OVERALL Of the 35,000 research grants awarded in 1998 by the National Institutes of Health (NIH), only 9 (0.0003%) of principal investigators/program directors (PI/PDs) were American Indian/Alaska Native (AI/AN). Twenty years later, that number has increased 13 fold, to 119 AI/AN PI/PDs, representing 0.003% of the 46,000 NIH research grants funded in 2016. Over this same period of time, the Native Elder Research Center (NERC), 1 of 7 National Institute of Aging-sponsored Resource Centers on Minority Aging Research (NIA; RCMAR), trained 48 AI/AN early-stage investigators, who published 435 papers on AI/AN health, conducted 97 Pilot Studies, and garnered more than $100 million in sponsored research support aimed at improving the health of our nation's Native elders. Our RCMAR scholars figure prominently in the growing presence of AI/ANs among NIH awardees. Clearly, the NIA effort to diversify the scientific workforce, with special emphasis on AI/ANs, has had a substantial and demonstrable return on its investment in the Native Elder Research Center. Our application seeks to renew that support and enable us to continue this legacy, thereby ensuring AI/ANs are even more represented among tomorrow's scientists working at the interface of culture, aging, and health. By virtually any measure, older AI/ANs are at greater risk than their non-Hispanic White counterparts for numerous acute as well as chronic illnesses. They also suffer more frequent comorbidities, have less access to high-quality services, encounter substantially greater delays in treatment, and are slower to seek needed care. Not surprisingly, their life expectancy?68 years for men, 74.3 years for women?is 7-8 years less than non- Hispanic Whites and significantly lower than either Hispanics or African Americans. We only recently have begun to alter the individual-, family-, community-, and system-related factors that contribute to these circumstances. Barriers to advancement in this arena have included the lack of relevant, immediately applicable research, a paucity of scientists working to close these gaps in our knowledge, and the resistance of Native communities to efforts that fail to incorporate their priorities and local systems of care in meaningful ways. The Native Elder Research Center?a 20-year partnership between Spero M. Manson, PhD, at the University of Colorado Anschutz Medical Campus and Dedra Buchwald, MD, now at Washington State University?has contributed significantly to addressing these challenges and is well poised to further this impact. It employs an innovative, theory-driven, well-tested, and thoroughly documented approach to diversifying the scientific workforce capable of acquiring and applying the relevant knowledge to ameliorate the health disparities that affect older American Indians and Alaska Natives.
NERC RCMAR addresses the barriers to reducing health disparities among older American Indians and Alaska Natives, which include lack of relevant, applicable research, paucity of scientists working to close the knowledge gaps, and failure to incorporate community priorities and local systems of care in meaningful ways.
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