Research to Reduce Maternal Mortality and Morbidity
In 2020, NHLBI established the Maternal Health Community Implementation Project (MH-CIP).
MH-CIP is a community-based approach to addressing health disparities in vulnerable populations over the life course. Addressing disparities is fundamental to identifying and implementing sustainable strategies to prevent maternal mortality and morbidity in the women most affected. NHLBI is supporting four community research coalitions, which are composed of research organizations, patient advocacy groups, and community partners, to pilot test the implementation of proven interventions in these at-risk populations.
Leveraging Local-Level Data to Advance Health Disparities Research
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD)–U.S. Health Disparities Collaboration is a strategic partnership of several NIH Institutes, Centers, and Offices (including NHLBI) and CDC, working closely with the Institute of Health Metrics and Evaluation at the University of Washington. The partnership was launched to examine local data on morbidity, mortality, life expectancy, and other measures of health and their links to socioeconomic markers, as well as structural and behavioral markers of risk. A recent report from the Collaboration confirmed that disparities in
life expectancy among racial/ethnic groups are widespread and enduring and that local-level data are crucial to addressing the root causes of poor health and early death among disadvantaged groups. Importantly, for all racial/ ethnic groups, improvements in life expectancy were more widespread across counties and larger from 2000 to 2010 than from 2010 to 2019.
Mitigating the Health Effects of Climate Change
A collaborative, cross-disciplinary approach is needed to address the urgent issue of climate change, which is one of the greatest existential threats to the health of the planet and to human health. Extreme weather, rising sea levels, rising temperatures, and increases in carbon dioxide levels disproportionately affect the most vulnerable communities. Some of these adverse health outcomes may be short-lived, but others lead to chronic cardiovascular or respiratory illnesses. NHLBI is working closely with the National Institute of Environmental Health Sciences (NIEHS) to fund climate change–related research, including community outreach efforts. The Alliance for Community Engagement-Climate and Health’s goal is to reduce health threats across the lifespan and build health resilience in individuals, communities, and nations around the world, especially among those at highest risk. NHLBI will work with climate scientists, citizen scientists, and decision-makers to develop, monitor, and evaluate programs to control sensitivity (e.g., age, access to green space), control exposure (e.g., wildfires, outdoor activities in extreme heat), and create adaptive environments (e.g., cooling centers, heat warnings). NHLBI is also targeting sleep research to improve the negative health impacts of climate change on heart, lung, and blood health.
Addressing COVID-19 in Communities with Significant Health Disparities
The COVID-19 pandemic provided a stark reminder of how social determinants of health can contribute to health disparities; for example, demographic groups that tend to have large numbers of essential workers, higher-density housing, and less access to health care saw the worst infection rates and outcomes. To reach those Americans hit hardest by the pandemic, NHLBI, in partnership with the National Institute on Minority Health and Health Disparities (NIMHD), established the NIH CEAL initiative.
- CEAL connects researchers to community-based organizations and local leaders to help underserved and vulnerable communities get accurate, up-to-date information about COVID-19; to facilitate COVID-19 testing and prevention (including face masks and vaccination); and to ensure opportunities to participate in and benefit from COVID-19 research.
- CEAL has focused on communities that have experienced high rates of COVID-19 infection and poor outcomes—as well as barriers to prevention and treatment—especially underserved African American, Hispanic/Latino, American Indian/Alaska Native, and Asian American/Pacific Islander communities.
- The CEAL network is now active in more than 20 states. Early in the pandemic, it helped people in hard-hit communities address misinformation, get tested for COVID-19, and find vaccine clinical trials; later, it set up local vaccination clinics. Nationally, CEAL continues to help people stay abreast of COVID-19 research, available vaccines, and preventive practices through information written in lay terms, in both English and Spanish. It provides a model and lessons learned to address other long- standing disparities in chronic heart and lung diseases.
- CEAL research teams developed a variety of innovative approaches to engage communities in reducing the spread of COVID-19. For example, teams in Michigan and North Carolina held contests that invited community members to develop poems, songs, graphics, and videos encouraging their neighbors to mask up and get vaccinated.