
WITH US. HOPEFULLY (INAUDIBLE).
KEAWE KAHOLOKULA.
>> HELLO, DR. VALDEZ, THANK YOU
FOR YOUR PRESENTATION, REALLY
ENJOYED IT. I HAVE A COUPLE OF
QUESTIONS, HOPEFULLY THEY ARE
SHORT OR SHORT RESPONSES TO, ONE
HAS TO DO WITH DIAGNOSTIC ERRORS
WORK THAT YOU PRESENTED, IT MADE
ME THINK ABOUT WORK WE ARE DOING
HERE AND ALSO MADE ME THINK HOW
DIAGNOSTIC TOOLS AND SCORES WE
USE BASED AN ETHNIC DIFFERENCES
OR ETHNICITY SUCH AS THE
ESTIMATED GFR FOR KIDNEY
DISEASE, AFRICAN AMERICANS AND
OTHERS END UP I HAVE BEEN
ADVERTENTLY CAUSING MORE
PROBLEMS PERHAPS AND BEING
HELPFUL, HAVE YOU -- IS THERE
MUCH WORK OR FUNDING FOR THINK
ABOUT PATIENT PROVIDER
RELATIONSHIPS AND PATIENT
CENTERED CARE, IMPLICIT BIASES
AMONG PROVIDERS, AND THE ROLE
MIGHT PLAY SIMILAR TO WHAT DR.
SHELL WAS REFERRING TO, IN
AFFECTING QUALITY OF CARE AND
HEALTHCARE OUTCOMES. THAT'S MY
FIRST QUESTION. SECOND IS
SIMPLE PROBABLY, WILL THERE BE
FUNDING OPPORTUNITIES TO
TRANSLATE TO OTHER LANGUAGES?
THINKING PACIFIC ISLANDER
LANGUAGES AS WELL AS PERHAPS
ASIAN AMERICAN POPULATIONS.
>> LET ME TAKE THE SECOND FIRST,
YES, WE ARE ALREADY WORKING ON
-- THAT WAS A TOOL THAT WAS
DEVELOPED IN HOUSE AND WE BOTH
HAVE ENGLISH AND SPANISH
CAPACITIES IN HOUSE. . SO THAT
WAS RELATIVELY EASY. WE ARE
LOOKING HOW TO BAND TO THE NEXT
SET OF LANGUAGES THAT ARE MOST
IN USE IN THE UNITED STATES.
CERTAINLY SINCE JOINING THE
AGENCY WE ARE ATTEMPTING TO NOT
ONLY DO OUR ANNOUNCEMENTS IN
MANY ENGLISH BUT ALSO IN
LANGUAGES OTHER THAN ENGLISH. I
HAVE BEEN PUSHING THE
DEPARTMENTS FOLKS BECAUSE THEY
HISTORICALLY ONLY PUT THINGS OUT
IN ENGLISH UNLESS THERE
SOMETHING SPECIFICALLY OTHER
LANGUAGE THEY WANT TO DO. THAT
IS NOT ACCEPTABLE BECAUSE WE
EXPECT OUR HEALTHCARE DELIVERY
SYSTEM TO RESPOND IN LANGUAGE
OTHER THAN ENGLISH. SO WE SHOULD
ALSO BE PROVIDING INFORMATION
AND MAKING ANNOUNCEMENTS IN
LANGUAGES OTHER THAN ENGLISH IN
THE DEPARTMENT. THE QUESTION
ABOUT FIRST QUESTION IS QUESTION
OF IMPLICIT BUYERS AND OTHER
ISSUES THAT AFFECT PATIENT
QUALITY OF CARE. OUR SEQUENCE
UNIT WITHIN THE AGENCY WHICH IS
THE KEY PART OF THE HEALTHCARE
QUALITY RESEARCH QUALITY IS
FOCUSED ON THAT ISSUE AND
FOCUSES ON DIAGNOSTIC ERROR AND
THAT LEADS TO POOR QUALITY CARE.
SO WE HAVE A NUMBER OF
INITIATIVES UNDERWAY AND WE ARE
RETHINKING THE WHOLE ISSUE
AROUND QUALITY, QUALITY HAS
LARGELY BEEN PARTICULARLY
AFFECTS MEDICARE AND MEDICAID,
ISSUES IS OFTEN FOCUSED ON THE
HOSPITAL SIDE OF THE SYSTEM. AND
YET WE KNOW THERE ARE MANY OTHER
SETTINGS WHERE QUALITY AND
UNDERSTANDING HOW TO PROVIDE
HIGH QUALITY CARE NEEDS TO BE
UNDERSTOOD THAT REQUIRE
DIFFERENT METRICS AND DIFFERENT
APPROACH. SO THAT IS AN AGENDA I
SET OUT FOR THE AGENCY, GIVEN
QUALITY AND QUALITY MEASUREMENT
IS A LONG STANDING AREA OF MY
WORK. (INAUDIBLE) AT MICHIGAN IS
ONE OF MY MENTORS, (INAUDIBLE)
AT THE RAND CORPORATION AND
QUALITY OF CARE WHEN I WENT TO
WORK FOR THE RAND HEALTH
INSURANCE EXPERIMENT. SO I
MAINTAINED MY CHIEF OPERATING
OFFICER ON THE QUALITY SIDE AND
HOPING THAT I CAN BRING BACK TO
WORK HERE AT AHRQ AND WITH DR.
PEREZ-STABLE AND WORK YOU ARE
DOING.
>> THANK YOU FOR THAT QUESTION,
KEAWE KAHOLOKULA. BRIAN.
>> NICE TO MEET YOU. I'M HEAVILY
INVOLVED IN THE INITIATIVE
AROUND THE USE OF IMPLEMENTATION
SCIENCE TO HELP AND THE HIV
EPIDEMIC. AS IMPLEMENTATION
SCIENCE HAS BEEN GROWING ACROSS
NIH NCI NIMH OTHER INSTITUTES, I
FREQUENTLY GET ASKED BY A
COLLEAGUE IS THEIR ROLE FOR
IMPLEMENTATION SCIENCE AT AHRQ,
OBVIOUSLY QUALITY IS AN
IMPORTANT COMPONENT OF
UNDERSTANDING HOW INTERVENTION,
NEW INTERVENTION BEING
IMPLEMENTED SO LOVE TO HEAR YOUR
THOUGHTS ABOUT WHERE
IMPLEMENTATION SCIENCE LIES AHRQ
PART OF OUR MANDATE YOU ALSO
MENTIONED PCORI IN YOUR
RELATIONSHIP, MAYBE HELP US
UNDERSTAND A LITTLE BIT ABOUT
HOW THESE THINGS LINK UP.
>> IMPLEMENTATION SCIENCE HAS
INITIAL HOME IN AHRQ, THAT'S
PARTS OF OUR MISSION. TO MOVE
EVIDENCE INTO PRACTICE. YOU
CAN'T DO THAT WITHOUT
UNDERSTANDING IMPLEMENTATION AND
IMPLEMENTATION SCIENCE AS A
RESULT OF THESE EFFORTS OVER THE
YEARS. OUR WORK WITH PCORI IS
THE RESULT OF THE FACT THAT AHRQ
IS RECIPIENT OF PART OF THE
PCORE TRUST FUNDS THAT CONGRESS
SET ASIDE. SO WHILE MOST OF
PCORI FOCUSES ON THE RESEARCH
ACTIVITIES, DISSEMINATION AND
IMPLEMENTATION HAS FALLEN NOW TO
AHRQ TO DO. THAT WAS PART OF THE
WORK I MENTIONED BRIEFLY IN MY
CONVERSATION ABOUT PUT TOGETHER
STRATEGIC PLANNING GROUP MUCH
MORE REPRESENTATIVE NOW OF OUR
NATION. IN PART RECOGNIZING
THAT WE NEED PEOPLE FROM
DIFFERENT PARTS OF THE COUNTRY
BECAUSE OUR HEALTHCARE SYSTEMS
OPERATE DIFFERENTLY IN DIFFERENT
PARTS OF THE COUNTRY, DIFFERENT
TREATMENT AND STYLES OF MEDICAL
CARE HEALTHCARE WELL DOCUMENTED
FOR REACHING THE REGION, AND
LOCATION TO LOCATION.
IMPLEMENTATION IS PART OF THE
BONE OF AHRQ AND HEALTH SERVICES
RESEARCH PORTFOLIO THAT INCLUDES
IMPLEMENTATION SCIENCE NIH IS
STILL RELATIVELY NEW AND YOUNG
AND DEVELOPING. OURS IS FAIRLY
WELL ESTABLISHED AS A LONG
TRADITION. WE CONTINUE TO HAVE
GRANTS THROUGH THE PCORE TRUST
FUND TRAIN IMPLEMENTATION
SCIENTISTS AS PART OF OUR AGENDA
WITH THE PCORI RUST FUND. SO WE
HOPE THAT IMPLEMENTATION
SCIENTISTS FIND HEALTH SERVICES
RESEARCHERS AND OTHER AREAS HAVE
FOUND AHRQ AS THEIR HOME AGENCY
>> THANK YOU, BRIAN. LISA. HI,
DR. VALDEZ. THANK YOU FOR YOUR
PRESENTATION. I AM ON CLINICAL
TASK FORCE FOR THE ALZHEIMER'S
DISEASE RESEARCH CENTERS AND WE
ARE WORK GROUP TO INTEGRATE OR
DEVELOP BATTERY FOR SOCIAL
DETERMINANTS OF HEALTH USED
ACROSS THE 30 PLUS CENTERS, I
SAW THAT YOU HAVE A SOCIAL
DETERMINANT BATTERY COMING OUT
SO MY QUESTION IS, WHEN WILL IT
BE AVAILABLE AND HOW MUCH DOES
IT OVERLAP WITH THE PHOENIX TOOL
KIT THAT I THINK NIMHD IF WE ARE
HOSTING IT OR WE JUST SIGNED ON
TO IT BUT I HAVE BEEN USING THAT
TOOL KIT AND I WANT TO KNOW HOW
MUCH OVERLAP YOUR DATABASE WILL
HAVE WITH THAT.
>> I CAN'T ANSWER THAT QUESTION,
NOT FAMILIAR, BUT I CAN TELL YOU
WE HAVE HAD A BETA TEST DATA SET
AVAILABLE, WE HAVEN'T MADE IT
ALL THAT WIDELY KNOWN. BUT THE
ACTUAL LAUNCH OF THE SOCIAL
DETERMINANTS OF HEALTH DATABASE
LAST REPORT I GOT SHOULD BE
READY FOR PUBLIC RELEASE IN MID
TO LATE JUNE.
>> JUST NEXT MONTH.
>> YES.
>> GREAT. ENTER WHERE CAN WE
FIND IT?
