Health Care

Leap Forward Research Challenge

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Leap Forward priority areas represent visionary science that aims to reshape the sciences of minority
health and health disparities. These leaps present bold progressive actions to improve minority health and
to reduce health disparities across relevant diseases, disorders, and conditions.

The Leap Forward priority areas represent one way the ICs will comply with the 21st Century Cures Act, as
described in Section 2031 of P.L. 114–255 (PDF, 989 KB),to promote collaborations of research
projects across
all NIH
ICs and Offices focused on reducing and/or eliminating health disparities.

Minority Health and Health Disparities Research

  • Promote research that reduces new HIV infections by 75 percent by 2030, especially in African American
    or Black, Hispanic or Latino, and SGM populations, which are disproportionately affected by HIV.
  • Promote research that increases viral suppression to 85 percent of persons with HIV from populations experiencing health disparities, especially African American or Black and Hispanic or Latino men who have sex with
    men and other SGM populations, by 2030.
  • Promote research that increases pharmacological curative treatment of hepatitis C infection among
    American Indian and Alaska Natives by 50 percent by 2030.
  • Foster research that uncovers contributors and develops interventions to reduce maternal mortality and
    severe maternal morbidity in the United States over the next 10 years in order to address the
    disparities between African American or Black and American Indian and Alaska Native women compared with
    White women.
  • Reduce racial and ethnic, socioeconomic, and/or geographic disparities in pre-term birth and infant
    mortality over the next 10 years.
  • Implement measures to increase diverse ancestral representation from African Americans or Blacks,
    Hispanics or Latinos, American Indians and Alaska Natives, and Pacific Islander populations in
    NIH-supported and analyzed genomic data sets, in order to approach proportional representation of the
    U.S. population by 2030.
  • Increase rates of colorectal cancer screening, follow-up, and referral-to-care among racial and ethnic
    minority populations, persons of less privileged SES, SGM populations, and underserved rural
    populations, to attain targeted national standards by 2030.
  • Increase access to medications for opioid use disorder among those incarcerated or recently released
    so that 75 percent of persons in all racial and ethnic subpopulations of the incarcerated or recently
    released persons are linked with such care by 2030.
  • Improve understanding of incidence patterns, symptoms, diagnosis, and disease trajectories for
    vascular cognitive impairment and dementia in racial and ethnic minority populations by 2030.
  • Bring curative genetic therapies for sickle cell disease (SCD) into first-in-human clinical trials
    within five years and increase the proportion of Medicaid and Medicare beneficiaries with SCD who
    receive disease-modifying therapies.
  • Support community-engaged, community-based implementation research to reduce cardiovascular health
    disparities, sustain adoption of evidence-based interventions, mitigate disparities in adoption of
    health behaviors, and promote enhanced characterization of social determinants of health to improve
    cardiovascular health and disease prevention across the lifespan and maximize impact on overall
    population health in five high-burden communities by 2030.
  • Build on global experiences to dramatically transform health care and clinical outcomes in rural and
    socioeconomically disadvantaged populations in the United States by engaging 25 percent of the training
    programs in certified biomedical engineering departments in the United States (approximately 30) by
    2030, to drive the development of recognized and active health care disparities technology development.
  • Support research to test at least three multilevel approaches to improve adoption of evidence-based
    asthma interventions in African American or Black, Hispanic or Latino (e.g., Puerto Rican), and
    socioeconomically disadvantaged communities with the goal of reducing asthma-specific emergency room
    visits, hospitalizations, and symptom days in these populations by 2030.
  • Support development of one synthetic or hybrid data set which conforms to FAIR (findable, accessible,
    interoperable, and reusable) open data principles and models racially and ethnically diverse communities
    in order to test methods and metrics and address possible biases due to underrepresentation of
    minorities and women within the next 10 years.
  • Define the rates of hearing impairment by race and ethnicity by 2030.
  • Support research that advances implementation of evidence-based interventions and tools for reducing
    untreated dental decay in racial and ethnic minority and low-income populations across the lifespan by
    10 percent to 25 percent by 2030, with the long-term potential for improved health for all communities.
  • Identify differences in factors that cause progression to end-stage renal disease (ESRD) and find
    informative subpopulations among African Americans or Blacks, Hispanics or Latinos, American Indians,
    Alaska Natives, Pacific Islanders, and Asians with chronic kidney disease by 2030.
  • Identify factors contributing to the disparity between Whites and African Americans or Blacks,
    Hispanics or Latinos, American Indian, Alaska Natives, Pacific Islanders, and Asians in control of HbA1c
    (glycated hemoglobin), and target those factors through rigorous clinical trials and adaptive
    population-based interventions by 2030.
  • Address the leading causes of morbidity and mortality in NIH-designated populations experiencing health disparities
    by 2030 by leveraging the network of Clinical and Translational Science Awards (CTSA) Program to (1)
    develop research into underlying factors related to clinical trial design and conduct to improve
    outcomes and/or reduce disparities, (2) demonstrate the effectiveness of delivering treatments that
    consider the health care context of a given minority or population experiencing health disparities(s), and (3) assess
    strategies for the pragmatic dissemination and uptake of these interventions into routine health care
    settings by 2030.
  • Identify mechanisms that account for marked differences in suicide rates across racial and ethnic
    groups and SGM populations, as well as develop and test strategies to improve suicide risk prevention
    and detection among population groups at risk within the next 10 years.
  • Develop and test innovative approaches to remediate barriers that contribute to documented inequities
    in access, engagement, and quality of mental health treatment and services, and/or the effectiveness and
    outcomes of evidence-based mental health interventions for populations experiencing health disparities by 2030.
  • Understand the underlying etiologic pathways for the higher rates of systemic lupus among African
    American women and Latinas compared to White women by 2030.
  • Assess the efficacy of interventions to reduce disparities between racial and ethnic minority
    populations and Whites in access to and use of existing surgical and nonsurgical interventions for
    osteoarthritis by 2030.
  • Characterize and understand how adverse environmental exposure profiles that occur during early life
    stages may enhance vulnerability to diseases of adulthood disproportionately in populations experiencing health disparities.
  • Understand the acute and long-term health impacts of natural and human-made disasters on less
    privileged SES and minority populations and the health care systems serving them. In addition,
    understand the individual, community, and health care system response prevention factors to improve the
    acute and long-term health, well-being, and resiliency of those affected.
  • Assess differences and similarities in wellness and disease prevention behaviors given the
    intersectionality of race and ethnicity, geographic area, SGM populations, and SES by 2030.
  • Understand the underlying etiologic pathways that help explain the higher rates of glaucoma among
    African Americans or Blacks compared with Whites by 2030.
  • Within the next 5 years, synthesize the latest evidence regarding the immigrant paradox in health
    outcomes to better define protective factors, such as resilience or social support; differentiate the
    protective factor profiles of various immigrant groups; and/or determine the extent to which
    methodological, measurement, or sampling artifacts explain the paradox.
  • By the year 2030, conduct research to examine the impact of laws, policies, and structural
    determinants of health on defined health disparities with emphasis on non-health societal sectors, such
    as transportation, housing, communications, water and energy providers, agriculture, land use, public
    safety, education, and criminal justice.
  • Support research to document and understand occupational health disparities as determined by the type
    of employment and work conditions (e.g., safety, work shifts, paid leave, health insurance and other
    benefits) controlling for race and ethnicity, SGM populations, SES, and geographic residence by 2030.
  • Over the next 5 years, support research to examine the effectiveness, financing, and sustainability of
    programs using community health workers, patient care coordinators, and other peers to deliver
    prevention and self-management interventions to reduce disparities.
  • By the year 2030, support research to achieve health equity in the use of recommended preventive
    services that target three leading causes of death in the United States—cancer, heart disease, and
    diabetes—through culturally derived and community-engaged interventions that include multiple clinical
    and community settings.
  • Promote research examining the role of the built environment and its interactions with multiple
    individual behavioral, biological, and cultural factors as well as health care systems that promote
    health equity in screening, early diagnosis, treatment and self-management, and prevention of
    complications of chronic diseases in the clinical setting across the next 5 years.
  • Support experimental research using simulations to understand potential bias in peer review of
    minority health and health disparity-related applications due to characteristics of applications or of
    reviewers by 2030.
  • Identify evidence-based interventions to prevent and reduce alcohol misuse, including underage and
    excessive alcohol use, among populations experiencing health disparities.
  • Over the next five years, support research that examines health information technology and its impact
    on minority health and populations experiencing health disparities access to care, quality of care, and overall health
    outcomes.

