A Journey from Russian Studies to Patient Safety and Healthcare Quality to Health Disparities, Cultural Competency, and Health Equity
By: Cheri Wilson; March 2014
Over twenty-five years ago when I was in high school, I would have been surprised if someone had suggested a career in health care or public health. At that time, my world revolved around languages—I studied French and Spanish and was denied a request to take up yet another language, Russian, which my public high school offered. I began studying Russian in college, however. I remember watching Mikhail Gorbachev’s speech on television on Christmas Day in 1991 signaling the dissolution of the Soviet Union and seeing how much of the Russian I could understand. After a Russian Studies internship at a think tank during the fall semester of my senior year in 1992, I completed a semester abroad in Russia and completed my Bachelor’s degree in Russian. My plans then called for completing a Master’s degree in Russian studies and pursuing a law degree. On the advice of my graduate school advisor, I combined my interests, pursued a doctorate in Russian history, and specialized in nineteenth-century Russian legal history. I received a Master’s degree Russian Area Studies in 1997. I later conducted research in Russian libraries and archives, taught college-level Russian history, and published and presented papers in the U.S. and abroad. Having advanced to doctoral candidacy (all but dissertation) with only the dissertation remaining, I withdrew from the doctoral program in 2006 following the deaths of my two advisors.
In 2003, while pregnant with my daughter, I decided to embark on a career change. I started a temporary job as a Data Coordinator, a position that only required a high school diploma/GED, and completed an online medical terminology course. I returned to work six weeks after my daughter’s birth and was soon hired as a Project Coordinator to coordinate and manage quality improvement and safety projects, analyze data, and create reports from hospital information systems. However, I encountered a major barrier: the skills I had crafted in my previous Russian history career—analytical, critical thinking, presentation, research, technological, and writing skills—were not considered transferrable to the healthcare field. Over a 2-year period, I applied for more than 200 positions, but only managed to receive three interviews due to the abovementioned barrier.
In 2006, I finally encountered someone who was able to stretch her thinking about the applicability or transferability of my previous skill set to the position. I took a position as Patient Safety Analyst. Among other things, I reviewed all near miss and adverse event reports, assisted in the dissemination of systems improvements, and conducted in-service educational presentations. As a non-clinician with an academic background, I struggled to gain credibility in the healthcare field. I had mixed feelings about which educational degree to pursue—BSN or MHA. With the encouragement of my boss and other mentors, I completed a master’s program in health finance and management (now master of health administration) while juggling full-time employment, a husband, and a young child with part-time studies until I graduated in May 2010.
How did I get into health disparities given my background?
It was while serving as a Patient Safety Analyst that I became interested in the issues of cultural competency and health disparities as they related to patient safety and healthcare quality. I had read a few newspaper articles about language access issues and decided to learn more about the topic. As part of this process, I did a study of near miss and adverse events associated with language access. Next, the collection of race, ethnicity, and language data was inconsistent across administrative and clinical information systems and even when collected, the data was often inaccurate.
I continued to advance in my career and in December 2007 was recruited to the Quality Improvement (QI) Department as the first non-nurse QI Team Leader, where I worked with the Departments of Pathology, Pharmacy, and Radiology. In September 2008, I became a Certified Professional in Healthcare Quality (CPHQ) and served as the President of the Maryland Association for Healthcare Quality (MAHQ) in 2009. At the time I left the QI Department in April 2010, I was the Acting Assistant Director, who supervised the QI specialists responsible for chart abstraction and tracking the organization’s performance on quality measures. As a result of these experiences, I was convinced that health equity was a quality issue.
In May 2010, I began as a Faculty Research Associate in the Hopkins Center for Health Disparities Solutions (HCHDS) in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. I currently serve as the Program Director for the Culture-Quality-Collaborative (CQC) and the Clearview Organizational Assessments-360 (COA360). I was recently promoted to Assistant Scientist. In my time in the HCHDS, I have fostered partnerships with a variety of organizations focused upon health and healthcare disparities reduction, such as the Commission to End Health Care Disparities, Center for American Progress, Gay and Lesbian Medical Association (GLMA), Institute for Diversity, and the Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Behavioral Health Equity. Over the past three and a half years, I have gained increased recognition for my expertise in cultural competency, health and healthcare disparities, and health literacy and the intersection with healthcare quality and safety, which is demonstrated by my participation and leadership on numerous committees and commissions related to these issues at the state, local, and national levels. I am particularly interested in health disparities as it relates to racial/ethnic, language, and sexual minorities and the provision of culturally competent patient-centered care in language understandable to all patients. As someone who works directly with the abovementioned groups, I view my primary role as a public health practitioner whose responsibility is to translate research into practice in both healthcare and community settings.
