For as much as COVID-19 has disrupted our healthcare system, it has also brought to light the various issues that limited our ability to properly respond to the pandemic like it – especially for people of color in particular. The issue of health equity in the state of Mississippi is an issue intertwined with a variety of others, and the data suggests a close association with race and how patients ultimately receive treatment. The nature of these disparities in the wake of COVID-19 is why the Purple and White sat down with Dr. Christina D. Jordan, the co-principal investigator of the All of Us research team stationed at the University of Mississippi Medical Center (UMMC), to better understand the scope of the issue. As a person of color herself who has committed her life’s work to opening up greater opportunities for medical care to minorities in the state, the P&W asked a variety of questions regarding the disparities themselves and how her work relates to combating them:
1. P&W: What can you tell me about health disparities against people of color in Mississippi based on your experience?
Jordan: Health disparities negatively affect how all minority groups in Mississippi access care, determine the type of care they receive from physicians, and their health outcomes after diagnosis. This leads to a decreased quality of life for these populations, who are typically African American, have low socioeconomic status, and a higher incidence of chronic diseases such as hypertension, Type 2 diabetes, stroke, cancer, and other inflammatory illnesses.
2. P&W: What kind of data or examples can you provide of the sorts of things that go through in the state’s healthcare system?
Jordan: Consider this scenario – An African American woman seeks care for her illness from a local health department because she cannot afford medical insurance. She must take an entire day off from work because the wait time varies between 2-3.5 hours on average, and she must retrieve her children from school soon after her visit. Once she sees the doctor, she is unsure whether she should ask questions because this will cause an additional delay. Also, the staff appears preoccupied as the lobby is full of patients seeking care. After providing a urine sample to the nurse, the doctor rushes in and out of the individual waiting room within 5 minutes and barely makes eye contact with the woman. The woman takes her prescription to the local pharmacy and proceeds to pick up her children. This scenario occurs often in MS. Because of socioeconomic status, the woman in this scenario must receive care from an understaffed free clinic, which is the primary source of healthcare for the uninsured. She must miss work and therefore lose
income to access this care. And while present, she communicates minimally with the doctor and receives no education about her diagnosis or how to prevent the illness in the future. Also, if the woman considers this to be an experience unworthy of losing income, she is very unlikely to return for help in the future. This increases her likelihood of continuing behaviors that made her vulnerable to illness and to suffer from chronic illnesses due to unregulated health practices in her daily life.
3. P&W: How have you worked to combat these disparities?
Jordan: My efforts to combat health disparities in Mississippi are two-fold. On one hand, I am refining a patent-pending hyperbaric device that has the propensity to improve inflammatory illnesses using a non-invasive, cost-effective methodology, artificial intelligence, and an enhanced dosing mechanism. On the other hand, I am using my title as co-Principal Investigator of the All of Us research program to regain trust in our minority communities through acts of service; share knowledge about the program with students, patients, researchers, clinicians, and physicians; and connect our participants with community partners who can provide the services needed to improve their behaviors and foster better health. A primary goal of the All of Us research program is to combat health disparities through the utilization of the precision medicine model, which considers lifestyles choices (ie: exercise frequency, alcohol intake, diet, etc.), genetic variants, and environmental exposures when determining the best course of action for disease treatment and prevention. This requires the accumulation and availability of an immense amount of data so that researchers and doctors can more accurately determine which clinical practices are best for the individual. Participating in the All of Us research program aids in our mission to build a large database of health information to study health and illness. This database, termed the All of Us Research Hub, safely stores all participant information so that health disparities are more easily observable and more accurately addressed in clinical practice. The Research Hub will foster other precision medicine practices, such as pharmacogenomics, which uses next generation sequencing to determine how a person’s genetic makeup affects their response to drug treatments.
4. P&W; What do you think can or should be done by the state to address these issues?
Jordan: To better address health disparities, I believe the state of Mississippi should more readily support efforts to train and educate minorities to pursue careers in biomedical research. Underrepresented populations are more receptive to information received from individuals who are a part of the same race and culture. I also believe our communities would benefit from the availability of more resources (such as fresh food options in food deserts, well-funded gardening programs, green spaces, etc.) as well as educational programs which increase technology access and aim to improve lifestyles and behaviors
that lead to unfavorable disease outcomes. Also, cultural competency training should be mandatory for physicians who treat underrepresented patients.
5. P&W: What role would All of Us play in implementing those efforts?
Jordan: When the opportunity presents itself, UMMC’s All of Us research program is ready to be involved as needed. We are currently seeking community partners interested in helping our program engage with the Jackson community in a related research effort, called Project iPEGAT: Improving Participant Engagement through Gardening and Access to Technology. We plan to engage All of Us participants by providing educational resources for home gardening from courses led by master gardeners, healthy food preparations from local chefs, physical activity guidance from certified physical trainers, and a COVID-safe tech space for free internet access. Though this project will not completely solve health disparity problems in our state, it will put us on the right track towards addressing this multifaceted issue.
While health disparities continue to plague minorities, the All of Us program hopes to create trust in healthcare for minorities going forth. Dr. Jordan specifically has been in close collaboration with groups committed to assisting minorities in non-medical settings to resolve the issues facing them on a social level, which can ultimately affect their experiences in the healthcare field anway. Among others, these include The Bean Path , a non-profit founded by Dr. Nashlie Sephus that aims to enrich small businesses and communities through greater technological access, and the Jackson Community Garden Initiative, which aims to build a network of urban gardens in the city and provide access to healthier food options.