>> IF YOU GO TO WEBSITE YOU
SHOULD BE ABLE TO FIND ATE AMONG
DATA SETS THAT ARE AVAILABLE. WE
HAVE H CUP AND MENTION AND WILL
WILL BE A SEPARATE LINE NEAR FOR
THE SOCIAL DETERMINANTS OF
HEALTH DATA WHICH YOU CAN GO ON
LINE AND DOWNLOAD THE DIFFERENT
SPECIFICATIONS OF DATA THAT YOU
WILL NEED OR WANT.
>> AWESOME. THANK YOU.
>> JUST CLARIFY, LISA, THE
PHOENIX TOOL KIT IS MEASURES SO
IT IS VETTED MEASURES WE
ENCOURAGE ALL INVESTIGATORS TO
USE, WHEN THEY COLLECT DATA, I
THINK BOB IS REFERRING TO
EXISTING DATA THAT IS LINKED TO
SOCIAL DETERMINANTS, SO NOT
MEASURED. TOTALLY COMPLIMENTARY,
I KIND OF REMEMBER HEARING THIS
MINORITY OFFICE OF MYFORTY
HEALTH DIRECTORS MEETING BUT
YEAH IT IS SOMETHING THAT WE ARE
AWARE OF AND PROBABLY BE ABLE TO
HELP OUR COMMUNITY KNOW ABOUT IT
BY PUSHING IT OUT THROUGH EMAIL
>> THANK YOU FOR CLARIFYING THAT
DISTINCTION.
>> DR. CALMAN. YOU WILL BE THE
LAST QUESTION.
>> HI. THANK YOU, THIS WAS
GREAT. YOU MADE REFERENCES TO
THE UNEQUAL TREATMENT REPORT SO
I SIT ON THE BOARD OF HEALTHCARE
SERVICES FOR NATIONAL ACADEMY OF
MEDICINE AND YOU KNOW THAT THERE
IS DISCUSSION ABOUT UPDATING THE
REPORT, A NEW IDEA WHICH I'M
PROMOTING TO SAY INEQUITABLE
SYSTEMS IN HEALTHCARE BECAUSE
THE TREATMENT IS A RESULT OF THE
SYSTEMS AND AS YOU POINTED OUT
BY MENTIONING SEGREGATED CARE,
THESE SYSTEMS ARE SORT OF THE
UNDERPINNING OF TREATMENT, THE
TREATMENT THAT TAKES PLACE BY
DOCTORS AND NURSES AND ALL THOSE
ARE REALLY REACTIONS TO THE
SETTINGS IN WHICH THEY PRACTICE.
SO I'M WONDERING IF YOU WERE TO
LOOK FORWARD FROM THAT TOE THINK
ABOUT THOSE SYSTEMS, ANY
THOUGHTS ABOUT WHAT THE FOCUS OF
THE NEXT REPORT LOOKS LIKE THAT
WOULD BE DIFFERENT THAN WHAT WE
SAID 20 YEARS AGO? AS WE POINTED
OUT NOT A LOT CHANGED. WE
PUBLISHED THE MONOGRAPH IN 2005
CALLED SEGREGATED CARE. SO NOT
MUCH CHANGED SINCE THEN BUT ANY
THOUGHTS MOVING FORWARD?
INTERESTED TO HEAR YOUR IDEAS.
>> THAT IS A GREAT QUESTION AND
ONE THAT AS I WAS TRYING TO
REVIEW UNEQUAL TREATMENT I ASKED
MYSELF AS WELL WHAT WOULD I DO
NEXT? HOW DO WE MOVE AS PEOPLE
SAY I HATE THIS TERMS, BUT WHAT
CAN SAY HOW CAN YOU MOVE THE
NEEDLE AND HOW CAN WE DO BETTER
THE NEXT 20 YEARS THAN WE HAVE
THE LAST 20 YEARS. QUITE
HONESTLY, IT IS REFLECTION OF
HOW OUR SOCIETIES MOVED. MORE
SEGREGATED TODAY THAN WE HAVE
EVER BEEN. PEOPLE JUST DON'T
RECOGNIZE SEGREGATION BECAUSE IT
IS NOT NECESSARILY ABOUT YOUR
SKIN COLOR, AS MUCH AS IT IS
ABOUT THE KINDS OF RESOURCES
THAT YOUR FAMILIES HAVE
AVAILABLE TO YOU. WE ALMOST LOST
HEALTHY PEOPLE SOCIAL GRADIENT
OF HEALTH DATA AND INDICATOR IN
FAVOR OF LOOKING AT RACE
ETHNICITY AS PROXY. FOR THOSE
RESOURCE ISSUES, WHICH MAKES
SENSE IN AREAS, BUT THERE'S
STILL SOME INDEPENDENT
INFORMATION IN THAT RESOURCE
ALLOCATION ISSUE THAT CUTS
ACROSS POPULATIONS. THE POOR
HAVE POORER HEALTH THE MORE WELL
OFF ARE GOING TO HAVE MORE
ACCESS TO THE RESOURCES TO
MAINTAIN THEIR HEALTH AND WELL
BEING. WE HAVE KNOWN THAT FOR
CENTURIES IT IS NOT A NEW
CONCEPT, IT IS NOT NEW ISSUE,
SOMETIMES SOME SOCIETIES DO
BETTER THAN OTHERS FOR SOME
PERIODS OF TIME. WE ARE A
SOCIETY QUITE HONESTLY HAS FELT
COMFORTABLE CREATING SEGREGATED
HEALTHCARE IN OUR SOCIETY. AND
ACCEPTS IT. EITHER ACCEPTS U IT
OR BLINDLY ACCEPTS IT BECAUSE WE
HAVEN'T BROUGHT TO THEIR
ATTENTION. THAT IS ONE THING
THAT I THINK AT LEAST DURING MY
SHORT TIME AT AHRQ I WANT TO DO,
MAKE IT MORE VISIBLE, MAKE IT --
MAKE CLEAR FOR THE AMERICAN
PUBLIC AND PRECISION MAKERS WHAT
THE UNDERPINNINGS OF OUR
HEALTHCARE DELIVERY SYSTEMS ARE
AND THAT IS IT IS NOT ONE SYSTEM
BUT IT IS MULTIPLE SYSTEMS AND
WE HAVE MULTIPLE POPULATIONS
THAT ARE SERVED BY IT. I
USUALLY GET ON MY SOAP BOX WHEN
I TALK ABOUT THIS, BY POINTING
OUT WE HAVE MANY DIFFERENT
HEALTHCARE SYSTEMS IN THE UNITED
STATES AND DIFFERENT PEOPLE HAVE
THIS INTERSECTIONALITY CONCEPT
OF MULTIPLE IDENTITIES DEPENDING
WHICH HEALTHCARE SYSTEM THEY GO
TO. VETERANS MY COUSIN FOR
EXAMPLE, HE GETS ALL HIS CARE IN
THE VA BUT HE CLEARLY BECAUSE OF
HIS WORK AND HIS RETIREMENT AND
HIS RETIREMENT AND PENSION FUNDS
COULD GET HIS CARE AT SORT OF
HIGH END TERTIARY MEDICAL
CENTERS, IF HE WANTED TO OR
CHOSE TO. WHEREAS HIS BROTHER
NEVER WAS IN THE MILITARY AND
NEVER DID WELL ECONOMICALLY, IS
ON MEDICAID. IN A PLACE LIKE
TEXAS. WHERE MEDICAID PROGRAM IS
NEVER SHOWN ITSELF TO BE A
PARTICULARLY EFFECTIVE DELIVERY
SYSTEM. YOU HAVE TO BE
COMPLETELY DIRT POOR TO GET ON.
THEY STILL HAVEN'T EXPANDED
UNDER THE ACA. SO I HAVE TO GET
OFF THIS SOAP BOX BUT CERTAINLY
ONE THAT YOU REMINDED ME THAT IF
I CAN COME UP WITH GOOD IDEAS, I
KNOW WHO TO SEND THEM TO.
>> THANK YOU SO MUCH. LET ME
BRING THIS DISCUSSION TO A
CLOSE. MORE OPTIMISTIC NOTE,
KNEEL YOU WORK IN A PARTICULAR
-- NEIL YOU WORK IN A
PARTICULARLY SEGREGATED SYSTEM
IN NEW YORK CITY I LEARNED
SEVERAL YEARS AGO, THERE ARE
OTHER MODELS WHERE I HAD
PATIENTS WHO WERE BOTH PRIVATELY
INSURED, HIGHER END,
SOCIOECONOMIC STATUS AND LOTS OF
MEDICAID PATIENTS OR OLDER
ADULTS WHO WERE DEFINITELY NOT
DIRT POOR BUT DEFINITELY NOT
WELL OFF. I DO THINK THAT THERE
HAVE BEEN IMPROVEMENTS NOT TO
SAY EVERYTHING IS GETTING WORSE,
THE RATE OF UNINSURED WAS CUT BY
A THIRD AMONG LATINOS, FROM 2014
TO 2020. IT WAS REDUCED ALSO FOR
AFRICAN AMERICANS AND OVERALL
FOR THE POPULATI POPULATION. ANE
THE EFFORTS OF THE PRIOR
ADMINISTRATION, IT DIDN'T
INCREASE BY MUCH, WENT UP A
LITTLE BIT SO I THINK THERE IS
OPPORTUNITY TO CONTINUE TO MAKE
PROGRESS. SEGREGATED CARE DOES
EXIST BUT NOT EVERYWHERE. TEXAS
IS A PARTICULARLY BAD EXAMPLE OF
MEDICAID, MEDICAID WORKS WELL IN
NEW YORK. THOUGH IT IS
SEGREGATED. SO I'M GOING TO TURN
IT BACK TO MONICA TO MOVE US ON.
I THIS HI WE HAVE A BREAK NOW. I
THINK WE HAVE A BREAK NOW.
>> THANK YOU VERY MUCH,
EVERYONE.
>> THANK YOU, BOB BOB FOR YOUR
WONDERFUL PRESENTATION.
>> THANK YOU.
>> THANK YOU. SO YES, IT IS TIME
FOR A 15-MINUTE BREAK. SO I WILL
ASK THAT EVERYONE RETURN AT 2:46
AND WE WILL START THEN WITH THE
DISCUSSION OF OUR SCIENTIFIC
CONCEPTS. THANK YOU.