I am a highly regarded speaker, who is frequently called upon to conduct trainings and educational sessions for clinical and support staff in healthcare organizations, public health, medical, and nursing students, K-12 students, and community members on the issues of cultural competency, overcoming language barriers, unconscious bias in health care, and health and healthcare disparities. In addition, I continue to present at national, state, and local conferences on these issues. I recently published an article on language access with commentary in the next issue by my colleague, Dr. Joe Betancourt from the Disparities Solutions Center at Massachusetts General Hospital.
My work primarily focuses upon improving the organizational cultural competency of a variety of settings, such as healthcare, behavioral health and social/human services organizations. However, I also have an interest in maternal and child health, specifically improving birth outcomes for Black women, e.g. reducing infant and maternal mortality, the elective caesarean-section rate before 39 weeks, preterm births, low birth weight babies, as well as increasing breastfeeding. To this end, I am a certified breastfeeding counselor and have completed training to become a certified doula (birth support professional) specifically focused upon improving birth outcomes in communities of women of color. This is my attempt to translate my health disparities work into actual practice.
Dr. Roland Thorpe
February 2014 Newsletter Feature
Roland J. Thorpe, Jr., PhD is an Assistant Professor in the Department of Health, Behavior, and Society at the Johns Hopkins Bloomberg School of Public Health, and the Research, Education and Training Director, and Director of the Program for Research on Men's Health in the Hopkins Center for Health Disparities Solutions. Dr. Thorpe is also a Faculty Associate in the Johns Hopkins Center to Reduce Cancer Disparities at the Johns Hopkins Bloomberg School of Public Health, a Faculty Associate in the Johns Hopkins Center of Aging and Health at the Johns Hopkins School of Medicine, and a Faculty Associate in the Johns Hopkins University School of Nursing Center for Innovative Care in Aging, and a Visiting Research Fellow in the Center on Biobehavioral Research on Health Disparities at Duke University.
Dr. Thorpe has a national reputation for scholarship at the nexus of health disparities and aging. His program of research focuses on understanding the etiology of race- and SES-related disparities in functional and health status of community-dwelling adults across the life course in three inter-related areas: 1) social factors (mainly race and SES) that influence functional and health outcomes in middle to late life; 2) race, segregation and health outcomes; and 3) men's health. Currently, he is the principal investigator of the National Black Men's Health Pilot Study. His work appears in leading journals such as Social Science and Medicine, Journals of Gerontology Medical Sciences, American Journal of Men's Health, International Journal of Men's Health, and Journal of the American Geriatrics Society. Dr. Thorpe's work has been supported by the Johns Hopkins Urban Health Institute, National Institute on Aging, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute and the National Center for Minority Health and Health Disparities of the National Institutes of Health.
He co-teaches courses on research design and methods in social and behavioral sciences, advanced methods in health services research, and seminar in health disparities. Dr. Thorpe was a 2011 recipient of the Advising, Mentoring and Teaching Recognition Award (AMTRA), and is a Fellow of the Gerontological Society of America. He is an Associate Editor of the inaugural Handbook on Minority Aging. He serves on the American Psychological Association Working Group on Health Disparities for Boys and Men. He is a Guest Editor of Family and Community Health on the topic of Social Determinants of Men's Health Disparities. How did you get into health disparities given your background?
My interest in health disparities research began in graduate school while serving as a research assistant in the Center for Aging and the Life Course at Purdue University. I published two papers that focused on examining the relationship between mortality and obesity using a life course perspective. A third paper examined race differences in hospitalizations using data from the NHANES I Epidemiologic Follow-up Study. This work sparked my interest in health disparities. It was this third paper that really sparked my interest in health disparities research. After graduating from Purdue, I accepted an Institutional NRSA Postdoctoral Fellowship funded by the National Institute on Aging in the Division of Geriatric Medicine and Gerontology, and the Center on Aging and Health at the Johns Hopkins University School of Medicine to bolster my understanding of health disparities and aging. During my fellowship, I became formally affiliated with the Hopkins Center for Health Disparities Solutions. Since that time, it has been a complete joy to collaborate with scholars who have a similar goal-to achieve health equity through education, research, practice and policy.
Economic Burden of Men's Health Disparities
Dr. Thorpe recently published an article on the Economic Burden of Men's Health Disparities in the United States, which appeared in the International Journal of Men's Health. A brief summary was published in the Baltimore Sun (see here).
