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CardioNerds (Amit Goyal and Daniel Ambinder) are joined by Dr. LaPrincess Brewer and Dr. Norrisa Haynes for a Narratives in Cardiology episode, with a special introduction by Dr. Sharonne Hayes. They discuss health inequities especially in communities of color, impact of projects utilizing community based participatory research (including FAITH! and SHARP founded by Dr. Brewer and Dr. Haynes respectively), and their experiences as underrepresented minority women physician-scientists.
This special discussion is brought to you in collaboration with the Association of Black Cardiologists (ABC). The ABC’s mission is to “Promote the Prevention and Treatment of Cardiovascular Disease, including Stroke, in Blacks and other Diverse Populations and to Achieve Health Equity for all through the Elimination of Disparities.” You may join and support the ABC at abcardio.org.
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Show notes for Health Equity, Community Based Participatory Research, & Underrepresented Minority Women Physician-Scientists
1. What healthcare disparities exist in communities of color?
- The life expectancy of black Americans on average is 3.4 years shorter than that of white Americans. CVD is estimated to explain over 32% of the mortality difference between AA and white men and 43% of the difference between AA and white women. Together these conditions contributed to > 2 million years of life lost in the AA population between 1999-2010. (1)
- The impact of COVID-19 on minority communities has caused disproportionate morbidity and mortality and devastating health and financial hardship. According to the CDC, black Americans are 1.9x as likely as whites to die from COVID-19. (2) Additionally, at the beginning of the pandemic, a staggering 41% of black owned businesses closed due to COVID-19 as compared to 17% of white owned businesses. (3)
2. Community engagement & Community based participatory research (CBPR) – what is it?
- CBPR often has a public health bend that focuses on and attempts to address social, structural and environmental inequities through active involvement of community members in all aspects of the research process (from conception to implementation). Community partners provide their unique expertise to enhance understanding of the community and facilitate implementation. (4)
3. What is FAITH!?
- The Fostering African American Improvement in Total Health (FAITH) program was started by the phenomenal Dr. LaPrincess Brewer. FAITH is a cardiovascular health and wellness program that uses a CBPR approach to promote heart health in the African American faith-based community.
- Participants in the FAITH program have shown significant improvement in heart health knowledge. Participants have also had improvement in key heart disease risk factors such as blood pressure. The FAITH app was created in collaboration with community members to achieve easy access and easy usability. It provides vital information and a community network that provides support and motivation for participants.
4. Specifics of SHARP?
- SHARP stands for Safe Haircuts as We Reopen Philadelphia. SHARP was started to assist local barbershops and salons implement proper COVID-19 safety practices to keep their businesses, clients, and staff safe. In partnership with community members, a safety blueprint was created to meet CDC and Philadelphia Health Department guidelines. Through donations from UPenn and Accenture, SHARP was able to distribute a significant number of PPE items to 30 businesses in West and Southwest Philadelphia.
- Additionally, due to the financial toll that the pandemic has had on small businesses, SHARP organized grant writing sessions through the Netter Center at Penn to help the coalition of businesses in West Philadelphia apply for governmental financial relief. Through collaboration with local mental health professionals, SHARP has also been able to offer free therapy to community members. SHARP is currently working with the coalition of businesses to assist them in becoming positive COVID-19 vaccine ambassadors.
5. What is the concept of #MeWho?
- #ME_WHO is a brilliant piece authored by Dr. Michelle Albert that was published in Circulation in 2018. In this piece, Dr. Albert eloquently describes how underrepresented minorities and specifically underrepresented minority women physician-scientists (URMWP) are tasked with maintaining an arduous balance.
- In her words “URMWP are faced with walking a tight rope in academic medicine that requires expertise and excellence in both clinical and scholarly domains, typically with insufficient academic support, social capital, and attainment of senior leadership roles that would turn their zeal and commitment into progress.”
- Dr. Albert then goes on to provide solutions which include: an inclusive ecosystem, academic institutions and professional organizations functioning as drivers of change through partnerships in their communities to elevate the professional and social climate, and federal entities and private funders committing to nurturing a diverse healthcare workforce committed to providing the best possible care to all communities. (5)
The CardioNerds Narratives in Cardiology series features cardiovascular faculty representing diverse backgrounds, subspecialties, career stages, and career paths. Discussing why these faculty chose careers in cardiology and their passion for their work are essential components to inspiring interest in the field.
