In 1974, Congress granted authority to form the National Institute on Aging (NIA) to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people. Today, millions of Americans are leading healthier lives based, in part, on discoveries from aging research. But more must be done to redress disparities in health among U.S. minority groups. Since the beginning of the 20th century, life expectancy at birth in the U.S. has increased from less than 50 years to more than 76 years. Life expectancy at birth has more than doubled for African Americans (and "other races" combined) since 1900, from 33 years to 69 years in 1991. For Caucasians, the increase was from 48 years to 76 years. The gap is narrowing, however, causes of this gap between minorities and non-Hispanic Caucasians are unclear. The NIA is supporting many research grants to help us better understand the problem. We know that the problem can be associated with wealth, income, at-risk behaviors, social and environmental factors, and race and ethnicity. The challenge for the 21st century will be to narrow and ultimately, eliminate this gap in life expectancy and to make the added years of life as healthy and productive as possible while maintaining or improving the current trend of decline in disability across all segments of the population, minority and non-minority alike.
For the past several months, NIH has been developing a comprehensive NIH Strategic Plan to Reduce and Ultimately Eliminate Health Disparities. The goal is for the Strategic Plan to be ready for submission as part of the NIH Fiscal Year 2002 budget request, as an outline of the NIH's priorities and commitment to research on health disparities. The Plan sets forth the NIH objectives for reducing and, ultimately, eliminating health disparities. While this goal appropriately highlights the critical importance of this endeavor, it is not clear to what extent its objectives can be achieved over the next decade, even with the most optimistic assumptions for improving health among minorities.
What science will be able to do in the next decade is to address and answer questions about causes of health disparities among older adults. The immediate goal will be to identify research needs, such as the need to understand the racial gap in life expectancy, and promote appropriate research and training activities in response to these needs. A longer-term goal will be to apply the outcomes of research to measures that will reduce and ultimately eliminate racial disparities in health.
Development of the NIA Strategic Plan to Address Health Disparities was started with the goal of addressing health disparities in older Americans. The NIA plan, like the NIH plan, focuses on three major areas: 1) research; 2) research infrastructure; and 3) public information, outreach and education, and includes ongoing and future initiatives. The plan is composed of over sixty activities to help the NIA advance research and better understand health disparities among ethnic and racial older adults.
We are committed to fulfilling our own role in the battle against health disparities in older adults. We have the responsibility to place special emphasis on those diseases and conditions that are major contributors to health disparities among older individuals, with the goal of making measurable progress against these and other problems. The NIA Strategic Plan to Address Health Disparities , in union with the NIA Strategic Plan for Aging Research and the recently completed Review of Minority Aging Research by the National Advisory Council on Aging, presents a vision and approach to redress health disparities in older adults.
This NIA plan is not meant to address all health disparities but rather a plan to address health disparities within the context of the congressionally mandated mission of the NIA. The NIA is working with other NIH Institutes and Centers to develop an overall strategy that in total will address the diseases and conditions that challenge older men and women. I am pleased to present this first public presentation of the NIA plan and welcome your comments on its content. The plans of other Institutes and Centers can be found on the NIH Home Page at: http://www.nih.gov/. The NIH Strategic Plan can be found at: http://www.nih.gov/about/hd/strategicplan.pdf.
Richard Hodes, M.D.
Director, NIA
