San Diego State University: SDSU Researchers Working To Tackle Health Disparities

Routine screening for cervical cancer can lead to earlier diagnosis, improved treatment outcomes and reduced mortality. But when a family’s basic needs aren’t being met, screening may be delayed.

“When you’re worried about where your next paycheck is coming from, or whether your kids will be able to eat, you’re not necessarily prioritizing cancer screening,” said public health researcher Corinne McDaniels-Davidson, who adds that screening and follow-up rates are lower among marginalized populations.

McDaniels-Davidson is one of many SDSU faculty who study how health disparities disproportionately impact marginalized populations by partnering with communities to better understand and implement interventions that address deeply-rooted social and economic inequities.

“When we think about health disparities we’re really talking about differences in health and health care between groups that stem from these broader inequities,” said speech and language professor Sonja Pruitt-Lord.

SDSU is well-positioned to take on health disparities. “We have been intertwined with the community for so long that the SDSU name is trusted in the community,” said McDaniels-Davidson. “That makes it possible to do work that others might not be able to do.”

Health Care Inequities

In addition to studying disparities in cancer screening, McDaniels-Davidson and her team partnered with the County of San Diego early in the COVID-19 pandemic to implement a community health worker-led contact tracing program. She also collaborated with epidemiologist Susan Kiene to implement a National Institutes of Health-funded community testing program, an effort that included middle schoolers in the Sweetwater Union High School District and their family members.

“When you are able to partner with communities to address whatever health issue is important to them, you start to build these very tight relationships,” said McDaniels-Davidson.

SDSU’s South Bay Latino Research Center (SBLRC), co-directed by psychology professors Greg Talavera and Linda Gallo, is another trusted community partner. It has long been a leader in community-engaged health disparities research and culturally-informed interventions to improve health among Latinx populations.

SBLRC studies have revealed high rates of undiagnosed diabetes in the Latinx community, as well as a relationship between neighborhood environments and an increased risk of hypertension and diabetes.

The SBLRC has also shown that an integrated care intervention addressing behavioral and physical health needs of people with diabetes improves both diabetes management and psychological well-being.

Environmental Justice

The San Ysidro Port of Entry, linking Mexico to the U.S., is one of the busiest border crossings in the world. But few of the people living in the adjacent community benefit economically from the trade that passes through. Instead, San Ysidro’s residents — mostly low-income and more than 90% of them Latinx — breathe in pollutants from idling vehicles waiting to cross the border and from trucks passing through their community.

Public health professor Penelope “Jenny” Quintana has partnered with Casa Familiar, a community development agency in San Ysidro, to measure exposure to traffic pollutants for more than 15 years.

Recently, she has received funding from Caltrans, California’s transportation agency, to monitor air quality related to heavy-duty truck emissions along the border and to share this information with the community. The project will serve as a baseline for assessing the effect of ongoing improvements to truck movement and emissions in the border region.

She thinks the air quality data will help shape policy, for example, increasing staffing at the border crossing in order to reduce wait times and building particulate-free gyms where children can safely exercise.

“When you start measuring it and publishing the data, it really brings a lot more attention and political will to the problem,” said Quintana.

Food Insecurity

Assistant professor of nutrition Amanda McClain has seen the choices families face when struggling to access nutritious, culturally appropriate food.

“Food insecurity isn’t just about money, it’s all the things that come along with living in or near poverty in the United States.” she said. “One month, you’re paying bills and not buying enough food, and the next month you’re buying enough food and not buying the necessary medication or paying bills.”

Her research has found links between the stress of marginalization— food insecurity, poverty, identifying as a racial or ethnic minority — and the risk of developing obesity and cardiovascular disease. Recently, her team found that San Diego agencies are tackling food insecurity holistically. In addition to connecting families to food and food assistance, cross-agency partnerships enable agencies to assist families with finding affordable housing, paying bills and accessing mental health services. “All of these things are connected,” she said.

BrightSide Produce, the brainchild of marketing professor Iana A. Castro, takes a direct approach to reducing food insecurity. Student interns and staff distribute fresh produce, purchased from wholesalers and local farmers, to underserved communities of National City and San Diego on a weekly basis.

“BrightSide’s primary goal is to make sure that everyone has access to fresh, affordable produce,” she said.

Castro said it is run like a non-profit, and the student interns take on responsibilities related to their interests and majors.

National City, a community in San Diego’s South Bay, has neighborhoods that are considered food deserts because they are located more than a mile away from a supermarket.
“Because of the presence of BrightSide in 13 stores in National City, all residents now have access to produce within a half mile of their homes,” said Castro.

Family and Community Interventions

Family and community connections can be a powerful way to address health disparities.

Through a partnership with the YMCA, psychology researcher Elva Arredondo and her team recently tested a pilot project that promotes physical activity and wellbeing among Latinx mothers and their pre-adolescent daughters. At this age, girls tend to become less active and are bombarded with social media messages about body image.

“We’re engaging their mothers because mothers still have an influential role at that stage,” said Arredondo. “They can role model physical activity, which is connected to lower risk of depression, to healthier eating, to family engagement and connections. So it’s a very holistic intervention and approach.”

Arredondo also studies how community-engaged interventions can be successful over the long term.

“SDSU has all these programs at work,” she said. “We are constantly thinking about how to translate them into practice, adapt them to diverse communities and sustain them.”