# Presentation: 488641

## NIAMS Health Partnership Program

- Reducing health disparities in arthritis and other rheumatic diseases
- U.S. Department of Health and Human Services
- National Institutes of Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Reviewed November 22, 2006

## National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

- A Federal agency that is part of the National Institutes of Health under the U.S. Department of Health and Human Services
- Responsible for basic and clinical research, training, and education about arthritis and diseases of bones, muscles, joints, and skin

## Arthritis and Other Rheumatic Diseases

- Rheumatic diseases involve the muscles, joints, and bones.  Many rheumatic diseases can cause arthritis.  Arthritis literally means joint inflammation.  Joints are places in the body where two bones meet.
- Many rheumatic diseases cause inflammation of joints and also muscles, bones, and other supporting structures, such as tendons and ligaments.  Rheumatic diseases can cause loss of function of these structures, may involve internal organs as well, and can be chronic.
- There are over 100 rheumatic diseases. Many people use the words “arthritis” and “rheumatism” to refer to all rheumatic diseases.

## Health Disparities in Arthritis and Other Rheumatic Diseases

- Health disparities exist among specific racial and ethic populations in the U.S., with higher rates of illness and death.
- The risk of osteoarthritis is higher among some minority women.
**osteoarthritis** occurs when the joint tissue wears away, causing bone-on-bone friction which leads to pain, stiffness, and decreased range of motion
- Lupus is more common and severe in some minority women.
**lupus **occurs** **when the immune cells go awry and attack healthy cells, inhibiting normal body functions in the organs and joints affected

**Notes:**
Osteoarthritis is the most common form of arthritis.  It affects cartilage, the tissue that cushions the end of the bones within the joints.  Osteoarthritis occurs when cartilage wears away, leaving a bone-on-bone joint.  Obesity is associated with knee and hip osteoarthritis, and it is more a risk factor for knee osteoarthritis in African Americans than in Caucasians.

Lupus, an autoimmune disease in which the body attacks its own healthy cells and tissue, can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.  It is three times more common in African American women than in Caucasian women, and it is also more common in women of Hispanic/Latino, Asian, and Native American descent.  Overall, nine times more women than men have lupus.  

## NIAMS Established the HPP to Address Health Disparities

- The Health Partnership Program (HPP) provides
- researchers the opportunity to:
- increase understanding of health disparities in rheumatic diseases
- provide health care to the community
- increase participation of minorities in research studies
- increase the number of underrepresented biomedical researchers
- train NIAMS medical residents to care for patients from minority communities.

**Notes:**
Health disparities are defined by the NIH as differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. Research on health disparities related to socioeconomic status is also encompassed in the definition. 

## NIAMS HPP Overview

- 	The Health Partnership Program, HPP, is a community-based research initiative initially established in the Washington, DC metro area with a focus on the African American and Hispanic/Latino communities.
- A mural in the Cardozo/Shaw neighborhood painted by participants at the 2001 Summer Youth Program sponsored by the Latin American Youth Center, an HPP partner since 2000.

## NIAMS HPP Overview (continued)

- The HPP was created:
-  to enhance scientific understanding of disparities in rheumatic diseases and their causes among minority populations
-  to provide direction for improving the health status and health outcomes of the minority communities affected.

## NIAMS HPP Overview (continued)

- The HPP responds to the Healthy People 2010 Initiative coordinated by the U.S. Department of Health and Human Services.

## NIAMS HPP Community Partners’ Purpose

- To provide insight on the community’s needs and concerns about arthritis care and research
- To share resources that enable the HPP to operate effectively in the community
- Some community partners and staff attending the 2004 Partnership Meeting and Recognition Ceremony.

## NIAMS HPP Community Partners’ Roles

- To provide advice for the program’s plans and activities
- To support the program’s goals and objectives
- To promote the program to communities in the Washington, DC area

## NIAMS HPP Community Partners

- 	The partnership includes, but is not limited to:
- local government agencies
- educational institutions
- community and faith-based groups
- health care, professional, and voluntary organizations
- residents
- Vehicles for communications include:
- meetings
- newsletters
- HPP Web page
- phone and e-mail

_**Health Disparities Research**_

_**Community Relations**_

_**Recruitment to Research Careers**_

- Community

- Community

- NIAMS HPP Five Program Areas

## NIAMS HPP Five Program Areas

**Public Health Education**
- 	Aims to increase awareness and knowledge about disease, treatment, and prevention
**Patient Care**
- 	Aims to improve access, quality, and monitoring of specialized medical care to patients from minority communities
**Health Disparities Research****  **
- 	Aims to increase the scientific information about the disproportionate burden of disease among affected racial and ethnic groups

