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HARVARD GAZETTE ARCHIVES
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| Sujatha Rao, member secretary of the National Commission on Macroeconomics and Health in India and an HSPH alumna, listens to other distinguished international participants. (Staff photos Kris Snibbe/Harvard News Office) |
Investigating health disparities
Representatives from various and varied countries investigate universal problem
HSPH Communications
Addressing health disparities is among the top priorities of the National Institutes of Health (NIH), said the agency's director Elias Zerhouni at the second of three Harvard symposia on April 14.
The symposia were convened by the Harvard School of Public Health (HSPH) to involve high-ranking health officials from several countries.
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Symposium webcast |
"Health disparities research is something that truly we're just at the beginning of understanding and promoting and stimulating," said Zerhouni. "It will require an integrative approach."
In addition to Zerhouni, the talk featured speakers representing Canada, India, and the Americas. Former HSPH Dean and Harvard Provost Harvey Fineberg, who now heads the Institute of Medicine, served as discussant for a subsequent panel discussion.
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| Zerhouni |
The meeting was a call to action, explained HSPH Dean Barry Bloom in his opening remarks. "The kind of leaders we have presented to you today are in a position - if we could be persuasive enough with both the analysis and the suggestion for improvements and interventions for action - to try to make a difference."
The NIH has more than doubled its spending on health disparities research in the past few years, said Zerhouni. In 2000, the National Center on Minority Health and Health Disparities (NCMHD) was established and now frames an official NIH strategic plan to address the issue. Part of the center's mission is to eliminate health disparities altogether.
One major challenge in understanding the nature of health disparities is to go beyond simply describing the problem. To encourage more scientists to research health disparities, the NCMHD has a program that makes payments - up to $35,000 per year - on qualified educational loan debts for scientists who undertake basic, clinical, or behavioral research directly relevant to health disparities.
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| Barry R. Bloom (left), dean of the School of Public Health, and Christopher Murray, director of the Global Health Initiative, listen to remarks. |
To involve communities and to encourage integrated work, the NIH established in 2003 eight Centers for Population Health and Health Disparities, funded at $60.5 million over five years. "It's one thing to do good surveys and good measurements, but what is very important here is to be able to compare different communities," said Zerhouni.
Community-based research is also important in understanding the nature of health disparities in India, a country of 1 billion people with 14 national languages, 6,000 dialects, and every major religious denomination. While southern Indian states enjoy relatively good health outcomes, communities in a swath of poorer, northern states account for more than 20 percent of the country's disease burden, explained Sujatha Rao, member secretary of the National Commission on Macroeconomics and Health in India and an HSPH alumna.
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The final talk in the 'Health Disparities & the Body Politic' series will be 'Making Disparities Count: From Government Statistics Systems to Action,' May 5, 2-5 p.m., Harvard Conference Center, 77 Avenue Louis Pasteur, Boston. Speakers: John Fox, director of statistics, Department of Health, United Kingdom; François Héran, director, Institut national d'études démographiques, Paris; Vickie Mays, professor of clinical psychology, University of California, Los Angeles, and director, UCLA Center on Research, Education, Training, and Strategic Communications on Minority Health Disparities; Eduardo Mota, chief of health statistics, Instituto de Saude Coletiva, Brazil Discussant: Godfrey Woelk, associate professor, Department of Community Medicine, College of Health Sciences, University of Zimbabwe This event is free of charge and open to the public. To register, visit http://www.hsph.harvard.edu/disparities. |
India offers both a public and private health care system. Those who can afford private health care have access to advanced technologies and trained specialists, and Rao is examining how to boost involvement of the private system in addressing health disparities. The issue of access will become even more important in the future as rates of chronic, noncommunicable diseases, such as asthma, become more prevalent in the country, she said.
Translating research into policy and practice was mandated by the Canadian government when it agreed to fund the Canadian Institutes of Health Research, the country's equivalent to the NIH, explained John Frank, who serves as scientific director of one of the institutes. As a result, his institute has funded seven centers - such as one dedicated to asthma in the workplace that involves the Hopital du Sacre Coeur de Montreal - to develop partnerships directly with policy-makers and community groups.
Unlike her fellow speakers, Mirta Roses Periago focused not on a single country but on a group of 38 nations that make up the Pan American Health Organization (PAHO), a regional office of the World Health Organization. PAHO is investigating widening disparities between and within countries and rising exclusions from health care systems, said Periago, who directs PAHO. The organization is currently focusing on the effects of inequity on health.
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