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Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop


Engelgau, Michael M.; Narayan, K. M. Venkat; Ezzati, Majid; Salicrup, Luis A.; Belis, Deshiree; Aron, Laudan Y.; Beaglehole, Robert; Beaudet, Alain; Briss, Peter A.; & Chambers, David A., et al. (2018). Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop. Global Heart, 13(2), 65-72. PMCID: PMC6504971


Four decades ago, U.S. life expectancy was within the same range as other high-income peer countries. However, during the past decades, the United States has fared worse in many key health domains resulting in shorter life expectancy and poorer health-a health disadvantage. The National Heart, Lung, and Blood Institute convened a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders. Recommendations for National Heart, Lung, and Blood Institute consideration were made in several areas including understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally enhancing and fostering a research workforce for implementation research. Key recommendations included exploring why the United States is doing better for health indicators in a few areas compared with peer countries; targeting populations across the entire socioeconomic spectrum with interventions at all levels in order to prevent missing a substantial proportion of the disadvantage; assuring partnership have high-level goals that can create systemic change through collective impact; and finally, increasing opportunities for implementation research training to meet the current needs. Connecting with the research community at large and building on ongoing research efforts will be an important strategy. Broad partnerships and collaboration across the social, political, economic, and private sectors and all civil society will be critical-not only for implementation research but also for implementing the findings to have the desired population impact. Developing the relevant knowledge to tackle the U.S. health disadvantage is the necessary first step to improve U.S. health outcomes.


Reference Type

Journal Article

Year Published


Journal Title

Global Heart


Engelgau, Michael M.
Narayan, K. M. Venkat
Ezzati, Majid
Salicrup, Luis A.
Belis, Deshiree
Aron, Laudan Y.
Beaglehole, Robert
Beaudet, Alain
Briss, Peter A.
Chambers, David A.
Devaux, Marion
Fiscella, Kevin
Gottlieb, Michael
Hakkinen, Unto
Henderson, Rain
Hennis, Anselm J.
Hochman, Judith S.
Jan, Stephen
Koroshetz, Walter J.
Mackenbach, Johan P.
Marmot, Michael G.
Martikainen, Pekka
McClellan, Mark
Meyers, David
Parsons, Polly E.
Rehnberg, Clas
Sanghavi, Darshak
Sidney, Stephen
Siega-Riz, Anna Maria
Straus, Sharon
Woolf, Steven H.
Constant, Stephanie
Creazzo, Tony L.
de Jesus, Janet M.
Gavini, Nara
Lerner, Norma B.
Mishoe, Helena O.
Nelson, Cheryl R.
Peprah, Emmanuel
Punturieri, Antonello
Sampson, Uchechukwu
Tracy, Rachael L.
Mensah, George A.