Health disparities research provides lessons for U.S. and LMICs
March/ April 2022 | Volume 21 Number 2
There is a regrettable truth about health care and medical advances: They do not benefit all people equally. The results are health disparities (HD)—preventable differences in wellness and medical outcomes that adversely affect certain populations but not others. The health inequities we see in low- and middle- income countries as well as in some of our own impoverished populations have been strongly linked to social determinants. Evidence of HD is not only visible in access to care but also in health statistics, such as life expectancy at birth, under-5 mortality in children, and maternal deaths.
opinion pieces from Fogarty Director Dr. Roger I. Glass. Naturally, Fogarty aims to reverse this by funding research that examines the influence of environments, social determinants, and other underlying mechanisms that lead to differences in medical and health outcomes. And what we learn from research in LMICs may open our eyes to the same problems at home.
Across our portfolio of grants, Fogarty supports programs to train researchers that study HD and social determinants. Our program based at Moi University in Kenya aims to
develop data science leaders who are equipped to capture and analyze data on social determinants of health and design more effective interventions for communicable and noncommunicable diseases. In Cameroon and South Africa, researchers at the African Institute for Mathematical Sciences in Cameroon and the University of Cape Town are
examining health disparities with risk factors associated with surgical disease linked to social disparities such as cost of care and access to transportation, to discover and address these compounding issues.
A South American program trains Quechua-speaking indigenous researchers from Argentina, Bolivia, Peru, and Paraguay at the Universidad de Buenos Aires and Universidad Peruana Cayetano Heredia, where they learn epidemiology, genetics and neuroimaging so that they can develop a greater understanding of the major psychiatric disorders in their own populations.
Finally, in our Malaysian program, researchers are
developing an artificial intelligence-based mobile health intervention to increase HIV testing among men who have sex with men who have worse health outcomes due to the discrimination and stigma they face.
All Fogarty investments attempt to support equity issues in global health but we want and need to do more. We’ve seen that, among U.S. researchers, those who are minorities show a special interest in research of HD, so we believe that if we increase the diversity of our grantees, we can improve health throughout the world. In essence, if we include previously disadvantaged individuals not only as research partners but also as research leaders, the benefits of our work will extend to neglected populations everywhere. This plan requires a greater understanding of how we can put these strategies into practice. To this end, Fogarty and the NIH have issued a
Request for Information (RFI) on approaches NIH might take to promote greater equity in global health research within low- and middle- income countries.
The RFI is an open invitation… to you. Please take the time to express your ideas about ways we could encourage the expansion and ensure the quality of global research collaborations including and among scientists and institutions in low resource settings. We welcome comments on current NIH practices that might be revised as well as new practices that could be implemented. Beyond this, we are interested in hearing your thoughts on: inclusive community research-engagement strategies; mutually beneficial data and material sharing approaches; publication access; training and career development; joint leadership strategies; and research priority setting.
We anticipate receiving many practical and beneficial ideas from global health researchers at all levels of their career. I thank you in advance for helping us improve Fogarty and the NIH by responding to this forthcoming RFI with your best ideas. It's time all humanity benefitted from the hard work and science we do together.
Updated May 23, 2022
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