Eliseo Perez-Stable

Eliseo Perez-Stable

NIMHD/NIH

Q&A: Incoming director charts new course for NIH’s minority health institute

In 2000, Congress created a center at the National Institutes of Health (NIH) to study the relatively high rates of disease such as diabetes in African Americans and Latinos. A decade later, lawmakers expanded the center to an institute, the National Institute on Minority Health and Health Disparities (NIMHD). This month, physician Eliseo Perez-Stable will take the helm of NIMHD, whose founding director John Ruffin retired last year.

Born in Cuba, Perez-Stable, 63, followed his father’s path into academic medicine, spending his career at the University of California, San Francisco (UCSF). His work has ranged from examining strategies for reducing smoking among minorities to studying health disparities in elderly minority populations. At NIMHD, Perez-Stable will oversee $270 million in research and training programs, and help coordinate minority health research across NIH.

“I think the disparities community has full confidence in Eliseo to rise to the challenge and exploit the opportunities as NIMHD continues to mature as a new institute,” says health disparities researcher Keith Norris of the University of California, Los Angeles.

Perez-Stable recently spoke with ScienceInsider about his new position and plans. This interview has been edited for clarity and brevity.

Q: You have not been funded by NIMHD. Do you know that community?

A: I'm not an outsider to the discipline and the community of scientists who have worked on it. The theme of my academic career has been Latino health care, and, more broadly, minority health, including tobacco control, cancer screening and survivorship issues, and aging. I’ve been very committed to diversifying the scientific workforce, both through my own individual efforts at UCSF and since 1997 through a center for minority aging research funded by the National Institute on Aging (NIA).

Q: Why leave San Francisco for NIMHD?

A: Some people would think I'm crazy, right? I saw the email when Dr. Ruffin retired, and I thought, “Oh, interesting.” Then, when the search process got started a few people sent me emails saying “You should consider applying.” What attracted me was the opportunity to have a leadership role in an area that I passionately care about—minority health and health disparities—at the national level.

I had gotten to know NIH at a little bit different level when I served on the council of NIA. I got a much broader view of portfolios, the work that program staff officers [and] deputy directors do. I also chaired a minority task force on the council.

Q: What are your priorities?

A: I will probably spend the first 3 months plus learning. I've met some of the more senior staff, had conversations with interim directors, but when I hit the ground as director I will make my own assessments on what issues there may be.

I see two roles. One is you run a shop, you run an institute. [How do you] make the place work administratively, make sure that the things that we're supposed to do get done? Then, there are the scientific questions to be oriented or shaped and, based on that, the programs that one announces and the grants that get funded. I think the opportunity there is large.

The other role of the institute is with other NIH [disease-oriented] institutes. Health disparities and minority health cut across the board. I think there is an opportunity to move the field independent of NIMHD's own resources by having good collaborations.

Q: What are the big questions in health disparities?

A: The issue is complex. Race and ethnicity play a central role but so does socioeconomic status and social determinants are critical. On the other hand, there are a number of behaviors that we know are important, a number of constructs related to individuals and ecological issues. The health care system that people interact with, especially for the most vulnerable, the chronically ill. And then there's this explosion of information on the biology of human systems. Genetics, but also mechanistic, cellular function.

So I’m excited about the scientific questions that can be asked using this laboratory of the diverse population in the United States. The issue of race, ethnicity, looked at not necessarily just from a social perspective, but also from a systems, behavioral, and biological perspective and how these interact. That's something that will not only help us reduce health disparities, but will also help us understand mechanisms of how disease operates and adverse outcomes develop.

Q: Four years ago, a study found that black grant applicants are much less likely to receive funding from NIH than white ones. What are your thoughts?

A: I think the message that got lost in that paper is that the absolute number of both black and Latino applicants was dismal. Two percent or 3%, really low. So I think we need to increase the flow and the pipeline. The efforts that have been launched by NIH—the BUILD [Building Infrastructure Leading to Diversity undergraduate program] and the mentoring network—certainly seem like a good direction.

There’s a twofold problem. One is, the number of young people coming through who are interested in science careers needs to be more diverse and needs to be supported in the initial phases.

My expertise is more toward the other end, when people have finished their Ph.D. or M.D. and their research training. How do we help nurture them so they become successful researchers? The NIA centers have a reasonably good model of how to do that. We have funded pilot studies for salary support in the case of faculty, or doing pilot data collection or maybe secondary analysis. The hook is that we make the investigators come twice a month to meetings with us—a work in progress seminar or a didactic session.

Our track record shows that if you fund people, you nurture them, you support them—there are very successful investigators who have come out of that program.