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Progress on identifying health disparities in Caribbean and U.S. populations: A Q&A with E. Nigel Harris, MD, Vice Chancellor, UWI


Nigel HarrisIn February 2015, the steering committee for the U.S.-Caribbean Alliance for Health Disparities Research (USCAHDR) gathered in snowy Alexandria, Virginia to hold its annual meeting. The Sullivan Alliance’s Communications Director Samantha Edwards sat down with Dr. Nigel Harris, the Vice Chancellor of the University of the West Indies, to discuss the progress the partnership has made in its first four (of five) years. Dr. Harris has been the USCAHDR’s principal investigator since the inception of the project.

One of the main goals of the USCAHDR partnership is to lessen knowledge gaps in health disparities between English-speaking American and Caribbean populations of African descent. What have you learned over the last 4 years? Have you made any interesting findings?

Well, what excites me is that this is an area of research that’s not had much attention. Over the last four years, there’s much that we have learned – but we’ve also learned that there are more questions than answers. For instance, one of the more exciting pieces of research is that we’ve looked at mortality trends and found that Caribbean populations have fared less well than those of African descent in the United States. There are also huge differences depending on which Caribbean nation you look at. For instance, French-speaking nations are doing better than the English-speaking ones. There is not much research comparing one island to another – and even less comparing the Caribbean to the U.S., hence this work is path-breaking.

One area of research that has opened up is looking at how immigrants have fared in comparison to those populations left behind in the Caribbean. Some studies compare UK immigrants to the majority of the UK population. Few [studies] compare the population they’ve left back in the Caribbean. The same research needs to be done in the U.S. because there are much larger Caribbean populations in the U.S. and Canada.

How do you think this project has advanced the global health disparities agenda?

It’s given us a window into the existence of health disparities between American and Caribbean populations. We now have the evidence that these disparities exist. We know that within the Caribbean there are disparities, but we would not have guessed how large these might be until now.

How is the project advancing the professional development of U.S. and Caribbean researchers and scientists?

First of all, this project has provided new and exciting avenues of research that had not previously been explored comprehensively. And secondly, a number of junior investigators have been supported to do the sort of work that’s potentially ground-breaking – and can be the basis for their career development.

The project also provides a platform to expand collaboration between U.S. and Caribbean scientists.

I understand that The Sullivan Alliance made it possible for your Caribbean colleagues to access and analyze a lot of U.S. research data. What new data do you find most interesting?

I think we’ve been enabled access to a comprehensive array of publications. For example, for research related to diabetes and cardiovascular disease, we’ve been able to access many new journal papers that are not readily available in the Caribbean and select the best data.

How do you hope that this project will continue and expand this year?

There is a considerable amount of work that needs to be done based on what we’ve seen so far. We still need to complete reviews of some disorders, such as depression, stoke and cardiovascular disease. We have seen some exciting differences with respect to trends but we now need to drill down into the causes of those differences.

We also want to find fora in which we can present some of this data since some of our findings could have huge policy implications with respect to healthcare for communities in the Caribbean, as well as for providers and policy officials in the U.S. We need opportunities to tell our story to key players in these communities.

How do you think that future researchers will use this new data?

First of all, this study opens a multitude of new questions and avenues for research. It’s not simply differences between U.S. and Caribbean populations, but also looking at how immigrant populations fare…looking for factors for the differences that one sees – and interventions that might be embarked upon to reduce the disparities observed.

What challenges has the project had to overcome? How will those challenges influence future partnerships such as this?

One challenge was accessing data from the vantage point of the Caribbean, so having that access is a win. The other is finding sufficient numbers of partners in the U.S. – and that’s probably linked to funding. But with more funding, I think more partners will come on board. We are actively pursuing publication of our research and that should also attract more investigators. The first peer-reviewed publication is available online as Open Access.

What are your best memories of this project so far?

By far and away, it is the preliminary findings – some of which were unexpected. I believe that they will have huge implications to the directions in which health policy and healthcare will need to take in the short, medium and long-term future. This was not an exercise in gathering knowledge for knowledge’s sake, but one in which there’s likely to be many practical benefits.

Is there anything else you’d like to say about the USCAHDR partnership?

The Sullivan Alliance has enabled us to access resources and avenues of exploration that would not have been possible had this partnership not occurred. We are grateful for Dr. Sullivan’s influence in the health policy community in the U.S. – as well as his access to leaders in the funding community – that have provided us the wherewithal to support the work we have done – and offer the opportunity for additional studies to sustain this important effort.

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