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Recommendations

Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop

Authors
  • Michael M. Engelgau
  • K.M. Venkat Narayan
  • Majid Ezzati
  • Luis A. Salicrup
  • Deshiree Belis
  • Laudan Y. Aron
  • Robert Beaglehole
  • Alain Beaudet
  • Peter A. Briss
  • David A. Chambers
  • Marion Devaux
  • Kevin Fiscella
  • Michael Gottlieb
  • Unto Hakkinen
  • Rain Henderson
  • Anselm J. Hennis
  • Judith S. Hochman
  • Stephen Jan
  • Walter J. Koroshetz
  • Johan P. Mackenbach
  • M.G. Marmot
  • Pekka Martikainen
  • Mark McClellan
  • David Meyers
  • Polly E. Parsons
  • Clas Rehnberg
  • Darshak Sanghavi
  • Stephen Sidney
  • Anna Maria Siega-Riz
  • Sharon Straus
  • Steven H. Woolf
  • Stephanie Constant
  • Tony L. Creazzo
  • Janet M. de Jesus
  • Nara Gavini
  • Norma B. Lerner
  • Helena O. Mishoe
  • Cheryl Nelson
  • Emmanuel Peprah
  • Antonello Punturieri
  • Uchechukwu Sampson
  • Rachael L. Tracy
  • George A. Mensah

Abstract

Four decades ago, U.S. life expectancy was within the same range as other high-income peer countries. However, during the past decades, the United States has fared worse in many key health domains resulting in shorter life expectancy and poorer health—a health disadvantage. The National Heart, Lung, and Blood Institute convened a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders. Recommendations for National Heart, Lung, and Blood Institute consideration were made in several areas including understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally enhancing and fostering a research workforce for implementation research. Key recommendations included exploring why the United States is doing better for health indicators in a few areas compared with peer countries; targeting populations across the entire socioeconomic spectrum with interventions at all levels in order to prevent missing a substantial proportion of the disadvantage; assuring partnership have high-level goals that can create systemic change through collective impact; and finally, increasing opportunities for implementation research training to meet the current needs. Connecting with the research community at large and building on ongoing research efforts will be an important strategy. Broad partnerships and collaboration across the social, political, economic, and private sectors and all civil society will be critical—not only for implementation research but also for implementing the findings to have the desired population impact. Developing the relevant knowledge to tackle the U.S. health disadvantage is the necessary first step to improve U.S. health outcomes.

Highlights

  • This is a summary of a NHLBI/National Institutes of Health—sponsored Think Tank meeting of global and U.S. health experts that provides recommendations for an implementation research agenda that tackles the U.S. health disadvantage.
  • The health disadvantage is characterized by shorter and less healthy lives among the U.S. population compared with the populations of peer countries of similar wealth and development.
  • Key areas considered were understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally, enhancing and fostering a research workforce for implementation research.
Published on Jun 1, 2018