Aging and Health Disparities
Mark Luborsky, Ph.D. – Director, Aging and Health Disparities Research Program
The IOG's Aging and Health Disparities Research Program seeks to understand and to eradicate health disadvantages among minority populations.
Current research projects include:
Adherence to HAART Among HIV+ African Americans
Aging and Urban Health Post-Doctoral Research Training Grant
Aging and Urban Health Pre-Doctoral Research Training Grant
Center for Urban African American Health (CUAAH)
Community Networks to Reduce Cancer Health Disparities (CNP)
Geriatric Education Center of Michigan
Helping Older Minority Women Transition from Homelessness
Michigan Center for Urban African American Aging Research (MCUAAAR) – web site
Healthier Black Elders Center and Community Core (MCUAAAR)
Web Portals for Improving Health in Urban Black Elders
Project descriptions:
Adherence to HAART Among HIV+ African Americans
PI: Sankar, A.
Co-PI: Luborsky, M.
NIH/National Institute on Allergy and Infectious Disease
2001-2006, $2.1 million
The goal is to develop factors related to long-term adherence to High Acting Antiretroviral Therapy among minorities and to develop best practice to increase the likelihood of compliance thereby reducing excess disability, deaths, and emergence of drug resistant strains of HIV.
Aging and Urban Health Post-Doctoral Research Training Grant
PI: Lichtenberg, P.A.
Co-PI: Luborsky, M.
Agency for Healthcare Research and Quality (T32)
2003-2008, $920,000
Through structured mentoring, didactics and an emphasis on interdisciplinary training this grant prepares post doctoral fellows to conduct health related research. Behavioral, social and communication sciences approaches are used to examine translational health research. To date, 14 post doctoral trainees have been admitted to the program.
.
Aging and Urban Health Pre-Doctoral Research Training Grant
PI: Lichtenberg, P.A.
Co-Director: Jankowski, T.B.
NIH/National Institute on Aging (T32)
2001-2011, $2 million
The Wayne State University training program in aging and urban health is continuing its exceptional pre-doctoral research training program. This NIH-supported training program furthers our success in training pre-doctoral students across a variety of disciplines, in the study of aging and urban health, with a focus on health disparities, functional independence, cognitive neuroscience as well as health and health care, over another 5-year period. Our model of using mentoring teams and “pseudo joint appointments” has enabled our trainees to develop a strong professional “fit” with gerontology. This is illustrated by the fact that all 23 of our graduates from 2001-present hold positions in aging and health research at top universities or research programs (e.g. University of Michigan, University of Colorado Colorado Springs, Indiana University-Purdue University in Indianapolis, University of Louisville, North Carolina State University, City University of London, University of Manchester, Yale University). Program excellence is demonstrated by (1) Trainee achievement, (2) Faculty achievement , (3) Program achievement, and by (4) Demonstrating growth in its reputation and widespread impact across campus, in the community, and nationally.
Center for Urban and African American Health (CUAAH) – web site
Administrative Core
PI: Flack, J.M.
The WSU Center for Urban and African American Health consists of a number of research projects and core facilities, with participation of 34 investigators from various Departments, Centers, and Programs across the WSU campus. The Center has invested heavily in coalescing and expanding a shared research infrastructure that is widely accessible to investigators. The projects are thematically linked through obesity, diet and other lifestyle factors including physical activity, and obesity-related cardiovascular disease and cancer. Research efforts are focused on understanding the mechanisms operating at multiple levels (environment, lifestyle, physiology, genetics) mediating known disparate chronic conditions and their precursors. We also seek to identify preventive strategies and therapeutic approaches that might alleviate the disproportionate burden of disease. Primary as well as interactive effects of environmental exposures (household and community-level) and psychological behavioral characteristics with physiological measures (e.g., 24-hour BP burden and oxidative stress), genes, and body composition will be explored in relation to their impact on study outcomes.
African Americans were selected as a primary focus for the Center because of their high burden of obesity-related disease such as breast cancer and cardiovascular diseases (hypertension, heart failure, diabetes mellitus, and coronary heart disease). Also, while Detroit has the third largest population of African Americans, it has the highest percentage (81.6%) of African Americans of any major city in the USA.
Objectives:
1) To elucidate the environmental, psychosocial, biological, and genetic factors, as well as their interactions, and the mediators of their effects, on physiological responses
2) To better understand the relationship of environmental exposures, socioeconomic status and psychosocial factors to biological, and genetic characteristics of free-living African Americans
3) To understand the contribution of environmental, social support, and individual characteristics that predict the success or failure of multi-faceted interventions that promote adoption of healthy lifestyles
4) To determine whether patients with advanced cardiovascular disease are more likely to adopt healthy lifestyles, and improve both physiological measures and disease-specific process of care measures, when counseling is provided to dyads versus counseling only of the affected patient
5) To develop a multi-disciplinary research infrastructure to effectively integrate established investigators as well as to identify and mentor junior investigators by providing shared research support consisting of essential research services and equipment, cognitive expertise, and a sense of common purpose for the pursuit of multi-level research into racial/ethnic health disparities
Recruitment and Clinical Measures Core
PI: Nelson, D.
Co-PI: Lichtenberg, P.A.
National Institutes of Health, $1 million
This Core will coordinate recruiting efforts for all Projects and pilot studies in conjunction with the investigators and will house key staff assigned to the four Projects and pilot studies. Also, this Core will be responsible for making nutritional assessments. Interviewer training for all Projects and pilot studies will be undertaken by this Core. Many study personnel for the Projects have been placed in this Core to facilitate staffing efficiencies, cross-training, and to provide a ready made infrastructure for cost-efficient execution of pilot studies. The location of this Core, its equipment and personnel will be in the Department of Medicine's CRC. The Karmanos Cancer Institute’s Nutrition Core, equipment, and personnel will be integral components of this Core.
