News Around NIDDK
Bridging the gap: NIDDK’s ongoing efforts towards greater diversity, equity, and inclusion
By Lisa Yuan
NIDDK has been committed to advancing workforce diversity and health equity for decades, but the events of 2020 illuminated the stark reality that much more work remains. The disparate burden of COVID-19 on minority populations and the repeated incidents of racial injustice led many across the country, including NIDDK leadership and staff, to grapple with tough questions about how we got to this point and where we will go from here.
“These events triggered deep soul searching about the structural racism that continues to deny justice and equal opportunity for all,” said Dr. Gregory Germino, NIDDK deputy director. “This is not just a civil rights issue for the streets of America. It’s also a health and workforce problem with important implications for NIDDK, where so many of the diseases in our mission disproportionately affect people from racial and ethnic minority groups.”
Germino and NIDDK Executive Officer Camille Hoover, at the direction of NIDDK Director Dr. Griffin P. Rodgers, have led the charge in developing a framework aimed to propel the Institute on a bolder path forward towards dismantling health and workplace inequities. Part of this framework involves engaging the NIDDK Advisory Council, which is made up of experts from the scientific and lay communities that represent NIDDK research areas, in collaborative, ongoing dialogue to dissect the constructs causing these inequities and turn this dialogue into actionable strategies.
The discussions kicked off at the September 2020 Council meeting, with a session centered on diversifying the scientific workforce. Staff from NIDDK’s Office of Minority Health Research Coordination presented data showing that, despite NIDDK’s success over 40 years in strengthening the pipeline of talented and diverse scientists, underrepresented minority researchers are still much less likely to be hired into faculty positions and to receive grant funding.
In January, the discussion continued, this time focusing on health disparities and NIDDK’s efforts in this underrepresented scientific area. Though NIDDK has made great strides in understanding the biological mechanisms of disease, the COVID-19 pandemic has shone a glaring light on the environmental, social, and economic factors that powerfully contribute to health disparities. These factors, known as the social determinants of health, are often created and sustained by structural racism.
“We each have different resources available that determine what happens to us beyond our biology, such as how much access we have to healthy foods, safe places to exercise, as well as quality education, employment, and health care,” said Dr. Pamela Thornton, NIDDK program director of health equity and type 2 diabetes research. “These social determinants help explain why we see health disparities so pervasively despite tremendous scientific advances.”
To help ensure that future research efforts address the full breadth of factors contributing to health disparities, NIDDK has initiated the establishment of an Advisory Council working group to develop an implementation plan for health equity research. This group will advise NIDDK leadership on how to integrate this line of research into the Institute’s core research program.
Other change-making initiatives include prioritizing diversity and equity as part of NIDDK’s five-year Strategic Plan, currently in development. In addition, a recently established NIDDK Civility, Diversity, and Inclusion steering committee will use feedback from staff to guide the Institute towards creating a more inclusive, culturally responsive workplace – one where all employees, regardless of their background, feel that they belong and have opportunities to excel. NIDDK will also join NIH-wide efforts to end structural racism in biomedical research, including the recently announced UNITE initiative.
These initiatives will be highlighted in greater detail in future issues of the NIDDK Director’s Update, which will chronicle more of the Institute’s diversity and inclusion efforts as they progress. NIDDK leadership envisions these efforts to be ongoing and evolving.
“I’m encouraged and optimistic about what lies ahead,” Rodgers said. “The events of the past year have inspired us to wrestle with our past, reflect on the present, and most importantly, reconfirm our commitment to building a future where all people have equal opportunities for good health and where our health workforce fully represents the rich and diverse tapestry of our nation.”
Statement from NIDDK Director Dr. Griffin P. Rodgers
NIDDK is committed to creating a culture of civility, diversity, equity, and inclusion. I join Dr. Francis Collins in his goal to end structural racism in biomedical research and support the important NIH efforts launched under his leadership, including the recently announced NIH-wide UNITE initiative. NIDDK’s response to this significant issue has also been robust, including developing strategies to address research questions linked to health care disparities and health inequities within our mission. We are also creating a framework to increase diversity within the NIDDK Intramural Research Program and our extramural workforce. In conjunction with these efforts, a newly established NIDDK Civility, Diversity, and Inclusion Steering Committee is advising the Institute on best practices for building a diverse, inclusive, and respectful 21st century workforce to continue to advance our research mission and to achieve health equity for all. Because, to echo Dr. Collins’ words, together we’re stronger.
