In the Department of Cardiology at the University of Colorado School of Medicine, Kamal Henderson, MD, is working to understand why marginalized communities bear a disproportionate burden of cardiovascular disease.
Dr. Curtis Henry of the CU Cancer Center is investigating whether obesity, a condition more common in underserved areas, including Black communities, inhibits the effectiveness of cancer-targeted immunotherapies. are researching.
Dr. Brandi Freeman of the University of California Department of Pediatrics is also part of a research team focused on addressing levels of infant mortality and preterm birth rates among Black women in Colorado that are higher than the national average.
Henderson, Henry and Freeman are just three of dozens of researchers at the University of California School of Medicine studying health disparities in Black communities.
“I think it's our duty as Americans to address health inequities,” said Henry, associate director of diversity, equity, inclusion and access at the CU Cancer Center. “We understand that our history has not always been beautiful. Some of it has been a nightmare for marginalized communities. We understand that our history has not always been beautiful. Some of it has been a nightmare for marginalized communities. If we want to protect life, liberty, and the pursuit of happiness, we must recognize that many of the inequalities that still exist today are hand-me-down inequalities that began a long time ago. No. Slavery continues through and beyond Jim Crow.”
roots of movement
These inherited inequalities include the fact that black communities have higher rates of smoking, obesity, and poverty, as well as higher risks of heart disease, stroke, asthma, diabetes, and cancer than white communities. included.
This is an area that medical researchers have begun to pay more attention to in recent years due to paradigm-shifting events.
“This new focus was unfortunately fueled by the murder of George Floyd and thankfully by the Black Lives Matter movement,” Henry says. “America hasn't had our pulse on the pulse for a long time. This terrible event has led us to say, 'There are still many inequalities, especially in health care and social justice.' What can we do as a country to leave this place better for the next generation of Americans? ”
system resolution
Much of Henderson's cardiology research concerns the systems that maintain inequality. For example, life-saving medications are much harder to obtain if you don't have insurance. One of his recently published studies examined how a national campaign to prevent heart disease is perceived and implemented in underserved communities in Denver. Thing.
“This is about understanding what resources are available and how those resources are being implemented to address chronic disease management and health-related social needs within the community. “It's a study that's built around it,” said Henderson, assistant professor of cardiology. “It's something that improves equity, like solving housing and food insecurity. Unfortunately, many of our patients are missing out on things that can improve their health and well-being.”
For example, Henderson's research found that resources to help people in marginalized communities quit smoking may not be as effective in the long term as efforts to reduce the stressors that lead to smoking in the first place. Similarly, programs implemented to help underserved communities are only effective for those who understand how to access them.
“Being poor in America is an expensive lifestyle,” he says. “Applying to these programs requires a lot of paperwork. Most of the time, people just need some help or support in that area. It's about understanding the resources that are out there and helping people It’s about executing a needs-based strategy.”
support for black mothers
In the wake of dire statistics about infant mortality and preterm birth rates among Black women in Colorado, Freeman, an associate professor of pediatrics, founded a project at Children's Hospital of Colorado aimed at improving social connections and health care access for Black families. Participated in the Black Health Initiative. Raise awareness and education about health disparities in Black communities, create policy and system changes to promote Black health, and improve patient-provider relationships for Black families.
As part of the latter effort, Freeman is helping coordinate a series of culturally sensitive clinical and behavioral health trainings at the Center for the Advancement of Professional Excellence on the CU Anschutz Medical Campus.
“This was a simulation exercise that looked at how race manifests in a clinical setting, and for those who went through it, it was a really rewarding experience,” Freeman said. “Providers are paired with members of the community to run simulations. It was helpful.”
Freeman said much of the simulation was based on experiences community members had within the health care system, some of which were traumatic.
“We received feedback from providers that it was a learning experience that impacted how they provide care,” she says. “As a side note, one of the health care providers who went through this experience told me that it helped her understand that a mother was showing signs of eclampsia when she brought her child to the emergency room. If they didn't have that training, they might not be able to understand those symptoms for what they are.”
Freeman is also involved in creating pathways for physicians from underrepresented communities and coordinating health equity education for pediatric residents, all of which contribute to health equity impacts that affect the youngest members of society. It's part of a continuum that starts with engagement.
“Our goal in pediatrics is to develop grown adults. We want our children to achieve their ultimate goal of becoming adults who are rich and productive members of society. ” she says. “Regardless of your background, where your family comes from, or your income, you should have the opportunity to achieve your best health. There are disparities in our society that make it difficult for all children to know that it is always possible. It's important that we look at these differences, change them, and work toward not just so-called health equity, but equitable health outcomes for children.”
Obesity and the immune system
Henry, who studies how social determinants of health influence cancer risk and treatment, is interested in the impact of obesity on triple-negative cancer, one of the leading causes of death among black women. Focuses on recent research.
“Obesity rates tend to be higher in communities of color for both men and women,” he says. “Blacks have the highest obesity rates in the United States, followed by Hispanics and Native Americans. Obesity also affects some cancers that are more prevalent in Black communities, such as triple-negative breast cancer and colon cancer. It is also a major cause of several cancers, including.
In a recent laboratory study, Henry and his team found that the presence of fat cells not only makes breast cancer cells more aggressive and more likely to metastasize, but also makes these cells less visible to the immune system. . It uses the body's own immune system to fight cancer cells, but it may be less effective in obese women. Henry recently applied for a grant to study whether anti-obesity drugs can strengthen the immune system.
“If anti-obesity drugs are found to have a positive effect on the immune system, it may be possible to combine anti-obesity drugs with immunotherapy to improve treatment response in patients with cancer and obesity,” he said. To tell. “Our first objective is to profile the immune system based on BMI levels and examine the effects on the immune system. Our second objective is to consider this in the context of solid tumors. , our third objective is to analyze the synergistic effects of anti-obesity drugs and CAR T-cell therapy against blood cancers. , we hope to provide much-needed short- and long-term insights.”
forward progress
Several other projects are underway on the CU Anschutz campus that address health disparities in Black communities and other underserved populations.
Henderson says this is an encouraging sign that progress is beginning.
“Oftentimes we approach these issues through a single lens rather than from a systems-level perspective,” Henderson says. “There are ways to use community engagement methods to bring together the right people, the right thinkers, and say, 'How can we strengthen our academic center with thinkers who want to do this kind of research?'” How do I put all these things together to have it?'' If you want to move forward, you have to be intentional. ”