Each talk will feature a cardiology faculty from an underrepresented group, within at least one of several domains: gender, race, ethnicity, religion, national origin, international graduate status, disadvantaged backgrounds, etc.
Featured faculty will also represent a variety of practice settings, academic ranks, subspecialties (e.g. clinical cardiology, interventional cardiology, electrophysiology, etc), and career paths (e.g. division chief, journal editor, society leadership, industry consultant, etc).
Faculty will be interviewed by fellows-in-training for a two-part discussion that will focus on:
1) Faculty’s content area of expertise
2) Faculty’s personal and professional narrative
As part of their narrative, faculty will discuss their unique path to cardiology and their current professional role with particular attention to challenges, successes, and advice for junior trainees. Specific topics will be guided by values relevant to trainees, including issues related to mentorship, work-life integration, and family planning.
To help guide this important initiative, the CardioNerds Narratives Council was founded to provide mentorship and guidance in producing the Narratives series with regards to guests and content. The CardioNerds Narratives Council members include: Dr. Pamela Douglas, Dr. Nosheen Reza, Dr. Martha Gulati, Dr. Quinn Capers, IV, Dr. Ann Marie Navar, Dr. Ki Park, Dr. Bob Harrington, Dr. Sharonne Hayes, and Dr. Michelle Albert.
The Narratives Council includes three FIT advisors who will lead the CardioNerds’ diversity and inclusion efforts, including the current project: Dr. Zarina Sharalaya, Dr. Norrisa Haynes, and Dr. Pablo Sanchez.
Guest Profiles – Health Equity, Community Based Participatory Research, & Underrepresented Minority Women Physician-Scientists
Dr. La Princess Brewer is an assistant professor and preventative cardiologist at the Mayo Clinic college of medicine. She is an innovative physician-scientist whose research focuses on creating visionary strategies to reduce heart disease and health disparities in minority populations and underserved communities. Dr. Laprincess Brewer also leads the Fostering African-American Improvement in Total Health (FAITH) program which she started as a cardiology fellow and has since brought to the Mayo clinic. The Faith program has since grown and evolved. It is now a mobile application which continues to improve cardiovascular health through the use of technology and digital health but now also focuses on COVID-19 education and COVID-19 mitigation in the African American Community. Dr. Brewer is also a member of the Association of Black Cardiologists (ABC).
Dr. Norrisa Haynes is a senior cardiology fellow at the University of Pennsylvania (UPenn). She attended Yale University for her undergraduate studies where she received a Bachelor of Science (BS) in Molecular and Cellular Biology. She went on to complete her medical school and internal medicine training at Columbia University College of Physicians and Surgeons. During medical school, she received a Master of Public Health (MPH) from Harvard University. After residency, she worked for Partners in Health (PIH) in Haiti for 2 years at Hôpital Universitaire de Mirebalais (HUM) as a junior attending. During those two years, she also worked as a Harvard Medical School instructor and Brigham hospitalist. After spending 2 years in Haiti, she started cardiology fellowship at UPenn. She is interested in imaging and is currently obtaining a Master of Science in Health Policy (MSHP). Dr. Haynes is a member of the ACC/AHA joint guidelines committee and is a member of UPenn’s Women in Cardiology group (WIC). Dr. Haynes also serves the fellow representative to the board of the Association of Black Cardiologists (ABC).
- Carnethon MR, Pu J, Howard G, Albert MA, Anderson CAM, Bertoni AG, et al. Cardiovascular health in african americans: A scientific statement from the american heart association. Circulation. 2017 Nov 21;136(21):e393–423.
- COVID-19 Hospitalization and Death by Race/Ethnicity | CDC [Internet]. [cited 2021 Jan 3]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html
- More than half of Black-owned businesses may not survive COVID-19 [Internet]. [cited 2021 Mar 5]. Available from: https://www.nationalgeographic.com/history/article/black-owned-businesses-may-not-survive-covid-19
- Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: Assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.