Getting to Know: Dr. Frank Hamilton
Dr. Frank Hamilton is a program director in NIDDK’s Division of Digestive Diseases and Nutrition, overseeing a program on digestive diseases clinical research and epidemiology and clinical neurogastroenterology studies. Hamilton spoke with Heather Martin about his career in public service, his most memorable accomplishments, and the power of mentoring.
You’ve been in public service for your entire career, first in the US Public Health Service (USPHS) and then at NIDDK. What inspired your service?
My senior year of medical school at Howard University, the late Dr. Hildrus Poindexter encouraged me to apply for to the USPHS Commissioned Corps to fulfill my military obligation. Dr. Poindexter was the first African American physician in USPHS who practiced tropical medicine in the late 1940-60s. He stressed to me and other students in public health that we could make a difference in health care by working within the USPHS. I’ve served 31 years in the commissioned corps and 19 years of civil service.
How has your work at NIDDK made a difference?
I had the opportunity to be a planning chairperson of several consensus conferences in collaboration with the NIH Office of Prevention that changed healthcare delivery and education in gastroenterology.
For instance, a conference on Helicobacter pylori and ulcer disease revolutionized how peptic ulcers are treated. In the early 1990s, there was skepticism that H. pylori had any impact on ulcer disease. The evidence presented at this conference changed the landscape and showed that it was a cause, and in fact the third leading cause, of peptic ulcers. After that conference, people could be tested for H. pylori and treated.
Other conferences brought common conditions like fecal incontinence to the forefront. Before the conference and subsequent public awareness campaign, this condition wasn't discussed. It gave people an opportunity to talk with their physicians and other health care providers.
Could you share more about the National Medical Association (NMA) program with NIDDK and your involvement? What are the goals of the program?
Until the 1960s, African American physicians were not permitted to join the American Medical Association. The National Medical Association, founded in 1895, is the premier medical association for people of color. These disparities continue to persist. In 1996, a landmark whitepaper showed that faculty at U.S. medical schools were less than 3% African American, 2% Hispanic, and less than 1% Native American. As members of the NMA, Drs. Lawrence Agodoa, Griffin Rodgers and I, along with the NIDDK director at the time, Dr. Phillip Gorden, met with NMA leadership to find solutions to bridge the divide.
After that meeting, NIDDK launched the NIH/National Medical Association Travel Award, which includes an annual academic skills workshop in conjunction with the annual NMA scientific meeting. The workshop’s goal is to support physicians to pursue research careers and encourage research in disease areas that disproportionately impact the health of underserved communities.
After overseeing the program initially for several years, the administrative operations of the program were transferred to NIDDK’s Office of Minority Health Research Coordination (OMHRC) in 2004. OMHRC manages other NIDDK programs aimed at addressing the burden of diseases and disorders that disproportionately impact the health of minority populations. I have continued to work closely with OMHRC on this program.
What have you found most rewarding in your work in this area?
The most rewarding aspect of my involvement with NIH/NMA program has been to see recipients of the travel award program launch their careers in academic medicine throughout the country. Close to 500 awardees have benefitted and gone on to develop academic careers and become division directors, academic department heads and more. Also, as a DDN program director, it has been rewarding to advise applicants who have applied to the NIDDK administrative supplement program for underrepresented scientists about research opportunities.
What advice would you give to people in school or just beginning their careers?
The advice I would give anyone starting their career is to take advantage of all the training opportunities that you can find. Ask questions, and when in doubt ask more questions. Be persistent and have a written roadmap of your career goals and take a periodic inventory of your goals.
Find a mentor, both a professional and life mentor, who will provide open and honest insights on how to achieve your career goals. Also be open in selecting a mentor, the best mentor may not always look like you. If someone is willing to help, take advantage of the helping hand because it makes a big difference in your career path.
NIDDK staff guide key COVID-19 research and serve on pandemic frontlines
NIDDK staff continue to serve on the front lines of the COVID-19 pandemic, sustaining and expanding efforts to better understand COVID-19, including providing clinical care and leading and supporting important research efforts.
Volunteers from NIDDK’s Phoenix Epidemiology and Clinical Research Branch in Arizona have been providing clinical care to people with COVID-19 at the Phoenix Indian Medical Center. In addition, several NIDDK staff, who also serve as Public Health Officers in the Commissioned Corps of the U.S. Public Health Service (USPHS), have been deployed across the country, providing patient care, coordinating testing sites, and guiding healthcare facilities in underserved areas.