WELCOME BACK. WE WILL
CONTINUE WITH THE MEETING AT
THIS TIME. SO IS THE NEXT ITEM
ON THE AGENDA IS THE REVIEW OF
AND DISCUSSION OF SCIENTIFIC
CONCEPTS, THERE ARE TWO CONCEPTS
FOR APPROVAL. TWO COUNCIL
MEMBERS REASON ASSIGNED TO
REVIEW EACH CONCEPT TO MAKE THE
BEST USE OF THIS TIME OTHER
MEMBERS WERE ASKED TO SHARE ANY
COMMENTS WITHIN AN ASSIGNED
REVIEWER AND ASSIGNED REVIEWERS
ARE ASKED TO INCLUDE THESE
THOUGHTS WITH THEIR OWN
COMMENTS. THERE IS OPEN
DISCUSSION PERIOD FOR ADDITIONAL
COMMENTS FROM ANY MEMBER AND
THEN A MOTION, TO APPROVAL OR
DISAPPROVE AND THE VOTE BY ALL
OF THE MEMBERS. DR. RINA DAS
WILL PRESENT THE FIRST CONCEPT,
TITLE IS STRUCTURED
INSTITUTIONAL NEEDS ASSESSMENT
AND ACTION PLAN DEVELOPMENT FOR
NSIs. THE COUNCIL REVIEWERS
ARE DR. WILLIAM SOUTHERLAND AND
DR. AMILA VEGA. I WILL TURN IT
TO DR. DAS AND PRESUME YOUR
SLIDES WILL BE APPEARING ON THE
SCREEN MOMENTARILY.
>> GREAT. GOOD AFTERNOON,
EVERYBODY. SO TODAY I'M
PRESENTING A CONCEPT FROM THE
UNITE eCOMMITTEE
IMPLEMENTATION TEAM AND THE
TITLE IS STRUCTURED
INSTITUTIONAL NEEDS ASSESSMENT
AND ACTION PLAN DEVELOPMENT FOR
MINORITY SERVING INSTITUTI INST.
LIKE THE ACKNOWLEDGE EFFORTS OF
TEAM MEMBERS CHARLENE BRUCE AND
DAVID WHO ARE FROM DIFFERENT
INSTITUTES AT NIH AND CENTERS
AND OFFICES. NEXT SLIDE PLEASE.
SO THE OVERALL GOAL OF THIS NIH
WIDE INITIATIVE IS TO SUPPORT
RESEARCH ACTIVE MINORITY SERVING
INSTITUTIONS IN CONDUCTING A
STRUCTURED NEEDS ASSESSMENT AND
THEN DEVELOP SHORT TERM AND LONG
TERM ACTION PLAN BASED ON THE
RESULTS. THE AWARDS ARE INTENDED
TO SUPPORT RESEARCH ACTIVE
QUANTIFYING INSTITUTIONAL
RESEARCH CAPACITY, NEEDS AS WELL
AS ASSETS AND STRENGTHS. SO JUST
TO GIVE YOU A BRIEF BACKGROUND
ON THE CONCEPT YOU MAY BE
FAMILIAR WITH NIH UNITE
INITIATIVE. WHICH IS COMPRISED
OF FIVE COMMITTEES. THIS
SPECIFIC CONCEPT IS PART OF THE
UNITE eCOMMITTEE AND THE
CHARGE OF THE UNITE eCOMMITTEE
IS TO PERFORM A BROAD SYSTEMATIC
EVALUATION OF NIH EXTRAMURAL
POLICIES AND PROCESSES TO
IDENTIFY CHANGE PRACTICES AND
STRUCTURES THAT PERPETUATE LACK
OF INCLUSIVITY, DIVERSITY,
WITHIN THE EXTRAMURAL RESEARCH
ECOSYSTEM. SO THIS INCLUDES
DEVELOPING STRATEGIES TO ADDRESS
FUNDING DISPARITIES AND INCREASE
APPLICATIONS TO SUPPORT
INDIVIDUALS FROM
UNDER-REPRESENTED GROUPS SO IN
THIS SLIDE, I'M TRYING TO SHOW
YOU SETTLE TEAMS WHO ARE WORKING
ON DIFFERENT INITIATIVES AND WE
ARE FOCUSED ON THE BOTTOM LEFT
ON RESOURCES AND CAPACITIES AT
MSIs. SO JUST TO REITERATE THE
NEED FOR THIS INITIATIVE HAS
BEEN GOING ON WITH DISCUSSIONS
TRYING TO INCREASE DIVERSITY OF
SCIENTIFIC WORK FORCE FROM
DIFFERENT BACKGROUNDS AND ALL
LEVELS. THOUGH NIH HAS BEEN
FUNDING SEVERAL PROGRAMS AT NIH,
SUPPORT FOR RESEARCH EXCELLENCE,
THE SHORE PROGRAM RCMI RESEARCH
CENTERS AND MINORITY
INSTITUTIONS ARE THE PATCHY
PARTNERSHIPS TO ADDRESS CANCER
HEALTH EQUITY. THERE IS STILL
EXISTS A HUGE GAP IN NIH
FUNDING. WHEN WE WERE LOOKING AT
SOME REPORTS WE FOUND NATIONAL
ACADEMY OF SCIENCE ENGINEERING
AND MEDICINE IN 2019 TITLED
MINORITY SERVING INSTITUTIONS,
AMERICAS UNDERUTILIZED RESOURCE
FOR STRENGTHENING THE STEM WORK
FORCE. SO THAT REPORT REALLY
OUTLINES CERTAIN STRATEGIES AND
ONE OF THEM WAS PROVIDING MORE
SUPPORT FOR MSIs. THAT REPORT
WAS MORE GENERAL SO WE STILL
NEED TO UNDERSTAND WHAT ARE SOME
OF THE RESEARCH CAPACITIES
SPECIFIC NEEDS. THIS INITIATIVE
IS STRUCTURED TO CONDUCT THAT
ASSESSMENT OF THE ORGANIZATIONAL
RESEARCH INFRASTRUCTURE
COMPONENT THAT WILL HELP US
UNDERSTAND SOME OF THE BARRIERS
MAYBE ENHANCE ADMINISTRATIVE
RESEARCH RESOURCES AND EXPAND
OPPORTUNITIES FOR STUDENTS AND
FACULTY FOR BIOMEDICAL RESEARCH
ENTERPRISE. NEXT SLIDE PLEASE.
SO THE PURPOSE OF THIS
INITIATIVE IS TO SUPPORT
RESEARCH ACTIVE MSI IN
CONDUCTING RIGOROUS RESEARCH
CAPACITY NEEDS ASSESSMENT AND
THEN CREATING ACTION PLAN. SO
THEY WILL CONDUCT A NEEDS
ASSESSMENT USING VALID
INSTRUMENTS THAT ALREADY EXIST.
OR COULD ADAPT THEM TO THEIR
NEEDS TO ASSESS THEIR
INSTITUTIONAL RESEARCH
INFRASTRUCTURE. ONCE THEY
CONDUCT THE NEEDS ASSESSMENT THE
NEXT PHASE WILL BE TO DEVELOP
SHORT TERM LONG TERM ACTION
PLANS, STRATEGIC PLANS, DEVELOP
METRICS AND METHODS, ON
EVALUATING THE PROGRESS OF THEIR
PROGRAMS. THE NOTION IS THAT NIH
INSTITUTES AND CEN WILL SIGN
ON TO FUNDING OPPORTUNITY
ANNOUNCEMENT THAT WILL BE
DEVELOPDEVELOPED. WHAT WE MEAN T
IS THAT THE INSTITUTES WHO ARE
INTERESTED IN SUPPORTING THIS
EFFORT WILL BE SIGNING ON TO THE
FUNDING OPPORTUNITY. WE WILL
ALSO HAVE ONE LEAD INSTITUTE AT
NIH WHO WILL COORDINATE THE
EFFORTS ACROSS NIH. SO IN TERMS
OF THE RESEARCH ACTIVE MSI WHEN
WE LOOK AT THE DATA WE REALIZE
THAT THERE IS A HUGE DIVERSITY
BETWEEN DIFFERENT INSTITUTIONS.
SO TO REALLY BE FAIR WE THOUGHT
WE NEEDED TO HAVE CERTAIN
CRITERIA FOR THESE DIFFERENT
TYPES OF INSTITUTIONS. NEXT
SLIDE PLEASE. SO BASED ON THE
NSF DATA AND THE CARNEGIE REPORT
WE REALIZED THAT NOT ALL MSIs
ARE SAME SO DO REALLY CREATE AN
EQUITABLE PLAYING FIELD FOR
INSTITUTIONS TO SUBMIT
APPLICATIONS WE DECIDED THAT
CREATING TWO SEPARATE
CATEGORIES, ONE WOULD BE LOW
RESEARCH ACTIVE CATEGORY WITH
CAP OF 6 MILLION PER YEAR NIH
RPG FUNDING FOR THREE OUT OF
FIVE YEARS. WHICH IS A SIMILAR
CATEGORY NIGMS USED FOR SOME OF
THEIR PROGRAMS, JUST A SHORE
PROGRAM. IT COULD BE INSTITUTION
THAT UNDERGRADUATE OR GRADUATE
DEGREE GRANTING INSTITUTIONS,
THEY NEED TO HAVE HISTORIC
MISSION TO SUPPORT
UNDER-REPRESENTED GROUPS. AT
LEAST 25% OF UNDERGRADUATE
STUDENTS SUPPORTED BY PELL
GRANTS BASED ON THE MOST RECENT
DATA AVAILABLE. FOR THE HIGH
RESEARCH ACTIVE INSTITUTIONS WE
PROPOSE A CAP OF 25 MILLION PER
YEAR OF RPG FUNDING IN THE LAST
THREE YEARS. THIS IS SIMILAR TO
THE RCMI PROGRAM WE HAVE AT
NIMHD, THIS SHOULD BE DOCTORAL
DEGREE GRANTING INSTITUTIONS,
HISTORICAL MISSION OF SUPPORTING
UNDER-REPRESENTED GROUPS IN
BIOMEDICAL SCIENCES, AND WE
PROPOSE LOWER CAP OF 6 MILLION
FROM THIS CATEGORY TO SEPARATE
FROM THE FIRST ONE. JUST WANT TO
MAKE IT KNOWN THAT THE CARNEGIE
RO1 CATEGORY INSTITUTIONS WILL
NOT BE ELIGIBLE. SO NEXT SLIDE
PLEASE IN TERMS OF TOPIC AREAS
FOR THE NEEDS ASSESSMENT, THESE
ARE A FEW SUGGESTIONS FOR
RESEARCH INFRASTRUCTURE AREAS
THAT COULD INCLUDE RESEARCH
READINESS IN VARIOUS AREAS SUCH
AS BASIC BEHAVIORAL OR CLINICAL
RESEARCH HUMAN SUBJECTS
RESEARCH, WHETHER THEY HAVE
SUPPORT FOR GRANTSMANSHMANSHIP
MR. THEY NEED SUSTAINABLE
PARTNER SHEEPS, COLLABORATIONS
WITH ASSOCIATIONS, INSTITUTIONS
WHICH ARE SUSTAINABLE FOR
RESEARCH SUPPORT CORE FACILITIES
HOW ARE THERE CORE FACILITIES OR
LAB EQUIPMENT, ALSO CAPACITY FOR
COMMUNITY ENGAGEMENT RESEARCH.
