Ending Health Disparities Starts with Good Data, National Authority Says

Solid and sharable research data must go hand in hand with collaboration and caring to tackle the health gaps that trouble minoritized and underserved populations in the San Joaquin Valley and elsewhere.

That was the main message from a national leader in minority health care disparities during a presentation Oct. 29 at UC Merced. Dr. Eliseo Pérez-Stable, director of the National Institute on Minority Health and Health Disparities (NIMHD), spoke to students and faculty at the invitation of the university's Public Health Department.

"I'm really proud of what you have accomplished in your first 20 years," he said, "and of how well you have understood the ultimate mission of what it meant to place a UC campus in the Central Valley."

Pérez-Stable has directed NIMHD since 2015. The institute, part of the National Institutes of Health federal medical research agency, was lauded for initiatives developed to fight the COVID-19 pandemic in communities of color.

Before NIMHD, Pérez-Stable worked for 37 years at the University of California, San Francisco. He provided primary care and internal medicine to the community and served as chief of the Division of Internal Medicine.

Here are five takeaways from Pérez-Stable's presentation at UC Merced:

What is a health disparity?

The National Institutes of Health defines a population as having health disparities when, compared to the general population, it suffers a higher burden of illness, injury, disability or death. Racial and ethnic minorities, people of underprivileged socioeconomic status, and underserved rural residents are among the defined populations, along with LGBTQ+ groups and people with disabilities.

Get data gatherers on the same page

Researchers in public health have increasingly powerful tools for analyzing data. However, those tools, such as artificial intelligence, are only as good as the data fed to them.

That means researchers working with affected communities and ethnic groups must agree on the questions they ask and the answers they want. "We have to adopt common data elements," he said. "We can't have people developing their own surveys."

Strive for diversity among scientists and clinicians

Pérez-Stable said about 14% of recent medical school graduates and current practitioners come from underrepresented groups (Latinos, Blacks, Native Hawaiians and Pacific Islanders; and Native Americans). By comparison, those groups account for about a third of the U.S. population.

"We're not going to reach equal representation. Maybe in your lifetime," Pérez-Stable said, acknowledging the students in the audience, "and I would only be cautiously optimistic about that. But we need to continue to work at it."

Communities deserve connections

In academics, community-based research means inquiries where local residents and organizations work hand-in-hand with researchers to gather data about the community's needs. The work calls for mutual respect and shared decision-making from start to finish.

It doesn't always work out that way, Pérez-Stable said.

"It can't be, 'Oh, I have a great idea and I'll going to tell you what to do,'" he said. "And yes, you might have great knowledge about the issue. But you've got to go and listen. You've got to talk to the community you're going to work with."

Once trust is established on both sides, it is equally important to create a research plan that is effective and sustainable, he said. Address the immediate health issue but build long-term solutions such as safe spaces for women and good eating habits for everyone.

Confronting structural racism

Pérez-Stable cited a 2023 survey by Kaiser Family Foundation that asked people if they ever felt disrespected or treated unfairly in a clinical setting over the past three years because of race or ethnicity. At least 10% of Black, Asian, Latino or Native American respondents said "yes." For Black respondents, it was 18%.

Structural racism - policies and social norms embedded in institutions that maintain inequality and disadvantages for racial and ethnic groups - is the worst accelerant for health disparities, Pérez-Stable said.

"As scientists, we owe it to society to really study this and to continue to demonstrate how it affects our health today and how we can address these inequities," he said.

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