Nutrition and Health Disparities Implementation Working Group

This working group seeks to advance NIH research to understand the interactions between diet, nutritional status, the environment, and biological and behavioral processes, and how they contribute to health disparities. It will also encourage research on how to prevent and treat nutrition-related diseases and reduce health inequities. Because “nutrition and health disparities” is a cross-cutting theme of the Strategic Plan for Nutrition Research, the workgroup will collaborate with the other IWGs to support nutrition and health disparities research. These activities will stimulate the development of research priorities that elucidate how diversity of all kinds — race, ethnicity, socioeconomic status, disability, sex, gender, gender identity, or geography — influences nutrition and health interrelationships.

Co-Chairs:
Alison Brown, NHLBI

Tanya Agurs-Collins, NCI

Members:

Samantha Adas, ONR
Ligia Artiles, NIMHD
Annina Burns, ORWH
Paul Cotton, NHLBI
Heather D'Angelo, NCI
Laurie Donze, NHLBI
Regine Douthard, ORWH
Sanae ElShourbagy Ferreira, NCATS
Mary Evans, NIDDK
Kimberlea Gibbs, NICHD
Margaret M. Grisius, NIDCR
Kirsten Herrick, NCI
Hiroko Iida, NIDCR
Bill Jirles, NIEHS
Lyndon Joseph, NIA
Brama Kowtha, ODP

Wayne Lawrence, NCI
Priscah Mujuru, NIMHD
Linda Nebeling, NCI
Holly Nicastro, ONR
April Oh, NCI
Charlotte Pratt, NHLBI
Amanda Price, NINR
Nishadi Rajapakse, NHLBI
Jill Reedy, NCI
Marissa Shams-White,NCI
Yang (Scarlet) Shi, NHLBI
Anil Wali, NCI
Dan Xi, NCI

Intramural Subject Matter Experts:
Tiffany Powell-Wiley, NHLBI

Nutrition Health Disparites Research Framework

Nutrition Health Disparities Research Framework

Domains of Influence (Over the Life Course)	Levels of Influence
	Individual	Interpersonal	Community	Societal
Biological	Taste Predispositions, Nutritional Status, Nutrition Metabolism, Nutrigenomics, Metabolomics, Microbiome, Food Allergies and Intolerances	Maternal -Child Interaction, Feeding Practices (e.g., breastfeeding), Family Microbiome	Community Illness Food Contaminant	Sanitation Pathogen Exposure (e.g., E Coli)
Behavioral	Dietary Intake, Dietary Habits, Eating Patterns, Coping Strategies	Family Dietary Practices (e.g., family meals) School/Work Dietary Behavior	Community Functioning Community engagement (lobbying for full- service grocery stores)	Nutrition Policies and Laws (e.g., food assistance programs and access) State- and City-level Food and Nutrition Policies (e.g., soda taxes)
Physical/Built Environment	Personal Food Environment and Access (e.g., exposure to fast food at home)	Household Food Environment School/Work Food Environment	Community Environment Community Resources Neighborhood Food Environment (e.g., food deserts, food marketing)	Societal Structures (e.g., zoning laws) Dept. of Education and School System Workplace Policies and Accommodations, Food Marketing
Sociocultural Environment	Food Preferences, Sociodemographic (e.g., discretionary income) Food Literacy and Preparation Skills Limited English Cultural Identity/Acculturation Response to Discrimination	Social Networks Family/Peer Norms Interpersonal Discrimination (e.g., dietary practice, body image)	Community Norms Local Structural Discrimination (e.g., dietary practice, body image)	Social Norms Food System (e.g., supply chain, food costs) Societal Structural Discrimination
Health Care System	Insurance Coverage, Access, Utilization Health Literacy Treatment Preferences Nutrition Medical Therapy	Patient-Clinician Relationship Medical Decision-Making (e.g., referrals to RDs)	Availability of Services Safety Net Nutrition Services (e.g., WIC, SNAP, food pantries)	Quality of Care Health Care Policies for Nutrition Services (e.g., screening & treatment)
Health Outcomes	Individual Health	Family/Organizational Health	Community Health	Population Heath

The Nutrition Health Disparities Research Framework was adapted from the NIMHD Minority Health and Health Disparities Research Framework. The framework highlights multiple factors and their intersection that are relevant to understanding and addressing nutrition-related health disparities. Our definition of health disparities includes race/ethnicity, low socioeconomic status, rural, sexual/gender, and minority populations. Additionally, other fundamental characteristics such as sex/gender, disability, and geographic region are included in the framework. For more information about the NIMHD Minority Health and Health Disparities Research Framework see https://www.nimhd.nih.gov/about/overview/research-framework/. We welcome your comments on the Nutrition Health Disparities Research Framework. Please submit feedback to nutritionresearch@nih.gov.