Many NIH investigators are studying COVID-19 and how it directly affects people with diseases in our mission. Their recently published studies include:
- Hydrating the respiratory tract: An alternative Explanation why masks lower severity of COVID-19 disease
- Immune transcriptomes of highly exposed SARS-CoV-2 asymptomatic seropositive versus seronegative individuals from the Ischgl community
- Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring
In addition to research being conducted on campus, NIDDK continues to support extramural COVID-19-related research. Recently published studies include:
- Implementation science to address health disparities during the coronavirus pandemic
- Multicenter analysis of liver injury patterns and mortality in COVID-19
- Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital
- Potentials of interferons and hydroxychloroquine for the prophylaxis and early treatment of COVID-19
With input from NIDDK, NIH published Research Opportunity Announcements as part of the Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) initiative. This opportunity aims to advance our understanding of post-infection recovery processes and help prevent and treat PASC, often called “long-haul COVID.”
In addition, NIDDK continues to participate in NIH’s Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative to speed research addressing the disproportionate burden of COVID-19 on underserved or vulnerable populations. (Editors’ note: Read more about NIDDK’s role in RADx-UP in the News Around NIDDK section.)
For additional excerpts of NIDDK’s COVID-19-related work, see previous NIDDK Director’s Update articles:
- NIDDK continues to support COVID-19 efforts
- NIDDK tackles COVID-19 through research, funding, and clinical care
- NIDDK brings scientific expertise to the fight against COVID-19
For more information on NIDDK’s response to COVID-19 and links to grant information and publications, visit the NIDDK COVID-19 Research Response page. To subscribe to NIH’s updates on COVID-19, visit www.nih.gov/health-information/coronavirus.
For more information on COVID-19, visit the Centers for Disease Control and Prevention (CDC) coronavirus webpage.
NIDDK publishes 2021 annual report
The NIDDK’s annual report for 2021 is now available. NIDDK Recent Advances and Emerging Opportunities highlights examples of NIDDK-funded research advances from fiscal year 2020 and includes special features such as those describing NIDDK’s efforts to combat COVID-19 and achieve health equity.
The report also contains “Stories of Discovery” that trace research progress over time and “Personal Perspectives” of people who have participated in NIDDK-sponsored clinical research.
The report concludes with a section on funding trends that illustrate the NIDDK’s commitment to its guiding principles, including a link to NIDDK’s online funding trend data.
NIDDK’s Office of Scientific Program and Policy Analysis leads the production of this report with input from the Institute’s extramural divisions and offices and the Division of Intramural Research.
NIDDK fellows envision and implement new learning initiative
NIDDK fellows continue to find innovative ways to enhance their training experience at NIH, despite the challenging circumstances of the current pandemic. With the support of NIDDK leadership, a group of intramural fellows created a virtual seminar series called “Trainees Recognizing Excellence and Diversity in Science,” or TREaDS, featuring presentations and discussions with leading scientists from underrepresented groups around the country.
“Our fellows contribute hugely to the rich and diverse community at NIDDK,” said Dr. Peggy Hsieh, director of the NIDDK Fellowship Office. “They drive research and discovery and are on the frontlines of clinical care. They represent the next generation of leaders, and we are proud of their accomplishments.”
Fellows make up a large and crucial part of the research staff at NIDDK. Principal investigators typically mentor three or four fellows each, working with them to shape the direction of research. The creation of TREaDS adds diversity to fellows’ experiences at NIH by introducing them to distinguished scientists from various fields and backgrounds outside NIH and expanding their scientific networks.
Seminars cover a wide range of topics, from obesity prevention among minorities to protein signaling mechanisms, and are presented by top researchers in their fields.
“This new initiative affords fellows the opportunity to learn about cutting-edge science and to network with role models via small group discussion,” said Dr. Valerie Darcey, postdoctoral fellow in NIDDK’s Laboratory of Biological Modeling and a driver of TREaDS.
“We are grateful to have the leadership and resources to start programs that enhance our fellowship experience,” added Dr. John Jimah, postdoctoral fellow in NIDDK’s Laboratory of Molecular Biology, and another founder of TREaDS.
The TREaDS initiative was also led by NIDDK fellows Melissa Arroyo-Mendoza, Joshua Dawson, and Ashley Pitt, with support from NIDDK Deputy Scientific Director Dr. Susan Buchanan, NIDDK Program Specialist Nicole Ray, and Hsieh.
