One of the major areas of focus for the most recent iteration of the historic Healthy People Initiative—Healthy People 2030—is achieving health equity and ensuring that people from all walks of life can access the health care that they need. As we know, there are vast disparities in health care and health care access among certain populations. These disparities affect groups that have historically and continually faced increased barriers to, or exclusion from, many aspects of life due to race, age, socio-economic status, or geographic location, among other factors.
Finding ways to remove barriers to healthcare access is a key component to achieving health equity. One way of removing barriers is to engage with communities directly. To that end, in collaboration with the National Heart, Lung, and Blood Institute (NHLBI), NIAMS has re-engaged with the local Washington, D.C. community through the Hope Center. The Hope Center, which operates under the direction of NIAMS’ Community Health Clinic, is not a walk-in clinic. Rather, it facilitates the NIAMS Intramural Research Program (IRP)’s efforts to engage with underserved populations in the local D.C. area who are living with rheumatic diseases and who qualify for research protocols. By becoming more involved with underserved communities, we can better understand the challenges they face, which, in turn, can better inform our research and responses in the future.
More broadly, the National Institutes of Health is also working to engage with local communities through the All of Us Research Program. This program recruits adults from across the country to share their health information with researchers, who then use that information to study many different diseases and conditions. Recently, All of Us released a dataset of whole genome sequences for use in research – almost half of which were donated by people who identify as part of a racial or ethnic group that has been understudied. Studying this diverse dataset can help advance health equity by leading to the development of more personalized healthcare approaches. In addition, NIAMS has joined other NIH Institutes to support research that seeks to understand how optimizing patient-clinician communication affects health care outcomes in populations that experience health disparities.
Funding researchers and organizations throughout the country who study health disparities is also a priority for NIH. As part of that effort, NIAMS recently re-issued a funding opportunity focusing on research to understand health disparities that contribute to the risk of COVID-19 infection in patients with underlying rheumatic, musculoskeletal, or skin diseases. While the number of new COVID-19 infections has thankfully diminished, the impact of long COVID remains a major concern – particularly among diverse populations. NIH continues to support the study of long COVID through the Researching COVID to Enhance Recovery (RECOVER) Initiative. The work of NIAMS’ Dr. Mariana Kaplan, chief of the IRP Systemic Autoimmunity Branch, ties in well with goals of this Initiative. Her lab is studying the long-term outcomes of COVID-19 infection and vaccination among patients with autoimmune diseases.
It is also vital that NIAMS provides access to accurate and clearly written health information for all Americans. By writing in plain language and taking steps to increase our organizational health literacy, defined in Healthy People 2030 as “the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others,” we can help those with whom we work be better informed and able to advocate for themselves and the health care that they deserve.
Understanding the root causes of health disparities and addressing them directly is an ongoing and evolving process. NIAMS is dedicated to supporting the research that will ultimately reduce or eliminate these disparity gaps and allow for a future where every person has access to needed health care.
Lindsey A. Criswell, M.D., M.P.H., D.Sc.
Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases