Health disparities researcher: We must build trust
Lorna McNeill, Ph.D.
As Jamaican immigrants, my parents stressed the importance of education. They felt that was the best way to succeed in America – and so I did.
I worked hard and graduated high school as valedictorian. I knew that I wanted to get out of New York for college, so that led me to The University of North Carolina at Chapel Hill. There, I focused on African American studies and got my first understanding of how I could make a mark on this world.
Discovering my passion for disparities in public health
After graduating college, I was unsure of my future. I was still in Chapel Hill and working on campus.
That summer, the rapper Tupac Shakur died. There was a shortage of his blood type, so some students from the School of Public Health wanted to hold a blood drive to promote blood donation among African Americans. It was my job to help them organize the event.
Those students introduced me to the concept of public health. Before that, I had wanted to be a physician. Our experience helped me decide to apply to get a master's degree in the field. That’s when I discovered my passion: disparities in public health.
Differences in communities and health care opportunities
My first job as a research assistant was on a study that investigated smoking cessation in pregnant women. The women enrolled in the study had stopped smoking during pregnancy, and my job was to call them to see if they had permanently kicked the habit.
Many of the women lived in rural areas of North Carolina, and many were white. When I spoke to them, I learned they had a lot of challenges with staying smoke-free. Their lives were difficult. They were dealing with many stressors at home.
I started to understand that peoples’ lived experiences – what we now call social determinants of health – impact their abilities to make healthy choices. The messages that we’re telling people, such as “just go walking, just eat right and just quit smoking,” don’t resonate across all communities. People don’t always have the same options to make good choices for their health. It depends a lot on where you live, what resources you have and your life circumstances.
Learning to listen and make connections in the community
Another early study I worked on aimed to increase the number of fruits and vegetables eaten by African Americans in order to reduce the prevalence of colorectal cancer in North Carolina. We partnered with churches in order to do that.
My mom is a preacher, so I was comfortable in that setting, but the woman who was the principal investigator of the study was a white Jewish woman. She had nothing in common with the individuals we were trying to reach, but I watched her make connections and engage. She built relationships in a community that looked nothing like her.
From her, I learned the practice of really listening to people, trying to understand their perspectives and how to incorporate them into a study.
We collaborate with as many groups, communities and organizations as possible in order to ease the burden of cancer that exists in the different populations in our country.
We also build relationships with the people we’re trying to serve. It’s important to me to partner with community groups that support the people who will ultimately benefit from our work. We can make a difference, but we must put it in the context of how it will change people’s day-to-day lives for the better.
For example, with the rollout of the COVID-19 vaccines, there’s been a lot of hesitancy in Black and Hispanic communities. That’s because there’s a lack of trust. To address this crisis as well as those in the future, we’re going to have to develop that trust with our institutions and within our health care system.
We need to show up for these communities and let them know we have their best interests at heart. That’s my goal. I want MD Anderson to be seen as a trusted source for everyone in our community.
My advice for the next generation of health disparities researchers
There’s more support than ever for the health disparities field. It’s a good time to join us.
In the past, health disparities research was a passion for people. It made them feel good, but it wasn’t substantial enough to build a career on. But the tide is changing. This is a bona fide career area.
Fortunately and also unfortunately, it’s an area of growth, too. As the U.S. demographics shift, health care is going to have to focus on people of color so that our country isn’t overwhelmed by a sick, underserved population.
So, don’t be afraid if someone tells you this isn't a real research area. Ignore that and pursue it. Reach out to people like myself and other leaders in this field for guidance and support.
If you have a heart, a passion for social justice and want to make a difference, this is the field for you.