IN TERMS OF ADMINISTRATIVE AREAS
THAT COULD INCLUDE ESTABLISHING
OR ENHANCING OFFICE SPONSOR
PROGRAM, PERSONNEL RESOURCES,
SUPPORT STAFF, GRANT AWARD
SUPPORT FOR PRE AND POST GRANT
AWARD WHICH IS ALSO CRITICAL TO
HAVE AN UNDERSTANDING OF THOSE
AREAS. IN TERMS OF STUDENT AND
FACULTY DEVELOPMENT, THERE COULD
BE NEEDS FOR TRAINING PURPOSES
FOR MENTORSHIP, SPONSORSHIP, FOR
OTHER FACULTY DEVELOPMENT AREAS.
IN TERMS OF INSTITUTIONAL
POLICIES, THAT CAN LOOK AT HOW
INSTITUTIONS ARE SUPPORTING
RESEARCH EFFORTS WHETHER THERE
IS PROTECTED TIME AVAILABLE TO
CONDUCT RESEARCH. SO THESE ARE
JUST SOME SUGGESTED AREAS EACH
AREA EACH INSTITUTION WOULD HAVE
DIFFERENT NEEDS SO THEY CAN
TAYLOR THE NEEDS ASSESSMENT
ACCORDINGLY. ONCE THE NEEDS
ASSESSMENT ARE COMPLETED, THE
INSTITUTIONS WILL THEN DEVELOP
ACTION PLAN FOR SHORT TERM LONG
TERM GOALS AND DEVELOP METRICS
FOR ASSESSMENT OF THOSE AREAS.
JUST KNOW NIH PLANS TO WORK WITH
GRANTEES TO CONNECT THE GRANTEES
WITH EXISTING OPPORTUNITIES AND
PROGRAMS THAT EXIST IN VARIOUS
AGENCIES. SO THAT IS ALL I
HAVE. NEXT SLIDE, HAPPY TO TAKE
ANY QUESTIONS OR COMMENTS.
>> THANK YOU VERY MUCH FOR
PRESENTING THAT FOR US, DR. DAS.
THE NEXT THING IS I WOULD LIKE
TO MAKE SURE OUR COUNCIL MEMBERS
WHO REVIEW THIS CONCEPT PROPOSAL
HAVE AN OPPORTUNITY TO COMMENT
SO DR. SOUTHERLAND DO YOU HAVE
ANY COMMENTS ON THIS CONCEPT?
>> I DO. FIRST THANK YOU FOR
ASKING ME TO REVIEW THIS CONCEPT
AND THE SECOND I WANT TO SAY
THAT THIS CONCEPT COULD NOT BE
MORE IMPORTANT AT THIS TIME OR
TIMELIER. YOU HAVE JUST HEARD
THE DETAILS OF GOALS OF THE
CONCEPTS SO I WON'T REPEAT THEM
IN WHAT I HAVE TO SAY. ONLY TO
EMPHASIZE THE CONCEPT AIMS TO
DEVELOP A CADRE OF MSI
INSTITUTIONS THAT HAVE
DETERMINED WHAT THEIR NEEDS ARE
AND DEVELOPED A PLAN TO ACHIEVE
THOSE NEEDS. SO THIS IS AN
OPPORTUNITY FOR MSI TO DETERMINE
UNDERSTAND WHAT THEY NEED TO
PARTICIPATE EFFECTIVELY IN
BIOMEDICAL RESEARCH AND DEVELOP
PLANNINGS TO HAVE THE ISSUE
ACCOMPLISHED. ALSO I SHOULD
NOTE THIS CONCEPT USES THE TERM
BIOMEDICAL COLLECTIVELY TO
INCLUDE BIOMEDICAL CLINICAL
BEHAVIORAL AND SOCIAL SCIENCE
RESEARCH. SO WE ALL KNOW AS A
NATION AND SOCIETY WE FACE
PERSISTENT AND EVER INCREASING
PROBLEMS AND CONCERNS IN THESE
RESEARCH AREAS. AND IN THE FACE
OF HERCULEAN EFFORTS THESE
PROBLEMS HAVE CONTINUED TO
PERSIST. ALSO WHILE WE RECOGNIZE
SOLUTIONS TO THE PROBLEM
REQUIRES TEAM EFFORT IT IS TRUE
THAT FOR TOO LONG AND TOO MANY
MEMBERS OF THE TEAM HAVE BEEN
LEFT SITTING ON THE BENCH. ALSO
FOR TOO LONG TOO MUCH NATION'S
POTENTIAL HAVE NOT BEEN UTILIZED
OR HAVE NOT BEEN CONSIDERED
VALUABLE IN THE NATIONS
BIOMEDICAL RESEARCH EFFORT. WHAT
I FIND SO EXCITING ABOUT THIS
CONCEPT IS IT REPRESENTS A E
MANY SURED METHODICAL AND
SYSTEMATIC APPROACH OF TAPPING
THE UNTAP POTENTIAL OF THE
NATION'S MSI COMMUNITY. THIS
CONCEPT RECOGNIZES THE VALUE
THAT THIS COMMUNITY INSTITUTION
BRINGS TO THE NATION RESEARCH
EFFORT. ALSO RECOGNIZES THE
GRANULARITY OF THE MSIss. THAT
GRANULARITY IS EXPRESSED IN WIDE
VARIABILITY OF THE CURRENT
RESEARCH CAPACITY OBSERVED IN
THIS COMMUNITY. ANOTHER POINT
WORTH NOTING THE MSI COMMUNITY
ITSELF IS A DIVERSE ENTITY.
PRIMARILY COMPRISED OF TRIBAL
COLLEGES TCUs, HISPANIC
SERVING INSTITUTIONS OR HSIs
AND HISTORIC BLACK COLLEGES AND
UNIVERSITIES HBCUs. OR MORE
GENERALLY SPEAKING, ANY
INSTITUTION WITH AN ENROLLMENT
OF 25% SPECIFIC MINORITY GROUP
MAYBE DESIGNATED AS MYFORTY
SERVING FOR THAT GROUP --
MINORITY SERVING FOR THAT GROUP.
SO THE DIVERSITY OF THE MSI
COMMUNITY EMPHASIZES THE
MULTIPLICITY OF PERSPECTIVE THIS
COMMUNITY PROMISES TO DELIVER
WHICH HAVE BEEN FOR THE MOST
PART LARGELY UNTAPPED. AS
SOMEONE WHO SPENT HIS CAREER AT
HBCU, THIS CONCEPTS IS VERY
ENCOURAGING AND HOLD IT IS
PROMISE OF ENHANCING THE
CONTRIBUTIONS OF MSIs TO THE
BIOMEDICAL RESEARCH EFFORT IN A
TIME IT REALLY COUNTS. ANOTHER
IMPORTANT ASPECT OF THIS CONCEPT
IS IT ALLOWS MSIs WHICH ARE AS
INDICATED EARLIER VARIOUS
INSTITUTIONS TO CHART THEIR OWN
COURSE AND PROCEED AT THEIR OWN
PACE. THE BUILT IN H PLANNING
COME POINT OF THIS COMPONENT
CHALLENGES THE MSI TO LOOK
CAREFULLY WHERE THEY ARE
CURRENTLY AND DECIDES WHERE YOU
WANT TO GO AND PLAN A PATH FOR
HOW THEY SHOULD GET THERE. IT
GIVES INSTITUTIONS THE
OPPORTUNITY TO TAKE THEIR
BIOMEDICAL RESEARCH DESTINY AND
THEIR OWN HANDS. IN ADDITION TO
CONDUCTING OBJECTIVE NEEDS
ASSESSMENTS THIS CONCEPT
PROVIDES OPPORTUNITY TO DEVELOP
SHORT AND LONG TERM GOALS AND TO
DEVELOP METRICS AND METHODS FOR
ASSESSING PROGRESS TO THOSE.
THERE IS A STATEMENT IN CONCEPT
THAT INDICATES GUIDANCE WILL BE
PROVIDED BY THE HUN PROGRAM
STAFF TO CONNECT AWARDEES TO
PROGRAMS AND FUNDING
OPPORTUNITIES AT DIFFERENT
FUNDING AGENCIES TO ADDRESS
IDENTIFIED NEEDS. THAT IS A VERY
POSITIVE RECOMMENDATION AND
MAYBE MORE NEEDED BY SOME MSIs
THAN FOR -- THAN FOR OTHERS SO
BECAUSE OF THAT IT WOULD BE
HELPFUL TO GET A BETTER IDEA OF
WHAT THE PROCESS LOOKS LIKE.
ANOTHER STATEMENT THAT CAUGHT MY
ATTENTION IS N NIH ICs WERE
SIGNED ON TO FOAs TO FOA
PROVIDE SHARED SUPPORT AND A
LEAD INSTITUTE WILL BE ASSIGNED
TO COORDINATE THIS SUPPORT
EFFORTS ACROSS THE NIH ICs,
THIS EXTENDED LEVEL SUPPORT
SHOULD HAVE TO ENSURE THE
SUCCESS OF THE AWARDEES. ONE OF
THE PERENNIAL ISSUES WITH THE
PARTICIPATION OF MSI IN RESEARCH
IS THEY HAVE BEEN TOO OFTEN
ASKED TO OR INDEED REQUIRED TO
MARCH TO THE TUNE INTEREST OF
RESEARCH INTENSIVE PARTNER.
WHILE THOSE ARRANGEMENTS HAVE
HAD SOME SUCCESS, IT ALSO
LIMITED THE UNFETTERED
EXPRESSION AND THEREFORE
CONTRIBUTIONS OF MSI PARTNER. I
HAVE PROPOSED NEEDS ASSESSMENTS
INCLUDE VERY BROAD CATEGORIES
WHICH PROVIDE INSTITUTIONS AMPLE
FLEXIBILITY AND CHARTING THE
WEST COURSE FOR THEIR OWN
INDIVIDUALIZED GOALS AND
INTERESTS. SO AS INDICATED
EARLIER, POSITIVE IMPACT OF THIS
PLAN IS INVITES MSIS TO LOOK
CRITICALLY AT THE CURRENT STATE
OF BIOMEDICAL RESEARCH AT THEIR
INSTITUTION, COMPARE PRESENT
STATE WHERE THEY ARE AND WHERE
THEY WANT TO BE, AND CHART A
PATH HOW TO GET THERE. THIS
CONCEPT PROVIDES FUNDING
ASSISTANCE IN DOING EACH OF
THESE STEPS AND ONCE THE PLAN IS
DEVELOPED Z THERE SEEMS TO BE
SUGGESTION WORKING WITH THE
INSTITUTIONS, ACQUIRE FUNDING
FROM OTHER SOURCES TO IMPLEMENT
DEVELOPED PLANS SO THIS CONCEPT
PROVIDE FUNDS FOR PLAN
DEVELOPMENT WHILE EFFECT
COMPLICIT FUNDS FOR PLAN
IMPLEMENTATION WILL COME FROM
ELSEWHERE. SO THE CONCEPT IN
ENACTED WILL INCREASE
PARTICIPATION OF MSI IN THE
NATIONAL BIOMEDICAL RESEARCH
CONVERSATION IN TWO WAYS. ONE
IN TERMS OF DIRECT CONTRIBUTION
BY EXISTING DIVERSE WORK FORCE
PRESENT AT MSI, AND ALSO BY
PROVIDING CONTINUAL FLOW OF
DIVERSITY INTO THE WORK FORCE BY
VIRTUE OF MSI ENHANCED ABILITY
TO PROVIDE APPROPRIATELY TRAINED
STUDENTS. TO ENTER INTO THE WORK
FORCE. IN SUMMARY I BELIEVE THIS
CONCEPT IS A STEP IN THE RIGHT
DIRECTION AND I GIVE IT MY FULL
SUPPORT. THANK YOU.
