November 4, 2008
Limb amputations, unintended pregnancies and the economic impact of smoking were just a few of the topics raised at the second annual UCSF Health Disparities Research Symposium on Oct. 24.
The symposium spotlighted the work of eight UCSF faculty members working to address the striking gaps in health and health care between various racial, ethnic and socioeconomic groups.
The event was part of UCSF’s ongoing effort to serve the local, regional and global communities and to eliminate health disparities – a key element of the University’s Strategic Plan, unveiled in June 2007. It was also timed to coincide with the UCSF diversity celebration, a monthlong series of special events.
“The intellect and collaborative culture at UCSF mean we’re in a unique position to help eliminate [health] disparities,” said UCSF Executive Chancellor and Provost Eugene Washington, MD, who called the symposium “an unequivocal success.”
Some of the research projects took the form of quantitative clinical trials, such as the one-year study by Michael Conte, MD, of survival, limb amputation and vein graft failure rates among 1,400 patients suffering from critical limb ischemia, a severe obstruction of the arteries leading to the extremities.
Conte, UCSF’s chief of Vascular Surgery, found that African American patients had inferior outcomes in nearly all categories, with African American females faring the worst: The female patients had higher rates of graft failure and limb loss than any other group.
Other projects featured at the symposium focused less on clinical observations and more on patients’ self-reported experiences.
In one such project, Margaret Fang, MD, MPH, UCSF assistant professor in the Division of Hospital Medicine, surveyed more than 180 people taking the stroke prevention drug warfarin, and attempted to see how much they knew about the drug and about strokes in general.
What she found was striking: Roughly 40 percent of respondents demonstrated an incomplete or flawed understanding of warfarin and the disease it is intended to prevent.
Patients with low levels of literacy or English proficiency made up a disproportionate share of that group, Fang’s survey indicated.
Like Fang, Allison Bryant, MD, UCSF assistant adjunct professor of obstetrics, gynecology and reproductive sciences, opted for a more qualitative approach to examining health disparities.
She and her colleagues spoke to women of various races and socioeconomic levels about unintended pregnancy and the amount of time they waited between births.
Both issues are of particular concern to African American women, who account for a disproportionate number of both unintended pregnancies and infant deaths due to low birthweight and preterm delivery, which have been linked to inadequate birth spacing.
In addition to the symposium’s eight featured researchers, a poster display after the main program showcased nearly 70 highly diverse projects whose topics ranged from homelessness among HIV-positive and indigent adults to oral health problems among agricultural workers in rural California.
The research and findings presented on Oct. 24 represented huge advancements in the understanding of health disparities, said Nancy Adler, PhD, professor and vice chair of the UCSF Department of Psychiatry.
As recently as the early 1990s, the medical community was still coming to terms with the fact that such disparities exist, Adler said. Today, the focus has shifted to “what’s creating them; how do we address them?” she said.
Transforming research-documented knowledge into action is of utmost importance, Washington agreed.
“We need to go beyond describing, defining and attacking these disparities and go about taking action and actually eliminating them,” he said in his closing remarks at the symposium.
Washington summed up his point with a quote from the German writer Johann Wolfgang von Goethe: “Knowing is not enough; we must apply. Willing is not enough; we must do.”
The symposium was sponsored by the UCSF Diversity Celebration Planning Committee and co-chaired by Barbara Gerbert, PhD, professor and chair of the Division of Behavioral Sciences, Professionalism and Ethics in the Department of Preventive and Restorative Dental Sciences, UCSF School of Dentistry; Eliseo Perez-Stable, MD, professor in the UCSF School of Medicine and director of the UCSF Medical Effectiveness Research Center for Diverse Populations; and Victor Y. Fujimoto, MD, associate clinical professor of obstetrics, gynecology and reproductive sciences in the UCSF School of Medicine.