New initiative to reduce health inequities

A major new initiative by the University of Maryland aims to eliminate health disparities in the state and extend the impact of health reform. The university's School of Public Health has recruited a team of nationally recognized faculty-researchers who will create action programs to improve primary care and expand public health outreach, so as to reduce the high rates of chronic disease in Maryland's medically underserved communities.

Led by Stephen B. Thomas, the team will open a new Maryland Center for Health Equity as a base for extensive community-level research and outreach focused on reducing disparities. Maryland has the fourth largest concentration of medically underserved racial and ethnic minorities in the nation. In addressing these disparities, the center plans to develop models for use by other states.

Thomas, whose innovative techniques brought health professionals to nontraditional locations such as African American barbershops and beauty salons, will bring his entire team from the University of Pittsburgh to assume tenure-track teaching and research positions at Maryland. This cluster hire represents an unprecedented single investment by the university to address these health issues for the state and amplifies extensive efforts already underway at the School of Public Health.

"This gives us critical mass to advance our commitment of transforming Maryland's health, and it comes just in time to build on the promise of health reform," says Robert S. Gold, dean of the University of Maryland School of Public Health. "This new Center will complement our current efforts. It puts us on a fast-track and will help extend our reach state-wide."

REDUCING HEALTH INEQUITIES

The center's work will stress evidence-based principles designed to overcome community resistance to medical and public health research, including:

•Action-orientation: research embedded in a community setting designed to produce tangible results and produce a model of best practices;
•Community partnership: working "with" the community, not doing things "to" it;
•Cultural sensitivity: techniques tailored to community needs and realities;
•Team science: a university-wide interdisciplinary approach; health needs and problems confronting underserved communities are too complex for any one field of expertise.

In addition to collaboration with other researchers in the School of Public Health, the center will draw on expertise from a wide range of disciplines, such as engineering, urban planning, sociology, public policy and journalism. Also, it will partner with other University System of Maryland institutions.

"We're focused on action, not talk," says Thomas, whose team has developed an arsenal of community engagement and research techniques to bridge the gap between minority communities and academic health science professionals.

"You'd think that communities lacking the most basic health care would welcome outside help," Thomas continues. "However, the burdens of race and history cannot be ignored. The reality is that we have to build trust and overcome cultural barriers first.

"Our challenge and mission is to find new ways to bring the fruits of health care reform to the underserved, poorly served and never served segments of our community," Thomas says. "We're all in this together, and the people in these communities must be fully engaged as equal partners in establishing a new community-based health infrastructure."

Sandra Crouse Quinn, who will join the School as senior associate dean of public health initiatives, stresses families as a key to success. "Culturally, in African American and Latino communities, it makes sense to focus on families," she explains. "This is where the transmission of social norms and lifelong behaviors begins."

Prince George's and Montgomery Counties, Washington, D.C., Baltimore and its suburbs, as well as rural parts of Maryland all have communities that can benefit from the center's focus on achieving health equity for everyone, "and we'd be remiss not to try," Thomas adds.

The center will open in the fall and begin extensive collaborative planning for work in communities across the state within a year.

CLUSTER HIRE

The cluster hiring of a cohesive scientific team comprised of tenure and tenure-track faculty is a first for the University of Maryland, and heightens the potential impact of the center. "It brings a team with complementary specialties and a clear track record of research success, and enables us to make a great leap forward," explains Dean Gold. The team's expertise includes:

•Stephen Thomas: internationally recognized for scholarship on the legacy of the Tuskegee Syphilis Study in shaping attitudes of African Americans toward medical care and clinical and public health research; conducted research on HIV/AIDS, youth violence, substance abuse, organ-tissue donation; currently translating NIH research into community-based interventions to prevent and manage chronic diseases;
• Sandra Crouse Quinn: national expert on health and risk communication and racial differences in response to disasters and bioterrorism; building community trust and community engagement research;
•James Butler: researches tobacco-related health disparities among residents of public housing; understanding how the social and environmental influences motivation for life-style changes designed to reduce risk of cancer, obesity and Type 2 diabetes;

•Craig Fryer: research focused on smoking behavior among minority youth and young adults and understanding the socio-cultural context fueling health disparities;
•Mary A. Garza: the influence of religion and faith in health behaviors associated with breast, colorectal and prostate cancer screening; domestic violence; use of community-based participatory research to design interventions to eliminate health disparities.
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The team developed successful national partnerships and collaborations in Pittsburgh, and these will continue at Maryland. These include arrangements with the Mayo Clinic, the University of Wisconsin, University of Colorado, as well as ongoing research with Pittsburgh community-based organizations and research partners at the University of Pittsburgh. The team has also established a highly successful career development pipeline with the Kellogg Health Scholars program headquartered in Washington, DC.

"The University is extremely pleased to have attracted this very talented team," said University of Maryland President C. D. Mote, Jr. "Each member brings extensive experience and professional specialization to the challenge of reducing health disparities. The team will extend and amplify the exceptional programs underway in the School of Public Health."

INITIATIVES UNDERWAY

The University of Maryland School of Public Health currently has extensive research and community outreach programs already active in Maryland, including the CDC-funded University of Maryland Prevention Research Center, the 10 year old City of Seat Pleasant - University of Maryland Partnership, the Herschel S. Horowitz Center for Health Literacy, the Cultural Competency in Healthcare initiative, and the new Center for Global Health Initiatives, funded by NFL player and Maryland alum, Madieu Williams.