By Sharon Brock
“We are the change agents. With health care reform, we need to improve outreach programs and restructure our research to promote change. Our research costs a lot of money; it needs to make a difference.”
That was a call to action by William Vega, PhD, provost professor at the University of Southern California, to nearly 300 faculty and staff gathered for a recent symposium focusing on health disparities research at UCSF.
“Social injustices, which lead to health care disparities, are not ending any time soon, so what we need to do is equalize within the system, be more cost effective with our resources and mitigate the worst impacts of these disparities over the next 10 years. It’s what needs to be done.”
Vega was the keynote speaker at the Fourth Annual Health Disparities Research Symposium on Oct. 22, at the UCSF Laurel Heights Conference Center. The symposium, organized by Barbara Gerbert, PhD, Victor Fujimoto, MD, and Eliseo Perez-Stable, MD, was one of the main events for UCSF’s diversity celebration month.
The symposium also featured presentations by eight top UCSF researchers about their current work on health disparities in the U.S. An additional 30 research groups were selected to give poster presentations.
“We have so much talent here at UCSF,” Gerbert said. “We have researchers who use their knowledge for policy change in Congress, but many researchers don’t know what other researchers are doing, so this is an opportunity to develop networks of collaboration. With this event, our goal was to build community and support for both junior and senior faculty and come together as experts on this important topic.”
Vega was chosen to be the keynote speaker because of his years of expertise in preventative medicine, psychiatry and family medicine. An elected member of the Institute of Medicine and an emeritus professor at UC Berkeley, Vega specializes in multicultural ethnic epidemiologic and services research and analysis of health disparities.
In his presentation, titled “Social Pathways and Remedies to Health,” Vega gave a broad spectrum of the pinnacle issues on health disparities, and defined the role of scientific research in resolving these issues. He identified key issues on health disparities, including:
- language barriers between physicians and patients;
- lack of coordination between physicians, researchers and policymakers regarding standards of care among different groups;
- an increasing need for physicians as populations increase;
- a need for sustained outreach programs over time to improve self-management and medication adherence.
“The search is to find a common ground, an empirical standard for health and health care,” Vega said. “Because unfair and unjust are in the eye of the beholder—and the current standard is what is fair and just for whites. So, we need to work together to be able to address all groups.”
To analyze health disparities, Vega studies the differences in exposures to social and environmental risk factors based on socioeconomic status, ethnicity and race, and gender. He analyzes how these factors lead to varying psychological development, employment opportunities and specific health outcomes.
Vega is currently taking his research a step further by studying epigenetics, gene-environment interactions and how they lead to health disparities. With this, he looks at the various levels of health: starting with DNA, building into physiological systems of the body, which compile into the entire individual which interacts in social and cultural systems of communities. Vega studies the linkages between these levels and how a health risk at one level can affect the other levels.
Maya Vijayaraghavan, a clinical fellow in the Department of Medicine, talks about her research focusing on the effects of housing instability at the health disparities research symposium, one of the main events for UCSF’s diversity celebration month.
“We need to understand these levels and how to link them together by integrating social and biological approaches,” said Vega. “Structural changes in DNA would take 200 generations, but transcription processes can change due to different environmental conditions and lead to various health outcomes.”
For example, he talked about a study done on lung cancer among Latino men. The study showed that lung cancer rates were higher among Latino men who migrated to the U.S. compared to men who lived in Mexico, even though they most likely had the same genetic predisposition to lung cancer.
“It is important to focus on place; the environmental factors such as greater access to cigarettes in the U.S. than Mexico,” said Vega. “In response, we need to garner resources and establish processes for equitable distribution of health information and health services for people in these vulnerable areas.”
As a response to health care reform, which may lead to fewer health practitioners, as well as a rapidly rising minority population, Vega also called for improved distribution of public health information, such as developing websites and online patient portals.
The UCSF researchers presented promising findings for improved distribution of public health information as well as improved quality of health care among minority groups.
Photos by Sharon Brock