Improving the Health of All People
A wealth of research studies at Alpert Medical School and the Division of Biology and Medicine’s Public Health Program work to identify and address disparities in health care. This work exemplifies the Division’s mission to improve the health of all people. The research seeks to identify and acknowledge health disparities, develop ways of mitigating them, and encouraging culturally competent care that is tailored to the needs of different groups. This is just a sample of recently published studies and ongoing research.
• At the VA: Better Care, But Minorities Still Lag Behind
Assistant Professor of Community Health Amal Trivedi found that care for seniors in the Veterans Affairs (VA) medical system is consistently better than what is available through private Medicare Advantage plans, but another analysis he published in the April issue of Health Affairs shows that while care has improved for both black and white patients, racial disparities persist in health outcomes. He found that during the last decade, VA doctors became significantly more likely to provide better care to members of each racial group, but because care for black veterans did not increase in quality faster than it did for white veterans, the disparity that existed before has remained stubbornly in place.
• Latino Siblings of Children with Disabilities
Professor of Psychiatry and Human Behavior (Clinical) Debra Lobato published a study in the Journal of Child Psychology and Psychiatry that found that Latino children who have a brother or sister with developmental disabilities experienced significantly more symptoms of internalizing psychological disorders, such as anxiety, than comparison children. These siblings also had more problems with their adjustment and coping skills, including difficulties with their relationships, particularly with their parents. Latino children showed a greater reluctance to express any negative experiences or feelings that they had about their siblings’ disability. In school, they had more absences and lower academic performances compared to their peers.
• Disparities in Pediatric Asthma
A study by researchers at the Bradley Hasbro Children’s Research Center and the University of Puerto Rico may help explain some of the well-documented ethnic disparities in pediatric asthma. Compared to non-Latino white children with asthma, Latino children in the study tended to think they were experiencing asthma symptoms, such as shortness of breath, when tests actually revealed normal lung function. According to researchers, inaccurate symptom perception was associated with more asthma-related emergency room visits, hospitalizations and unscheduled clinic visits. The study, published in the American Journal of Respiratory and Critical Care Medicine, is the first to demonstrate clear differences in pulmonary function perception ability between Latino and non-Latino white children with asthma.
• Nursing Home Care
While wealthier people have chosen alternatives to urban nursing homes, theurban poor still depend on them for long-term care. A study led by Assistant Professor of Community Health Zhanlian Feng found that nursing home closures in the US were concentrated disproportionately in poor, urban, and predominantly minority neighborhoods. The research, reported in the January 10, 2011, Archives of Internal Medicine, indicates that minorities have less access to nursing home care.
• A team led by Professor of Sociology and Community Health Mary Fennell found that Hispanic elderly are more likely than whites to live in nursing homes of poor quality. The research was featured in the January 2010 edition of Health Affairs. The study followed up on earlier research led by Florence Pirce Grant University Professor of Community Health Vincent Mor, which found that blacks are more likely than whites to live in poor-quality nursing homes in cities across the US. The research, also published in Health Affairs, was the first to document the relationship between racial segregation and quality disparities in US nursing homes.
• Stopping AIDS
Research Assistant Professor of Medicine Amy Nunn worked with religious leaders in Philadelphia to organize a citywide attack on the stigma associated with HIV infection. More than 100 pastors and imams are reaching out to their congregations to encourage HIV testing, education, and compassion in Philadelphia, where the rate of HIV infection is five times the national average. Nunn called for HIV researchers to “get out of [their] offices” and partner with leaders in affected communities in order to have an impact on public policy.
• Latino Smoking
Latinos looking to quit smoking are more successful when they have a significant other and partner support, say Professor of Psychiatry and Human Behavior (Research) Belinda Borrelli and researchers from The Miriam Hospital’s Centers for Behavioral and Preventive Medicine. According to the study, published in the May/June 2011 issue of the American Journal of Health Promotion, this support can also buffer the demonstrated negative effect that depression can have on smoking cessation. In a related study, Borrelli and colleagues set out to determine whether smoking behavior and attitudes differ among Puerto Ricans and Dominicans and if so, how they compare to non-Latino whites. Exploring differences between these two subgroups as well as how each differs from non-Latino whites is important for determining whether smoking cessation interventions developed for the majority population are relevant to specific Latino populations.
Research Studies Currently Under Way
• Your Healthy Life: Translating a Tailored Nutrition Intervention through WIC and Minority Health Promotion Centers
Principal investigator Kim M. Gans, PhD, MPH, LDN is studying a tailored nutrition intervention that has been shown to be effective in improving fruit and vegetable intake in diverse low income audiences. The research will study the process of translating the fruit and vegetable components of the intervention into the established practice of 20 different community organizations in Rhode Island such as Minority Health Promotion Centers and WIC clinics.
• SisterTalk – ADHERE: Home-Based Weight Loss for African-American Women
Principal investigator Patricia Risica, DPh, is testing this home-based health program delivered by video to self-reported African American/Black/Cape Verdean women age 18 and older who need to lose weight by eating better and increasing their level of physical activity and reducing their stress level.