Current Centers for Population Health and Health Disparities

Rush University Medical Center
Family Rush Center for Urban Health Equity

Contact Information
Lynda Powell, PhD and Steven Rothschild, MD
Rush University Medical Center
Department of Preventive Medicine
1700 West Van Buren Street, Suite 470
Chicago, IL 60614
lpowell@rush.edu; (312) 942-2013
steven_k_rothschild@rush.edu; (312) 942-3476

Lynda H. Powell, PhD – Contact Principal Investigator

Abstract: Researchers have been measuring and describing health disparities in the United States for well over a century. Despite this, persistent health disparities continue and translate into lost lives every day in the city of Chicago as well as in cities across the country. In Chicago alone, if the mortality rate for blacks was the same as for whites, then 4,000 fewer black people would die each year. The Rush Center for Urban Health Equity is based upon the principle that continued documentation of avoidable deaths and disabilities from these disparities in observational studies is insufficient. Instead, the Center is dedicated to preventing them through rigorous behavioral clinical trials in partnership with communities. The Center has convened an interdisciplinary group of medical and social science investigators and community residents who have shared visions, values, and passions. We aim to find ways to promote enhanced cardiopulmonary health, all the way from policy to biology, and to eliminate cardiopulmonary health disparities affecting the residents of America's cities, in particular those who are low-income persons of color. Recognizing that populations at higher risk of cardiopulmonary disease are often characterized by high degrees of traumatic experience and life stress, the Center's mission is to integrate the management of stress and trauma into multilevel interventions that will reduce health disparities in cardiometabolic risk and cardiopulmonary disease. The long-term objectives for the Center are to: (1) develop and integrate rigorous clinical trial methodology into disparities-focused behavioral clinical trials; (2) test innovative multilevel interventions across the lifespan from children to the elderly; (3) empower inner-city communities to become active participants in the design and conduct of interventions to improve their health; and (4) provide training opportunities for promising individuals from underrepresented and underserved communities to pursue careers in transdisciplinary research on health disparities. The Center's location–situated in the middle of communities of extreme poverty–its interdisciplinary research team, its expertise in behavioral clinical trials and community-based participatory research, its broad educational programs, and the Rush culture of clinical and research collaboration combine to create a powerful site for the development and testing of interventions to reverse disparities. Funding is sought to bring these resources together to establish a unique center of excellence in cardiopulmonary health disparities interventions.

Center Aims

• Develop and integrate rigorous clinical trial methodology into disparities-focused behavioral clinical trials;
• Test innovative multilevel interventions across the lifespan from children to the elderly;
• Empower inner-city communities to become active participants in the design and conduct of interventions to improve their health;
• Provide training opportunities for promising individuals from underrepresented and underserved communities to pursue careers in transdisciplinary research on health disparities.

Project 1 will test the value of a culturally-sensitive, multilevel, chronic care intervention for low-income patients hospitalized with heart failure.

Specific Aims

• Determine if a culturally-sensitive, multilevel chronic care intervention that targets patients and doctors simultaneously is better than education alone in reducing hospital days for all-cause hospitalization over a 2.5-year follow up in patients after hospitalization for acute decompensated heart failure;
• Determine if a multilevel intervention, compared to education alone, will:
  • improve patient adherence to drug therapy and salt restriction;
  • improve doctor adherence to evidence-based guidelines;
  • improve patient functional capacity, depression, self-efficacy, health status, and quality of life.
• Determine if a multilevel intervention, compared to education alone will:
  • reduce C-reactive protein and B-type natriuretic peptide, two key biomarkers of heart failure progression;
  • be less effective in patients who have experienced current or past major and traumatic stressors;
  • have a differential impact on heart failure hospitalizations.

Project 2 will determine whether the BRIGHTEN (Bridging Resources of a Geriatric Health Team via Electronic Networking) Heart intervention can reduce depression symptoms in older adults with metabolic syndrome.

Specific Aims

• Determine whether the BRIGHTEN Heart intervention can result in reduced prevalence of metabolic syndrome when compared to a control population;
• Test the mediating hypothesis that the BRIGHTEN Heart intervention results in improvements in adherence with medications;
• Explore the impact of trauma and major life stressors on the results of the intervention.

Project 3 will develop an intervention that effectively targets comorbid asthma and obesity.

Specific Aims

• Collect community perceptions about how best to address comorbid asthma and obesity, to inform the design of interventions to improve asthma control in overweight and obese minority children with asthma;
• Pilot test a home intervention (individual-level) and a school-wide intervention (community level) to determine the feasibility and efficacy of each intervention to improve asthma control in overweight and obese minority children with asthma;
• Explore the relationships between caregiver major and traumatic stressors, biomarkers of stress in caregivers, child reported major and traumatic stressors, and biomarkers of stress in children with comorbid asthma and obesity.