NIH-Designated Populations Experiencing Health Disparities

Health disparities are largely preventable health differences that adversely affect populations who experience greater challenges to optimal health and are closely linked with intergenerational social, economic, and/or environmental disadvantages—primarily based on identification as an individual from a racial and/or ethnic minority group and/or by low socioeconomic status (SES) in society.

Health disparities may be observed in the risks, prevalence, or problems resulting from specific behaviors, as well as the incidence, prevalence, and mortality from conditions, diseases, and/or disorders. Health disparities also can be observed in health care access, quality, and utilization, and within the delivery of clinical care.

NIH-Designated Populations with Health Disparities:

Racial and/or Ethnic Minority Populations as defined by the U.S. Office of Management and Budget, Directive 15:

• American Indian or Alaska Native: Individuals with origins in any of the original peoples of North, Central, and South America, including, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, and Maya.
• Asian: Individuals with origins in any of the original peoples of Central or East Asia, Southeast Asia, or South Asia, including, for example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese.
• Black or African American: Individuals with origins in any of the Black racial groups of Africa, including, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, and Somali.
• Hispanic or Latino: Includes individuals of Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, and other Central or South American or Spanish culture or origin.
• Middle Eastern or North African: Individuals with origins in any of the original peoples of the Middle East or North Africa, including, for example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, and Israeli.
• Native Hawaiian or Pacific Islander: Individuals with origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including, for example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, and Marshallese.

Low Socioeconomic Status (SES): SES is a multidimensional social construct and demographic factor that encompasses indicators such as income, educational attainment, occupational status, and access to resources, such as housing and health care. Individuals and households considered low SES include those earning a low income (sometimes referred to as the “working poor”) or experiencing varying levels of poverty. People with lower SES typically have limited access to financial, educational, social, and health resources compared to those with higher socioeconomic status.

Note that SES is complex, dynamic, and influenced by various individual, family, and societal factors. Additionally, definitions and thresholds of low SES can vary depending on the context, such as the region, or specific research study.

Evidence-based individual-level measures of low SES include:

• Education Level:
  
  • Less than a high school diploma
  • No college degree

  
  




• Income Level:
  
  • Below 200% of the federal poverty threshold
  • 80% of the area median individual income

  
  




• Occupation:
  
  • Unemployed or underemployed
  • Working in low-wage, high-risk jobs (e.g., food service, labor)

  
  

Underserved Rural Populations: Rural is defined as all populations, housing, and territory not included within an urbanized area or urban cluster. The degree of rurality is driven by geographic distance; counties and other geographic locations that are not considered part of a Metropolitan Statistical Area (MSA), as defined by the Office and Management and Budget (OMB) are considered rural and referred to as non-metro. Additionally, rural locations can be identified using rural-urban commuting area (RUCA) codes, which classify U.S. census tracts using measures of population density, urbanization, and daily commuting to access needed resources. Underserved rural communities include health professional shortage areas with limited or inadequate access to economic and social resources, and/or medical services in locations outside of an MSA.

People with Disabilities: Refers to individuals who experience impairments that substantially limit one or more major life activities or major bodily functions, thereby affecting their capacity to carry out routine activities essential to daily living [Americans with Disabilities Act (ADA), 2008 amendments and Section 504 of the Rehabilitation Act (Section 504); Centers for Disease Control and Prevention (CDC)].

The ADA and Section 504 define a person with a disability as an individual who has a physical or mental impairment that substantially limits one or more major life activities.1 Major life activities include walking, standing, thinking, seeing, communicating and hearing. The 2008 amendment to the ADA broadened the scope to include “major bodily functions,” recognizing that impairments affecting bodily functions such as the circulatory, respiratory, digestive, or reproductive systems can also substantially limit an individual’s daily functioning. Additionally, the CDC emphasizes the impact of impairments on an individual’s capacity to engage in activities necessary for independent living and full participation in society.

Sexual Minority Groups: Sexual minority refers to an individual whose sexual orientation differs from the heterosexual majority. Sexual minority status is often defined by self-identification, behavior (e.g., disclosure of same-sex sexual partners within a specified timeframe), or attraction (e.g., romantic or sexual attraction to people of the same or both sexes).

Page published March 7, 2025