NIDA has developed a Health Disparities Initiative that will help uncover the reasons why minority populations incur serious health and social problems related to drug abuse at far higher rates than White abusers. African Americans and Hispanics represent roughly 11 percent and 12 percent, respectively, of the U.S. population and similar proportions of the drug-abusing population. Yet African Americans account for 50 percent and Hispanics 23 percent of injecting drug users diagnosed with HIV. Minority drug abusers also have disproportionately elevated rates of other illnesses—hepatitis B and C and tuberculosis, for example—that result from injection drug abuse. And African American cocaine abusers develop more severe drug-related cardiovascular disease than do White cocaine abusers.

The disproportionate representation of African Americans in the criminal justice system as a consequence of drug abuse is another important disparity. The U.S. prison population nearly doubled between 1990 and 2000, and research suggests that about 75 percent of the increase is drug related. African American males, who are nearly 8 times more likely to be incarcerated than White males, make up roughly 42 percent of the male prison population. African Americans constitute 45 percent of the female prison population, and female offenders are twice as likely as male offenders to be infected with HIV.

As part of its Health Disparities Initiative, NIDA recently announced an opportunity for supplemental research support for NIDA-funded scientists to investigate the reasons for minority involvement in drug abuse and criminal activity, and the impact of imprisonment and criminal justice supervision on drug use, continued criminal behavior, and HIV risk. Other projects supported through the Initiative will strengthen the institutional infrastructure for conducting research within minority populations, provide the scientific foundation for improved prevention and treatment for racial and ethnic groups at highest risk for drug abuse, and disseminate information about health disparities to the research community, minority populations, and the public.

Build Research Capacity. To conduct scientifically valid research into health disparities we need well-trained minority scientists in the research infrastructure. Our Initiative will continue support of the NIDA Intramural Research Program's Minority Recruitment and Training Program, and our Research Supplements for Underrepresented Minorities. NIDA will also continue support for programs such as the National Hispanic Research Network, which conducts workshops, conferences, and other programs that foster the development of Hispanic scientists.

Focus the Research Agenda. Over the next 5 years, the Initiative will support research that adds depth and detail to our picture of drug abuse and its consequences in racial and ethnic minority populations. This effort will help epidemiologists sample and provide statistically accurate descriptions of hard-to-reach populations such as Pacific Islanders, Native Americans, and Hispanic subgroups such as Mexicans and Puerto Ricans. We also will support research in the science behind different responses to drugs and drug abuse in specific populations. Does the high preference for menthol cigarettes among African American compared with White male smokers contribute to their 40 percent higher death rate from lung cancer or poorer (35 percent v. 50 percent) success rate when they try to quit smoking? If biologically based differences lead to such disparities, they might also suggest a path to the discovery of new treatments, including tailored medication or prevention strategies. The Initiative will assure that minority populations are fully represented in treatment research. NIDA's Clinical Trials Network will include minority groups in the development of its protocols for evaluating pharmacological and behavioral treatments for addiction and abuse.

Disseminate Research Information. NIDA understands the importance of making research results available to the widest possible audience. We currently produce Spanish language versions of NIDA's science-based treatment and prevention information and, under the new Initiative, NIDA will intensify efforts to engage community leaders, educators, and service providers in helping to identify mechanisms for further dissemination. Communication with minority groups will range from simple translation of published information, to convening national conferences on drug abuse, to addiction research that focuses on minority populations.

NIDA's Health Disparities Initiative will bring us closer to the goal of effective prevention and treatment for everyone at risk of drug abuse, regardless of race, ethnicity, or socioeconomic status.

Volume 19, Number 6 (May 2005)