Breast Cancer Blog 102821_SocialCard
By Faustine Williams Ph.D., M.P.H., M.S.
Stadtman Tenure-Track Investigator and NIH Distinguished Scholar
Health Disparities & Geospatial Transdisciplinary Research Program
Division of Intramural Research
National Institute on Minority Health and Health Disparities
Although we have seen substantial progress over the last 30 years in breast cancer incidence and outcomes, geographical and racial/ethnic disparities across the cancer care continuum persist.1, 2 As shown in the NIMHD research framework, the factors contributing to these disparities are complex, numerous, and interrelated sets of individual, interpersonal, community, and societal determinants.3 However, early breast cancer detection or diagnosis and treatment initiation can lead to better outcomes. For example, the 5-year relative survival rate for localized-stage disease that has not spread to other sites/organs is 99.0%.4
Despite the advances in medicine and technology, cancer is still the word no one wants to hear. Years ago, when I interviewed breast cancer survivors about their experiences, they described it as a family experience because they could not have gone through it without the support from family and friends that helped them cope.5 The journey from diagnosis and treatment to survivorship does not just touch the affected individual, but family, friends, and loved ones as well. I thought I understood their stories, but I was wrong until I became the de facto caregiver to my friend/sister Yaa. Continue reading “Breast Cancer Is a Complex Journey”
By Shameka Poetry Thomas, Ph.D.
NIH Intramural Research Program
Health Disparities Unit
Social and Behavioral Research Branch
National Human Genome Research Institute
Dr. Shameka Poetry Thomas
My grandmother was a traditional healer and a medicine-woman in Georgia’s rural South. Although I grew up in Miami’s Opa-Locka (a small urban neighborhood tucked between Miami-Gardens and the cusp of Hialeah / Little Havana), I spent most summers near middle Georgia’s farmland, listening to my grandmother. I observed how grandmother, who did not have a Ph.D., gathered Black women in circles. She described the process of listening to Black women’s pregnancies, births, and wellness experiences as “chitchatting and holding space.”
Learning how to ‘hold space’ is what draws me to narrative medicine. My first dose of learning how to conduct narrative medicine, I suppose, came from my grandmother. This methodology (before I knew it was such) was simply understood as the process of sitting in kitchens and beauty salons in the South—just listening. During childhood, I was merely curious about how Black women described their pregnancies, births, and reproductive health—from their side of the story. Thus, when it came to reproductive health, my grandmother taught me a powerful tool: how to “hold space” for people’s narratives. Continue reading “Storytelling Through Narrative Medicine: Measuring the Lived-Experiences of Black Women’s Reproductive Health”
Ali H. Mokdad, Ph.D.
Chief Strategy Officer, Population Health
Professor, Health Metrics Sciences
Institute for Health Metrics and Evaluation
University of Washington, Seattle
Ali Mokdad, Ph.D.
Despite greater public awareness about the social determinants of health, health inequities in the United States remain severe. Reducing disparities in health outcomes are a persistent challenge for policymakers, public health officials, and medical professionals. Due in part to these gaps, the U.S. underperforms against other industrialized countries in key health metrics, such as overall and healthy life expectancy. The reasons that the U.S. lags behind its peers are manifold. Most importantly, however, are the health discrepancies by geographic location, race/ethnicity, and socioeconomic status (SES). Understanding and reducing disparities among those most affected must be of central interest to policymakers to ensure that every person in the U.S. can lead a healthy life. A dearth of sufficient evidence on local health patterns produced from high-quality scientific research weakens our ability to understand the problem and design interventions. A particularly pressing need is for comprehensive and comparable examination of health outcomes for individuals in the U.S. by race/ethnicity and SES at the local level. Continue reading “All Health is Local: Measuring the Burden of Disease by U.S. County, Race/Ethnicity, and Socioeconomic Status”
Photo of Dr. Jeremy Goldbach
By Jeremy T. Goldbach, Ph.D., LMSW
Chair, USC Social Behavioral Institutional Review Board
Director, Center for LGBT Health Equity
University of Southern California
Suzanne Dworak-Peck School of Social Work
I remember it like yesterday. I stepped into the small, cramped meeting room of a local LGBTQ drop-in center. The room served triple duty as a social milieu, computer lab, and meeting room. Posters and homemade art covered the walls, displayed proudly everywhere the eye could see like wallpaper, almost demanding inspiration and hope from passive onlookers. The warm room, paired with the anxiety that no title or position can ever seem to overcome, made my hands clammy. I had arrived seeking feedback on an intervention we had been developing for nearly a decade. Bracing myself for the brutal honesty only found in adolescence, I opened the floor. “So, what do you think?” Continue reading “Don’t Forget the Good: Reflections from LGBTQ+ Youth Before and During COVID-19”
By Larissa Avilés-Santa, M.D., M.P.H.
Director, Clinical and Health Services Research
National Institute on Minority Health and Health Disparities
Dr. Larissa Avilés-Santa
Hurricane season starts on June 1. Tracking of storms that are formed along the Northwestern coast of Africa moving westward, and predictive models of increasing wind force and rain are the norm in every daily news in the Caribbean during this time of the year. Perhaps, the ships that brought our enslaved ancestors from different regions of Africa, and from different parts of Europe, the Middle East and Asia navigated the same routes of these tropical storms. And those may be the same routes that our other ancestors, those who had lived millennia on this side of the globe, navigated when facing seasonal changes in nature, wars and survival in paradise. All those peoples, all those ancestries met and blended In the New World and gave us a rich inheritance of history, traditions, and health.
The indigenous people of my archipelago named my land Borikén – the land of the mighty Lord- where they worshiped the god Yukiyú. Yet, they anticipated the devastation after the almost annual ravages caused by the evil god Juracán, where the name hurricane comes from. Hurricane season brings remote and very recent memories of our fragility and resilience. Hurricane season also brings memories of school days off (¡Qué chévere! Nice!), doing homework under the candle lights and eating canned tuna and soda crackers while waiting for electricity to be restored. It also reminds us that catastrophic events like hurricanes can impact our physical surroundings and our physical health.
Right before the end of the hurricane season comes Thanksgiving, the preamble to our traditionally long Puerto Rican Christmas season: parrandas (impromptu gathering of friends or relatives caroling house to house throughout the night), and of course, preparing and eating food beyond January 6… music, food and drink learned from our ancestors that feed our souls and make our bodies happy…so happy and so sweet. Continue reading “The Sweetness of our Ancestors: Thoughts on Diabetes, Genetics, and Ethnic Diversity in Research”
Addiction Should Be Treated, Not Penalized
NOTE: NIMHD Insights is reposting this op-ed piece with permission from the Health Affairs Blog. It is written by the Director of NIH’s National Institute on Drug Abuse (NIDA), Dr. Nora D. Volkow, and is available in Spanish on the NIDA website.
By Nora D. Volkow, M.D.
Director of the National Institute on Drug Abuse
Dr. Nora D. Volkow
The COVID-19 pandemic has highlighted the large racial health disparities in the United States. Black Americans have experienced worse outcomes during the pandemic, continue to die at a greater rate than White Americans, and also suffer disproportionately from a wide range of other acute and chronic illnesses. These disparities are particularly stark in the field of substance use and substance use disorders, where entrenched punitive approaches have exacerbated stigma and made it hard to implement appropriate medical care. Abundant data show that Black people and other communities of color have been disproportionately harmed by decades of addressing drug use as a crime rather than as a matter of public health.
We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance. Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized. The U.S. must take a public health approach to drug addiction now, in the interest of both population well-being and health equity. Continue reading “Addiction Should Be Treated, Not Penalized”