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June 23, 2023

New institute looks to shake up health equity research

A large brick building with columns and a large gold dome on top sits behind a gate with steps leading up to it. Photo | Flickr | Ajay Suresh The Massachusetts State House

Taking aim at gaps in the existing constellation of health care analysis, a statewide community health center association will launch a first-in-the-nation research arm focused on better understanding poorer health outcomes among certain groups.

The new Institute for Health Equity Research, Evaluation and Policy, part of the Massachusetts League of Community Health Centers, will work to unpack the root causes of structural health inequities and how they can be mitigated with policy and clinical reforms.

Officials tapped Dr. Cheryl Clark, a medical researcher and associate chief of general internal medicine and primary care at Brigham and Women's Hospital, to lead the new institute that a League spokesperson said aims to "stand traditional academic medical research on its head."

"This is not something that has been done before," Clark said in an interview. "This would be the first time that an institute would be really embedded within a community health center infrastructure, and that's important for several reasons. It means we're going to be quicker in terms of asking the kinds of questions relevant to communities, but we'll also be quicker on implementation."

Clark said the research institute will focus on "emancipatory research," which will examine and attempt to address the divergent experiences faced by marginalized and underserved communities -- many of which include patients at the state's 300-plus community health centers.

Health inequities, like the disproportionate burden of premature deaths borne by communities of color, have drawn heightened scrutiny since the COVID-19 pandemic thrust them more clearly into the spotlight. But Clark said what has "been missing is lived experience."

"Fundamentally, one of the needs we fill is being close to lived experience so the kinds of research questions that are asked are the most pertinent," Clark said. "One example is that we just completed one of our very first polls for the institute. It was very clear there are some conditions that are chronic disease conditions that are high priority for CHCs and the patients they serve. We'll be able to take that information and prioritize how we work collaboratively with academic institutions, how we work collaboratively with private entities."

In a summary about the new institute, a spokesperson for the League said it would "raise critical questions that push back on standard narratives and mine the root causes of structural inequities."

Preliminary polls and conversations are already underway, and Clark will start in her new role at the nascent institute on July 1. She forecast the organization will produce briefs in its first few months to help better inform both the public and research specialists about priority issue areas.

Another focus for the institute, Clark said, will be making better use of "an enormous amount of data" that community health centers collect from the roughly 1 million patients they serve in Massachusetts.

The institute could offer access to and expertise about that data, Clark said, to other researchers and health care entities that in the past have performed rigorous analysis of the community health center patient population.

Patients at community health centers face higher risks for chronic and serious illness, and many are low-income, publicly insured or uninsured.

"Many other academic and research organizations are wanting this collaboration," she said.

Clark said the institute will be backed in part by a $1.5 million contribution from Mass General Brigham.

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