Community Network Partnerships to Reduce Cancer Health Disparities
PI: Albrecht, T.
Co-PI: Lichtenberg, P.
NIH/National Cancer Institute (U01)
2005-2010, $2.58 million
This application proposes an active, comprehensive, and sustainable program to reduce disparities for breast, prostate, colorectal and lung cancers that adversely affect older, underserved, African American adults in metropolitan Detroit. We propose to mobilize an integrated and interdependent system of community-based participatory education, training, and research to address this serious problem affecting the citizens living in our region. Data from our region demonstrate that older African Americans disproportionately experience higher rates of these cancers, are first diagnosed at advanced stage disease, and suffer higher mortality rates. The goal of the Community Network Program (CNP) is to catalyze and sustain a strong community based movement to significantly improve access to and enactment of beneficial interventions to increase cancer screening and early stage detection, diagnosis and treatment.
Geriatric Education Center of Michigan
PI: Dwyer, J
Co-PIs: Yonker, J., Lichtenberg, P.A.
U.S. Department of Health Professions, Health Resources and Services Administration – Geriatric Initiatives Branch, sub-contract from Michigan State University
2007-2010 $60,000
The mission of the GECM is to advance geriatric education within the state. The GECM works with its partners to plan, develop, and implement training programs for multidisciplinary groups of practitioners who provide health care to older adults in primary care settings such as community health centers, as well as in long term care facilities. The GECM initiatives are intended to strengthen geriatric care in medically underserved communities and to improve the organization and delivery of unique services for older adults.
Helping Older Minority Women Transition from Homelessness
PI: Washington, O.G.M.
Wayne State University President’s Research Enhancement Program
2005-2007, $160,682
The 24-month study focuses on examining systematically the issues that, African American women who are 45 years of age and older face and determining how these issues compromise successful transition. Action research methods are employed, which include older minority homeless women in transition as expert participants to identify issues they face and design assessment tools to evaluate barriers impeding their successful emergence from homelessness. This study also will facilitate the use of documented issues confronting older minority women in the development and refinement of transitional issues assessment tools and an advocacy intervention designed to help resolve issues presenting during their transition out of homelessness. This research also seeks to augment women’s awareness, motivation and skills in resolving issues they perceive as most serious and relevant to them personally.
Michigan Center for Urban African American Aging Research (MCUAAAR) – web site
PI: Jackson, J.S.
PI: Lichtenberg, P.A.
NIH/National Institute on Aging (P30)
1997-2012 $8.9 million
The Michigan Center for Urban African American Aging Research (MCUAAAR) promotes health research on minority elders, particularly African American elders, that will lead to the reduction and elimination of health disparities as called for in Healthy People 2010 through several approaches consistent with the NIA’s 2005-2010 Strategic Plan. Exemplars of MCUAAAR’s efforts include a successful mentoring program focused on building a network of minority investigators who are committed to becoming productive scholars in the area of health and aging. Health promotion and the reduction and elimination of health disparities is only possible with the effective recruitment and retention of African American and other minority elders in health research. We will continue to build upon our productive research program in this area, and continue to reach out to seniors in the city of Detroit with the explicit purpose of building upon our developed databases of research participants. This volunteer participant pool is comprised of individuals who have agreed to be contacted to engage in health-related studies that have significance for their communities.
MCUAAAR is one of six center grants on Minority Aging Research funded by the NIA. Our particular center is a joint effort between Wayne State University and the University of Michigan, and includes several departments and colleges from both institutions. To date, 30 pilot investigation studies have been completed. The center sponsors a summer conference each year to help further educate junior faculty in the research process, research methods, and grant writing.
Healthier Black Elders Center and Community Core (MCUAAAR – HBEC)
Core Directors: Washington, O.G.M.
Core Faculty: Jankowski, T.B. & Underwood, W.
One of the major aims of the MCUAAAR is to create partnerships with minority elders and community leaders that will enable researchers to investigate the health issues that are most important in urban, minority communities. The center also has a strong community education component to it, in which educational efforts are conducted on topics such as stroke, diabetes and hypertension. Link to the Healthier Black Elders Center from the MCUAAAR web site.
Telling My Story
Using Humanistic Social Science to Illuminate First Person Accounts of Women Surviving Homelessness in Late Life
PI: Washington, O.G.M.
Humanities Center Innovative Proposal Competition & Institute of Gerontology
2003-2006, $8,000
Documenting First Person Accounts of Women Surviving Homelessness in Late Life
PI: Washington, O.G.M.
Wayne State University Women of Wayne Alumni Association Annual Research Grant
2004-2006, $1,000
Expanding Autoethnographic Content of the Telling My Story Project: Incorporating Visual Representations of Trauma and Recovery by Women Surviving Homelessness in Late Life
Co-PI: Washington, O.G.M.
Wayne State University Humanities Award
2005-2006, $2,000
This series of three studies explores how homelessness influences the life course of older African American women and documents stories about their survival of homelessness through organization and integration of multiple forms of media and presentations combined with narratives about the struggle, recovery, and healing process. A range of data is collected (i.e., poetry, letters, sketches) and recovery scrapbooks to amplify each story from the perspective of the story-teller—a women who has survived homelessness in late life.
The progression and development of these studies break new ground in the humanities through the translation of qualitative data into visual representations. This translation further amplifies the narrative voices of the women, and the content of each visual representation augments knowledge of how descent into and emergence out of homelessness occur from the perspective of people whose lived experience is often ignored by health and human service professionals.
To enhance the action research design of the “Telling My Story Projects,” the investigators support and encourage collaboration between each woman and a graphic artist to create portraits of each woman’s journey into and recovery from homelessness.