IHR Education and 
Awareness on Minority 
Health Disparities 
Initiatives

Understanding and addressing health disparities in all of their complexity and promoting health equity

The National Institute on Minority Health and Health Disparities (NIMHD) defines a health disparity as a health difference that adversely affects disadvantaged populations on the basis of one or more of the following health outcomes:

1. Higher incidence or prevalence of disease.

2. Earlier onset or faster progression.

3. Poorer daily functioning or quality of life.

4. Premature or excessive mortality.

5. Greater global burden.

Health disparities are often the result of earlier exposures to adverse events and risk factors. Life course perspectives theorize how socially patterned physical, environmental, and socioeconomic exposures at different stages of human development shape health within and across generations. Therefore, IHR Minority Health Disparity Initiative will work to include the needs to more broadly incorporate life course perspectives, such as assessing the lived experience and considering whether time, opportunities, and agency are racialized.  Health disparities are caused by many factors and operate at multiple levels. Thus, IHR will address health disparities through an understanding of the complexity and pathways linking upstream and downstream factors. IHR uses educational interventions that address multiple levels, ranging from the individual to the structural, as well as interventions that address risk factors common across multiple health conditions are also needed.

Furthermore, IHR has determined that advancing the understanding of the mechanisms for how social determinants of health influence health behaviors is important.  An important reason for differences between White and non-White populations is racism and discrimination. Thus, IHR is working to strengthening the conceptualization, measurement, and understanding of interpersonal, internalized, and structural racism as a social determinant of health is essential.  IHR is also working on a paradigm shift that is needed to assess potential risks and harms to distal intervention targets (e.g., effects of an intervention on a community as a whole, not just the individual.

Understanding and addressing health disparities in all of their complexity and promoting health equity requires applying a multidimensional lens.  IHR Education and Awareness Minority Health Disparity Initiative is based on the National Institute on Minority Health and Health Disparities (NIMHD) framework tool for conceptualizing and depicting the wide array of determinants that promote or worsen minority health or cause, sustain, or reduce health disparities. These determinants reflect etiological factors related to health outcomes as well as intervention targets to improve minority health or reduce disparities. IHR considers the framework as a foundation to work but may change in response to changes in research conceptualizations as well as feedback from the extramural community and other stakeholders.  According to the legislation that created NIMHD, a health disparity population is characterized by a pattern of poorer health outcomes, indicated by the overall rate of disease incidence, prevalence, morbidity, mortality, or survival in the population as compared with the general population. IHR education and awareness initiatives are rooted in the current NIMHD designated health disparity populations include Office of Management and Budget– defined racial/ethnic minorities, socioeconomically disadvantaged populations, underserved rural populations, and sexual and gender minorities (which include lesbian, gay, bisexual, transgender, and gender nonbinary or gender nonconforming individuals.

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IHR Minority Health Disparity Initiative – COVID-19

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Beyond the complex logistical task of prioritizing, distributing and safely storing millions of doses of COVID-19 vaccines, state and local governments must simultaneously devise and carry out transparent plans that center equity and overcome the barriers to vaccination facing minority communities. Using insights gleaned from interactions with health care and social service professionals serving minority communities from several states, as well as from existing research on vaccination, IHR promotes education and awareness that emphasize that vaccine hesitancy and access barriers-particularly within minority communities-pose significant hurdles to achieving widespread uptake of COVID-19 vaccines. IHR maintains that overcoming barriers requires community-engaged campaigns that acknowledge and address the historical injustices and on-going inequities that drive distrust within communities of color, emphasize understandable and culturally appropriate messages that directly address people's concerns about vaccine safety and access, and tap existing community infrastructure to make full use of trusted voices to deliver timely and accurate information about vaccines. Given emerging data and changing conditions, IHR education campaigns are developed based on self-reflective and adaptive, assessing progress and outcomes and reevaluating strategies as needed. However, above all, IHR primary goals remain focused on transparency, equity and building trust