Health Disparities Research Program
Clinical Research Center
OBJECTIVE:
The elimination of health disparities remains a priority of the National Institutes of Health and the National Institute of Dental and Craniofacial Research. Disadvantaged and vulnerable subgroups of the population continue to have disproportionate levels of disease despite many improvements for the population overall. Disparities in dental caries, periodontal diseases, and oral and pharyngeal cancer persist and are priorities of this initiative. The purpose of this initiative is to continue to stimulate research that will accelerate efforts to alleviate oral health disparities in disadvantaged and vulnerable populations. A complex array of factors - biological, behavioral and environmental – and their interactions must be understood and addressed in culturally appropriate ways if improvements are to be made and sustained. Given the complex array of factors and approaches involved, multidisciplinary teams that include well established, documented community partnerships are required.
Disadvantaged and vulnerable people and the communities in which they live, work and socialize are the focus of this research initiative. Disadvantaged and vulnerable populations are minority race/ethnic populations, low income rural or urban dwellers, special needs populations, those with acquired or developmental disabilities, the immunocompromised, elders, and the homebound or institutionalized. A full range of research approaches may be utilized. This might include basic, translational, and clinical research including epidemiological research, behavioral/social sciences, randomized clinical trials, dissemination/implementation research and health promotion research. The results of the research of the Centers for Research to Reduce Oral Health Disparities should ultimately lead to changes in public health policy, clinical practice, community action, personal skills development, and/or environmental action.
BACKGROUND:
Oral Health in America: A Report of the U.S. Surgeon General indicates that oral, dental and craniofacial diseases and disorders are among the most common health problems affecting the population. While improvements for several oral diseases/conditions were documented in a recent report of the National Health and Nutrition Examination Survey, significant disparities persist for racial/ethnic minorities and the poor. Much remains to be learned about the complex array of factors that may contribute to these disparities. As the factors that contribute to disparities are understood, successful interventions that are easily adopted and culturally appropriate must be developed, tested and disseminated.
CURRENT PORTFOLIO OVERVIEW:
NIDCR is supporting five Centers for Research to Reduce Oral Health Disparities through August of 2008 with co-funding by the Office of Behavioral and Social Sciences. The Centers were initially co-supported by the National Center for Minority Health and Health Disparities. The current Centers include a wide-range of research varying from genetic and social epidemiology to randomized clinical trials. Four of the current Centers are addressing a particularly devastating form of tooth decay that affects young children - Early Childhood Caries - and one of the Centers is focused on oral and pharyngeal cancer. The NIDCR also supports several health disparities-related R01s, R21s and R03s. Significant gaps in the NIDCR portfolio exist in terms of various populations, life-stages and diseases/conditions. This initiative will take portfolio balance into consideration. Given the rich and growing diversity that exists within society and the documented disparities in oral health status, much remains to be accomplished if health disparities are to be reduced and ultimately eliminated.
COLLABORATIVE ACTIVITIES:
The scope of this initiative is broad and will require the scientific expertise of scientists and others from many disciplines. Established collaboration with community partners will be essential. The NIDCR will solicit the participation of other Institutes and Centers at the NIH as well as that of other agencies and draw upon their collective expertise to enhance the quality of the science and other outcomes of this initiative.
FUNDING MECHANISMS:
This initiative will utilize the U54 cooperative agreement mechanism.