Research Agenda Preamble

Health research provides the foundation for understanding health. However, Hispanics/Latinos are disproportionately underrepresented in research activities. Without adequate and targeted research, Hispanics/Latinos are disadvantaged in policy- making, resource allocation, program planning, and program implementation activities.

Currently, our body of knowledge about Hispanic/Latino health is limited at best. There are few culturally appropriate theoretical frameworks, and many research methodologies (instruments, data collection, and data analysis) are inadequate for addressing the unique health services research and delivery needs of the diverse Hispanic/Latino population groups.

Problems

1. Underfunding of Hispanic/Latino health research initiatives and agendas.
2. Lack of culturally appropriate theories, models, and methodologies.
3. Underrepresentation of Hispanics/Latinos at all levels of research activities, including students, research faculty, and administrators of research programs.
4. Lack of U.S. and international multi-disciplinary Hispanic/Latino health research and lack of coordination of efforts among diverse areas of investigation.

   Summary of Keys Strategies

   1. Increase funding to (I) determine high-priority health problems that affect morbidity and mortality of Hispanic/Latino groups (such as cardiovascular disease, cancer, diabetes, HIV/AIDS, substance abuse, violence, accidents, environmental and occupational hazards, and tuberculosis); (2) assess the impact of gender, ethnicity, and physical ability on the health status of urban and rural Hispanics/Latinos across their lifespan; and (3) assess the role of factors such as assimilation, country of origin, and migratory status.
   2. Increase Hispanic/Latino representation on multi- disciplinary grant review bodies, advisory groups, and task forces to identify and implement Hispanic/Latino research priorities at local, State, and Federal levels.
   3. Create and update directories of multi-disciplinary Hispanic/Latino researchers for use by publicly or privately funded health departments, agencies, organizations, and/or institutions.
   4. Reform the curricula of multi-disciplinary health professional institutions and continuing education programs to include Hispanic/Latino health research theories, methodologies, and models.
   5. Ensure the recruitment, training, and retention of Hispanic/Latino investigators and administrators.

   Specific Strategies

   Key Audiences: Local, State, and Federal administrators and officials.

   Policy

   Local and State

   • Create Hispanic/Latino representation on multi-disciplinary grant review bodies, advisory groups, and task forces to identify and implement Hispanic/Latino research priorities at local, county, and State levels.
   • Create linkages to local educational, philanthropic, corporate, and research organizations.
   • Utilize community-based organizations and neighborhood opinion leaders as distribution channels for information and service delivery. These groups and opinion leaders should also be used as a way of providing feedback to the scientific community on the effectiveness of research in addressing the needs of the communities and population groups.
   • Create registries and update directories of multi-disciplinary Hispanic/Latino scientists and researchers for use by publicly or privately funded health departments, agencies, organizations and/or institutions.
   • Reform curricula of multi-disciplinary health professional institutions and continuing education programs to include Hispanic/Latino health research theories, methodologies, and models.
   • Assess the results of programs such as the Minority Behavioral Research Supplement, Minority Access to Research Careers, and Health Careers and Opportunity Programs with respect to recruitment and retention of Hispanic/Latino students and researchers.
   • Develop innovative research internship and fellowship programs for Hispanic/Latino students and scientists at the Federal and State levels.
   • At the local levels, develop and enhance publicly and privately funded training and mentorship programs at various sites, such as the Minority High School Mentorship Program.
   • Develop programs and initiatives to fund research on the role of assimilation, acculturation, country of origin or background, and socioeconomic status and migratory history on the health status of Hispanics/Latinos.
   • Develop programs and initiatives to fund research on the impact of age, gender, geographic location, and functional ability on the health status of Hispanics/Latinos.

   Federal

   • Enhance Hispanic/Latino representation on multi-disciplinary grant review bodies, advisory groups, and task forces to identify and implement Hispanic/Latino research priorities at Federal health departments and agencies.
   • Enhance opportunities for and appointment of Hispanics/Latinos in key administrative and policy making jobs in Federal agencies.
   • Create and/or enhance Hispanic/Latino research agendas and health training in PHS and other agencies of DHHS. These programs should incorporate and emphasize the cultural, linguistic, and socioeconomic aspects and needs of the subpopulations.
   • Create and/or enhance linkages within and across Federal agencies to replicate "best practices" and augment research and training resources.
   • Establish county, State, and national clearing-houses to collect and disseminate information on Hispanic/Latino health research and funding opportunities.

   Resources

   • Increase funding to determine high-priority health problems (such as cardiovascular disease, cancer, diabetes, HIV/AIDS, tuberculosis, and substance abuse) that affect morbidity and mortality of Hispanic/Latino groups.
   • Increase funding for enhanced recruitment, training, retention, and promotion of Hispanics/Latinos into health research leadership positions.
   • Allocate funding for increased recruitment, training, retention, and promotion of Hispanic/Latino researchers employed by county, State, and Federal health departments and agencies.
   • Examine and reapportion institutional funding, with special emphasis on discretionary funds, spent on Hispanic/Latino health research, particularly in the inner cities and rural areas.
   • Develop and fund Distinguished Scholars programs to enhance career development for Hispanic/Latino researchers at the undergraduate, graduate, and postgraduate levels.
   • Allocate funds, including set-aside funds, to ensure that research on Hispanics/Latinos is responsive to their subgroup needs and priorities.
   • Fund a repository of Hispanic/Latino survey instruments, research methodologies, and data within PHS, with special emphasis on making the information accessible and affordable to Hispanic/Latino institutions or researchers.
   • Establish a directory of Hispanic/Latino researchers to disseminate for use by county, State, and Federal health departments and agencies.
   • Fund activities and programs that will promote linkages between community-based health delivery systems serving Hispanics/Latinos and academic institutions.

   Public-Private Partnerships

   • Establish collaborative partnerships between academic and health institutions.
   • Collaborate with public officials, corporate leaders, and foundation administrators in establishing multi-disciplinary mechanisms for determining Hispanic/Latino research priorities and funding sources.
   • Establish and support ongoing U.S.-Latin American health conferences and research collaborations.

   Advocacy

   • Collaborate with editorial boards of established professional journals to focus on Hispanic/Latino health issues.
   • Establish new information dissemination strategies to meet the needs of Hispanic/Latino researchers and health service providers. (For example, include specific columns in the Journal of the American Medical Association and local newsletters of professional organizations.)
   • Establish new health information dissemination strategies to meet the needs of the general Hispanic/Latino community.
   • Continue and expand interaction with legislative bodies (city council members, mayors, county commissioners, State and Federal legislators, Hispanic Congressional Caucuses, and committee staff).

   Legislation

   • Consider alternatives that could allow U.S. trained, foreign medical graduates to maximally participate in research activities, particularly those related to Hispanic/Latino issues.
   • Ensure reauthorization of the Disadvantaged Minority Health Act and appropriations of related Federal agencies.
   • Amend the Disadvantaged Minority Health Act to specifically address the health needs of the Hispanic/Latino populations.
   • Enhance tax incentives and programs for businesses that provide funding for Hispanic/Latino research and training.