The Science of Health Disparities Research

1 Cover

2 Title Page

3 Copyright Page

4 List of Contributors

5 Foreword

6 Acknowledgements

7 1 Definitions, Principles, and Concepts for Minority Health and Health Disparities Research 1.1 Introduction 1.2 NIMHD Mission 1.3 Definitions and Concepts of Minority Health and Health Disparities 1.4 The NIMHD Research Framework: Health Determinants in Action 1.5 Inclusion of Diverse Participants in Clinical Research 1.6 Conclusions 1.7 Key Points Disclaimer References

8 2 Getting Under the SkinPathways and Processes that Link Social and Biological Determinants of Disease 2.1 Introduction 2.2 Allostasis and Allostatic Load 2.3 The HPA Axis 2.4 Anticipatory Biology and Behavior: The Embedding of Exposures Across the Life Course 2.5 Sleep 2.6 How We Feed: Nutrition and Nutrition‐related Health Disparities 2.7 How We Feel: Mood and Depression 2.8 Summary 2.9 Key Points Disclaimer References

9 3 Racial/Ethnic, Socioeconomic, and Other Social Determinants 3.1 Introduction 3.2 Introduction to the Topic, Including Key Definitions 3.3 Used and Recommended Measures and Research Methods 3.4 How and Why this Topic is Important to Minority Health and Health Disparities Research 3.5 Selected Examples of the State of the Science in the Field to Illustrate Best Practices 3.6 Challenges and Future Opportunities 3.7 Summary 3.8 Key Points Disclaimer References

10 4 Behavioral Determinants in Population Health and Health Disparities Research 4.1 Introduction 4.2 Importance of Behavioral Determinants to Minority Health and Health Disparities Research 4.3 Relevant Metrics and Research Methods 4.4 State of the Science: Promising Practices 4.5 Challenges and Future Opportunities 4.6 Summary 4.7 Key Points Disclaimer References

11 5 Sociocultural Environments and Health Disparities ResearchFrameworks, Methods, and Promising Directions 5.1 Introduction 5.2 Selected Overarching Sociocultural Environment Factors 5.3 Social Capital and Health Disparities 5.4 Implicit Bias of Healthcare Providers 5.5 Sociocultural Factors that Influence the Quality of Healthcare Provider‐Patient Interactions and Communication 5.6 Synthesis 5.7 Key Points Disclaimer References

12 6 Physical Environment, and Minority Health and Health Disparities Research 6.1 Introduction 6.2 Methodologies and Measures 6.3 Importance of Physical Environment Determinants to Health Disparities Research 6.4 Case Study 6.5 Challenges and Opportunities 6.6 Key Points Disclaimer References

13 7 Genome‐wide Genetic Approaches to Metabolic and Inflammatory Health Disparities 7.1 Introduction 7.2 Landscape of Genetic Variation 7.3 Pathogenic Potential of Low‐frequency and Rare Variants 7.4 Admixture in the Americas 7.5 Identifying Disease Genes Associated with Health Disparities: Methods and Approaches 7.6 Joint Admixture Mapping and Genome‐wide Association Studies for Gene Discovery in Admixed Populations 7.7 Whole‐Genome and Whole‐Exome Sequencing Approaches to Health Disparities 7.8 Summary 7.9 Key Points Definitions Disclaimer References

14 8 Biologic Factors and Molecular Determinants in Inflammatory and Metabolic Diseases 8.1 Introduction and Approaches 8.2 Asthma 8.3 Metabolic Syndrome, Obesity, and Diabetes 8.4 Lupus and Other Rheumatologic Diseases 8.5 Kidney Disease 8.6 Key Points Disclaimer References

15 9 Insights into the Genomic Landscape of African Ancestry PopulationsImplications for Health and Disease Disparities 9.1 Introduction: Viewing the Complex Architecture of African Genomes from a Global Perspective 9.2 Adaptive Forces that Shaped the Human Genome in Health and Disease among African Ancestry Populations 9.3 Pharmacogenomics 9.4 Considerations for Future Studies 9.5 Conclusions 9.6 Key Points Disclaimer References

