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Health disparities research tops NIH agenda

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Courtesy of Meharry Medical College

Dr. Raynard Kington, deputy director of the National Institutes of Health, speaks at the summit.
Nov. 11, 2005

By David Hefner*

NASHVILLE, Tenn. (UMNS) — Health disparities research is at the top of the agenda for the National Institutes of Health, along with creating consistent “streams of funding,” according to a top official of the agency.

“There are amazing differences in life expectancy and death in this country,” said Raynard Kington, deputy director of the National Institutes of Health. African Americans are at the bottom of “almost every measure in health status and well-being.”

“Absolutely,” he concluded, “health disparities research is at the top of our agenda.”

Kington’s remarks kicked off an Oct. 30-Nov. 2 summit examining the unequal burden of illness and disease borne by Nashville residents who are racial or ethnic minorities. United Methodist-related Meharry Medical College sponsored the second annual event, called Nashville Community Health Disparities Summit2.

LINK: Click to open full size version of image
Courtesy of
Meharry Medical College


A collective response is needed, says John E. Maupin Jr., president of Meharry Medical College.
Summit2, supported by an NIH grant from the National Center for Minority Health and Health Disparities, brought together researchers, health care providers and laypeople to address local health disparities. In sponsoring the event, the Meharry EXPORT Center for Health Disparities partnered with Vanderbilt University School of Medicine and the Metropolitan Nashville Public Health Department.

“We can sum up the problem in a single sentence,” said Meharry President John E. Maupin Jr. at the summit’s opening. “The health of too many people is at risk because of their racial or ethnic background. However, while the problem can be easily summarized, we know the solutions are far from simple. A collective response that involves sharing information and enhancing collaboration is the only way we can reduce the health disparities that exist for people of color.”

In 2004, Tennessee ranked as the 48th lowest state out of 50 in “America’s Health: State Health Rankings,” a report compiled by the United Health Foundation. The state ranked in the bottom 10 states on other individual measures, including a high prevalence of smoking, obesity, violent crime, deaths from cardiovascular disease, cancer deaths and premature deaths.

A stark indication of ethnic-based health disparities in the state is summed up in the premature death rate: blacks experience 14,538 years of potential life lost before age 75 per 100,000, while whites experience 8,395 years of potential life lost before age 75 per 100,000.

LINK: Click to open full size version of image
Courtesy of Meharry Medical College

The theater of Vanderbilt Children’s Hospital provided a setting for discussing HIV/AIDS at the summit.
Health disparities in Nashville, Tennessee’s capital city, mimic those across the state.

“He who has a why to live, can bear any how,” said Stephanie Bailey, director of the Metro Public Health Department. “Our how is partnering.”

From discussions of cultural competency to metabolic syndrome to HIV to drug abuse, the four-day summit covered a spectrum of topics involving basic science and clinical and behavioral research areas. The daylong events were held on alternate days on the campuses of Meharry and Vanderbilt.

“This summit brought together different facets of the community that don’t always collaborate to discuss the causes of health disparities in Nashville and to collectively develop strategies for addressing them,” said Paul D. Juarez, program director of the Meharry EXPORT Center for Health Disparities.

The Oct. 31 discussion focused on diabetes, cardiovascular disease and stroke, beginning with the epidemiology and treatment of the illnesses and ending with prevention and implementation of proven medications. Exercise and a healthy diet were themes consistently touted as empowering solutions for both prevention and intervention of metabolic syndrome.

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Courtesy of Meharry Medical College

Dr. James Hildreth (right), director of Meharry’s Comprehensive Center for Health Disparities Research in HIV, speaks with Dr. Maria de Fatima Lima, dean of Meharry’s School of Graduate Studies and Research.
The next day’s discussion moved to HIV, led by James Hildreth, director of the Center for Health Disparities Research in HIV at Meharry. In Nashville, African Americans make up 51 percent of cumulative HIV/AIDS cases yet represent only 25 percent of the population.

“This problem is not going to be solved without the help of the black church,” Hildreth said. His center is approaching HIV research in three ways: biology, behavior and community outreach. “It’s very important that we have close interaction both at Meharry and Vanderbilt.”

In 2003, the Vanderbilt-Meharry Center for AIDS Research became one of 20 such centers established worldwide to address the global AIDS pandemic. Among the center’s goals are community outreach and faculty recruitment.

“The number of HIV/AIDS cases in Nashville is not going down,” said Richard D’Aquila, the Addison B. Scoville Jr. Professor of Infectious Diseases at Vanderbilt University.

Discussions about HIV/AIDS addressed such topics as genetics and intervention, and the development of microbicides to prevent HIV transmission. The summit also heard from a panel of community HIV advocates.

“We want to improve outcomes by knowing patients’ genetics,” said David W. Haas, director of the AIDS Clinical Trial Center at Vanderbilt.

LINK: Click to open full size version of image
Courtesy of Meharry Medical College

Drivers receive instruction on how to properly secure child seat belts at the Nashville Community Health Disparities Summit.
Hildreth discussed his research involving the sugar betacyclodextrin, which is used to bind cholesterol, a necessary component of HIV transmission. In 2001, Hildreth and his team of researchers discovered that betacyclodextrin can be used to extract cholesterol from HIV, blocking transmission of the disease. The Meharry scientist is working to develop a vaginal cream using betacyclodextrin.

“The impact of this vaginal cream could potentially be quite considerable,” he said. “It could literally slow down, if not stop, the progression of AIDS. One of the exciting things about the technology that we’re exploring is that a vaginal cream based on a natural product will be fairly inexpensive, within the reach of many people in the world, especially in developing countries.”

Concluding with a focus on behavioral research, summit participants discussed the nature of drug addiction, particularly alcoholism. Researchers have long drawn the correlation between addiction and high-risk behaviors that lead to illness and disease.

Meharry also offered free child passenger safety seat tips to the community and gave away about 75 car seats. That outreach was sponsored by the Meharry-State Farm Alliance with the Vanderbilt Children’s Hospital, the Tennessee Health Department and the Tennessee Governor’s Highway Safety Office.

“We all have a stake in this,” said Nathan Stinson Jr., director of Meharry’s Center for Optimal Health.

“The elimination of health disparities is our collective responsibility. We mustn’t miss our opportunity. Not on our watch.”

*Hefner is publications manager at Meharry Medical College.

News media contact: Linda Green, (615) 742-5470 or newsdesk@umcom.org.

 
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Resources
Meharry Medical College
Black College Fund: Meharry
Health Disparities Facts