In her first communication as founding director of the new Michael Reese Foundation Center for Health Equity Research at Rosalind Franklin University, social epidemiologist Amanda Simanek, PhD, MPH, offered up a definition and laid down a challenge.
“Health inequities are differences in health across groups that are systematically perpetuated by unjust social structures, and importantly, differences in health that healthcare providers, public health professionals and government officials have a duty to act on by working to disrupt these structures and ensure the conditions necessary for obtaining optimal health are in place for all.”
The Center for Health Equity Research will take up the call to act, said Dr. Simanek, who arrives on campus this summer, by fostering health equity-focused research collaborations that are responsive to community needs, address socio-structural determinants of health and involve implementation of interventions aimed at improving health equity.
“Public health has built a mountain of evidence on health inequities over the past 20 years. So now the question is, ‘How do we translate data into action?’ ”
“Dr. Simanek emphasizes the importance of listening to the community,” said Carl Lawson, PhD, MPH, interim assistant dean for diversity and inclusion and CMS director of Interprofessional Global Health, who served on the search committee for the director. “She understands that the foundation of community-based research is actually engaging the community in conversation about what research is, because many people equate research with experimentation. Given our nation’s history, that’s not surprising. So we need to listen and learn how our neighbors define their own well-being. We have to ask questions of them. We have to gather data from them. That process is research, and it informs actions we can take together to improve community health and advocate for change.”
The center will serve as the nucleus for the existing ecosystem of RFU initiatives aimed at improving health equity: the Community Care Connection mobile health clinic; educational pathways in partnership with local schools, including the Nursing Education to Workforce Pathway — a hallmark program of the new College of Nursing; the Interprofessional Community Clinic for the uninsured; the Innovation and Research Park and its contributions to the local economy and public health; and a new emphasis on lifestyle medicine, the social determinants of health, and diversity, equity and inclusion across academic programs and curricula.
“We needed a hub,” said Chicago Medical School Assistant Professor of Medicine Maureen Benjamins, PhD, an epidemiologist with CMS partner Sinai Urban Health Institute (SUHI) on Chicago’s West Side. “We needed a home for people who are dedicated to advancing equity and who are working on various pieces of that. Public health has built a mountain of evidence on health inequities over the past 20 years. So now the question is, ‘How do we translate data into action?’
“The center, headed by Dr. Simanek, will help us be very intentional,” added Dr. Benjamins, who also served on the search committee. “It will help keep our eyes on the fact that we’re trying to eliminate a gap. We want to implement new programming or policies and use evaluation techniques that are centered on equity. Advances in medical care might benefit the larger population, but often have little or no impact for communities that have been historically marginalized. Life expectancy — which is as much as 10 years shorter for Black people than white people who live near RFU — is one very powerful metric that measures the gap.”
Northern Lake County offers evidence of the stark reality behind the National Academy of Medicine’s observation that “disparities reflect and contribute to the impact of structural racism on health at the systems level.” Demographic data collected by the Healthcare Foundation of Northern Lake County, an RFU philanthropic partner, reveals persistent racial disparities in income, education and health — with the largest inequities in three communities along Lake Michigan. There, Black and Hispanic people make up 68% of the population, 23% of adults lack a high school diploma and 50% spend more than a third of their income on housing. The coal-fired power plant that has belched toxins for decades will close this year. But massive dumps of coal-ash pollutants will remain — a risk factor equal to smoking a pack of cigarettes a day for anyone living nearby, the U.S. Environmental Protection Agency once estimated.
Executive Vice President for Research Ronald Kaplan, PhD, has been the driving force behind the Center for Health Equity Research.
“I saw how effective SUHI was in documenting and addressing inequities in underserved Chicago neighborhoods, and I saw the great need in Lake County,” he said. “We have a responsibility, as an anchor institution, to try to help solve some of the inequities in our closest communities. We realize this is a lifetime endeavor, that these are systemic issues. But there’s a saying in Hebrew, ‘tikkun olam,’ which means ‘heal the world’ one action at a time.”
Both Dr. Kaplan and Chicago Medical School Dean Archana Chatterjee, MD, PhD, recognize the growing interest among RFU students and faculty in issues of equity, in the 80% of health determinants that exist outside of doctor appointments and hospital visits.
“It will be an engine for scholarship and research that can translate into improved health and well-being,” Dr. Chatterjee said. “We want to continue to extend research opportunities to aspiring students from our community. We must be inclusive of our whole community, paying special attention to those who are disenfranchised, discriminated against, who don’t have access.”
“We have a responsibility, as an anchor institution, to try to help solve some of the inequities in our closest communities.”
The center is expected to be powered by interprofessional collaboration among RFU’s faculty and students in more than 30 graduate health profession programs.
“There are so many ways to collaborate and connect that will be of interest to those within our respective schools and colleges — medicine, pharmacy, podiatric medicine, nursing, psychology and so many other programs in our College of Health Professions,” Dr. Lawson said. “It’s an incredible opportunity to take our collective skills and our collective will and interact with our communities in a way that engages them with respect. All of us working together can design and provide interventions and programs that lead to better health outcomes for populations most in need.”
Health psychologist Kristin Schneider, PhD, associate professor in the Department of Psychology and associate dean of research for the College of Health Professions, has previously conducted research in collaboration with the Lake County Health Department and North Chicago public schools, work that was difficult to sustain, especially during the pandemic.
“I’m looking forward to a much more concentrated effort and synergy around community-based research,” she said. “The center will definitely be helpful, especially in terms of establishing relationships with different organizations and community folks. Its biggest role, in my mind, is going into the community, learning what the needs are and what needs to be done, and using that input to facilitate connections with researchers.”
Dr. Benjamins has seen first-hand the disconnect between “what researchers think might work and what people who live in the community think will work.”
“We will really need to engage the community to guide this effort,” she said. “We have to do more than inform them or consult with them or ask them to serve on advisory committees. Effective changes only happen when you share the decisions, share the power. We need to help researchers get comfortable with that idea. We have to follow the community’s lead.”
Judy Masterson is a staff writer with RFU’s Division of Marketing and Brand Management.