16 10 Applying Self‐report Measures in Minority Health and Health Disparities Research 10.1 Introduction 10.2 Measurement Issues When Using Self‐report Measures in Diverse Populations 10.3 Methods for Evaluating Conceptual and Psychometric Properties of Self‐report Measures 10.4 Locating and Selecting Self‐report Measures for Use in Diverse Populations 10.5 Adapting Measures for Diverse Populations 10.6 Future Directions 10.7 Conclusions 10.8 Key Points Disclaimer References

17 11 Conducting Community‐based Participatory Research with Minority Communities to Reduce Health Disparities 11.1 Introduction 11.2 Conducting Community‐based Participatory Research with Minority Communities to Reduce Health Disparities 11.3 Evidence of CBPR Effectiveness and Advancement in CBPR Evaluation 11.4 Case Studies 11.5 Anticipating Challenges and Opportunities in CBPR 11.6 Research Support for CBPR 11.7 Conclusions 11.8 Key Points Disclaimer References

18 12 Racial/Ethnic Health and Healthcare Disparities MeasurementThe Application of the Principles and Methods of Causal Inference 12.1 Introduction 12.2 Aligning Definitions of Disparity with Appropriate Statistical Methods 12.3 A Method of Measuring Healthcare Disparities Incorporating a “Counterfactual” Scenario 12.4 Extending the Use of “Partial Differencing” to Identifying Targets for Health and Healthcare Disparities Reduction Using Decomposition Methods 12.5 Adapting Causal Models to Identify Interventions to Reduce Racial/Ethnic Health Disparities 12.6 Investigating the Meaning of the Race/Ethnicity Coefficient in Regression Models 12.7 Statistical Methods Used to Evaluate Causal Effects in Intervention Studies 12.8 Conclusion and Limitations 12.9 Key Points Disclaimer References

19 13 Small Area Estimation and Bayesian Disease Mapping for Minority Health and Health Disparities 13.1 Introduction 13.2 Basic Statistical Models for Small Area Estimation 13.3 Small Area Estimation: A Brief Practical Guide 13.4 Small Area Estimation for Quantifying Health and Health Disparities of Small Populations 13.5 Bayesian Disease Mapping 13.6 Conclusions 13.7 Key Points Disclaimer Acknowledgments References Further Reading

20 14 Applications of Big Data Science and Analytic Techniques for Health Disparities Research 14.1 Introduction 14.2 Characteristics of Big Data 14.3 Importance of Big Data for Minority Health and Health Disparities Research 14.4 Goals of Big Data Analytics and Opportunities for Health Disparities Research 14.5 Research Methods in Big Data 14.6 Selected Examples Illustrating Best Practices 14.7 Challenges and Opportunities on Big Data Approaches in Health Disparities Research 14.8 Summary and Conclusion 14.9 Key Points Disclaimer References

21 15 Complex Systems Science 15.1 Introduction 15.2 Unique Properties of Minority Health and Health Disparities Research 15.3 Data and Methodological Challenges in Health Disparities Research 15.4 Strong Alignment Between Hypothesized Causes of Minority and Health Disparities and Complex Systems Science Approaches 15.5 Types of Questions that Complex Adaptive Systems Models Can Help Answer 15.6 Elements of a Successful Complex Adaptive Systems Model 15.7 Systems Science as Iterative Research 15.8 Limitations and Challenges 15.9 Key Points Disclaimer References

22 16 Improving Equity in Healthcare through Multilevel Interventions 16.1 What Are Multilevel Interventions? 16.2 Challenges of Multilevel Interventions 16.3 Multilevel Interventions: 2012–2017 16.4 Future Directions 16.5 Case Study to Illustrate Multilevel Interventions 16.6 Key Points Disclaimer References

23 17 Using Implementation Science to Move from Knowledge of Disparities to Achievement of Equity 17.1 Introduction 17.2 Selected Implementation Frameworks Applied to Health Disparities Research 17.3 Best Practices in Health Disparities Implementation Science: Selected Examples 17.4 Challenges and Opportunities for Implementation Science in Health Disparities Research 17.5 Summary and Implications for Future Research, Practice, Policy, and Social Change 17.6 Key Points Disclaimer References