The Science of Health Disparities Research. Группа авторов

et al. (2011). Heterogeneity of diabetes outcomes among Asians and Pacific Islanders in the US. The Diabetes Study of Northern California (DISTANCE). Diabetes Care 34: 930–937.

      6 6 Karter, A.J., Ferrara, A., Liu, J.Y. et al. (2002). Ethnic disparities in diabetic complications in an insured population. Journal of the American Medical Association 287: 2519–2527.

      7 7 Centers for Disease Control (2015). Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States — 2009–2013. Morbidity and Mortality Weekly Report 64 (17): 469–478.

      8 8 Rudd, R.A., Seth, P., David, F., and Scholl, L. (2016). Increases in drug and opioid‐involved overdose deaths––United States, 2010–2015. Morbidity and Mortality Weekly Report 65: 1–8.

      9 9 Chetty, R., Stepner, M., Abraham, S. et al. (2016). The association between income and life expectancy in the United States, 2001–2014. Journal of the American Medical Association 315 (16): 1750–1766.

      10 10 Cubbin, C., Pollack, C., Flaherty, B. et al. (2011). Assessing alternative measures of wealth in health research. American Journal of Public Health 101: 939–947.

      11 11 Garcia, M.C., Faul, M., Massetti, G. et al. (2017). Reducing potentially excess deaths from the five leading causes of death in the rural United States. MMWR Surveillance Summaries 66 (2): 1–7.

      12 12 Global Burden of Cardiovascular Diseases Collaboration (2018). The burden of cardiovascular disease among US States, 1990‐2016. JAMA Cardiology 3 (5): 375–389.

      13 13 Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist 32 (7): 513–531.

      14 14 Hill, C.V., Perez‐Stable, E.J., Anderson, N.A., and Bernard, M.A. (2015). The National Institute on Aging Health Disparities Research Framework. Ethnicity & Disease 25 (3): 245–254.

      15 15 Paradies, Y., Ben, J., Denson, N. et al. (2015). Racism as a determinant of health: a systematic review and meta‐analysis. PLoS One 10 (9): e0138511. https://doi.org/10.1371/journal.pone.0138511.

      16 16 Bhardwaj, A., Sanjeev, K., Alsam Khan, M. et al. (2017). Racial disparities in prostate cancer: a molecular perspective. Frontiers in Bioscience, Landmark 22: 772–782.

      17 17 Starfield, B. (1998). Primary Care: Balancing Health Needs, Services and Technology. New York: Oxford University Press.

      18 18 Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 346 (6): 393–403.

      19 19 Popejoy, A.B. and Fullerton, S.M. (2016). Genomics is failing on diversity. Nature 538 (7624): 161–164.

      20 20 Martin, R.M., Donovan, J.L., Turner, E.L. et al. (2018). Effect of a low‐intensity PSA‐based screening intervention on prostate cancer mortality. The CAP randomized clinical trial. Journal of the American Medical Association 319 (9): 883–895.

      21 21 Schröder, F.H., Hugosson, J., Roobol, M.J. et al. (2014). Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow‐up. Lancet 384 (9959): 2027–2035.

      22 22 Andriole, G.L., Crawford, E.D., Grubb, R.L. et al. (2009). Mortality results from a randomized prostate‐cancer screening trial. New England Journal of Medicine 360 (13): 1310–1319.

      23 23 Sturgeon, K.M., Hackley, R., Fornash, A. et al. (2018). Strategic recruitment of an ethnically diverse cohort of overweight survivors of breast cancer with lymphedema. Cancer 124 (1): 95–104.

      Notes

      1 1 https://www.nimhd.nih.gov/about/overview/history/

      2 2 https://www.whitehouse.gov/wp‐content/uploads/2017/11/Revisions‐to‐the‐Standards‐for‐the‐Classification‐of‐Federal‐Data‐on‐Race‐and‐Ethnicity‐October30‐1997.pdf

      3 3 https://www.healthypeople.gov/2020/about/foundation‐health‐measures/Disparities

      4 4 https://www.nimhd.nih.gov/about/overview/research‐framework.html

      5 5 https://grants.nih.gov/grants/funding/women_min/guidelines.htm

2 Getting Under the SkinPathways and Processes that Link Social and Biological Determinants of Disease

       Chandra L. Jackson1, Rada K. Dagher2, Jung S. Byun3, Tilda Farhat4, and Kevin L. Gardner5

       1 Epidemiology Branch, Social and Environmental Determinants of Health Equity, National Institute of Environmental Health Sciences, National Institutes of Health, Cary, NC, USA

       2 National Institutes of Health, National Institute on Minority Health and Health Disparities, Division of Scientific Programs, Bethesda, MD, USA

       3 National Institutes of Health, National Institute on Minority Health and Health Disparities, Division of Intramural Research, Bethesda, MD, USA

       4 National Institutes of Health, National Institute on Minority Health and Health Disparities, Office of Science Policy, Planning, Evaluation, and Reporting, Bethesda, MD, USA

       5 Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA

2.1 Introduction

      A fundamental aspect of health disparities research is to understand the differential influences through which “where” and “how” we live affects our daily lives, and to provide everyone with an opportunity to reach and maintain their greatest health potential. “Where and how” we live encompasses, for instance, how we feed, how we sleep, and how we feel. It is also characterized by the differing ways in which we each respond to the vicissitudes of life. These influences on health are complex, multifactorial, interact with each other, accrue throughout the life course, and differentially affect various populations.

The domains that have the greatest influence on health and health disparities include the healthcare system, the sociocultural environment, the physical environment, and behavioral and biological determinants. Of note, modifiable environmental exposures and social factors, combined with a certain level of susceptibility may trigger epigenetic changes, thus producing biological processes contributing to health disparities. These domains are inextricably linked and may combine to produce synergistic effects on health, but their impacts are not distributed uniformly throughout the population. Several diseases and conditions can occur with increased frequency and severity (producing worse outcomes) in certain population groups. Understanding how these domains interact and combine to determine health outcomes (along the dimensions of race, ethnicity, socioeconomic status, and lifestyle) requires a transdisciplinary approach [1]. A transdisciplinary perspective cuts across different areas of expertise while filling in gaps of knowledge and understanding. Through cooperative and integrated efforts, subject matter experts must work together across disciplines and with communities to understand the causes/determinants and environmental or social pathways, as well as biological mechanisms of health disparities in order to implement interventions to eliminate or reduce disparities. A precision perspective in this effort requires the recognition of heterogeneity in the environmental, social, and