NIA Health Disparities Objectives

Health disparities are associated with a broad, complex, and interrelated array of factors. Diagnosis, progression, response to treatment, caregiving, and overall quality of life may each be affected by race, ethnicity, gender, environment, socioeconomic status (SES), age, education, occupation, and other as yet unknown lifetime and lifestyle differences. For example, a multi-ethnic epidemiologic study indicated that prevalence rates for Alzheimer’s disease may be higher for African Americans and Hispanics than for other ethnic groups. Another study found a striking relationship between SES and health and longevity. Gender differences in health and longevity are observed across racial and ethnic groups. We must first understand these differences and their interactions and then work to develop behavioral and public health interventions to reduce disparities and increase quality of life for all of our older citizens.

NIA objectives in this area include:

• Understand health differences and health inequities associated with race, ethnicity, gender, environment, socioeconomic status (SES), geography, access, and sociocultural factors among older adults.
• Develop strategies to promote active life expectancy and improve the health status of older adults in minority and other underserved populations.
• Use research insights and advances to inform policy on the health, economic status, and quality of life of all older adults.

Minority aging and health disparity research is conducted throughout the Institute’s research programs. For example:

• NIA co-led the Rapid Diagnostic Accelerator for Underrepresented Populations (RADxUP) funding opportunity announcements, which are focused on NIH-designated health disparities and other COVID-19 vulnerable populations, with our partners at the National Institute of Minority Health and Health Disparities (NIMHD) and other NIH institutes, centers, and offices. NIA also co-led NIH efforts to strengthen data collection on COVID-19 to rapidly assess the needs and impact of COVID-19 across different population groups, particularly vulnerable populations.
• Satellite Diagnostic and Treatment Centers, part of the national Alzheimer’s Disease Centers (ADC) Program, have successfully recruited African Americans, Hispanics, Native Americans, and American Indian/Alaska Natives to AD prevention and treatment studies.
• NIA’s participation in an R03 Grant Program specifically invites researchers to submit grant applications that address access to participation in research for populations such as: those under-represented in biomedical and clinical research of U.S. minority populations, underserved populations, and populations who may be vulnerable to coercion or undue influence; barriers to participation and potential approaches to overcome these; as well as conducting biomedical and clinical research in resource-limited countries.
• The NIA supports several specific programs to assist in the development of research careers for minority investigators whose research topics are relevant to the NIA mission. These include dissertation awards for minority doctoral students and awards to institutions hoping to increase numbers of students from underrepresented populations.
• The Resource Centers for Minority Aging Research (RCMAR) represent a long-standing program established to enhance the diversity of the aging research workforce by mentoring promising scientists from under-represented groups for sustained careers in aging research. RCMAR Centers have a long track record of supporting the study of aging in diverse communities, which is a core component of the RCMAR mission. The program was expanded to address Alzheimer’s disease (AD) and AD related dementias (ADRD), given rising cases of the diseases due to world-wide increases in the older adult population, the disproportionate burden in communities of color, and the need for a strong, diverse workforce to tackle this pressing challenge.
• NIA strongly supports NIH’s UNITE initiative, NIH to end structural racism and racial inequities in biomedical and behavioral research. Through UNITE, NIA and the broader NIH will work together to identify short- and long-term actions to combat structural racism — in which public policies, institutional practices, cultural representations, and other norms culminate in various, often reinforcing ways to perpetuate racial group inequity — at NIH, in our grantee institutions, and beyond.
• NIA also invests in a number of programs to enhance the pipeline of training and career development. Some highlights of that investment include the Medicine, Science, Technology, Engineering, and Mathematics (MSTEM) program, designed to enhance diversity in undergraduate science education, and the NIA diversity supplement program to foster a diversity of scientists at multiple levels of training. The Butler-Williams Scholars Program provides opportunities for junior faculty and researchers new to the field to learn more about aging research and find ways to address health disparities among older adults.
• NIA’s Alzheimer’s Disease Research Centers make outreach and education efforts in minority and underserved communities a high priority, working with local churches, community health centers, and other organizations for recruitment of a diverse research population. NIA’s Alzheimer’s Clinical Trials Consortium is similarly dedicated, with a specific focus on increasing recruitment and support of minority scientists. And as part of NIA’s National Strategy for Recruitment and Participation in Alzheimer's and Related Dementias Clinical Research, we are piloting new means of making outreach to communities underrepresented in research to overcome barriers to AD/ADRD clinical trial participation.