OHDR Retreat Focuses on Closing Gaps for Underserved

Over 100 researchers, clinicians, educators and administrators from across Mayo Clinic, as well as outside community members, gathered in Rochester, Minnesota, for the Office of Heath Disparities Research (OHDR) Annual Retreat in October. The meeting was a platform to share science updates, learn about study support and other resources, delve into health disparities topics and collaborate on future research projects and publications.

Keynote speaker Eliseo J. Pérez-Stable, M.D., director of the National Institute on Minority Health and Health Disparities (NIHMD), gave the talk “NIMHD’s Research Agenda to Improve the Health of Racial and Ethnic Minorities.”

Dr. Pérez-Stable made several key points about the NIMHD’s agenda:

• Minority health and health disparities research are two different spheres. Minority health involves the distinct needs of racial and ethnic minorities; while health disparities are differences that adversely affect populations based on actual health outcomes (for example, incidence, prevalence, or health-related quality of life). Health disparities research aims to define the mechanisms behind health disparities and develop interventions. This work spans not just racial and ethnic minorities, but also low income people, women, underserved rural residents, and other populations subject to discrimination.
• The mechanisms that lead to health disparities are complex and fall into the broad domains of biology, behavior, physical environment, sociocultural environment, and the health care system. For example, sociocultural stressors like food insecurity, racism or familial dysfunction can contribute to health disparities, as can biological factors such as gene variants or metabolic differences.
• Biomedical workforce diversity is a priority for the NIMHD and “an urgent societal issue,” said Dr. Pérez-Stable. “We live in a society where 40 percent of the population is going to identify as one of [the] minority groups….Yet only about 5 percent of NIH grants submitted or awarded are going to African-Americans or Latinos.” African-American investigators are half as likely as white investigators to resubmit a scored grant.
• Inclusion of diverse participants in research studies is also critical. “It’s not just being a good investigator….It’s actually good science,” said Dr. Pérez-Stable. “There are things we’re not going to find out if we don’t have a diverse sample.” He cited a recently published study that found a genetic variance common in African-Americans was misclassified as a risk factor for hypertrophic cardiomyopathy, because African-Americans were not included in the control group. As a result, for over a decade, patients and physicians made care decisions based on faulty information on their risk of developing this serious heart condition.
• The NIH needs to improve accountability in grant applications and recognition of investigators who do address minority inclusion. Too often, inclusion is “just a checkbox” in the review process, said Dr. Pérez-Stable.
• Recruiting minorities is hard, and usually takes added resources and skills. Barriers exist, such as lack of trust, but the research community needs to end the myth that these barriers are insurmountable. “We have to be at the table,” said Dr. Pérez-Stable. “We have to be part of it….Otherwise, you’re on the menu.”

Reports on health disparities research at Mayo Clinic

In other OHDR Annual Retreat presentations:

• OHDR pilot project awardees presented results in research areas such as Somali tobacco use, childhood obesity disparities, positive health changes in rural African-American women, cognitive research in African-Americans, joint pain in obese populations, and wellness behavior in Alaska health aides.
• Leaders from diversity offices provided updates on addressing health disparities “across the shields.” Sharonne Hayes, M.D., Office of Diversity and Inclusion, discussed the success of Mayo’s workplace climate survey and stated that some results showed that employees value teamwork and support their teammates. John Knudsen, M.D., Office of Health Equity and Inclusion, stressed the importance of cultural competence training for all Mayo employees. Barbara Jordan, Office for Diversity, Mayo Clinic College of Medicine, elaborated on the charge to advance the diversity of learners and their experiences in the biomedical workforce.
• Linda Larkey, Ph.D., Arizona State University, discussed strategies to overcome the multifactorial challenges to recruiting minorities in research studies.
• Toni Mangskau, Mayo Clinic Cancer Center, reported on successes using a recruitment process called “CEO” (Call, Educate, Opportunity) for clinical trials.
• Michelle van Ryn, Ph.D., Health Sciences Research, discussed unconscious bias and discrimination in health care and what can be done about them. She emphasized that a commitment to an inclusive environment in the workplace maximizes employee contributions and creates a better health care setting for all patients.
• Jon Tilburt, M.D., General Internal Medicine, and Wesley Petersen, Ph.D., Office of Health Disparities Research, discussed tips for surviving and thriving in a competitive research environment.

— Kris Schanilec