Health Disparities
The Institute for Health Research conducts studies to identify health disparities and interventions to reduce them for Kaiser Permanente members and the broader community in several areas of prevention and chronic disease treatment. The Centers for Disease Control and Prevention (CDC) defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations”.
Ongoing studies include:
- Multiple studies to improve the identification of disparities in basic resource needs such as housing, food, and transportation among Kaiser Permanente members and develop strategies to help members address those needs
- An NIH-funded study to examine the social determinants of drug use risk behavior and overdose
- A systematic review of research on disparities in opioid use disorder treatment access, retention, and outcomes
- A study examining the risk of opioid overdose among people with a felony conviction
Health Disparities Researchers
Featured Projects
Investigators: Stacie L. Daugherty, MD, MSPH and Ingrid A. Binswanger, MD, MPH, MS
The goal of the SCHARP study is to learn about structural conditions, such as policies, practices, and attitudes that affect the health of people who have been released from prison. We will measure organizational structural conditions in diverse healthcare systems, link exposure to structural conditions to care access and health outcomes among a cohort of people released from prison. We will examine outcomes according to baseline cardiovascular risk and disseminate recommended organizational practices for improving access and outcomes.
Funder: National Heart, Lung, and Blood Institute, NIH
Study End Date: 06/30/2027
The goal of the SCHARP study is to learn about structural conditions, such as policies, practices, and attitudes that affect the health of people who have been released from prison. We will measure organizational structural conditions in diverse healthcare systems, link exposure to structural conditions to care access and health outcomes among a cohort of people released from prison. We will examine outcomes according to baseline cardiovascular risk and disseminate recommended organizational practices for improving access and outcomes.
Funder: National Heart, Lung, and Blood Institute, NIH
Study End Date: 06/30/2027
Investigators: Morgan Clennin, PhD, MPH and Stacie L. Daugherty, MD, MSPH
Elevated blood pressure (BP) is the most prevalent risk factor for cardiovascular disease. The proposed research will leverage KP cohort data to address the following specific aims: 1) determine the extent to which structural conditions contributes to racial and ethnic disparities in BP; and 2) determine the extent to which cumulative neighborhood inequalities influence the relationship between structural racism and BP disparities. A better understanding of the root causes driving BP disparities will help identify ways to develop targeted clinic-based strategies and community-level interventions. This Career Development Award will provide the candidate, Dr. Morgan Clennin, with the opportunity to augment her expertise in neighborhood environment assessment and social epidemiology with new training in (1) decomposition modeling to understand how multilevel SR influence BP outcomes; and (2) time-varying spatial modeling to account for cumulative neighborhood exposures.
Funder: American Heart Association
Study End Date: 03/31/2025
Elevated blood pressure (BP) is the most prevalent risk factor for cardiovascular disease. The proposed research will leverage KP cohort data to address the following specific aims: 1) determine the extent to which structural conditions contributes to racial and ethnic disparities in BP; and 2) determine the extent to which cumulative neighborhood inequalities influence the relationship between structural racism and BP disparities. A better understanding of the root causes driving BP disparities will help identify ways to develop targeted clinic-based strategies and community-level interventions. This Career Development Award will provide the candidate, Dr. Morgan Clennin, with the opportunity to augment her expertise in neighborhood environment assessment and social epidemiology with new training in (1) decomposition modeling to understand how multilevel SR influence BP outcomes; and (2) time-varying spatial modeling to account for cumulative neighborhood exposures.
