Weekly InSight: Martin Luther King, Jr. Health Equity Symposium

We attended the 4th annual Martin Luther King, Jr. Health Equity Symposium, hosted by Penn Medicine’s Office of Inclusion and Diversity, on January 23. This year’s theme was “Achieving Population Health Through Health Equity.”

Keynote speaker Jonathan Woodson, MD, addressed the question: “What would Martin Luther King, Jr. do [in today’s world]?” Dr. Woodson, former Assistant Secretary of Health Affairs for the U.S. Department of Defense, highlighted MLK’s Letter from Birmingham Jail, which he wrote in April 1963 in response to white clergymen who publicly disapproved of his nonviolent protests.

The letter “provides a blueprint for action that is scalable and appropriate,” Dr. Woodson told the audience.

And that action needs to come not just from medical doctors, nurses, and public health practitioners, Woodson emphasized during a Q&A session; the conversation needs to expand to employers and other segments of society.

Health equity was also touched upon in a recent Inquirer column exploring the phrase “black don’t crack,” which stereotypes African-Americans as aging more gracefully than their white peers. Columnist Elizabeth Wellington points out that no matter how individuals appear, there are serious health disparities between races due to various factors, including economic, social, and genetic.

“This is a good opportunity to think about what’s going on inside as we praise ourselves on the outside,” Lisa Walke, MD, Chief of Geriatric Medicine at the University of Pennsylvania, told The Inquirer. “People are looking good because they are taking care of themselves. We need to take the time to celebrate and acknowledge that.”

Though Wellington did not address Alzheimer’s disease specifically, it’s important to bring it up when discussing race and aging. According to a recent paper published by our colleagues at the Washington University School of Medicine, Alzheimer’s disease biomarkers may vary by race. Researchers looked at 1,255 individuals, 173 of whom were African-American. Some of the participants had Alzheimer’s disease, and others did not report serious cognitive complaints.

Their findings revealed African-Americans often have lower levels of the protein tau—one Alzheimer’s disease biomarker—than non-Hispanic whites. However, they’re more likely to be affected by the disease. This suggests Alzheimer’s may develop differently, depending on race.

“If we only study Alzheimer’s in Caucasians, we’ll only learn about Alzheimer’s in Caucasians,” lead study author John C. Morris, MD, the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology, said in a statement. “If we want to understand all the ways the disease can develop in people, we need to include people from all groups. Without a complete understanding of the illness, we’re not going to be able to develop therapies that work for all people.”

Some limitations of the study should be noted, which cognitive neuropsychologist Lisa L. Barnes, PhD, of the Rush Alzheimer’s Disease Center in Chicago, discussed in an accompanying editorial.

For example, the authors didn’t consider sociocultural variables, such as perceived discrimination or quality of education. Additionally, there was a small sample size of African-Americans, but Dr. Barnes applauded recruitment efforts, noting that it took the research team 11 years to obtain biomarker data from 173 African-Americans in St. Louis.

“It is clear from these efforts how much harder it is to recruit minority participants in invasive studies of this nature,” she wrote. “The work is not only challenging, it is labor intensive and requires extensive community outreach and relationship building.”

At PMC, we have a mission to increase diversity of clinicians, researchers, and participants involved in Alzheimer’s research. One example of this is our Penn Minority Scholars in Aging Research program, an academic opportunity that launched in 2017 for students enrolled in a medical or doctoral degree program who are underrepresented in the field of aging research.

With regard to participants, our goal is to have our population mirror the population of Philadelphia. Even if you don’t have Alzheimer’s disease or mild cognitive impairment, you may be able to help us achieve this goal. We’re actively trying to gain more participants in 2019, particularly controls for our Aging Brain Cohort (ABC) study. To learn more about the ABC study and other research at PMC, join the Brain Health Research Registry, a confidential database we use to contact you periodically with current research opportunities.