Two decades of work to bring attention to the unequal burden of illness and death experienced by racial and ethnic minorities, rural and poor populations in this country has culminated in the creation of the National Institute on Minority Health and Health Disparities at NIH. The Patient Protection and Affordable Care Act (P.L. 111-148) also known as the health care reform law signed by President Obama on Mar. 23, 2010, re-designated the National Center on Minority Health and Health Disparities to an institute. The official re-designation was announced in the Federal Register on Sept. 13.

The law authorizes NIMHD to plan, coordinate, review and evaluate all minority health and health disparities research activities conducted and supported by the institutes and centers. It reaffirms the authority of the NIMHD director as the primary federal official with responsibility for coordinating all such activities. It also expands the eligibility criteria of the NIMHD Research Endowment program to include active NIMHD Centers of Excellence. In addition, it transfers all of the responsibilities of NCMHD to the new institute. This includes coordinating development of the NIH health disparities strategic plan and budget.

“We have created a strong foundation to address health disparities, and have made some progress, but we have unfinished business. We have to reexamine our strategy and accelerate the pace through innovative, sustainable and results-oriented approaches.”

“I want to congratulate [NIMHD director] Dr. [John] Ruffin and his staff on the center becoming an institute,” said NIH director Dr. Francis Collins. “This change by Congress reflects the importance of studying the issue of health disparities with an even greater intensity. We need to learn much more about what causes disparities— including the role of society, the environment, genes and socioeconomics—and to find effective ways of overcoming or changing them. Our discoveries should translate into health benefits for everyone.”

Ruffin has been the driving force, since 1990, behind NIH efforts to address minority health and health disparities in a coordinated way. He joined NIH as associate director for minority programs, overseeing the Office of Minority Programs in the Office of the NIH Director. The office transitioned to the Office of Research on Minority Health through the NIH Revitalization Act of 1993, and to NCMHD as a result of the Minority Health and Health Disparities Research and Education Act of 2000.

“We have created a strong foundation to address health disparities, and have made some progress, but we have unfinished business,” said Ruffin. “We have to reexamine our strategy and accelerate the pace through innovative, sustainable and results-oriented approaches.”

In spite of having a budget of approximately $211 million and a current staff of 35, NIMHD has been successful due to a tradition of collaboration and partnerships. It has worked with all of the ICs since its days as an office, as well as other federal agencies across HHS and beyond to support hundreds of research, training, research infrastructure and outreach projects.

“We will strengthen our partnership base and build upon lessons learned to establish an integrated research enterprise to address the complexity of health disparities,” Ruffin said.

NIMHD funding has been vital to the work being done by other ICs to address minority health and health disparities including NHLBI’s Jackson Heart Study, NIEHS’s Sister Study, NIAMS’s Osteoarthritis Initiative, NIDCR’s Oral Health Disparities Research Centers, NIGMS’s Bridges to the Future program, NIA’s Research Centers on Minority Aging Research and NIDDK’s ASSK Study.

Through its own programs, NIMHD’s reach stretches across all 50 states and beyond U.S. borders to more than 50 countries where undergraduate and graduate students participate in research training each year and U.S. territories where ongoing multidisciplinary research is taking place.

NIMHD, through its predecessor NCMHD, has supported the training of more than 2,000 health professionals in 49 states through loan repayment awards; funded more than 88 Centers of Excellence around the nation to conduct research on health disparities; assisted academic institutions in developing their capacity to conduct research with an emphasis on health disparities; introduced community-based participatory research to the scientific community as a viable approach to studying health disparities and engaged the community’s involvement in all aspects of research.

NCMHD organized and sponsored the NIH Science of Eliminating Health Disparities summit in 2008 to review the state of health disparities research. In 2009, it launched its Intramural Research Program and its career transition award program, which aims to retain its loan repayment program recipients in health disparities research and prepare them to become independent investigators. Recent initiatives on the social determinants of health, faith-based approaches to health disparities, bioethics research infrastructure and comparative effectiveness research point to the new institute’s readiness to confront fresh challenges.