Advancing the Science of Health Equity Research
As we turn the corner into a new academic year, with luck, you were able to fit in a restful and regenerative summer break! Either way, I hope what I have to share with you today can be a mini-vacation for your mind, offering inspiration and fresh perspective for the important work that you do.
Last year, AAMC teamed up with researchers at AcademyHealth for a first of its kind analysis within the Health Services Research Projects in Progress (HSRProj) Database, a comprehensive collection of ongoing health services research projects funded by federal agencies and foundations. After applying a tiered sorting process to the over 6,900 US health services research projects newly funded between 2007-2011, our team identified over 2,000 abstracts for projects with a health equity focus. These projects were further classified by type, targeted subpopulation(s) and health conditions to highlight trends and identify gaps. The results are detailed in a new AAMC-AcademyHealth joint report, The State of Health Equity Research: Closing Knowledge Gaps to Address Inequities.
Perhaps the most surprising—and promising—finding was the relatively rapid shift that occurred during this studied time frame from a predominant focus on detecting and understanding health disparities towards research on interventions to reduce or eliminate disparities.
These data tell the story of a responsive and connected research community, building on the established base of knowledge to develop and test potential solutions. In the next 5-10 years we will look for the results of this new generation of health equity research, and then hope to see another shift in focus, this time towards scaling and spreading interventions that work.
The rising profile of health equity research
Health services research is just one piece of the picture—it will take the combined efforts of researchers across the spectrum of science to determine the best ways to eliminate health disparities. In recent years, confidence in stable, predictable increases in federal research investments has diminished in the charged political atmosphere and protracted debate about the US debt and economic growth. Still, through this period, the nation's commitment to health equity research has not faltered. According to an AAMC analysis of the NIH RePORTER database, R01-equivalent awards tagged as 'disparity' or 'disparities' grew from 208 grants for $95.7 Million in 2003 to 796 grants for $378.5 Million in 2013.
$125.7 Million of the funding for grants initiated in 2013 was awarded to AAMC member institutions. I believe this is proof of the tandem commitment of the NIH and the academic medicine research community to bringing the full spectrum of health sciences—from basic science to community-based participatory research—to bear on the complex mix of factors which result in preventable differences in health and health outcomes.
Our analysis also revealed steady growth in NIH investments in career development awards for health equity researchers, helping to prepare a cadre of scientists to continue innovating in this space far into the future. Career development awards tagged with 'disparity' or 'disparities' grew over 5-fold over the last decade to an annual award amount of $30.6 Million in 2013. 62% of these important awards were granted to researchers at AAMC member institutions.
These numbers are inscrutable evidence that the academic medicine research community has embraced the pivotal role it is playing in advancing the science and practice of health equity.
What do these inspiring trends look like on the ground?
While the best way to see what cutting edge health equity research and research training looks like is first hand, the second best way is through what we're calling a Health Equity Research Virtual Site Visit.
We've done the work of curating the resources and creating a one-stop-shop learning hub on promising practices for health equity research and research training. The first institution to be featured on the hub is the University of Massachusetts Medical School (UMMS). Whether you have ½ hour to watch a few informative video clips or ½ an afternoon to scan publications and program designs, I think you'll be impressed and want to replicate this approach at your institution.
And finally, share your stories!
What do you think of when you hear 'health equity research'? Have you witnessed this expansion of equity researchers and the shift towards solutions-focused research? Has health equity research at your institution influenced the larger research, education and practice communities at your institution or within your region? We'd like to hear from you. Please share your stories via email to firstname.lastname@example.org, or on our AAMC Facebook or Twitter feeds.
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