The Health Disparities Fellowship Program was developed to increase the number of biomedical researchers dedicated to reducing and eliminating health disparities in the United States. Reflecting the objective of this fellowship program, Dr. Ramos has worked with her mentor, Dr. Kenneth Olden, to address two of the ten high priority objectives set forth by the U.S. Department of Health and Human Services to reduce and/or eliminate health disparities. These two high priority objectives are obesity and access to heath care.? ? The project addressing obesity involved the analysis of nationally representative data from the Centers for Disease Control and Prevention. The population of interest was the US female population of childbearing age, 19-44 years of age. The hypothesis of the study was whether the prevalence of metabolic syndrome had increased and what was contribution for the risk of metabolic syndrome due to race/ethnicity and maternal disease history. Metabolic syndrome is a clustering of risk factors for cardiovascular disease (i.e. obesity, impaired glucose metabolism, hypertension, dyslipidemia). The findings from this study (see research accomplishments below) have been written into a manuscript which is currently in review by the American Journal of Public Health. ? ? The project addressing disparities in health care access reflects the multi-factorial nature of poor health outcomes. Thus, it currently has two well-defined sections and a third section under consideration. The first section was an assessment of the published evidence regarding the disconnect between the ability of US healthcare delivery system to deliver appropriate and satisfactory health care to Americans and the general health of Americans compared to other industrialized countries. A manuscript based on the results of this project is in preparation and will be submitted for publication by the end of October 2007. ? ? The second section of the health care access project involves the investigation of the relationship between disparities of income, health insurance coverage, and availability of physicians, and health outcomes of the population (i.e. infant mortality, life expectancy at birth, and mortality rate that could have been prevented by appropriate/ timely health care). The unique aspect of this project is that the data analysis is between the 50 US states. The data sources for this project are from the US Census Bureau and from various agencies within the US Department of Health and Human Services. We anticipate that a manuscript the data reflecting the results of this project will be ready for peer review by January 2008.? ? The third section of the health care access project that is under consideration is an assessment of the relationship between disparities of income, health insurance coverage, and availability of physicians, and the prevalence of chronic disease. Again the analysis will be conducted at the state level to examine the variability of treated chronic disease between the 50 US states. Data sources for this project have been obtained which include data from the Robert Wood Johnson Foundation funded Community Tracking Survey and various agencies within the US Department of Health and Human Services. Further analysis of the medical expenditure variability by state based on the respective states prevalence of chronic disease is a sub-aim of this project.

Agency
National Institute of Health (NIH)
Institute
National Institute of Environmental Health Sciences (NIEHS)
Type
Intramural Research (Z01)
Project #
1Z01ES102125-02
Application #
7594027
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
2
Fiscal Year
2007
Total Cost
$335,576
Indirect Cost
City
State
Country
United States
Zip Code
Ramos, Rosemarie G; Olden, Kenneth (2008) Gene-environment interactions in the development of complex disease phenotypes. Int J Environ Res Public Health 5:4-11
Ramos, Rosemarie G; Olden, Kenneth (2008) The prevalence of metabolic syndrome among US women of childbearing age. Am J Public Health 98:1122-7