From Egypt to Alabama, health disparities plague underresourced communities

As a child growing up in Egypt, Mona Fouad’s parents groomed her to become a world-class musician.

When, as a teenager, she scored high enough in school to attend medical school, her piano teacher urged her to dismiss her attraction to science.

“My piano teacher told me medicine isn’t for women,” Fouad, MD, MPH, recalled Nov. 12 at Learn Serve Lead 2022: The AAMC Annual Meeting.

It wouldn’t be the last time Fouad went against the grain.

During her final year of medical training in Egypt, Fouad was assigned to work in an underserved rural town outside of Alexandria. This experience opened her eyes to what she would later call the social determinants of health.

“People in this town were unable to afford medical care and they suffered from chronic illnesses to a degree that I had never seen before,” Fouad said. “Patients die before they have had their turn to be seen at the Free Teaching Hospital. I saw the situation the men and women were in and wondered, even if they could afford to see a doctor, how would they get there? Who would babysit her children?

These questions came back to her when, in the 1980s, she and her husband were living in Birmingham, Alabama, where her husband was offered a job at the University of Alabama at Birmingham (UAB). Fouad, after completing a master’s degree in public health at UAB, began volunteering at a preventive medicine clinic, eventually securing a fellowship.

“At that time, national research was beginning to demonstrate the same thing that UAB researchers were discovering: that health outcomes were different for different groups of people,” Fouad said. “Certain demographic groups were more likely to develop chronic or acute illnesses and were less likely to survive.”

In Birmingham, as in the city outside Alexandria, Fouad recognized that social problems contributed to poor health outcomes in underserved communities, an idea that was not widely accepted at the time.

He was told by many fellow physicians and researchers that working on health disparities did not really contribute to medical science and was just “community wellness work”.

“Even hearing these things, I persisted,” she said.

In the decades since beginning his research, Fouad has built a distinguished career in health disparities research and health equity initiatives.

It is in recognition of her contributions to research on health disparities that she received the 2022 Vilcek-Gold Prize for Humanism in Health Care, which was established by the Vilcek Foundation and the Arnold P Foundation. Gold to recognize outstanding immigrant healthcare professionals whose work has demonstrated a commitment to humanism. Previous recipients include Mona Hanna-Attisha, MD, MPH, who spoke out about the Flint, Michigan water crisis, and Denisse Rojas Marquez, MD, MPP, and Jirayut “New” Latthivongskorn, MD, co-founders of the Pre-Health Dreamers organization, aimed at assisting recipients of the Deferred Action for Childhood Arrivals (DACA) program.

Fouad has developed models for recruiting and retaining minority people in clinical trials and innovative community-based approaches to reduce racial disparities in breast and cervical cancer, and chronic disease prevention and control. She also founded the UAB Minority Health and Health Disparities Research Center (MHHDRC), which focuses on research, training, and community engagement.

MHHDRC has worked on national programs and formed partnerships with historically black colleges and universities to recruit and retain researchers from diverse backgrounds, which, in turn, helps expand research on health disparities , said Fouad.

Programs like the ones Fouad has developed have been implemented across the country, and even internationally, including in Egypt, but she finds Alabama an opportune location for her research due to its poor rankings. health matter.

“Alabama ranks near the bottom 5% [in the United States] in almost every major [health] category,” Fouad said.

Through his work at MHHDRC, Fouad and his colleagues hope to change that with initiatives ranging from building sidewalks and bike lanes in neglected neighborhoods to introducing mobile grocery vans and preventative screening clinics to communities. underserved.

But above all, Faoud learned the importance of listening to people to understand how best to meet their needs.

“I learned a lot from my colleagues and staff who took me out into the community and taught me how to communicate and present our work to the community,” she said. “First, they said to me: ‘Trust is earned, it is not given.’ So you have to work to gain people’s trust.

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