Funder: American Heart Association
Study End Date: 03/31/2025
Investigators: Morgan Clennin, PhD, MPH and Sheridan Green, PhD, MS
Funder: Colorado Department of Public Health & Environment, Office of Health Equity
Study End Date: 06/30/2025
- The CDPHE Office of Health Equity funds two separate grant programs under the Health Disparity and Community Grant Program (HDCGP, two programs under a single contract)
- The first grant program funded 14 lead agencies with multi-sector partnerships to implement evidence-based strategies to overcome health disparities in the prevention, early detection, and treatment of cancer, cardiovascular and pulmonary diseases in underrepresented populations by working on systems and policy changes that are community led. Community organizations were funded by the Health Disparities and Community Grant Program (Amendment 35). The goal of this evaluation was to conduct a comprehensive evaluation to assess 1) how the grant program built community power through authentic community engagement, capacity building, and establishing strategic and diverse partnerships; 2) the extent to which improved community power advanced progress towards policy, system, and environmental (PSE) changes to improve social infrastructure (e.g., housing insecurity, food insecurity, unemployment); and 3) the impact of achieved PSE changes on access to upstream social and economic resources (that will eventually lead to improved health outcomes and reduced health inequities and disparities).
- The second grant program provided funding to 30 community and grassroots organizations to develop local plans and capacity toward achieving health equity. Goal is to create a foundation to improve social infrastructure and health outcomes that eventually lead to the reduction of health inequities and disparities. Funds are explicitly intended for projects that create and/or launch a foundation for making changes to public, systems-level, and/or organizational practices, rules, laws, and regulations that influence the health of underrepresented communities. Using the power ecosystem framework, the goal of this project is to conduct a comprehensive evaluation to document how grantees’ build community power and resilience; develop community-led, collaborative solutions that contribute to systemic change; and shift power in communities.
Funder: Colorado Department of Public Health & Environment, Office of Health Equity
Study End Date: 06/30/2025
Investigator: Stacie L. Daugherty, MD, MSPH
The study aims to address patients’ communication challenges (barriers) in the primary care setting (use of services) by comparing two interventions for increasing providers’ use of communication strategies (mediators: providers’ communication skills) among patients with communications disorders.
Funder: Patient-Centered Outcomes Research Institute
Study End Date: 06/30/2023
The study aims to address patients’ communication challenges (barriers) in the primary care setting (use of services) by comparing two interventions for increasing providers’ use of communication strategies (mediators: providers’ communication skills) among patients with communications disorders.
Funder: Patient-Centered Outcomes Research Institute
Study End Date: 06/30/2023
Investigator: Anh P. Nguyen, PhD
This study assesses health and healthcare disparities in opioid exposed populations across three health systems.
Funder: National Institute on Drug Abuse
Study End Date: 06/30/2023
This study assesses health and healthcare disparities in opioid exposed populations across three health systems.
Funder: National Institute on Drug Abuse
Study End Date: 06/30/2023
Investigators: Stacie L. Daugherty, MD, MSPH and John F. Steiner, MD, MPH
The aims of this project are (1) to compare the effects of a values-affirmation exercise with a control exercise on antihypertensive medication adherence in African American patients across three clinical settings; and (2) compare the effects of the values-affirmation exercise in African American patients with its effects in white patients with similar socioeconomic and clinical characteristics.
Funder: National Heart, Lung, and Blood Institute, National Institutes of Health
Study End Date: 05/31/2021
The aims of this project are (1) to compare the effects of a values-affirmation exercise with a control exercise on antihypertensive medication adherence in African American patients across three clinical settings; and (2) compare the effects of the values-affirmation exercise in African American patients with its effects in white patients with similar socioeconomic and clinical characteristics.
Funder: National Heart, Lung, and Blood Institute, National Institutes of Health
Study End Date: 05/31/2021
Investigator: Ingrid A. Binswanger, MD, MPH, MS
A project to improve the measurement of health indicators among people with criminal justice involvement.
Funder: U.S. Department of Justice
Study End Date: 07/01/2020
A project to improve the measurement of health indicators among people with criminal justice involvement.
Funder: U.S. Department of Justice
Study End Date: 07/01/2020
Investigator: John F. Steiner, MD, MPH
The goal of this project was to improve care for patients with hypertension at the First Nations Community HealthSource, an Urban Indian Health Organization in Albuquerque New Mexico. The study supported a randomized, controlled trial of interactive voice-response outreach to patients with hypertension, with the goal of improving blood pressure control through reducing missed clinic appointments and improving medication adherence.
