Developing the Inaugural NIDDK Health Disparities and Health Equity Research Implementation Plan

In January 2021, the Advisory Council of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), established a Health Disparities and Health Equity Working Group in response to NIDDK’s three-part Council Forum on Underrepresented Investigators and Science. The Working Group’s Report was accepted by the NIDDK Advisory Council on January 25, 2023, and NIDDK now seeks further input from the community.

Working Group Goal

The goal of the Working Group is to identify a range of research opportunities and actionable recommendations addressing high-priority NIDDK research needs on health disparities and health equity. In addition, the Working Group will identify opportunities for strategically implementing the recommendations with goals that NIDDK could pursue to eliminate health disparities and advance health equity research within NIDDK’s mission. The recommendations and opportunities will be compiled into an Implementation Plan to advance NIDDK health disparities and health equity research.

Background

NIDDK funds research on some of the most common conditions that disproportionately affect groups or communities that have been historically marginalized or experience contemporary forms of discrimination or oppression. The COVID-19 pandemic, which has affected these communities most severely, has heightened awareness of the devastating consequences of health disparities and the compelling need for more research to accelerate the elimination of disparities and promote health equity for all. Health equity and the reduction of health disparities are also important cross-cutting aspects of the NIDDK Strategic Plan for Research, published in December 2021. The Implementation Plan will complement the Strategic Plan by elaborating on specific research needs and opportunities NIDDK could pursue to enhance the Institutes’ health equity research portfolio.

Working Group Organization and Subgroup Goals

The Working Group comprises external researchers from across the country with expertise in interdisciplinary research fields related to health disparities and health equity, community members with diverse perspectives and valuable, lived experiences to inform our efforts, and NIDDK staff.

The Working Group is divided into five subgroups and each subgroup has defined goals: 

Subgroup 1. Engaging communities and building sustainable partnerships

• Identify effective engagement strategies to enhance participation in all phases of research (from idea conception through award close) by communities that experience disproportionately worse health outcomes
• Propose strategies to create and sustain partnerships for research
• Identify strategies for developing community-driven research priorities

Subgroup 2. Understanding social determinants of health (SDoH) effects on the biology of health and disease

• Identify biological factors affected by SDoH
• Examine how these factors contribute to disease development, severity, and long-term outcomes
• Identify biological consequences of intergenerational stressors and their long-term impact on health and risk of disease
• Identify promising intervention targets for prevention and treatment

Subgroup 3. Identifying interventions to address SDoH effects, eliminate disparities, and improve health

• Identify interventions that help people overcome adverse SDoH to improve health
• Meet individuals “where they live, work, play, learn, and pray” to understand strengths, resources, and challenges in their environments
• Examine healthcare and community-based supports that will improve equitable access to health promoting services and care

Subgroup 4. Addressing upstream causes of SDoH and health disparities from an NIDDK perspective

• Identify ways to understand/address systemic barriers to improve a community’s social environment and advance health equity
• Identify cross-Federal or public-private-academic partnership opportunities to test natural experiments or participate in pilot demonstration projects to inform policy and healthcare practice

Subgroup 5. Listening to community perspectives

• Gather input from people living with and at risk of NIDDK mission diseases including
  • perspectives about health and healthcare experiences;
  • research needs, values, and priorities;
  • community strengths and living conditions that promote or hinder achieving optimal health; and
  • collaborations and partnerships needed