A Conversation About Health Equity and Community-Based Research

hello and welcome to the Health Equity lecture series presented by the FDA office of minority health and Health Equity this month as part of our observance of Asian American native Hawaiian and Pacific Islander heritage month we are presenting a conversation about Health Equity and community-based research with Dr Frankie Wong of Florida State University I'm rear Admiral ricarde aroho the associate commissioner for minority health and director

of fda's office of minority health and Health Equity where we have a dedicated mission to protect and promote the health of diverse populations through research and communication of science that addresses Health disparities and I'm glad to welcome Dr Wong who is the McKenzie endowed professor of Health equity research and founding director of the center of population science for Health Equity at Florida State University Dr Wong

is an expert in community-based research among racial ethnic and underserved populations he is also a behavioral and social sciences researcher who conducts nih-funded research addressing the sexual health and substance use and abuse as well as other health disparities among Asian American and Pacific Islanders in the United States Dr Wong's nih-funded research focuses on the social epidemiology of Alcohol Tobacco and Other Drugs HIV and other non-hiv

sexually transmitted infections among populations in the United States South Africa China Tajikistan Vietnam and Russia welcome Dr Wong and thank you so much for joining us thank you Admiral it's a pleasure to be here this afternoon Dr Wong your career path is an interesting one and includes a variety of work you've done across disciplines can you tell us more about your career trajectory and personal Journey

yeah I think the two people that comes to mind is my mother my mother and my late undergraduate advisor my mom always have to say that try everything one you don't like it you don't have to do it again and she was an extremely adventurous person um she passed away when she was 93 but she didn't have me when she was 34. so if you think

about her generation of Asian woman is phenomenal right because she had a career she worked what have you she met my dad uh in the dancing so she's very adventurous and she let me give me free reign in terms of what I want to do I can show you an example about how she caught in my mind uh intellectual interests and adventurism I was a teen

I was I I was a good student I got good Grace but it was also very rebellious so there was I think I was 13 14 and then one day I went out to hang out with friends I told her that I was going to go out and she said no problem I didn't show back up in the house two o'clock in the morning she locked

the door so that was her way of telling me that okay you have your responsibility as an individual you wouldn't make a decision so I learned my lesson okay so like if I promise something I need to deliver so I think that taught me a great lesson my undergraduate advisor John Hunt will be in Canada uh was the one that opened up my mind in terms

of like uh experience psychology and different things and he's always from Scotland but when I looked at John's live he married a Texan so the the combination is so interesting and both Margaret and John has been a wonderful Mentor almost like a second parents so they are the one that encouraged me like to um pick up so I think these Personal Touch really have an influence

in terms of like what I end up doing because I thought about medicine and being a nation man I know because like oh Asian men The Stereotype like you're going to go into medicine and I said to myself I don't like blood that kind of wrote me out and so what am I good at I'm very analytic I'm very it's like quantitative so I end up

like follow John footstep again I think we're in psychology you know I I think that personal approach is so important you talked about that intersection from your family your mother and then your professional mentors and you know I want to expand on that a little bit more how has um your interdisciplinary approach inspired your work and how does it influence the ways you hope to serve

vulnerable and underserved communities uh I was very fortunate when I started Graduate School uh my backgrounds in Psychology and normally like being a psychology student you've been placed in Psychology department for your internship for your research training what have you I was not assigned in Psychology department I was assigned to a public policy Department so very early on I learned about the importance of like public

policy so I work with pretty much like political scientists from the get-go so I was exposed to different disciplines and I said oh actually there's more Delight than psychology there are other things that different way of looking issue so I learned how to do polling uh and I work with sociologists I think that original uh very early on exposure kind of opened up my mind that

yes psychology is good but there's more to love it's like or just what I'm interested in other disciplines and Dr Wong how would you advise people who are just starting out in their careers to seek out interdisciplinary research or work my mom say try everything once you don't like it you don't have to do it again but it's important that it's a journey okay so now

I have a PhD I'm fairly well established uh but you never use I don't stop learning I learn every single day uh to give you another example like learn from anyone whether that person has a degree or no degree one might cause a stress he never gone to University but he's probably the most brilliant researcher I have ever like a man and on top of that

he said tomorrow it's already from Guam so I learned a whole lot about what's it like to be a tomorrow living in the mainland versus like I actually know all his family so I actually been to Guam visited his time a family what happening so every day I learn something so don't fixate on a degree don't fixate on like a technique relax learn some other people

and I think that is so important you know you're you have to continue to learn along your journey and as you know with the work that you've done I want to shift now to talk a little bit more specifically about your research um as we continue to observe Asian American native Hawaiian and Pacific Islander heritage month can you share some of your most recent work with

those communities to address Health disparities my current work in the API Community I'm mostly focusing on HIV is uh hiv-positive individual living HIV is a chronic disease so in addition to HIV they also have other health issues part of aging such as hypertension diabetes so have a cohort study of Asian Pacific Islander including native Hawaiian in Hawaii and also compared to African-American gained by sexual men

living with HIV infinite healthier you think about it collectively these two group of individual ratio ethnic minority in addition they are also sexual minority so above and beyond HIV what are some of the medical social determinants such as racism sexism ageism affect bad condition meaning Interstate living HIV and hypertension um it turns out that the individual living in Philadelphia is the most African-American they report much