## NIAMS HPP Five Program Areas (continued)

**Recruitment to Research Careers**
- 	Seeks to increase the number of underrepresented researchers, physicians, and allied health professionals
**Community Relations**
- 	Aims to increase involvement of people from minority communities in the medical research process

## NIAMS Community Health Center:A Major Component of the HPPLocated inside Unity Health Care’s Upper Cardozo Health Center14th and Irving Streets, NW, Washington, DC

## NIAMS Community Health Center

- routine medical exams
- prescription medication
- physical therapy, x rays, and lab tests
- transportation to NIH,            if needed
- patient liaison/escort at NIH,  if needed
- referral to other clinical studies, if eligible

- Natural History Study of Rheumatic Diseases in Minorities includes:

## NIAMS HPP Outcomes

- The partnership has. . .
- opened the channels of communications between scientists and the community
- established the NIAMS CHC, a rheumatology clinic located in the Cardozo/Shaw community in Washington, DC
- implemented the Study of the Natural History of Rheumatic Diseases in Minority Communities, which has more than 800 patients enrolled

**Notes:**
The NIAMS Community Health Center is a medical and health information facility providing health care services to people affected by arthritis, lupus, and other rheumatic diseases.  

## NIAMS HPP Outcomes (continued)

- started a rheumatology consultation service in another neighborhood in southeast DC
- enhanced current health education efforts through participation in community health fairs and NIH’s speakers bureau
- increased training for careers in research, nursing, pharmacy, and physical therapy

**Notes:**
The Rheumatology Consultation Service at Unity’s Congress Heights Health Center links Unity doctors with rheumatologists (or arthritis specialists) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIAMS

## What Is in the Future for the NIAMS HPP?

- There is more work to do. . .
- implementing a 5-year plan to address goals and objectives
- extending the partnership to other sectors of the community strengthening relationships with the community
- promoting new community research at the CHC
- developing new publications

## HPP Partners List

- Advocates for Justice and Education
- American Academy of Orthopaedic Surgeons
- American Public Health Association
- Arthritis Foundation
- Arthritis Foundation,
-    Metropolitan Washington Chapter
- Baltimore City Health Department
- Barney Neighborhood House
- Centro de Recursos Centroamericanos
-    (CARECEN)
- Centro de Rehabilitación Salomon Zelaya
- Change, Inc.
- City of Baltimore, Hispanic Community
-    Liaison
- Columbia Road Health Services
- Comité Hispano de Virginia

- Congress of National Black Churches, Inc.
- Congressional Hispanic Caucus Institute, Inc.
- Council of Latino Agencies
- D.C. Baptist Convention
- D.C. Department of Health
- D.C. Family and Child Services
- D.C. Office on Aging
- D.C. Office on Latino Affairs
- Education Organization for United Latin
-    Americans (EOFULA)
- Friendship House Association
- Greater Washington Urban League
- Hermanas Unidas
- Hispanic CREO
- Howard University
- La Clínica Del Pueblo, Inc.

## HPP Partners List (continued)

- Latin American Youth Center
- Latino Council on Alcohol and Tobacco
- League of United Latin American Citizens
-    (LULAC)
- Life Skills Center
- Links Media
- Lupus Foundation of America
- Lupus Foundation of Greater Washington
- MANA - A National Latina Organization
- MarshalL Heights Community Development
-    OrganizationMaryland Department of Health and Mental
-    HygieneMary's Center for Maternal and Child Care
- Michaux Senior Center

- Montgomery County, MD Department of
-    Health and Human Services Montgomery County African American Health
-    Initiative
- Montgomery County Latino Services
- Multicultural Community Services
- My Sister's Place
- National Alliance for Hispanic Health
- National Association of Hispanic Journalists
- National Association of Hispanic Nurses
- National Community for Latino Leadership,
-    Inc.
- National Council of La Raza
- National Fibromyalgia Partnership, Inc.
- National Hispanic Council on Aging

## HPP Partners List (continued)

- Office of Minority Health Resource Center,
-    U.S. Department of Health and Human
-    Services
- Planned Parenthood: Marjorie Shumacher
-    Center
- Self Reliance Foundation
- Tenants and Workers' Support Committee
- United Planning Organization
- Unity Health Care, Inc.
- University of the District of Columbia
- USA Latino
- UPO Project Keen
- Whitman Walker Clinic

## NIAMS HPP Resources

- 	For more information about the partnership, please contact the NIAMS Office of Communications and Public Liaison
- 	**Office of Communications and Public Liaison****National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)****National Institutes of Health**
- 	Building 31/Room 4C0531 Center Drive, MSC 2350,Bethesda,  MD 20892-2350Phone: 301-496-8188TTY: 301-565-2966Fax: 301-480-2814Email: _[http://www.niams.nih.gov/](http://www.niams.nih.gov/)__ _