Research projects that involve community partnerships can be difficult to get off the ground due to a lack of funding for the initial phase of the research. CEMHD has developed a University-funded grant program that helps resolve this problem by providing funds for pilot studies that employ community-based participatory research (CBPR) methodologies. Each year, it awards several grants of $5,000-$6,000 for projects that show promise to develop into fully-funded, large-scale investigations. Five pilot studies are currently in progress.
The purpose of this project, known in its local focus community as the Women’s Health Project, is to identify strategies for encouraging underserved and minority women to seek regular reproductive healthcare services, including family planning, STI screening, and breast and cervical cancer screening. The Project is rooted in the recognition of significant disparities in disease incidence and health outcomes for adult African American women on multiple indicators of reproductive health, and focuses on the city of Hudson, New York. It is led by Drs. Annis Golden and Anita Pomerantz of the Department of Communication, and is conducted in collaboration with Upper Hudson Planned Parenthood.
The two primary interventions of the Project are community health education events on themes related to women’s reproductive health and a transportation voucher program for improving access to care. The community health education events have two distinctive features. One is to bring women in the community together with representatives of community-based health and human service organizations, which helps to build knowledge and trust on both sides. Events begin with resource fairs during which women can get on-site preventive health screenings (e.g. blood pressure, cholesterol, glucose, STI/HIV screening) and receive assistance from Upper Hudson Planned Parenthood in scheduling an annual GYN appointment and obtaining a taxi voucher for transportation to the appointment. The second distinctive feature of the health education events is to have presentations made by persons who are from the community and reflect the diversity of the audience. This not only represents best practice in terms of connecting with the audience but also is a strategy for building a sustainable model of community health promotion past the life of the grant. The research team is incorporating lessons learned during the initial phase of the project into its strategies for working with the community, as well as continuing to document its activities and outcomes through an innovative mix of qualitative and quantitative methods.
This project seeks to determine whether the reproductive health of women of the St. Regis Mohawk Tribe on the St. Lawrence River has been adversely affected by exposure to chemical pollutants, primarily polychlorinated biphenyls (PCBs). The Akwesasne community is adjacent to one federal, and two state Superfund sites. There is considerable concern in the Akwesasne community regarding difficulties in conceiving and bearing healthy children. This project is a collaborative effort between the St. Regis Mohawk Health Service (SRMHS) headed by Debra Martin, and the University at Albany/CEMHD. The community is solidly behind the project, and we greatly appreciate all the help SRMHS has given us. When the study began, then Tribal Chief James Ransom remarked, “Akwesasne has long been impacted by PCBs from neighboring industries. Women of child-bearing age are a particularly vulnerable at-risk group. We hope this research leads to improved health in our community and we thank UAlbany for the opportunity to participate with them on this important project.”
The study will follow 180 women ages 21-38 through one menstrual cycle to investigate the effect of PCBs, DDT, lead and other pollutants on the pattern of hormones that affect reproduction. In addition to Dr. Schell who is the principal investigator, Drs. Mia Gallo, David Carpenter, Glenn Deane, and Cheryl Frye are collaborating on this multifaceted project. PCBs and other organic toxicants are analyzed by Dr. Carpenter’s team in the School of Public Health. An innovative aspect of this project is that some of the hormones are measured in saliva that is collected daily through the menstrual cycle. Measurements of these hormones in blood supplement these salivary measurements. An additional innovation of this study is that it examines the effects of several pollutants simultaneously whereas most studies have looked at one pollutant at a time. Results from an earlier study of Akwesasne youth conducted by this group showed that age at menarche, a commonly used marker of the progress of sexual maturation, was delayed in relation to lead levels but advanced in relation to PCB levels. Thus, these results support the community's concern about larger effects of pollutants on reproduction.
The overarching goal of this project is to examine the nature and determinants of health disparities not only between but also within racial/ethnic groups (non-Latino whites, Latinos, African-Americans, Asians, American Indians/Alaskan Natives) in the US. We focus on community size (e.g., urban vs. rural) as a potential determinant of disparities. The basic premise of the study is that by targeting the most vulnerable of the vulnerable groups, the health disparity between groups and in the overall population can be reduced more effectively. Different groups have different quality of health as well as different socioeconomic and demographic characteristics that can affect health and health inequality. Thus, the causes of health inequality might differ for different racial/ethnic groups.
We use several nationally representative, secondary data sets in this study, including the Health & Retirement Study (HRS), the Panel Study on Income Dynamics (PSID), and Behavioral Risk Factor Surveillance System (BRFSS). Part of our work involves constructing indices of individual quality of health. These indices are based on a 5-category self-assessed health status measure and other binary ill-health indicators (e.g., diabetes, obesity, asthma etc.), supplemented by several objective determinants of overall health including different diseases/risk factors and socio-demographic characteristics. Initial analyses in older adults have examined disparities not only in the frequency of chronic conditions but also in the extent to which individuals are unaware that the condition is present. Analyses of children have assessed the magnitude of health disparities and their impact on educational achievements.