Funder: American Heart Association
Study End Date: 06/30/2020
The goal of this project was to improve care for patients with hypertension at the First Nations Community HealthSource, an Urban Indian Health Organization in Albuquerque New Mexico. The study supported a randomized, controlled trial of interactive voice-response outreach to patients with hypertension, with the goal of improving blood pressure control through reducing missed clinic appointments and improving medication adherence.
Funder: American Heart Association
Study End Date: 06/30/2020
Investigators: Ingrid A. Binswanger, MD, MPH,MS, and Jason Glanz, PhD, and Anh Nguyen, PhD
The diversity supplement to the parent Naloxone trial aims to: 1) augment the parent trial database of EHR and survey data with social and environmental determinants of health 2) determine the predictive validity of risk behavior survey measures by examining associations between survey responses and measures of risk behavior from the EHR and 3) identify predictors of opioid risk behavior in trial eligible patients. It also supports post-doctoral training and career development of a research fellow.
Funder: National Institute on Drug Abuse
Study End Date: 2020
The diversity supplement to the parent Naloxone trial aims to: 1) augment the parent trial database of EHR and survey data with social and environmental determinants of health 2) determine the predictive validity of risk behavior survey measures by examining associations between survey responses and measures of risk behavior from the EHR and 3) identify predictors of opioid risk behavior in trial eligible patients. It also supports post-doctoral training and career development of a research fellow.
Funder: National Institute on Drug Abuse
Study End Date: 2020
Investigator: Ingrid A. Binswanger, MD, MPH,MS
This study explored ways to improve justice-involved veterans' access to and use of pharmacotherapy for opioid use disorder through qualitative interviews with veterans, VA justice outreach staff, criminal justice system staff, and VA and community health care providers who work with justice-involved veterans.
Funder: National Institute on Drug Abuse
Study End Date: 02/28/2020
This study explored ways to improve justice-involved veterans' access to and use of pharmacotherapy for opioid use disorder through qualitative interviews with veterans, VA justice outreach staff, criminal justice system staff, and VA and community health care providers who work with justice-involved veterans.
Funder: National Institute on Drug Abuse
Study End Date: 02/28/2020
Investigator: Stacie L. Daugherty, MD, MSPH
The overall goal of this project is to better understand the effects of discrimination on CVD risk, via allostatic load, in American Indians/ Alaska Natives (AI/AN). The three specific aims were to assess AI/AN individuals’ exposure to discrimination and examine associations with (1) an established panel of biomarkers of allostatic load, (2) physiological reactivity and recovery in a laboratory discrimination-challenge task, and (3) ambulatory BP during 24 hours of real-life experience sampling.
Funder: American Heart Association, Strategically Focused Research Network on Cardiovascular Disparities
Study End Date: 06/30/2019
The overall goal of this project is to better understand the effects of discrimination on CVD risk, via allostatic load, in American Indians/ Alaska Natives (AI/AN). The three specific aims were to assess AI/AN individuals’ exposure to discrimination and examine associations with (1) an established panel of biomarkers of allostatic load, (2) physiological reactivity and recovery in a laboratory discrimination-challenge task, and (3) ambulatory BP during 24 hours of real-life experience sampling.
Funder: American Heart Association, Strategically Focused Research Network on Cardiovascular Disparities
Study End Date: 06/30/2019
Investigator: Stacie L. Daugherty, MD, MSPH
This study conducted a randomized controlled trial testing values affirmation on improving adherence to medication in American Indian and White patients with hypertension.
Funder: American Heart Association, Strategically Focused Research Network on Cardiovascular Disparities
Study End Date: 06/30/2019
This study conducted a randomized controlled trial testing values affirmation on improving adherence to medication in American Indian and White patients with hypertension.
Funder: American Heart Association, Strategically Focused Research Network on Cardiovascular Disparities
Study End Date: 06/30/2019