Health Equity
Family physicians develop deep relationships with patients and take a holistic approach to patient health. This unique connection with patients and their communities positions us to play an important role in addressing the health care disparities that can impact our diverse patient population. We understand that social determinants of health (SDoH), including education, employment, socioeconomic status, social support networks, and neighborhood characteristics, are the primary drivers of health inequities and have a great impact on the overall health outcomes of our patients — and our research reflects this understanding.
We approach much of our research with a health equity lens, and our research intersects with health equity in a wide range of areas, including maternal-child health, community health, immigrant health, substance use disorder and specialty care. When appropriate, we collaborate with government, community groups, and health and social service organizations to affect positive change for the populations we serve. In all our research, we strive to mitigate health inequities to support the highest level of health for all people.
Research areas include:
- Improving health care access and equity for immigrant and refugee patients: This body of work aims to improve health access and equity for immigrant and refugee patients, many of whom are non-literate or non-English-language speakers, by determining what interventions would be most helpful in reducing barriers to health care access.
- Use of acupuncture to promote health equity: Our work in this area is focused on demonstrating the safety, acceptability and beneficial contributions of acupuncture in health care, especially within marginalized populations, and to build support for integrating acupuncture into a variety of treatment settings.
- Using implementation science to improve care delivery in the safety net setting: Most discoveries and evidence-based practices are not utilized in clinical care and public health. Implementation science aims to close this “know-do” gap. It is an important approach to promote health equity because it is often marginalized and minoritized communities who do not receive evidence-based care. Our faculty have used implementation science to overcome language barriers for patients with limited English proficiency, improve the hospital discharge process, increase detection of non-alcoholic fatty liver disease, and address the overuse of antibiotics.
- Supporting improved breastfeeding outcomes: This body of work focuses on health system and community-based research that promote increased access to human milk and help families achieve their infant feeding goals, particularly in vulnerable, high-risk, and minoritized populations such as refugees, non-English speakers, and those with substance use disorders. Multiple systemic and social factors contribute to lower rates of breastfeeding among Black families, worsening maternal and infant health disparities. By supporting improved breastfeeding outcomes, we can address these disparities.
- Developing global health competencies for family medicine residents to better address local health: This project is working to refocus medical schools from hospital-based medical education to training local doctors in the communities in which they work. Our programs are focused on providing health care services to communities that have no or little access to health care, training local teachers, doctors and leaders to ensure sustainability.
- Strengthening primary health care systems in low- and middle-income countries in Southeast Asia: This project works with medical schools to develop curricula in primary care and family medicine and to revise outdated undergraduate medical curricula. The goal is to provide all people with access to well-trained family doctors.
- Religions, medicines, and healing; intersections of American Muslim identities: This research examines the way that multiple cultural identities affect how communities, families, institutions, and healthcare workers provide and receive care to address physical, mental, social, and spiritual health concerns. The goal of this work is to listen to individuals and groups seeking to transform their neighborhoods, congregations, and families and to advocate for policies that remove structural barriers to citizenship, employment, transportation, housing, education, insurance and access to quality healthcare.
- Using buprenorphine to treat opioid use disorder: This series of projects examines the impact of buprenorphine treatment on health outcomes for patients with opioid use disorder. Relevant topics include the impact of buprenorphine dosage, specifically, on the likelihood that someone stays in care, and whether access to high-quality treatment with buprenorphine varies by characteristics like sex, race, and demographics.
- Primary care utilization among low-income populations: This area of research aims to understand who gets access to care, what kind of care, and where disparities emerge in receipt of primary care among low-income populations.
- Access to substance use treatment: This group of projects aims to understand factors that influence access to treatment for patients with substance use disorders (SUDs). Specific examples include how policy changes around residential treatment influences residential utilization, and the way that telehealth influences receipt of primary care services for patients with SUDs.
- Restorative justice and storytelling to heal medical mistrust: This work examines the efficacy of restorative justice and storytelling on healing medical mistrust.
- Leading clinical trials to bring community partners to the table: Our physicians are leading the local arm of an international study evaluating the impact of Pfizer’s Paxlovid in high-risk children who are infected with COVID-19. These trials have specifically used community engagement methods, including tabling at community events and having participants record and tell their stories, to build trust with communities that do not traditionally enroll in clinical trials.
- Building the voice of our community: Our team was awarded a CTSI grant to build and evaluate best practices for hospital-based youth advisory boards. This work culminated in our safety net hospital creating its first youth advisory board, a strong voice that continues to help shape hospital policies and actions.
- Curriculum to address medical mistrust: This work is based on an ongoing NIH Community Engagement Alliance (CEAL) grant that uses restorative justice and storytelling to build a curriculum that brings together medical providers and community members to create a relationship of trust.