February 6, 2023
NOT-HD-23-010 - Notice of Participation of the NICHD in NOT-MD-23-002, "Notice of Special Interest (NOSI): Addressing the Etiology of Health Disparities and Health Advantages Among Immigrant Populations"
NOT-HD-23-011 - Notice of Participation of the NICHD in NOT-MD-23-003, "Notice of Special Interest (NOSI): Addressing Health Disparities Among Immigrant Populations Through Effective Interventions"
NOT-HL-23-119 - Notice of NHLBI Participation in NOT-MD-23-002 Notice of Special Interest (NOSI): Addressing the Etiology of Health Disparities and Health Advantages Among Immigrant Populations
PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
PAR-22-145 - Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)
PAR-21-358 - Risk and Protective Factors of Family Health and Family Level Interventions (R01 - Clinical Trial Optional)
PAR-22-233 - Time-Sensitive Opportunities for Health Research (R61/R33 Clinical Trial Not Allowed)
National Institute on Minority Health and Health Disparities (NIMHD)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Drug Abuse (NIDA)
National Cancer Institute (NCI)
National Heart, Lung, and Blood Institute ( NHLBI)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
The purpose of the immigrant health initiative is to support innovative research to understand factors uniquely associated with the immigration experience that contribute to health disparities or health advantages among U.S. immigrant populations. This includes but is not limited to risk/protective factors associated with immigration processes from influences that spur migration from the sending country, through the experience of immigration, to the experience of resettlement, short- and long-term residence in the U.S. and the process of acculturation that affects the health of U.S. immigrant populations (particularly agricultural workers, first generation immigrants, and children of immigrant families). For this Notice of Special Interest (NOSI), the term "1st generation" refers to people who were born outside of the U.S. and its territories and relocated to the U.S. The term "2nd generation" refers to the U.S. born children of 1st generation immigrants.
Background and Goals
In 2022, the U.S. immigrant population was 47 million accounting for 14.3% of the population and this population is expected to almost double within the next 4 decades. Census data indicates that approximately 18% of U.S. immigrants are under 15 years of age. Immigrant families often have incomes below the federal poverty level and 41% of today's new immigrants tend to have a high school education-equivalent or less. These data do not reflect the changing situation for most immigrants as they settle into a range of communities, acculturate to different social and cultural values, food choices, employment and educational opportunities, and health challenges.
Factors associated with immigration processes prior to and while deciding to immigrate, during the migration experience, and throughout the course of becoming accustomed to a new environment can translate into higher risk for diseases in the face of multilevel challenges when settling into the U.S. Many immigrants also face multiple ongoing challenges, such as lower health literacy, lack of health insurance, limited English proficiency, others barriers to effective patient-clinician communication, other limitations in accessing health care as well as maintenance selected traditional health practices. Discrimination and prejudice are common and affect daily experiences with individuals and organizations within the host society. Structural factors such as local and national laws and policies, the availability of affordable housing, suitable employment, local infrastructure that hinders or facilitates mobility to jobs, schools, medical care, among other things may also impact immigrant health.
Health disparities for specific conditions among immigrant populations are well documented. Yet, most immigrant populations tend to have better health outcomes than U.S. born populations for the leading causes of death, despite the adversities they encounter. Despite numerous challenges facing 1st generation immigrants, recent immigrants have reported better health outcomes than U.S. born populations, a status that is thought to deteriorate with increasing length of U.S. residence and in subsequent generations increasing one’s risk for chronic disease. More research is needed to understand the drivers of the immigrant paradox, protective and resiliency factors, health advantages, and why later generations may experience worse health outcomes and how to sustain and promote protective factors.
Risk factors and disease outcomes also vary by immigrant subpopulations based on their country of origin; yet many studies consider immigrants as homogeneous groups according to their region of origin (e.g., Latin America, Asia, Africa), despite different languages, cultures, U.S. policies, and immigration experiences. For example, U.S. immigrants from approximately 20 Latin American countries are treated as one Hispanic/Latino group and not separated into subpopulations based on country of origin and/or ethnic group. Asians (from more than 30 countries) or Africans (from over 20 countries) are treated as one immigrant population when the health outcomes often vary by subpopulations. More research is needed to better understand the risk and protective factors unique to each immigrant subpopulation.
Most research on immigrant health does not consider factors and processes (e.g., civil unrest, financial goals, education, armed conflict, exposure to criminal violence ) that spur the migration of groups or subsets of groups from one’s country of origin. Little attention has been given to the pre-existing experiences and/or trauma (e.g., starvation resulting from rapid environmental changes, changing food sources, violent outbreaks, exposures to toxic chemicals and pesticides), and how the experience of migration itself, or how the process of adjustment and adaptation to a new cultural, social, political, and ecological environment, may affect health outcomes. Also, it is imperative to consider the receiving communities where immigrants settle and the potential effects on one’s health. Likewise, it is essential to consider the period(s) in the life course when migration occurs and how that experience may affect health outcomes.
Given current knowledge on the determinants of immigrant health, (e.g., social, environmental, behavioral, and structural) and the mechanisms driving these factors to influence health status, improve health outcomes and reduce observed disparities within these populations, more research to understand the risk and protective factors operating at multiple levels for U.S. immigrant subpopulations is necessary.
Research Objectives
This NOSI calls for multidisciplinary and multilevel research to understand the interplay of multiple factors that cause health disparities or health advantages among underserved immigrant populations and the mechanisms through which they operate. Research should focus on understanding the etiology of the health outcomes among immigrant subpopulations by targeting the complex causes or consequences of health disparities and health advantages.