The discussion stated that the estimated costs in the study could actually be underestimated due to various factors including the exclusion of institutionalized populations. Do you believe the inclusion of any excluded data and their associated costs would help push for the creation of an Office of Men's Health within the Department of Health and Human Services as suggested within the article?
We believe that the inclusion of the institutionalized populations would further increase the economic burden of men's health disparities. Nevertheless, we are confident that the findings presented in the article is more than sufficient to begin some dialogue about the need to create an Office of Men's Health within the Department of Health and Human Services as well as how to improve the lives of minority men.
For more information, subscribers can contact Dr. Thorpe at firstname.lastname@example.org.
Dr. Darrell J. Gaskin
January 2014 Newsletter Feature
Dr. Gaskin is Associate Professor of Health Economics and Deputy Director of the Center for Health Disparities Solutions. He is an internationally known expert in healthcare disparities, access to care for vulnerable populations, and safety net hospitals. His goal is to identify and understand barriers to care for vulnerable populations; to develop and promote policies and practices that improve access to care for the poor, minorities and other vulnerable populations; and to eliminate race, ethnic, socioeconomic and geographic disparities in health and health care.
Dr. Gaskin's has published in the leading health services research journals. Currently, he serves on the Editorial Boards of the journals, Health Services Research and Medical Care Research and Review. Currently, he is a member of the Board of Directors of AcademyHealth and the National Economic Association. He has served on the Governing Council of the American Public Health Association. He served on the Institute of Medicine's Committee on the Future of Emergency Care in the United States Health System and the Committee on Valuing Community Based Non-Clinical Prevention Policies and Wellness Strategies.
The Governor of Maryland has appointed him to the Board of Directors of the Maryland Health Benefits Exchange Board where he serves as Vice Chairman. Also, Dr. Gaskin served for four years on the Board of Directors of the Maryland Health Insurance Plan - the state's high-risk insurance pool.
Dr. Gaskin has been a member of the faculties of the University of Maryland-College Park and Georgetown University. His Ph.D. is in health economics from The Johns Hopkins University. He holds an M.S. degree in economics from the Massachusetts Institute of Technology, and a B.A. degree in economics from Brandeis University. Dr. Gaskin is an ordained minister in the African Methodist Episcopal Zion Church. Currently, he serves as Pastor of the Beth Shalom AME Zion Church in Washington, DC.
How did you get into health disparities given your background?
I started my career studying uncompensated care and safety net hospitals. I published an article in the Journal of Urban Health describing the populations safety net hospitals served and to no one's surprise these hospitals are the premier providers of care to low income minority populations. Also, I published an article in Medical Care that demonstrated that hospitals serving minority communities were at greater risk of reducing services and closing. As I discussed the policy implications for safety net hospitals, I was frequently asked whether what was good for the providers was good for the patients. It was those articles and this question in particular that encouraged me to look beyond safety net hospital care and to study health and healthcare disparities in general.
Dr. Janice Bowie
December 2013 Newsletter Feature
Dr. Bowie, PhD, MPH, is an Associate Professor in the Department of Health, Behavior and Society (HBS) and the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health as well as the Center for Reducing Health Disparities in Cancer.
Prior to joining HBS in 1998, she worked as a health educator and later, as director of chronic disease control programs for the Virginia Department of Health. Her public health experience spans more than 30 years and most of her work has centered on community health and health disparity. Her research includes minority and women's health, community-based participatory research (CBPR), cancer control and spirituality. She is currently collaborating on research studies in weight management, prostate cancer, men's health, and therapeutic misconception in patients with Duchenne muscular dystrophy.
Dr. Bowie has designed and implemented interventions in partnership with community-based organizations and within faith settings. Some of these projects ranged from increasing awareness and participation in cancer early detection to the promotion of a healthy homes project for safer neighborhood housing demolition.
How did you get into health disparities given your background?
I became interested in addressing health disparities through my early work as a health educator with the Virginia Department of Health. As part of a team of social workers, nutritionists, outreach workers and public health nurses, we made home visits and provided comprehensive care to families. It was this experience coupled with then Secretary Margaret Heckler's Minority Health Report that solidified my decision to make the health of African Americans and other underrepresented groups impacted by disparate outcomes a focus of my life's work. Joining the Hopkins Center for Health Disparities Solutions has afforded me opportunities to collaborate with like-minded colleagues to advance the research, policy and practice to limit racial and ethnic disparities and the social determinants that perpetuate their existence