higher level racial discrimination than the Asian and Festival island in Hawaii is not to say that aapr in Hawaii don't experience but then Hawaii is a very very different environment so I was a faculty employee briefly and I remember my good friend was saying to me you being Asian actually care nowhere in Hawaii I said what do you mean and she said that here is either

your local or not local you're a Hawaiian born or you're not Hawaiian born but nonetheless many of my API participant still report high level or racism had nothing to do with the HIV condition so I think it's important to keep in mind that when you are living with a chronic DC on top of that you also have to deal with all the sexual thing is really

challenging so yeah and Dr Wong I know as you just described that a lot of your work has centered on HIV and the stigma that many of these communities experience can you talk a little bit now about where you think we've seen progress and what challenges remain well I came from that generation my generation was the one that got decimated by the HIV so I remember

the old days like when there were no treatment okay uh for better of us I do think that we can make some tremendous progress uh we like perform or a former President Bush um and the global fund and the fact that this day you flick on the TV there is commercial of our HIV drugs I remember days we cannot talk about condoms on TV we cannot

talk about treatment on TV we cannot talk about openly about sex on TV we still have a long way to go but I do think we have made progress that some of this issues become more mainstream I mean every day every night when I flick on TV there is a commercial about HIV drugs they exactly treatment job but remember if you remember the old day like

you have to take so many regimen but this day you take one pill and that's it and I do think we can make progress but we still have a long way to go be able to openly infose actuality it's something it's not the issue yeah I think that is that is so true and of course next month June is pride month and I know you've done

a lot of your work around Health Equity that involves lgbtqi plus populations and I wondered if you could discuss some of the unique challenges facing lgbtqi communities as we continue the work to address Health disparities among all underserved populations well we are living an interesting time I mean even follow all the national uh conversation there is a lot of like anti-lgbt movement anti-trans movement um but

we cannot give up we have to keep keep on pushing the envelope and also it's important to remind ourselves that LGBT is not a monolithic uh like Community okay for someone like myself you meet me the first time you probably don't know I'm gay right you probably think about just like another Asian guy down the road okay so it's important to actually try to know the

Kong along new Hong Kong so foreign intensive purposes my upbringing is very British but I also graduate in Canada so uh like the undergraduate will help you so the LGBT community these days does have its own challenge because of the political and social climate right now but we cannot give up we must push the envelope we if you we don't continue to bring the conversation to

the table then we're just going backward we I am not interested in going backward I'm interested in moving forward and that's why it's so important for us to work directly with communities and you've acknowledged the importance of working with communities why is it working with Community Partners critical to advancing Health Equity let me give you one example like in the two mid 2000 I decide I

want to do a particular and I study involving testing among Asian and Pacific Islander MSM women having sex with men at that time I already have the relationship with the community but this is a very big study this is a national study involving seven study Los Angeles Oakland San Francisco New York Boston it is because I know the community partner I just call my colleagues and

friends I said listen we need to do something this is what I have in mind are you on board are you willing to support me it's not that I'm the brilliant the most brilliant scientist but they trust me because I have that relationship with them so everybody came on board for that study and that study was a little bit challenging but ultimately three of the Community

Partners that I worked with two of them eventually able to use this lesson learned they are currently uh fqxc clinic now so they would build capacity and then grow and the other one is also doing some wonderful work so working with Community is about trust it is people need to know that you're not doing helicopter research you're here to really work with them that done at

the end of the day someone should benefit from your research not because like I can publish another paper and shelve it on the show no one would want to reads it yeah I think that's so important and really highlighting that trust and and the importance of building that trust and based on your experience is there any advice that you have for individuals or communities hoping to

drive greater diversity and inclusion in clinical research um diversity is our strength coming from different having different perspectives given what uh we we may end up coming with different solutions uh to address the problem and or more efficient more effective what I am going to say is that I want my generation step up the play to Mentor the Next Generation so what if tomorrow I decide

not to do what I'm doing someone have to be able to carry the torch but I am concerned about this younger generation don't have the history of what we've gone through history if you don't learn from history even make the same mistake again so I am making a plea to my peers of my generation step up the play do something do more they're doing something but

I want them to do more yeah mentoring is so very important especially as we think about those ways that we can advance diversity and inclusion as well as advanced diversity and clinical research and I'd like to close by asking you about any other steps that researchers can take to bring Health Equity to the Forefront of Public Health or any other discipline I would say it's important

to make sure that the research finding uh are digestible and being able to disseminate uh to the community um my co-director uh who's also my uh co-founder of the center she's originally from Panama she currently is finishing up her 2023 presidential leader scholarship it is because of her connection uh I got to know different people from her cohort and one of her colleagues was so wonderful

they said that I have this tech company I'm more than happy to help you guys to disseminate things so think Beyond just your own discipline think about what can other people to share your vision that can work together with you the disseminated dirty information back to the community I think if the community can hear you they may not understand everything I think we'll remove the needle

a little bit and with that I want to thank you again Dr Wong for joining us today for informing us about the important work you're doing and for a great conversation before we close I want to encourage our viewers to visit the FDA office of minority health and Health Equity website at fda.gov forward slash Health Equity to learn more about our initiatives and resources thank you

for tuning in to the discussion and happy aanhpi Heritage Month [Music] [Applause] [Music]