Applications should include multidisciplinary research to understand the interplay of multiple factors that cause health disparities among underserved immigrant populations and the mechanisms through which they operate. Projects that examine factors at multiple levels and domains are strongly encouraged (see the NIMHD Research Framework for examples of determinants of health at different levels: https://www.nimhd.nih.gov/about/overview/research-framework/nimhd-framework.html).
Investigators are strongly encouraged to employ a common set of tools and resources that will promote the collection of comparable data on social determinants of health (SDOH) across studies. Studies should incorporate measures from the Core and Specialty collections that are available in the SDOH Collection of the PhenX Toolkit (www.phenxtoolkit.org).
Since cumulative processes across the life course at the individual, family, community, and society levels are critical for understanding health disparities and advantages among immigrants, applicants are encouraged to focus on critical time periods and interaction with phases of the immigration process across the lifespan. Attention to premigration experiences, cultural values and related health practices, the experience of migration itself, or how the process of adjustment, adaptation and assimilation to a new cultural, social, political, and ecological environment may affect health outcomes, is encouraged. It is important to consider processes that support resilience and well-being in the lives of immigrants throughout the immigration experience that may buffer the effects of adversity. The role that ethnic enclaves, social networks, resilience, and frequent contact and visits to their native countries play in explaining some health advantages needs to be considered.
Applications are encouraged to integrate multiple approaches, such as biological assessments with consideration of sociocultural or behavioral variables and processes for better understanding of complex interactions for excess risk or resilience to health outcomes. Comparison of immigrant health factors between the U.S. and country of origin is encouraged, as is use of existing data from the country of origin, when possible, for comparison.
Projects should involve collaborations among relevant groups and organizations working with U.S. immigrant population groups, such as researchers, community leaders and organizations, public health organizations, consumer advocacy groups, faith-based organizations, and healthcare providers. As appropriate for the research questions posed, inclusion of key immigrant community members in the conceptualization, planning and implementation of the research is required to generate better-informed hypotheses, development of measurement tools that reflect the lived experience of community members, address issues of significance to the community, and enhance the translation of the research results into relevant and sustainable practice.
Projects must include a focus on immigrants from one or more NIH-designated populations who experience health disparities in the U.S., which includes racial and ethnic minorities (Blacks or African Americans, Hispanics/Latinos, Asian Americans, and Pacific Islanders). Studies focused on exploring the immigration experience of residents of U.S. territories (Guam, Puerto Rico, American Samoa, Commonwealth of the Northern Mariana Islands, and US Virgin Islands) to the contiguous U.S. are encouraged. Please see: https://www.nimhd.nih.gov/about/overview/ for more information.
Please note that exclusion of non-English speaking immigrant participants without compelling scientific justification (e.g., studies focused on second-generation immigrant youth) is discouraged and that appropriate translation services should be provided for in the research plan and the budget.
Research is encouraged among distinct immigrant subpopulations based on the country of origin, rather than larger racial/minority populations when feasible (e.g., Koreans, Vietnamese, Cambodians, rather than Asian Americans). For projects involving comparisons across populations, these comparisons should illuminate immigrant-specific phenomena rather than represent more global comparisons between immigrants with Whites or the general U.S. population. Examples of appropriate comparisons include but are not limited to:
Research Topics
Specific research topics of interest associated with the immigration processes among immigrant populations in the U.S. include but are not limited to:
The National Cancer Institute (NCI) coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients. NCI’s interest in this FOA centers on research directed toward understanding the relationships between environmental or occupational exposures and cancer etiology, cancer survival, and cancer control. Exposures that occur in the home country prior to immigration to the United States as well as exposures that are the result of the unique lived experiences of immigrant populations are of specific interest. Examples of environmental and occupational exposures relevant to the mission of NCI include, but are not limited to: (i) lifestyle factors; (ii) infectious agent; (iii) physical and chemical agents, and (iv) the social and built environment. Research may include investigating the interplay between these factors exposed throughout the life span as related to cancer risk and outcomes. The NCI is also interested in research that leads to the development of prevention and intervention strategies to reduce environmentally induced cancer risk.
Application and Submission Information
This notice applies to due dates on or after June 5, 2023 and subsequent receipt dates through June 8, 2026.
Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcements through the expiration date of this notice. Applicants should verify that the target Institute/Center to which they intend to apply participates in the FOA through which they will apply.
All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:
Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.
Scientific/Research Contact
Randy Capps, PhD
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-827-5423
Email: [email protected]
Deborah E. Linares, Ph.D., M.A.
NIMHD
Telephone: 301-402-2516
Email: [email protected]
Crystal Barksdale, PhD, MPH
NIMHD
Telephone: 301-402-1366
E-mail: [email protected]
Rada Dagher, Ph.D.
NIMHD
Telephone: 301-451-2187
Email: [email protected]
Curt Tavis Dellavalle, Ph.D.
NCI
Telephone:240-276-7225
Email: [email protected]
Tatiana Balachova, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Telephone: 301-443-5726
Email: [email protected]
Mary Theresa Macdonald
National Institute on Drug Abuse (NIDA)
Phone: 301-827-6239
E-mail: [email protected]
Peer Review Contact(s)
Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).
Financial/Grants Management Contact(s)
Margaret Young
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-642-4552
Email: [email protected]
Priscilla Grant, J.D.
NIMHD
Telephone: 301-594-8412
Email:[email protected]
Crystal Wolfrey
NCI
Phone: (240) 276-6277
E-mail: [email protected]
Judy Fox
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Telephone: 301-443-4707
Email: [email protected]