UAB symposium examines healthcare needs of world’s underserved
UAB's Huacong Wen (right), School of Health Professions, discusses her study about the racial and ethnic differences in obesity in individuals with spinal cord injury, based on the impacts of residing in a disadvantaged neighborhood. Wen traced numerous variables using the National Database on Spinal Cord Injury at UAB, among other sources. (Donna Cope/Alabama NewsCenter)
The first step in providing better healthcare for everyone is identifying the roots of disparate levels of care, leading to a lessened well-being of the underserved in the population.
UAB’s Dr. Mona Fouad and a panel of healthcare experts from England led the charge in investigating Social Determinants from the Global Perspective during the 13th annual Health Disparities Research Symposium on March 19 in Birmingham. The meeting featured an international dialogue about how the U.S. and Great Britain can improve the health incomes of their populations through information-sharing.
“There are lots of similarities between the countries,” said Fouad, director of UAB’s Minority Health and Health Disparities Research Center (MHRC). When she visited Staffordshire University in Stoke-on-Trent, Fouad realized there were many similarities in the work done by both universities, especially regarding the quality of healthcare and health disparities.
“Working with communities, there are a lot of similarities,” Fouad said. “If you’re under-sourced, the problems are the same. You must learn to listen and learn, then react. Evaluating the work in the community is very challenging – it’s not like being in the lab.”
UAB associate professor Dr. Doug Moellering had the chance to share ideas and results of his cross-sectional study about the effects of stress on the body. He joined about 120 young researchers in discussions during the poster session, in which academic investigators, scholars and community partners shared their research findings.
“I want people to realize that even perceived stress is bad for the body and can directly affect metabolism,” said Moellering, whose study featured 30 African-American women and 30 Caucasian women in greater Birmingham. “Under a chronic condition, you’re flooding the ‘fight-or-flight’ hormone, cortisol, into the body. It’s chronic stress that increases wear and tear on your system.”
Moellering, an instructor in Nutrition Sciences at UAB, said the African-American women faced higher levels of perceived stress, coinciding with increased levels of oxidative stress, and higher waist circumference and weight.
UAB director of Employee Wellness Anna Threadcraft shared with many researchers her insights into UAB’s HealthSmart program, ongoing for two years. She promotes screening and early treatment of colorectal cancer.
“Colorectal cancer is one of the most preventable cancers with early detection and early screening,” she said. UAB is partnering with Alexandria University in Egypt how to determine the reason behind young deaths related to colorectal cancer.
“There is a significantly higher death rate for 20- and 30-year olds in Egypt, and we want to see if that is related to nutrition, genetics, lack of physical activity or, potentially, all of these,” Threadcraft said.
UAB symposium brings international focus to healthcare disparities from Alabama NewsCenter on Vimeo.
In April, Fouad will lead a UAB team in partnering with an Egyptian team at Alexandra University to conduct focus groups, interview patients and determine how to impact, in a positive way, to reduce deaths from colorectal cancer.
The panel discussion featured Fouad and three U.K.-based experts on health disparities: Judy Kurth, director – Centre for Health and Development (CHAD) at Staffordshire University; Dr. Chris Gidlow, CHAD academic director and associate professor at Staffordshire University; and Aliko Ahmed, director – Public Health England for East of England and a professor at Staffordshire University. Ahmed also is a senior fellow at Chatham House Centre on Global Health Security and the Institute of Public Health at the University of Cambridge.
Kurth said that CHAD draws heavily on the MHRC model. She said that England has a minority population of about 8 percent.
“Since the banking crisis in 2008,” Kurth noted, “there’s been less money going into patient health. Poverty is the issue we’re addressing. Disparities is about disadvantage and being disenfranchised. Stress communities start obesity.”
She said that England is moving toward changing individual behavior in preventing obesity. The country has created a 10-point plan to prevent obesity in children, and many English healthcare experts agree there should be a tax on sugar.
While much of the health disparities research conducted in the U.S. anchors around race, Gidlow said that ethnicity in England is a social construct, with a focus on income.
“The main driver to health inequality is income and the opportunities one can get,” he said. Gidlow said the creation of green spaces in some neighborhoods has proven to reduce stress and mitigate noise.
Ahmed believes that funding should be made on the basis of public good. “When 42 individuals have as much wealth as 3.7 billion of the world’s people, that is a truly disparate situation. The main driver to inequality is income and the opportunities one can get.
“We need researchers to know the role that they have in government,” Ahmed said. “Policymaking is about relationships – the engagement can be challenging. In Africa, there has been a gap between those who produce knowledge – the researchers – and those who implement it. The knowledge we generate is intended to improve the population’s health and to improve communities’ lives.”
Fouad said that it’s important to open up conversations with communities and to provide them guidance.
“If you can, ask and say, ‘What assets do you have?’ Get the community to start thinking in a positive way. You want to turn the problems into a program of action – focus on the positives. Progress needs to be celebrated. If you focus on the negative, you get discouraged and can do nothing about the situation.”
Fouad presented the 2018 Mentoring Awards to Dr. Brian Rivers of the Morehouse School of Medicine in Atlanta, Georgia and Wendy Demark-Wahnefried, associate director for Cancer Prevention and Control for the UAB Comprehensive Cancer Center. Demark-Wahnefried is also a professor and Webb Endowed Chair of Nutrition Sciences at UAB. Mentoring award recipients are nominated by UAB students.
The 13th annual symposium was produced by the UAB MHRC and co-sponsored by the Mid-South Transdisciplinary Collaborative Center, led by Fouad, and the Gulf States Health Policy Center, led by Dr. Regina Benjamin, founder and CEO of BayouClinic and 18th U.S. surgeon general.
