The National Institutes of Health, the largest public funder of biomedical research in the world, recently awarded Elizabeth “Beth” Merwin, PhD, RN, FAAN, Ann Henshaw Gardiner Professor of Nursing and executive vice-dean of Duke University School of Nursing and her team, nearly $3 million for her study entitled “Reducing Health Disparities in SMI, Rural and Minority Populations.” The study will run for a four-year period.
“This funding will allow our team of experienced interdisciplinary researchers to conduct research that can reduce health disparities for individuals under the age of 65 and are eligible for Medicare due to a disability and mental illness,” said Merwin. “Results from this study will inform the development of interventions and policies to improve access to care, quality of care and health outcomes such as length of life or mortality as well as to indicate needed changes in practice.”
According to the Centers for Disease Control and Prevention, health disparities are preventable differences in the burden of diseases or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. Research has shown that people under the age of 65 who qualify for Medicare appear to have significant preventable diseases, mortality and high health costs, but little is known about what contributes to their poor health outcomes.
This research study addresses the effects of disability and comorbid mental illness in Medicare recipients under the age of 65 years old, and will be compared to individuals over the age of 65. The study will examine self-care capacity (self-care ability, self-management of specific health conditions and health behaviors) and its relationship to health status. In addition, it will examine selected illness trajectories and health outcomes, community capacity to support health, the quality of health care and the intersecting effects of gender, race and rurality.
Comorbid mental health problems including serious mental illness (SMI) increase the complexity of care needed and appear to worsen long-term health outcomes. Excess morbidity and mortality may be influenced by self-care failures, inadequate prevention and access to quality health care.
“Being able to understand the needs and care received by Medicare recipients with mental illness, and those residing in rural areas and minority populations will inform the design of early and more effective interventions to ensure changes in health behaviors or services that reduce illness and improve health outcomes in the Medicare disabled population,” Merwin said.
Merwin serves as one of two principal investigators (PI) for this project. Emily Hauenstein, PhD, LCP, RN, FAAN, Unidel Katherine L. Esterly chair in Health Sciences and senior associate dean of Nursing and Healthcare Innovation for the University of Delaware College of Health Sciences, serves as the other PI. Wei Pan, PhD, associate professor for Duke University School of Nursing, and Steven Stern, PhD, Merrill H. Bankard Professor of Economics for the University of Virginia Department of Economics are also a part of the team.