Researchers at the University of Michigan were awarded the Javits Neuroscience Investigator Award for their work researching health inequities, specifically related to strokes, in Corpus Christi, Texas. This marks only the second time the Javits Award has been granted to researchers in epidemiology.
The Javits Award is named after Jacob Javits, a United States senator from New York who died from amyotrophic lateral sclerosis, commonly known as Lou Gehrig’s disease, in 1986. This disease causes a breakdown of neurons that eventually leads to respiratory failure and fatalities. U.S. Congress established the award to honor Senator Javits and award grants to neuroscientists in the U.S. The award is presented by the National Institute of Neurologic Disorders and Stroke.
Lynda Lisabeth, professor of epidemiology and neurology, and Lewis Morgenstern, professor of epidemiology and neurology emergency medicine and neurosurgery, are the lead researchers of the recognized study, known as the Brain Attack Surveillance in Corpus Christi study.
The BASIC study began in 1999 and has continued over two decades. In an interview with The Michigan Daily, Morgenstern said the study’s original objective was to understand health disparities in the Mexican-American population by using the incidence of stroke amongst the population of Corpus Christi as a model. Overtime, the project has looked at other health issues as well.
“BASIC is fundamentally a health equity study,” Morgenstern said. “We use stroke as a model disease, but we also look at sleep apnea. We’ve looked at dizziness, we have another project in the same community where we look at dementia from causes like Alzheimer’s … we think that a lot of the work that we do kind of transcends different minority populations and speaks to the broader U.S. population.”
Public Health student Chen Chen, who has worked on the BASIC study, wrote in an email to The Daily he feels the study is significant because it allows scientists to understand the physiology of strokes.
“With the inclusion of all non-hispanic white and Mexican American stroke cases aged greater than 45 years, this project enables many studies to understand various aspects of stroke,” Chen wrote. “For example, BASIC provided important data on trends in stroke recurrence and mortality by ethnicity and by sex.”
The initial data revealed the rate at which Mexican-Americans suffer from strokes was much higher compared to their white counterparts. Morgenstern explained how current research has revealed a decrease in these disparities over time.
“Over the course of the study, we’ve seen remarkable reductions in some of the disparities,” Morgenstern said. “There is really no difference now for stroke incidence between Mexican Americans and non-Hispanic whites. The recurrence rates are also very similar, as are deaths following stroke.”
However, Morgenstern and Lisabeth are still seeing inequalities when it comes to stroke recovery. The BASIC study suggests Mexican-Americans are still experiencing worse cognitive and quality of life outcomes as compared to non-Hispanic white Americans. In an interview with The Daily, Lisabeth said one potential factor may be the long-term care received after a stroke, as Mexican-Americans are more likely to complete rehabilitation through outpatient programs or home therapies.
“One of our early findings suggested that Mexican-American stroke survivors were less likely to go to inpatient rehab, which is the most intensive form of rehabilitation,” Lisabeth said. “So we’re trying to understand whether or not that might contribute to some of those differences in outcome, potentially.”
Morgenstern elaborated that this difference in long-term care can also exacerbate population inequalities.
“If children remain at home and care for parents and grandparents, they don’t finish their education,” Morgenstern said. “They have problems with occupational growth and stuff like that. So that tends to perpetuate the socioeconomic status differences between populations.”
With the funding from the Javits Award, Lisabeth and Morgenstern plan to begin the sixth five-year cycle of the study and expand the populations included in their research.
“We’re dipping down to the 35 to 45-year age range,” Lisabeth said. “In our population, but across the United States, there’s been a suggestion that stroke rates are on the rise in younger populations.”
Lisabeth and Morgenstern will also look at differences within the Mexican-American population, rather than comparing between ethnic groups. Lisabeth detailed that this will allow researchers to increase their understanding of the factors influencing differences in health outcomes within the Mexican-American population. They hope to identify what they call “resilience mechanisms,” or behaviors that help some individuals do recover better after a stroke.
According to Morgenstern, the next phase of the study will also help put Corpus Christi data into a national context.
“We’re also going to link the information with big data that we obtained from Medicare to look at health expenditures after people have a stroke, and to try to figure out some of the things that hopefully we can prevent in terms of negative consequences for patients who have had a stroke,” Morgenstern said.
Daily Staff Reporter Amanda Venclovaite Pirani can be reached at amandavp@umich.edu.
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