There are well-documented, pervasive, and unacceptable racial and ethnic disparities in the health of children across a variety of exposures,conditions, diseases, and treatments. Such disparities not only directly burden children themselves, their families, and their communities, but also have long-term effects across multiple generations. The Washington, DC-Baltimore region is characterized by significant income inequality, residential segregation, and marked disparities in child health. This renewal application establishes the Healthy Children for a Healthy Future: a Collaborative Health Disparities Research Center of Excellence (HC4HF) and builds on the long-standing collaborative commitment of Howard University (HU), Children's National Medical Center (CNMC), and the Department of Pediatrics at Johns Hopkins (JH) to child health disparities research and training under the DC-Baltimore Research Center on Child Health Disparities. Our work incorporates a conceptual model of child health disparities and a lifespan perspective and Is specifically committed to the development of interventions to overcome child health disparities. The overall goal of HC4HF is to provide a broadly collaborative, multi-disciplinary and multi-institutional "home" for efficient and effective research, training, and community engagement designed to improve minority child health and overcome child health disparities in the Washington DC-Baltimore region. To achieve this overall goal, we address the following Specific Aims: 1): To implement a program of rigorous intervention research to optimize health during the critical developmental period of adolescence, which links early exposures to long-term adult and intergenerational health. This work will draw on emerging technologies in "mobile health" (m-health), such as text messaging, to test interventions targeting two highly relevant conditions disproportionately affecting urban African American adolescents (Type 2 diabetes risk/obesity and violence exposure);2) To train and mentor junior faculty in the required clinical and translational research skills required to conduct rigorous research relevant to minority health and health disparities;3) To strengthen bidirectional community engagement and outreach in the Washington, DC-Baltimore region by providing an innovative program of dialogue based on review and evaluation of geo-located health indicators;and by integrating the community advisory process into training;4): To lead a broadly based, multi-disciplinary, multi- institutional, and collaborative consortium to coordinate and strengthen research and training relevant to child minority health and health disparities in the Washington, DC-Baltimore region and nationally.
Adverse social and environmental determinants of health, commonly referred to as health disparities, affect individuals and populations across the lifespan. An unacceptable burden of poor health often takes root in childhood. The research activities of the Healthy Children for a Healthy Future (HC4HF) will address multiple child health disparities in its research studies, its research training and education and its community outreach in the public health effort to reduce and ultimately eliminate racial/ethnic disparities.
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