Diabetes in America now available on NLM Bookshelf
The 3rd Edition Diabetes in America report is now available on the National Center for Biotechnology Information (NCBI) Bookshelf. In partnership with the National Library of Medicine, NIDDK has provided further access to this free, comprehensive resource for the entire research community.
Other resources related to Diabetes in America can still be found on NIDDK’s website.
For insulin’s 100th anniversary, NIDDK and Canadian counterpart host virtual symposium
To commemorate the 100th anniversary of the discovery of insulin, NIDDK and its Canadian counterpart, the Institute of Diabetes, Metabolism, and Nutrition of the Canadian Institutes of Health Research, will host a joint virtual symposium on June 2-3. This Symposium will bring together research leaders in both countries to tackle the challenges and opportunities presented by investigation of heterogeneity of diabetes and to inform on next steps for research in this area. The symposium will include in depth sessions on pancreatic biology, clinical phenotyping of diabetes and perspectives on the future of precision medicine in diabetes.
For updates about the symposium and to follow NIDDK’s tributes to the milestone, check out @NIDDKgov on Facebook, Twitter, and Instagram.
Office of Nutrition Research transfers to NIH Office of the Director
In January the Office of Nutrition Research (ONR) moved from NIDDK to the Division of Program Coordination, Planning, and Strategic Initiatives, located in the NIH Office of the Director.
The move aims to elevate ONR’s visibility and nutrition research initiatives while increasing the office’s ability to coordinate and lead NIH-wide efforts to implement the 2020-2030 Strategic Plan for NIH Nutrition Research. In addition, a large cohort study—designed to advance the strategic plan’s overarching goal of answering key questions about precision nutrition —is being developed by the NIH Common Fund and All of Us Program.
Given the crosscutting nature of nutrition and research on it, NIDDK and other institutes and centers across NIH will continue to fund nutrition research independently. The move does not transfer existing NIDDK nutrition grant programs to the new office, but rather will open up new cross-cutting research programs and funding opportunities.
“NIDDK supports the Office of Nutrition Research transfer and we look forward to working with ONR staff in their new home,” said NIDDK Director Dr. Griffin P. Rodgers. “NIDDK will continue to support a robust nutrition research portfolio as part of its efforts to address the many common, chronic and costly conditions in its mission.”
NIDDK director discusses his life and career in ‘Giant’ interview
NIDDK Director Dr. Griffin P. Rodgers was featured in “Conversations with Giants in Medicine,” a video series from The Journal of Clinical Investigation (JCI). During the in-depth interview with JCI Editor-at-large Dr. Ushma Neill, Rodgers discussed his upbringing, education, and scientific accomplishments, including his research that led to the first FDA-approved treatment for sickle cell anemia. He also shared why, even after more than 30 years at NIDDK, he continues to find joy and excitement in his work.
“If you’re a researcher or an administrator of that research… you potentially have a mark on millions, perhaps tens of millions of people, worldwide,” Rodgers said. “When you're doing what you truly love and you actually get paid for it, you can't ask for anything better.”
Speeding up COVID-19 testing innovation with RADx
Early in the coronavirus pandemic, it became clear that, while underrepresented populations and communities of color were facing disproportionate disease burden, they were also disproportionately facing barriers in getting tested for COVID-19. To address these disparities, NIH launched the Rapid Acceleration of Diagnostics, or RADx, initiative, which fast-tracked nationwide efforts to develop and implement innovative COVID-19 testing technologies.
As part of that initiative, NIDDK currently supports two projects in the RADx-Underserved Populations (RADx-UP) program, aimed at bolstering access to COVID-19 testing among underserved and/or vulnerable populations in the U.S. who are disproportionately affected by the disease.
Key to the RADx-UP effort are the close ties between the NIDDK-supported institutions and their partners from local and community organizations, governments, health systems, as well as church and civic leaders, according to NIDDK’s Pamela Thornton, Ph.D., program director in NIDDK’s Division of Diabetes, Endocrinology, and Metabolic Diseases.
“Building local capacity and removing barriers to COVID testing, education, and treatment in underserved communities through trusted partnerships and culturally appropriate programs is an important step in fighting this pandemic,” said Thornton. “Ultimately, the goal is to understand the patterns of testing in the community to develop strategies that will eliminate testing disparities and reduce the burden of disease.”
NIH’s website about RADx-UP initiatives will be updated as new programs are funded.
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