>> THANK YOU VERY MUCH FOR THOSE
COMMENTS. DR. VEGA, DO YOU HAVE
COMMENTS TO ADD ON THIS CONCEPT?
PLEASE.
>> THANK YOU. THERE ARE MORE
THAN 100 MIGHTY SERVING SAUCE
AND THEY ARE -- PARTICULAR
INTEREST STUDENTS OF COLORND
THOSE WITH LOW INCOME
BACKGROUNDS. MSI SERVE ABOUT 30%
OF UNDERGRADUATES SOME OF THE
ISSUES THAT MSI FACE LACK OF
RESEARCH SUPPORT, LACK OF
INAPPROPRIATE RESEARCH
ENVIRONMENT AND LACK OF FACULTY
AND STAFF. SO MENTIONED BEFORE,
DR. DAS MENTIONED THAT THE GOAL
OF THESE CONCEPT NOW IS TO
INCREASE TO HAVE ASSESSMENT
INSTITUTIONAL RESEARCH CAPACITY
AND (INAUDIBLE) PLAN, THIS IS A
VERY IMPORTANT TIMELY TOPIC B I
CAN SEE THE CONCEPT WOULD
BENEFIT FROM INCLUDING MORE
INFORMATION HOW IT IS GOING TO
BE IMPLEMENTED, HOW THEY DEFINE
IT TO CATEGORIES AND ARE THERE
DIFFERENT GOALS FOR EACH
CATEGORY AND HOW DO MSI COMPARE
WITH RESPECT TO OTHER
NON-SCIENCE INSTITUTIONS IN
TERMS OF NIH SUPPORT. WE ALSO
RELEVANT TO CONSIDER MSI
INSTITUTIONS NEED TO ASSESS THE
SUSTAINABILITY OF THEIR
INITIATIVES. IT IS ALSO RELEVANT
THIS INITIATIVE INCLUDES
IMPLEMENTATION RESEARCH CAPACITY
AT MS I. GIVEN THE
HETEROGENEITY AS MENTIONED
BEFORE AND POPULATION YES SERVE,
MANY MAYBE READY TO START
INTERVENTION STAGE. SO MSI
REQUEST FUNDS TO IMPLEMENT
INTERVENTIONS BASED ON THE MOST
PRESSING NEEDS AS THEY MAY HAVE
ALREADY DONE THEIR OWN
ASSESSMENT AND PROVIDE TOOLS OF
IMPLEMENTATION SUSTAINABILITY OF
THIS INTERVENTION. THE PREVIOUS
REPORT OF THE NATIONAL ACADEMY
OF SCIENCE PROPOSE QUANTITATIVE
INTERVIEWS WITH MSI LEADERSHIP
AND SOME SEEM TO INDICATE THAT
THEY HAVE IDENTIFIED THE MOST
PRESSING RESEARCH CAPACITY NEEDS
SO TIMING IS OF ESSENCE AND MSI
REQUIRES SUPPORT. IT WOULD BE
RELEVANT TO NEED IN DIFFERENT
STAGES OF IDENTIFICATION OF
INSTITUTIONAL RESEARCH CAPACITY
NEEDS. I JUST WANT TO HIGHLIGHT
THE IMPORTANCE OF RELEVANCE TO
THIS TOPIC FOR THE MARKET MANUAL
ASPECT, SO FIRST POPULATION IS
BECOMING RACIALLY DIVERSE, IT IS
EXPECTED MSI WILL SERVE A LARGER
PROPORTION OF UNDERGRADUATES IN
THE U.S. AND MANY NOT EQUIPPED
TO PROVIDE IDEAL RESEARCH
ENVIRONMENTS TO ALLOW STUDENTS
PURSUE DIFFERENT CAREERS THAT
INCREASE DIVERSITY OF THE WORK
FORCE. SECOND, PREVIOUSLY SEARCH
DOCUMENTED THAT IS CAUSING JOB
REPLACEMENT OF SKILLED WORK
WORKERS. THIS IS IDEAL WORK
FORCE. FINALLY LARGE PROPORTION
OF MINORITY ADULTS FACING
LIMITED WORK OPPORTUNITIES
DURING THEIR PRIME YEARS AND
THAT RESULTS IN WORK
OPPORTUNITIES GIVEN OLDER AGES.
SO IF THIS INITIATIVE CONSIDERS
INCLUDING A IMPLEMENTATION OF
INTERVENTIONS OPPORTUNITY IN
SHORT TERM, IF WE USE LIFE CYCLE
LIFE COURSE APPROACH
INTERVENTIONS TO PRODUCE IN THE
SHORT RUN STARTED THIS IN
EMPLOYMENT AND DIVERSIFY THE
WORK FORCE WITH LONG TERM
EFFECTS ON HEALTH AND WELL BEING
OF MINORITY POPULATION. IT ALSO
PRODUCE INTERGENERATIONAL IN
TERMS OF POTENTIAL SOCIAL
MOBILITY. I JUST IN SUM I THINK
THIS IS A VERY IMPORTANT
INITIATIVE AND THANK YOU FOR THE
OPPORTUNITY TO REVIEW THIS
CONCEPT.
>> THANK YOU VERY MUCH FOR THOSE
COMMENTS. THE FLOOR IS NOW OPEN
FOR DISCUSSION. ARE THERE ANY
COMMENTS OR QUESTIONS FROM OTHER
ADVISORY COUNCIL MEMBERS ON THIS
SCIENTIFIC CONCEPT? PLEASE
INDICATE QUESTION OR COMMENT OR
RAISE YOUR HAND.
>> THIS IS JUDITH. I COMMENTED
YESTERDAY THAT I THINK THAT THIS
IS INCREDIBLY IMPORTANT BUT I
WOULD -- I DIDN'T HEAR MUCH
ABOUT HOW SUSTAINABILITY IS
BEING CONSIDERED IN THESE PLANS
AND NEEDS ASSESSMENT AND THINK
THERE WOULD BE A LOT OF VALUE IN
EXPLICITLY CALLING OUT
SUSTAINABILITY AS WELL AS PARTS
OF THE NEEDS ASSESSMENT?
>> THANK YOU FOR THAT COMMENT.
>> DR. DAS.
>> SO I WANT TO THANK ALL THE
COUNCIL MEMBERS, I THINK THE
COMMENTS PROVIDED BY THEM ARE
VERY USEFUL AND JUST WANT TO
REITERATE THIS IS A CONCEPT SO
ONCE WE DEVELOP FUNDING
OPPORTUNITY ALL THE DETAILS
WOULD BE INCORPORATED AS TO WHAT
KIND OF MECHANISM WE ARE -- WE
CAN USE FOR PROVIDING SUPPORT
THAT DR. SOUTHERLAND MENTIONED,
WE ARE THINKING ABOUT USING A
COOPERATIVE AGREEMENT MECHANISM
FOR THIS PARTICULAR FUNDING
ANNOUNCEMENT WHICH ALOUSE MORE
PROGRAM STAFF INVOLVEMENT
THROUGHOUT THE COURSE OF THE
FUNDED GRANT. THAT WILL REALLY
HELP US ADDRESS THE NEEDS EACH
INSTITUTION MAY HAVE. AS YOU
INDICATED THERE ARE DIFFERENT
DIVERSE TYPES OF MSIs SO THE
NEEDS WOULD BE QUITE DIFFERENT
AND WE HAVE TO ACKNOWLEDGE AND
TRY TO ADDRESS NEEDS OF ALL THE
MSIs WHO ARE AT DIFFERENT
LEVELS. NIH PROGRAM WOULD BE
INVOLVED IN PROVIDING SUPPORT
FOR DURING THIS PROCESS. IN
TERMS OF DR. (INAUDIBLE)
COMMENTS, I APPRECIATE YOUR
FEEDBACK THAT SOME OF THE
INSTITUTIONS MAY HAVE ALREADY
CONDUCTED THEIR NEEDS
ASSESSMENT. I UNDERSTAND THAT
NIH HAS BEEN PROVIDING FUNDS FOR
PROGRAMS ON TRAINING, SPONSORED
RESEARCH PROGRAMS, DEVELOPING
CERTAIN AREAS, SO IT WOULD BE
REALLY GOOD TO KNOW WHAT TYPE OF
NEXT STEPS WOULD BE NECESSARY TO
REALLY ADDRESS SOME OF THE
CRITICAL GAPS AND WE THOUGHT
HAVING STRUCTURED NEEDS
ASSESSMENT WILL GIVE US SOME
CLUES WHAT TYPE OF FUNDING
OPPORTUNITY WE NEED TO CREATE
ADDRESS THE NEEDS OF THOSE
SPECIFIC AREAS. SO INTERVENTIONS
ARE PROBABLY MUCH NEEDED, BUT IT
WOULD BE PROBABLY IN THE NEXT
ITERATION OR DIFFERENT FUNDING
ANNOUNCEMENT. I APPRECIATE THE
SUSTAINABILITY COMMENT AND WE
ARE DEFINITELY WILL CONSIDER
THAT MANY THE NEEDS ASSESSMENT.
THANK YOU.
>> IF I CAN JUST ADD, I WANT TO
SUGGEST THAT AS I LOOK OVER AND
READ THE CONCEPT, I THINK
BECAUSE OF THE VARIABILITY IN
THIS COMMUNITY OF INSTITUTIONS,
THIS PROGRAM CAN BE OF
SIGNIFICANCE AND GREAT
ASSISTANCE NO MATTER WHERE
INSTITUTION IS ALONG THE
CONTINUUM. THE INFUSION OF THIS
ASSISTANCE COULD BE A HELP TO
THE INSTITUTION. REALIZING THAT
ALL INSTITUTIONS RELY ON A
CONTINUUM OF THEIR RESEARCH
CAPACITY AND WHAT THE RESEARCH
CAPABILITY. BUT THIS COULD HELP
THEM NO MATTER WHERE THEY ARE.
