Saturday , November 27 2021

Study to assess the impact of a multi-component intervention in reducing racial health disparities



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In an unusual effort to address the damaging effects of structural racism on health, 60 particularly Black Weeks in Philadelphia will be part of an ambitious study to assess the impact of a multi-component intervention that addresses both environmental and economic injustices on health and wellness, led by Penn Medicine researchers Eugenia C. South, MD, MHSP, and Atheendar Venkataramani, MD, PhD.

At the community level, the study includes tree planting, low-lying lot augmentation, ash cleaning, and rehabilitation of dilapidated, abandoned homes. For households, the study will help participants connect with local, state, and federal social and economic benefits, including food, unemployment, and prescription drugs, provide financial advice, and provide tax relief services, and provide emergency assistance.

This randomized controlled trial (RCT), funded by a nearly $ 10 million grant (1-U01OD033246-01) from the National Institutes of Health (NIH), awarded to researchers at the Perelman School of Medicine at the University of Pennsylvania Through the NIH Common Fund’s Transformative Research to Health Disparities and Advance Health Equity initiative, the NIH announced 11 grants totaling $ 58 million over five years for highly innovative research on health inequalities in the US

Earlier efforts to reduce differences in racial health have had less impact than we would like, as they often address only a small number of the many mechanisms by which structural racism harms health. Our multi-component intervention is designed to address these multiple mechanisms simultaneously. “

Atheendar Venkataramani, Assistant Professor Professor of Medical Ethics and Health Policy and Director of the Opportunity for Health Lab

Recent research illustrates that the roots of poor health in black neighborhoods are structural, as a result of decades of disinvestment and neglect. The effects of structural racism are reflected in neighborhood-level factors such as demolished homes, lack of greenspace, garbage collection, and declining economic opportunity. The impact on the health of individuals living in those communities is profound, and includes increased rates of depression, post-traumatic stress disorder, and heart disease compared to their White counterparts.

The researchers also aim to make it easier for individuals to navigate the process of determining their suitability and get help from multiple providers through the development of a platform that makes collaboration between municipal financial services simpler and more efficient. Community partners, including the Pennsylvania Horticultural Society, Campaign for Working Families, Benefits Data Trust, and Clarifi will conduct the interventions.

“Black communities are central to this proposal,” said Eugenia South, MD, MSHP, an assistant professor of Emergency Medicine, and faculty director of the Penn Urban Health Lab. “Collectively, our team has spent a significant amount of time talking and collaborating with leaders and community groups in neighborhoods Black Philadelphia and with this study we are committed to responding to the economic and environmental needs they have identified. We will also hired four full members of the community to join the Penn Medicine team to advise on the entire process and lead recruitment. “

The researchers will enroll 720 predominantly Black adults in the 60 study neighborhoods, half of whom will receive the proposed interventions. The study will meet participants where they are through door-to-door recruitment, instead of relying on clinic referrals as answers to flyers, which may exclude the most vulnerable adults. Researchers will use standardized surveys to evaluate participants’ overall health and well-being multiple times throughout the course of the trial. They will also evaluate the impact on violent crime.

The overall goal is to show that deeply rooted racial differences in health can be closed by concentrated investment in Black Weeks. Researchers are hopeful that their interventions will be successful in improving the health not only of study participants but other members of the household and of the entire community. The findings of this bold project can serve as evidence to policymakers that these intrusive, “large-scale” interventions work, and need to be broadly implemented.

Co-researchers on the study are: George Dalembert, MD MSHP, Assistant Professor of Clinical Pediatrics, Courtney Boen, PhD MPH, Assistant Professor of Sociology, Meghan Lane-Fall, MD MSHP, Associate Professor of Anesthesiology and Critical Care, and Epidemiology in Biostatistics, and Epidemiology, and the Director of Acute Care Implementation Research at the Penn Implementation Science Center, Kristin Linn, PhD, Assistant Professor of Biostatistics, John MacDonald, PhD, Professor of Criminology and Sociology, Christina Roberto, PhD, Assistant Professor of Medical Ethics and Health Policy, and Charles Branas, PhD, an adjunct professor of Epidemiology in Biostatistics and Epidemiology.

Source:

University of Pennsylvania

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