Objective 3: Investigate factors that account for differences in health among populations

Variations exist between populations—grouped by such factors as age, sex, race, and ancestry—in susceptibility and resilience to heart, lung, blood, and sleep (HLBS) diseases and in disease course and outcomes. While some of these variations are caused by genetic and other biological factors, a wide range of behavioral factors and socioeconomic inequities also contribute to health disparities. Research is needed to better understand the causes of population health differences and to identify strategies to effectively address these differences. Investigations in this area may range from basic laboratory studies to population science to community-centered implementation research.

Envision a future in which we are able to...
  • Leverage a deeper understanding of biologic differences related to sex or ancestral groups (e.g., variation in ancestry leading to differences in asthma phenotypes among ethnic subgroups) to devise more precise, targeted intervention strategies and further improve clinical outcomes.
  • Reduce health disparities and inequities in an era of information technology by leveraging epidemiology and the power of data science to understand and solve complex health problems.

Related Priorities

Compelling Question
What community-based effectiveness and implementation research strategies can help address HLBS health inequities? (3.CQ.01)
Compelling Question
How can we improve the representation of women, minority, and disadvantaged populations in clinical research studies and ensure that findings are applicable to these populations? (3.CQ.02)
Compelling Question
What are the environmental, genetic, and epigenetic factors and molecular, cellular, and systemic mechanisms that determine sex-related differences in HLBS health and disease? (3.CQ.03)
Compelling Question
Do the factors that render individuals or populations subjected to the same exposures (e.g., diet, smoking, other environmental and social exposures) resilient or susceptible to disease differ across the lifespan and by sex/gender? (3.CQ.04)
Compelling Question
How can cardiometabolic risk be managed to improve health trajectories in specific populations (e.g., according to race, ethnicity, sex/gender, socioeconomic status)? (3.CQ.05)
Critical Challenge
Sex/gender-specificity is needed in basic, translational, and clinical studies; data analyses; and management guidelines for HLBS conditions. (3.CC.01)
Critical Challenge
Novel experimental strategies and tools are needed to evaluate the effect of sex differences on HLBS health, resilience, and disease. (3.CC.02)
Critical Challenge
Integrated analysis of expanding collections of health information from individual patients-including genetic, epigenetic, and "omic" data-is needed to allow more precise medical management of patients at risk for or afflicted with an HLBS disorder, especially among groups that are understudied or have disparate morbidity and mortality (e.g., minorities, women). (3.CC.03)
Critical Challenge
Advances in methods of and models for assessing and characterizing exposures (e.g., diet, smoking, other environmental and social exposures) are needed to understand differences in health among populations. (3.CC.04)

Overarching Objectives

  1. Understand normal biological function and resilience
  2. Investigate newly discovered pathobiological mechanisms important to the onset and progression of HLBS diseases
  3. Investigate factors that account for differences in health among populations
  4. Identify factors that account for individual differences in pathobiology and in responses to treatments
  5. Develop and optimize novel diagnostic and therapeutic strategies to prevent, treat, and cure HLBS diseases
  6. Optimize clinical and implementation research to improve health and reduce disease
  7. Leverage emerging opportunities in data science to open new frontiers in HLBS research
  8. Further develop, diversify, and sustain a scientific workforce capable of accomplishing the NHLBI’s mission