>> THAT IS MY PERSPECTIVE.
>> THANK YOU. IN TERMS OF THE I
FORGOT TO MENTION ONE COMMENT
DR. AGILA HAD IN TERMS OF
IMPLEMENTATION OF THE RESEARCH
ACTIVE VERSUS HIGH RESEARCH
ACTIVE, WE HAVE DETERMINED BY
THE DOLLAR AMOUNT AND SOME OF
THE OTHER CRITERIA LISTED IN MY
SLIDE BUT AS WE GO FORWARD WE
REALIZE THESE ARE PROBABLY EVER
CHANGING AREAS AND IF SOMEBODY
IS AT THE TIME OF APPLICATION IF
THEY QUALIFY LOW RESEARCH ACTIVE
THAT'S WHERE THEY SUBMIT HAIR
APPLICATION. THEY DEVELOP THEIR
NEEDS ACCORDINGLY IF FOR SOME
REASON LOW RESEARCH ACTIVE
BECOMES A HIGH RESEARCH THAT IS
FANTASTIC. WE WOULD LIKE TO
UNDERSTAND SOME OF THOSE
STRATEGIES THAT HAVE BEEN
WORKING THAT ALLOW THEM TO MOVE
TO THAT HIGH LEVEL. FROM 6
MILLION TO 25 MILLION. THAT
WOULD BE FANTASTIC AND THAT IS
WHERE WE WANT MOST INSTITUTIONS
TO GET THEIRS TO REDUCE THESE
FUNDING GAPS. SO WE DEFINITELY
WANT THEM TO CAPTURE THEIR
STRENGTH AND SEE WHAT STRATEGIES
ARE WORKING IN THEIR
INSTITUTION. WHAT ARE THE
STRUCTURAL FACTORS THAT THEY
HAVE CHANGED IN THE INSTITUTION
THAT ALLOW THEM TO REACH THAT
LEVEL. DURING THE REVIEW PROCESS
MAYBE WE CAN EVEN HAVE A
SEPARATE REVIEW PANEL TO HAVE A
FAIR ASSESSMENT OF EACH OF THOSE
MSIs AT THE LOW RESEARCH
ACTIVE VERSUS HIGH RESEARCH
ACTIVE. THOSE ARE SOME OF THE
AREAS. AS WE DEVELOP THE
FUNDING ANNOUNCEMENT WE WILL
HAVE MORE DETAILS COMING OUT OF
THOSE.
>> ANY OTHER POINTS OF
DISCUSSION. IN ORDER FOR A
CONCEPT TO MOVE FORWARD FOR
DEVELOPMENT AS A FUNDING
OPPORTUNITY WE WOULD NEED A
MOTION AND SECOND. MAY I HAVE A
MOTION TO MOVE THIS CONCEPT
FORWARD FOR FUNDING OPPORTUNITY
DEVELOPMENT? THE
>> SO MOVE MOVED.
>> MOTION TO APPROVE AND MOVE
THIS CONCEPT FORWARD.
>> MAY I HAVE A SECOND?
>> SECOND.
>> OKAY SO IN THE CHAT BOX
COUNCIL MEMBERS WILL VOTES.
PLEASE ENTER WHY IF YOU ARE IN
FAVOR OR NO IF YOU ARE NOT IN
FAVOR. IF YOU ARE OPPOSED.
LOOKS LIKE WE HAVE THE VOTE.
AFTER HAVING MOVED PROPERLY
SECONDED THE CONCEPT WE WILL
MOVE TO FORWARD OPPORTUNITY
ANNOUNCEMENT DEVELOPMENT. THANK
YOU ALL. NOW WE MOVE TO THE
SECOND SCIENTIFIC CONCEPT FOR
YOUR CONSIDERATION. DR. RADA
DAGHER WILL PRESENT THIS
CONCEPT, ENTITLED ADDRESSING
HEALTH AND HEALTHCARE
DISPARITIES IN SEXUAL AND GENDER
MINORITY POPULATIONS. THE
COUNCIL REVIEWERS ARE DR.
MUSTANSKI AND DR. RESNICOW. SO
SOON AS SLIDES ARE UP I WILL
TURN THE FLOW OVER FOR THE
PRESENTATION BY DR. DAGHER.
THANK YOU.
>> THANK YOU DR. HOOPER. GOOD
AFTERNOON EVERYONE. BEFORE I
START MY PRESENTATION, I WOULD
LIKE TO ACKNOWLEDGE THE MEMBERS
OF THE TEAM WHO ARE WORKING ON
THIS CONCEPT WITH ME, DR.
(INAUDIBLE) CRYSTAL BARKSDALE
AND DEBRA (INAUDIBLE). I WOULD
ALSO LIKE TO ACKNOWLEDGE THE
GREAT GUIDANCE AN SUPPORT WE
RECEIVED FROM DR. AVILA SANTA
FOR THIS CONCEPT AND ALSO WOULD
LIKE TO THANK STAFF FROM THE
SEXUAL GENDER MINORITY RESEARCH
OFFICE DR.S KAREN PARKER,
CHRISTOPHER BARNHART AND RYAN
FOR THEIR SUPPORT AND HELP OF
THE PORTFOLIO ANALYSIS. SO JUST
TO GIVE YOU BACKGROUND ON WHY
THIS IS AN IMPORTANT PROBLEM.
THERE ARE 11 MILLION LESBIAN GAY
BISEXUAL AND TRANSGENDER
INDIVIDUALS WHO LIVE IN THE
UNITED STATES. THIS IS
APPROXIMATELY THE POPULATION
SIZE OF OHIO. SEXUAL GENDER
MINORITY POPULATIONS INCLUDE
LESBIAN GAY BISEXUAL ASEX WALL
TRANSGENDER, QUEER AND/OR
ENTERSEX. SAME SEX OR GENDER
ATTRACTIONS OR BEHAVIORS IN
DIFFERENCES WITH SEX DEVELOPMENT
AND THOSE WHO DO NOT
SELF-IDENTIFY WITH ONE TERM BUT
WHOSE SEXUAL ORIENTATION GENDER
IDENTITY OR EXPRESSION OR
PRODUCTIVE DEVELOPMENT IS
CHARACTERIZED BY NON-BINARY
CONSTRUCTS OF SEXUAL ORIENTATION
GENDER AND/OR SEX SO THIS IS THE
OFFICIAL DEFINITION THE NIH HAS
FOR SEXUAL AND GENDER MINORITY
POPULATIONS. AS POPULATIONS
HAVE BEEN SHOWN TO HAVE INCREASE
RISK FOR HEALTH DISPARITIES
INCLUDING CARDIOVASCULAR
DISEASE, CANCER VIOLENCE AND
HIV, FOR EXAMPLE, THEY HAVE
HIGHER ODDS OF RISK FACTORS
CERTAIN RISK FACTORS FOR
CARDIOVASCULAR DISEASE SUCH AS
DIABETES AND HYPERTENSION. THEY
ALSO EXPERIENCE DISPARITIES IN
MENTAL HEALTH SUBSTANCE USE AND
BEHAVIORAL HEALTH FOR EXAMPLE
YOUNG POPULATION VERSUS
HEIGHTENED ANXIETY AND
DEPRESSIVE SYMPTOMS AND GREATER
SUICIDALITY THAN IF WE COMPARE
THEM TO HEAD OWE SEXUAL OR CIS
GENDER POPULATIONS. THEY ALSO
REPORT LESS HEALTHY SLEEP. THE
NEXT SLIDE PLEASE. SO THERE ARE
BUNCH OF RESEARCH GRAVES WE FIND
IN THE LITERATURE FOR SGM
POPULATIONS. SO THERE IS
SCARCITY OF RESEARCH ON EVIDENCE
BASED INTERVENTIONS, AND
LONGITUDINAL STUDIES THAT EMPLOY
A LIFE COURSE PERSPECTIVE. THERE
IS ALSO NEED FOR STUDIES HOW
STRUCTURAL STIGMA DEVELOPS AND
EVOLVES ACROSS THE LIFE SPAN TO
HEALTH AND HEALTHCARE
DISPARITIES AND SGM POPULATIONS.
FOR EXAMPLE STRUCTURAL STIGMA
RESEARCH DOES NOT HAVE MUCH
FOCUS ON INTERSECTIONALITY WITH
OTHER HEALTH DISPARITY
POPULATIONS FOR EXAMPLE RACIAL
ETHNIC MINORITIES OR THOSE WHO
LIVE IN RURAL AREAS OR THOSE WHO
ARE SOCIOECONOMICICALLY
DISADVANTAGED. THERE IS ALSO
NEED FOR INTERVENTION THAT
ADDRESS DISPARITIES FOR SEXUAL
GENDER MINORITY POPULATIONS WHO
LIVE IN RURAL AREAS OR WHO ARE
PERSONS OF COLOR AND WHO ARE
SOCIOECONOMICICALLY
DISADVANTAGED. THERE IS ALSO A
NEED FOR INTERVENTIONS TO
IMPROVE ACCESS TO CALL OF THE
WARE FOR SEXUAL AND GENDER
MYMORE I POPULATIONS. THERE IS
SCARETY OF STUDIES THAT EXAMINE
SOCIAL DETERMINANTS OF HEALTH
AND DIFFERENTIAL ACCESS TO
OPPORTUNITIES AND RESOURCES MAY
IMPACT HEALTH AND HEALTHCARE
DISPARITIES IN SGM POPULATIONS.
