Funding Opportunity Number: PAR-24-077
Background
Although scientific and technological discoveries have improved the health of the U.S. population overall, populations affected by health disparities such as sexual and gender minorities (SGM) from racial and ethnic minoritized populations and from less privileged socioeconomic statuses (SES) continue to experience a disproportionate burden of disease and risk factors, and unmet healthcare needs.
SGM populations experience a wide range of health disparities. Compared to heterosexual women, lesbian and bisexual women have higher odds of risk factors for cardiovascular disease (CVD) thought to be related in part to higher levels of mental distress, higher rates of current smoking, and greater obesity. Breast cancer may also be more common among SGM women in part related to higher rates of obesity and lower rates of pregnancy. Transgender adults are more likely to have elevated rates of myocardial infarction and CVD risk factors than their cisgender counterparts. SGM populations are also disproportionately affected by disparities in mental health conditions, as LGBTQ individuals experience increased anxiety, depression, and suicidality than people who identify as heterosexual and cisgender. People who identify as LGBTQ+ also experience greater substance use and behavioral health disparities than heterosexual cisgender individuals, including greater use of tobacco, alcohol, and illicit drugs. SGM populations also experience greater disparities in sleep disturbances compared to non-sexual minority persons.
Research Objectives
The main objective of this funding opportunity is to solicit research to address health and healthcare disparities among SGM populations by identifying etiological mechanisms and pathways and developing and evaluating interventions focused on racial and ethnic minoritized populations and those of lower SES.
For intervention-based studies, implementation science is encouraged especially in terms of integrating clinical research to facilitate the timely translation of interventions into practice to promote SGM health (e.g., hybrid trials that combine clinical effectiveness and implementation research). Specifically, when it comes to SGM populations interacting with the healthcare system, a need exists for interventions that promote culturally sensitive and supportive health care (e.g., care that addresses intergenerational trauma) to address barriers to care, including financial and systems-level barriers. Also important are community-led research approaches such as community-based participatory research to ensure the prioritization of SGM community needs and to ensure non-stigmatizing responses to these needs.
For observational and etiological studies, research is encouraged on the biological mechanisms linking chronic stress to SGM health outcomes (e.g., the effects of stress on the microbiome). Investigators should use an intersectionality perspective to acknowledge the interlocking major systems contributing to health disparities including structural racism, sexism, heterosexism, transphobia, classism, and ableism, that affect health outcomes in SGM populations with multiple intersecting identities. Longitudinal multi-level research is encouraged to investigate the roles of policies at the federal and state levels, SGM-specific, and school or educational policies on health outcomes. Research must consider the role of individual and structural social determinants of health (SDOH) such as poverty, housing instability, food insecurity, poor access to and quality of care, as potential mechanisms driving SGM health disparities. Studies focusing on examining protective and resiliency factors and promoting well-being are also encouraged.
For more information, please see the announcement website.