The National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health (NIH), is launching the Transdisciplinary Collaborative Centers (TCC) for Health Disparities Research on Chronic Disease Prevention programme. This programme responds to the need for more robust, ecological approaches to address chronic diseases among racial and ethnic minority groups, under-served rural populations, people of less privileged socio-economic status, along with groups subject to discrimination who have poorer health outcomes often attributed to being socially disadvantaged.

Two centers will focus their research efforts on development, implementation, and dissemination of community-based, multilevel interventions to combat chronic diseases such as heart disease, cancer and diabetes. The centers will share approximately $20 million in funding over five years, pending available funds.

Where people live, work and play has significant impact on the development and progress of chronic diseases and conditions. The new TCC programme looks beyond individual behavioral risk factors to engage the family, community, healthcare systems, and policy impacts that also affect one’s health.

“Multilevel interventions that take into account complex interactions between individuals and their environments can better address determinants of health and enhance chronic disease prevention and health promotion for local communities,” said NIMHD Director Dr. Eliseo J. Pérez-Stable. “Studies in these centers will add to our knowledge of what works in health disparities populations, thus advancing knowledge towards our nation’s health.”

Heart disease, stroke, cancer, diabetes, and arthritis are among the most common, costly and preventable of all health problems. Many of these conditions disproportionately affect health disparity populations and in advanced stages can lead to significant limitations in activities of daily living. According to the Centers for Disease Control and Prevention, seven of the top 10 causes of death in 2015 were chronic diseases.

Prevalence rates of obesity in African American and Latino adults are significantly higher than among White adults.

Cigarette smoking is the leading cause of preventable death in the US, yet more adults living below the poverty level or with less than high school education are current cigarette smokers compared to those who live at or above the poverty level.

Hypertension, a major risk factor of cardiovascular and chronic kidney disease, is more prevalent and/or not as well controlled in African Americans and Latino adults compared to Whites.

Women (link is external) from poor, low-income, and middle-income households are less likely to receive a screening mammogram compared with women from high-income households.

Encouraging researchers to use a transdisciplinary, collaborative and systems approach to address disparities in chronic disease prevention, the programme will emphasize prevention, early detection, and early treatment. Studies have shown that early treatment improves health outcomes in many conditions, implying that early detection is important to combatting disease progression. However, people from health disparity populations, generally have lower detection rates, leading to later-stage diagnosis and treatment, which can negatively impact disease outcomes.

Designed for broad impact, the TCCs comprise regional coalitions of research institutions and partners working together to develop and disseminate effective health interventions that can be implemented in real-world settings.  “Involving different stakeholders and ensuring community engagement, the new TCC programme will create synergized methods to build a healthy community for health disparity populations” said Dr. Xinzhi Zhang, NIMHD programme officer.

The composition of each center includes community organizations, academic institutions, clinicians and health care systems, as well as state and local public health agencies. The research programmes will translate community needs into practice at local clinics, churches, and community centers. The following projects have four future year commitments.

The Native-Controlling Hypertension and Risk Through Technology; Dedra S. Buchwald, M.D. and Spero Manson, Ph.D.; Washington State University, Pullman.

Researchers will develop intervention projects to control hypertension among American Indians, Alaska Natives, Native Hawaiians and Other Pacific Islanders with the objective to reduce cardiovascular diseases and stroke among these underserved populations with high disparities in health. Three projects based on multilevel approaches—individual, family, community and policy levels—are proposed with a long-term goal to translate the findings into behavior change, treatment innovation and new policies.

The Flint Center for Health Equity Solutions; C. Debra Furr-Holden, Ph.D.; Michigan State University, East Lansing.

Researchers will apply community-engaged health disparities research in the Flint area, where they will investigate the effectiveness of multilevel interventions aimed at improving physical activity and healthy food consumption among community members. They will also evaluate a multi-tiered intervention programme of peer coaching with advocacy support, as well as family reunification and support for both men and women in recovery from substance abuse.