SO THE PURPOSE OF THIS CONCEPT
IS TO SOLICIT RESEARCH TO
ADDRESS AND UNDERSTAND HEALTH
AND HEALTHCARE DISPARITIES IN
SGM POPULATIONS. USING AN
INTERSECTIONAL LENS WHEN
FEASIBLE. THERE IS A NEED FOR
STUDIES THAT EMPLOY
INTERVENTION, OBSERVATIONAL
STUDIES AND DATA ANALYSES AMONG
OTHERS. THE HEALTH DISPARITY
TOPICS OF INTEREST THAT WE THINK
THERE IS A NEED FOR MORE
RESEARCH INCLUDE CARDIOVASCULAR
DISEASE, DIABETES, OBESITY,
CANCER, COVID-19, MENTAL HEALTH
INCLUDING SUBSTANCE USE SUICIDE
AND REPRODUCTIVE HEALTH. SO IF
WE LOOK AT THE PORTFOLIO
ANALYSIS OF SGM RELATED PROJECT
NIMHD WE FIND THE NUMBER OF
PROJECTS THAT WERE AWARDED HAS
INCREASED BY 69% FROM 2015 TO
2020. THE LARGEST POPULATION
REPRESENTED HAVE BEEN MEN WHO
HAVE SEX WITH MEN, FOLLOWED BY
LGBT POPULATION WHOSE ARE NOT
SPECIFIED, TRANSGENDER, BISEXUAL
AND LESBIAN INDIVIDUALS. LESS
THAN 5% OF THE STUDIES FOCUS ON
THE FOLLOWING TOPICS. CANCER,
SUBSTANCE USE, ALCOHOL OR
TOBACCO USE, AGING COVID-19,
DEMENTIA OR REPRODUCTIVE HEALTH
AND OPIOID. THERE WERE
NON-CARDIOVASCULAR DISEASE. MOST
USED THE FOLLOWING MIX METHODS
OF ORIGINAL STUDIES APPELLEE
FEASIBILITY STUDIES RANDOMIZE
INTERVENTION STUDIES FOLLOWED BY
ANALYSIS OF EXISTING DATA. LESS
THAN 5% OF THE STUDIES INCLUDED
NATIVE AMERICAN ALASKA NATIVE,
NATIVE HAWAIIAN AND OTHER
PACIFIC ISLANDER. SO THE
POTENTIAL RESEARCH AREA THAT WE
ARE THINKING WILL NEED MORE WORK
WOULD BE EXAMINING THE
INTERSECTION OF SGM AND OTHER
POPULATIONS THAT EXPERIENCE
HEALTH DISPARITIES, RACIAL
ETHNIC MINORITIES UNDERSERVED
RURAL AND SOCIO -- TESTING TO
REDUCE MGM HEALTH AND HEALTHCARE
DISPARITIES, EVALUATION THAT
EFFECT SGM POPULATION INCLUDING
THOSE POLICIES THAT ARE SOCIAL
DETERMINANTS OF HEALTH BASED.
AND CONDUCTING SECONDARY DATA
ANALYSIS OF DISPARITIES IN
HEALTHCARE AND OUTCOMES USING
NATIONAL COHORT STUDIES THAT
INCLUDE SEXUAL ORIENTATION AND
GENDER IDENTITY MEASURES. THIS
IS THE END OF MY PRESENTATION. I
WOULD BE HAPPY TO ANSWER
QUESTIONS AND HEAR THE POINTS OF
VIEW OF THE COUNCIL MEMBERS.
>> THANK YOU VERY MUCH, DR.
DAGHER. SO THE COUNCIL REVIEWERS
WILL ASK FOR COMMENTS AT THIS
TIME STARTING WITH DR.
MUSTANSKI, DO YOU HAVE COMMENTS
ON THIS CONCEPT?
>> IT IS MY PLEASURE TO GIVE
SOME COMMENTS ON THIS CONCEPT
FOCUSED ON SGM DISPARITIES,
WHICH ARE VERY WELL DOCUMENTED
FOR DECADES AND NUMBER OF
OUTCOMES AS DESCRIBED HIV
SUBSTANCE USE CANCER AND OTHER
DISPARITIES GETTING LIKE
CARDIOVASCULAR DISEASE,
DIABETES, THERE HAS BEEN FOR THE
LAST 20 YEARS MAJORITY OF LGBT
HEALTH RESEARCH IS FOCUS ON
DOCUMENTING EXISTENCE OF THESE
DISPARITIES AND EXCITING THAT
THE FIELD IS MOVED TO A POINT
WHERE IT IS NOW TIME TO TURN OUR
ATTENTION TO MORE WORK FOCUSED
ON THE MECHANISMS THAT DRIVE
THOSE DISPARITIES THAT LINK
SOCIAL DETERMINANTS OF HEALTH TO
THESE OUTCOMES INTERVENTIONS
INFORMED BY THE WORK AND
IMPLEMENTATION SCIENCE TO GET
INTERVENTIONS MOVED TOWARDS
UTILIZATION. AS WAS SHOWN THE
NIH PORTFOLIO ANALYSIS
DEMONSTRATES A STRIKING INCREASE
IN THE NUMBER OF GRANTS FOCUS ON
SGM HEALTH AND ALSO IMPORTANTLY
THAT THE PROPORTION OF GRANTS
FOCUSED ON HIV HAVE -- FOCUS ON
AREAS OUTSIDE OF HIV, HAVE
INCREASE FROM JUST 28% IN 2015
UP TO 40% IN 2020 WHICH STILL
MEANS MAJORITY OF PROJECTS HAVE
FOCUS ON HIV AND THAT
DEMONSTRATES THERE HAS BEEN A
BROADENING IN THE SCOPE OF SGM
HEALTH RESEARCH BEYOND HIV BUT
ALSO THERE IS AREAS BEYOND HIV
THAT STILL DESERVE
INVESTIGATION. AS MENTIONED IN
TERMS OF POPULATIONS, THERE HAS
BEEN A TREMENDOUS INCREASE IN
RESEARCH ON TRANSGENDER HEALTH
THE PAST FEW YEARS BUT THERE ARE
SOME POPULATIONS STILL VERY
UNDERSTUDIED SUCH AS LESBIAN
WOMEN. AND SOME TOPICS THAT
RECEIVE LIMITED ATTENTION FOR
EXAMPLE, SUICIDE IS THE NUMBER
TWO CAUSE OF DEATH AMONG YOUNG
PEOPLE IN THE UNITED STATES, BUT
ONLY 3% OF SGM HEALTH FROM NIH
FOCUSED ON SUICIDE SO THERE'S
CLEARLY SOME AREAS WHERE WE NEED
TO STIMULATE NEW RESEARCH AND
SGM HEALTH RESEARCH. COUPLE OF
COMMENTS ON THE CONCEPT AS IT
CONTINUES TO BE DEVELOPED. AS
MENTIONED IN AREA OF TO CUSS IS
INTERSECTIONALITY, WHICH I THINK
THE IOM REPORT AND OTHERS HAVE
IDENTIFIED AS AN IMPORTANT LENS
FOR SEXUAL GENDER MINORITY
HEALTH RESEARCH. IT IS IMPORTANT
TO CONSIDER INTERSECTIONALITY
RESEARCH WHEN DONE WELL IS
INCREDIBLY COMPLEX GIVEN THE
NEED TO ATTEND TO SUB GROUPS OF
SGM HEALTH COMMUNITIES SUCH AS
LESBIAN GAY BISEXUAL TRANSGENDER
NON-BINARY AND INTERSECTING THAT
WITH MANY RACIAL ETHNIC SUB
GROUPS CAN BE QUITE COMPLEX.
MUCH BETTER INTERSECTIONALITY
WORK THAT IS DONE AS QUALITATIVE
AND WE ARE BEGINNING TO
UNDERSTAND HOW TO TRANSLATE THIS
INTO QUANTITATIVE AND
INTERVENTION RESEARCH SO IT IS
AN AREA WE NEED METHOD LOGICAL
DEVELOPMENT. SO GLAD TO SEE THAT
IDENTIFIED AREA OF FOCUS BUT WE
HAVE TO UNDERSTAND THAT IT MAY
NOT BE THE RIGHT LENS FOR EVERY
STUDY SO IT MAKES SENSE AREA OF
FOCUS RATHER THAN REQUIRED
ELEMENT. FINALLY I'M GLAD TO SEE
THERE WAS MENTION OF THE NEED
FOR LONGITUDINAL RESEARCH, THAT
SHOULD BE CALLED OUT AS A
SPECIFIC AREA OF FOCUS. THERE IS
FEW LONGITUDESNAL STUDIES OF OUR
COMMUNITY. COHORT STUDIES IS
SORT OF AT LEAST COMMUNITY
UNDERSTANDING THAT COHORT
STUDIES DON'T ALWAYS FAIR SO
WELL IN STANDING STUDY SECTIONS,
AND WE DO NEED LONGITUDINAL
COHORT STUDIES THAT IDENTIFY
RISKS AND PROTECTIVE FACTORS TO
INFORM INTERVENTIONS SO
INCLUDING THAT MAKES A LOT OF
SENSE IN AREA OF FOCUS. THE
PORTFOLIO ANALYSIS SHOWED FEW
CLINICAL TRIALS FOCUSED ON SGM
HEALTH RESEARCH SO CALLING OUT
INTERVENTION RESEARCH, ALSO
IMPLEMENTATION RESEARCH MAKES
SENSE. I THINK THIS IS AN
EXCELLENT CONCEPT AND SUGGEST
THESE CONSIDERATIONS AS IT IS
MOVED FORWARD AND I HOPE THAT
OTHER ICs WILL SIGN ON IF THIS
BECOMES AN RFA PARTICULARLY SOME
OF THE ICs THAT THE PORTFOLIO
ANALYSIS HAS SHOWN HAVE BEEN
UNDERINVESTED IN THIS AREA OVER
TIME. SO HUE FOR THE OPPORTUNITY
TO GIVE FEEDBACK ON THIS
CONCEPTS.
>> THANK YOU, DR. MUSTANSKI.
>> THANK YOU VERY MUCH. DR.
RESNICOW DO YOU HAVE COMMENTS TO
ADD ON?
>> I DO AND I THINK I NEED VIDEO
RIGHTS.
>> YOUR VIDEO WON'T TURN ON?
>> IT SAYS HOST HAS STOPPED IT,
IT'S IN THE A BIG DEAL I CAN BE
AUDIO ONLY IF IT'S NOT EASY TO
FIX.
>> YOU CAN BEGIN TO GIVE YOUR
COMMENTS AND I'LL ASK THE HOST
TO --
>> DOESN'T EFFECT ME. OKAY.
FIRST I WOULD LIKE TO CONCUR
WITH DR. MUSTANSKI THAT THOUGH
INTERSECTIONALITY IS A WONDERFUL
OPPORTUNITY FOR NOVEL RESEARCH,
I DON'T THINK IT SHOULD BE A
REQUIREMENT. SO FOLKS WHO MIGHT
WANT TO FOCUS ON INTERVENTIONS
OR EPIRESEARCH JUST ON ONE SLICE
OF THE SGM POPULATION, THAT
SHOULD STILL BE ACTIVATED. I
LIKE INTERSECTIONALITY BUT NOT A
FORMAL REQUIREMENT POTENTIAL
RESEARCH THAT MIGHT COME OUT OF
THIS. I THINK THE CONCEPT COULD
USE A LITTLE STRONGER RATIONALE
ABOUT TWO THINGS. AS DR.
MUSTANSKI SAID THERE IS DECREASE
AT PERCENT OF SGM RELATED
RESEARCH, HIV FOCUS, AND THAT IS
CONSIDERED TO BE SOMETHING GOOD
LOOK AT CHRONIC DISEASE AND
LONGER TERM EFFECT BUT I DON'T
THINK THE CONCEPT DISCUSSES THAT
SO WHY IS IT IN THE BEST
INTEREST OF THE RESEARCH
COMMUNITY TO EXPAND SGM RESEARCH
BEYOND HIV? SECONDLY, GIVEN IT
IS ALREADY ESTABLISHED DISPARITY
GROUP, WHAT IS THE NEED FOR A
UNIQUE POTENTIAL RFA IN THIS
AREA? WHAT IS NOT GETTING DONE?