Research-Sustaining Goals

  • Increase the overall proportion of participants from diverse populations included in NIH-funded
    clinical research to 40 percent by 2030 and within specific major disease categories.
  • Increase the diversity of institutions conducting genomic research and training by investing in
    faculty at such institutions, along with curriculum-building partnerships, to accelerate workforce
    development in underrepresented and under-resourced communities within the next 10 years.
  • By 2030, promote research collaborations between U.S. and Latin American scientists addressing
    prevention of childhood obesity and diabetes in U.S. Latinos and in Latin America.
  • Increase training opportunities for students from populations experiencing health disparities, including
    underrepresented groups, to learn about health equity and biomedical research in low- and middle-income
    countries.
  • Increase our understanding of cancer trends and outcomes in the context of disparities and
    subpopulations through the expansion of the Surveillance, Epidemiology, and End Results program to
    include 50 percent of the population by 2030.
  • Increase the number of underrepresented biomedical scientists as defined by the National Science
    Foundation from current levels by 25 percent by 2030.
  • Cultivate a cadre of biomedical and behavioral investigators trained in implementation research who
    are fully prepared to bridge NIH mission areas in both clinical and nonclinical, real-world settings by
    increasing (a) the number of investigators overall and (b) the number of investigators from
    underrepresented backgrounds with requisite skills by 25 percent by 2030.
  • Develop a toolbox of consensus common data elements (CDEs) on sociodemographic characteristics,
    population descriptors, and social determinants of health, and require use of CDEs in future Funding
    Opportunity Announcements (FOAs) by 2030.
  • Develop a new program to enable investigators who have participated in diversity-enhancing programs
    sponsored by NIH to recognize and apply for continuing educational opportunities, such as the Ruth L.
    Kirschstein National Research Service Award (NRSA) and institutional training awards for predoctoral or
    postdoctoral training positions, K99-R00, and other training grant opportunities.
  • Support individual-level programs to train individuals from populations experiencing health disparities, including
    those that are underrepresented in the biomedical sciences.

Page updated Jan. 12, 2024

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