ERASING INEQUITIES

Hope Landrine strives to make health disparities a thing of the past

Growing up just outside the Bronx, Dr. Hope Landrine witnessed the damage that chronic diseases wreaked upon her community.

“Everyone was sick,” she recalled.

Landrine knew she wanted to do something about it. Now at East Carolina University, she’s doing just that.

Since August, Landrine has been director of the ECU Center for Health Disparities Research. She’s the center’s first director, which has put a heavy weight on her shoulders to get it running strong and solid — obtaining grants, developing programs and making inroads on the significant health inequities that have long plagued eastern North Carolina.

“She really came out of the gate very quickly,” said Dr. Robert Hickner, a professor in the Department of Exercise and Sports Science who is co-leader of the research core group of the center. Before she arrived, he said, she was putting plans in place and bringing faculty aboard. Landrine is excited about the opportunities. “It’s hard not to be optimistic when your name is Hope,” she joked.

Over the course of her career, Landrine has studied racial, ethnic and socioeconomic disparities in rates of chronic disease and cigarette smoking as well as the pernicious health effects of residential segregation of racial and ethnic groups. Her current research and grant proposals focus on interdisciplinary efforts to reduce diabetes and cancer disparities in eastern North Carolina.

She came to ECU from the American Cancer Society in Atlanta, where from 2007 to 2010 she was director of multicultural research. There, she dealt with urban health disparities in a city filled with resources — the ACS and the Centers for Disease Control and Prevention, as well as medical schools at Morehouse and Emory universities.

Before that, she was research director of the Behavioral Health Institute at San Diego State University. There, she studied the disparities that abounded among the myriad ethnic and racial groups of the region.

From 1993 to 2000, she was senior research scientist at the Public Health Foundation of Los Angeles County.

At ECU, in addition to her role with the center, she is also a professor of psychology. Landrine has a bachelor’s degree in psychology from Westminster College in Pennsylvania and a doctorate in clinical psychology from the University of Rhode Island.

While the places she’s lived, learned and worked seem very different from eastern North Carolina, the problems populations face here are similar to problems faced elsewhere. Those include some of Landrine’s research specialties: geographic and sociocultural factors, health behavior, area-level segregation and poverty, and individual-level acculturation and discrimination.

Mostly rural and with higher rates of poverty than other parts of the state, eastern North Carolina faces formidable challenges. According to the ECU Center for Health Services Research and Development, eastern North Carolina has a greater mortality rates than the rest of the state in 15 of 19 types of illness and injury.

For example, the mortality rate for heart disease is 20 percent greater as are risk factors such as hypertension, diabetes and obesity – for the region as a whole and particularly for minorities. Breast and prostate cancer also affect blacks disproportionately.

Coupled with that is a scarcity of primary care physicians, mental health services dental care and other necessities for good health.

“The disparities are so extreme and the resources are so limited,” Landrine said.

Nevertheless, she believes the center’s 67 affiliated faculty, assembled from divisions and departments throughout the university, are up for the task.

“I came because there are such great people here to work with that I was convinced we could make a difference,” Landrine said.

The need to reduce health disparities is not only a scientific challenge, but also a financial one. Between 2003 and 2006, health disparities cost the nation $1.24 trillion dollars, Landrine said, citing data from the American Journal of Public Health and the Joint Center for Political and Economic Studies, a Washington, D.C.-based nonprofit that focuses on issues of particular concern to African-Americans and other people of color.

Within five years, Landrine said, she hopes the center can apply for federal funding to become self-sustaining.

Health disparities research has been a growing field in recent decades. In 2000, Congress authorized the establishment of the National Center on Minority Health and Health Disparities. Last September, the national center was elevated to full institute status within the National Institutes of Health, and its name was changed to the National Institute for Minority Health and Health Disparities. Theoretically, the development could mean more available research dollars.

Dr. Doyle Cummings, a pharmacist and co-leader of the ECU center’s research core, said funding could be the biggest challenge facing the center.

“There’s some possibility that NIH and other major funders are going to get their budgets cut, so while we really want to see the center grow, its research mission, that’s going to be increasingly challenging if the economy doesn’t improve substantially,” Cummings said.

Already, the center has created pilot study grant research programs for faculty and communities, and has awarded eight small grants. As of March, affiliated faculty members have been awarded at least 14 grants from various external funding sources — a tally that is expected to grow quickly.

The center, the University of North Carolina system’s newest, is also the only one in the system to use the arts to improve health disparities. Plays, videos and songs, Landrine said, will capture people’s attention — and stay lodged in their memories — far longer than statistics in a pamphlet.

“[The arts] are probably our best hope for changing hearts and minds and behaviors and attitudes,” she said. “People are more likely to listen to a song about health than take a class on health, let alone read a book on health. But if there’s a song on health and the song is clever enough that people hum it to themselves and learn the lyrics, then I think we can do something.”

While the statistics are daunting, Landrine is ready to make a difference in the region among a variety of racial, ethnic, income and geographical groups.

“This is a challenge unlike any other I’ve faced,” she said. “Trying to improve the health among people who have not only many, many health problems but who live in rural isolated communities is the challenge here.”

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