ARE YOU NOT ATTRACTING ENOUGH
PROPOSALS, DOES IT ALLOW YOU TO
SET ASIDE MONEY, WHAT ARE THE
BENEFITS HAVING CALL OUT FOR
POTENTIAL FOA GIVEN IMPLICITLY
INVESTIGATORS APPLY FOR SGM
RELATED RESEARCH WITHIN THE
CURRENT DISPARITY FRAMEWORK. IT
WOULD BE INTERESTING TO BROADEN
THE RATIONALE OR THE SCOPE OF
PROPOSALS NOT JUST TO BE BASED
ON BETWEEN GROUP DIFFERENCES,
NOT JUST BECAUSE SGM GROUPS
LESBIAN AND GAY MEN MAY USE MORE
TOBACCO OR DRINK MORE BUT EVEN
WITHIN GROUP JUST TO LOOK AT
TAILORED INTERVENTIONS, FOR
EXAMPLE, UNIQUE DETERMINANTS IN
THESE COMMUNITIES YOU MENTIONED
SOME IN CONCEPT FOR EXAMPLE
STIGMA, YOU CAN ENCOURAGE WITHIN
GROUP HETEROGENEITY AS THESE
UNIQUE DETERMINANTS NOT DRIVEN
BY A DISEASE OR RISK FACTOR
DISPARITIES SO EVEN IF A RISK
FACTOR MIGHT HAVE THE SAME
PREVALENCE, JUST SAY SMOKING
THOUGH GAY LESBIAN ADULTS DO
SMOKE MORE, SAY THEY SMOKE THE
SAME AMOUNT AS STRAIGHT COUNTER
PARTS, THERE WOULD BE AN
ARGUMENT TO BRING IN PROPOSALS
THAT ADDRESS THE UNIQUE
DETERMINANTS WITHIN GROUP EVEN
IF WILL IS NOT ANY BETWEEN GROUP
DIFFERENCES. JUST SOME SMALLER
THINGS INCLUDED AS HOPEFULLY
PROGRESSES TO SOME FORM OF FOA.
SPECIFICALLY ENCOURAGE THE
RESEARCH THAT LOOKS AT IMPACT OF
RECENT POLICIES THE FLORIDA
PARENTS RIGHTS AND EDUCATION
BILL WHICH SOME OF US REFER TO
AS DON'T SAY GAY TYPE OF
LEGISLATION, WHAT IS THE IMPACT
OF THAT. AND SIMILAR, MYRIAD OF
ANTI-TRANS LEGISLATION BEING
PROPOSED. WHAT IS IS THE IMPACT
OF THAT PSYCHOLOGICALLY AND
MEDICALLY ON THOSE COMMUNITIES.
FINALLY, TO LOOK AT SOME I THINK
NOVEL DETERMINANTS, SUCH AS
FUTURE ORIENTATION, THERE ARE
SOME UNIQUE INTERVENTIONS THAT
HAVE NOT BEEN FULLY TESTED USING
THOSE TYPES OF VERY NOVEL
INTERVENTIONS YOU DO MENTION
STIGMA AS I SAID BUT THAT LIST
IS SUGGESTED TOPICS TO BE
BROADENED. FINALLY JUST TO BE
CONSCIOUS THAT THIS TYPE OF
RESEARCH THAT THE RIGOR OF THE
CONTROL GROUP IS ESSENTIAL. THAT
WE DO OUR BEST TO ISOLATE THE
CULTURALLY TAILORED COMPONENTS
OF THE INTERVENTION AND THAT CAN
BE DONE THROUGH A VARIETY OF
DESIGNS. BUT I THINK THE DAYS
WHEN WE SAY WE HAVE A CULTURALLY
TAILORED INTERVENTION VERSUS
SOMETHING MINIMAL LIKE A
BROCHURE, I THINK WE MOVED
BEYOND THAT, AND I THINK THE
MOST OF THE TIME THE PROPOSALS
THAT ARE BEING SOLICITED SHOULD
THEMSELVES HAVE MORE RIGOROUS
ARE CONTROL GROUPS. OTHER THAN
I'M ENTHUSIASTIC AND LOOK
FORWARD TO SEEING THIS PROGRESS
TO THE FOA PROCESS.
>> THANK YOU. I WANT TO MAKING
IT TRUE THIS IT IS ONE OF THE
POPULATIONS AFFECTED BY HEALTH
DISPARITIES THAT WE IS PART OF
OUR INSTITUTE BUT WHEN WE LOOK
AT THE LITERATURE WE FOUND A LOT
OF RESEARCH GAPS MANY THAT
LITERATURE. WE ALSO LOOK AT OF
COURSE ANNOUNCE NIH RELATED
PROJECT AND OF SWG RELATED
PROJECT AND WE FOUND CERTAIN
DISEASES THERE IS NO OR VERY
LITTLE RESEARCH ON. ALSO THAT IN
THE LITERATURE WE FIND THAT
THERE ARE VERY FEW EVIDENCE
BASED INTERVENTIONS DONE TO
DECREASE DISPARITIES IN THESE
POPULATIONS. SO THERE ARE NUMBER
OF REASONS WHY WE THOUGHT IT
WOULD BE IMPORTANT TO PUT FORTH
THIS CONCEPT. ONE OF -- LOOKING
AT THE INITIATIVES THAT HAVE
BEEN GENERATED AT NIH ON SGM
POPULATIONS THEY WERE NOT VERY
SPECIFIC SO WE ARE TRYING TO
MAYBE PUSH A LITTLE BIT FOR
INITIATIVE THAT TRIES TO
SPECIFICALLY ADDRESS SOME OF THE
GAPS IN THE RESEARCH AND TO
COMPLIMENT OUR PORTFOLIO IN
THESE POPULATIONS.
>> I FIND THOSE REASONS
COMPELLING AND WELCOME
INTEGRATIONS MORE EXPLICITLY IN
THE CONCEPT BUT HERE HERE, THOSE
ARE STRONG REASONS TO HAVE
SEPARATE OR UNIQUE FOA.
>> THANK YOU, WILL DO.
>> SO THE FLOOR IS OPEN FOR
DISCUSSION. IF THERE ARE OTHER
COMMENTS OR QUESTIONS, FROM ANY
OF OUR COUNCIL MEMBERS, PLEASE
INDICATE THAT BY RAISING YOUR
HAND OR INDICATING YOU HAVE A
QUESTION OR COMMENT IN THE CHAT
BOX. SEEING NO QUESTIONS OR
COMMENTS HERE NOTED. SO TO MOVE
THIS CONCEPT FORWARD TO FUNDING
OPPORTUNITY DEVELOPMENT WE WOULD
NEED TO HAVE A MOTION ON THE
FLOOR TO MOVE THE CONCEPT
FORWARD. MAY I HAVE A MOTION TO
MOVE THE CONCEPT FORWARD?
>> I MOVE TO MOVE IT FORWARD.
>> MAY I HAVE A SECOND?
>> SECOND.
>> NOW WE WILL VOTE. ALL IN
FAVOR ENTER Y OR YES IN THE CHAT
BOX, OR N OR NO IN THE CHAT BOX
>> I THINK WE HAVE THE VOTE. SO
AFTER HAVING BEEN MOVED AND
PROPERLY SECONDED THIS CONCEPT
WILL MOVE FORWARD TO FUNDING
OPPORTUNITY ANNOUNCEMENT
DEVELOPMENT. THANK YOU AND THANK
YOU DR. DAGHER FOR THE
PRESENTATION.
>> THANK YOU.
>> SO WE HAVE COME TO THE END OF
OUR AGENDA, AT THIS TIME I WOULD
LIKE TO TURN THE MEETING OVER TO
DR. PEREZ-STABLE FOR CLOSING
REMARKS AND ADJOURNMENT.
>> FIRST OF ALL THANK YOU,
MONICA FOR MAKING -- MAGNIFICENT
JOB STEERING US THROUGH THESE
TWO DAYS OF VIRTUAL MEETING. AND
I WANT TO THANK THE STAFF THAT
SUPPORTED THE MEETING AS WELL.
AND PRESENTERS BOTH YESTERDAY
AND TODAY. BOTH INVITED
PRESENTERS AND RINA DAS AND RADA
DAGHER. ESPECIALLY THANK THE
COUNCIL MEMBERS THOSE NOT
JOINING US IN SEPTEMBER I TRUST
THAT YOU WILL CONTINUE TO BE
STRONG SUPPORTERS OF THE SCIENCE
NIMHD REPRESENTS AND NIH. I DO
THINK OVER THE COURSE OF THE
PAST DECADE LOTS HAS CHANGED.
THE STEREO TYPES OF NIH ARE FAR
FROM BEING CONSISTENTLY THE
CASE. THERE IS A LOT OF
IMPLEMENTATION SCIENCE THAT
HAPPENS AT NIH, A LOT OF HEALTH
SERVICES RESEARCH, A LOT OF
MINORITY HEALTH AND HEALTH
DISPARITIES RESEARCH. NOT JUST
NIMHD THERE IS A LOT OF INTEREST
IN THIS -- IN THESE AREAS,
ACROSS THE INSTITUTES. AND EVEN
MORE IN THE LAST SEVERAL YEARS
AS THERE HAS BEEN NEW LEADERSHIP
IN SEVERAL INSTITUTES. SO I
WANT TO MAKE SURE WE EXPLICITLY
STATED THAT. I THINK THIS WAS
OUR 7TH FULLY VIRTUAL MEETING.
IT HAS NOT MEANT THAT WE HAVE
BEEN ABLE TO SEE EACH OTHER TO
HAVE INFORMAL CONVERSATION.
SOMETHING THAT IS OVERRATED. I
PERMLY KIND OF ENJOY IT AND LIKE
THE INTERPERSONAL INTERACTIONS
IN REAL TIME. BUT WE HAVE
ADAPTED TO TIMES AND WHAT THE
NEXT COUNCIL WILL BRING WE WILL
SEE. BUT I WANT TO THANK ALL OF
YOU FOR YOUR EFFORTS, FOR THE
SCIENTIFIC EFFORTS YOU DO ON
YOUR OWN WORK AND FOR YOUR
SERVICE TO NIH AND NIMHD BY
PARTICIPATING IN OUR COUNCIL. SO
WITH THAT I WILL BRING THIS TO A
CLOSE. I DON'T HAVE A GAVEL. BUT
JUST IMAGINE YOU HEAR A GAVEL
AND GO ON TO REST OF YOUR DAY.
THANK YOU, KEAWE KAHOLOKULA AND
THANK YOU ALL.
THANKS, EVERYONE.