Columbia Center for the Health of Urban Minorities (CHUM)
In February 2003, the Center for Community Health Partnerships, at the Columbia University Health Science Division, received a $6 million grant from the National Institute of Health's (NIH) National Center on Minority Health and Health Disparities (NCMHD) to establish a research center on minority health and health disparities. This interdisciplinary center, which is called the Columbia Center for the Health of Urban Minorities (CHUM) will conduct and support research, training, education, and community partnerships aimed at improving the health of Latinos and African-Americans in northern Manhattan. The establishment of CHUM originates in a longstanding relationship between Columbia University's Health Sciences Division and two Northern Manhattan minority communities one Washington Heights/Inwood, which is predominantly Latino and the other, Harlem, which is mostly African-American. Building on these relationships and existing research programs at Columbia University's Health Sciences Division, CHUM proposes to lead, coordinate and support efforts at the Health Sciences Campus in identifying ways in which access to care shapes racial and ethnic disparities and to contribute nationally towards the reduction and ultimate elimination of health disparities.
Over the next five years, twenty-seven researchers (including 13 minority investigators) from Columbia University's College of Physicians and Surgeons, the New York Psychiatric Institute, Harlem Hospital and the Mailman School of Public Health will join together with members of the northern Manhattan community to explore ways of improving health in minority populations within northern Manhattan. Olveen Carrasquillo, M.D., MPH, assistant professor of medicine at the College of Physicians and Surgeons is the principal investigator of the center. Rafael Lantigua, M.D., professor of clinical medicine at P&S, will serve as the co-principal investigator.
Investigators will be organized into five distinct research cores, a health education core, a health disparities training core, and a community action core as follows:
Community Action: A central feature of CHUM will be to establish a culture of community collaboration within the medical center's research activities. One of CHUM's goals is to make a paradigm shift in the way community-based research is conducted. Rather than holding the traditional academic perspective in which research is done either "on" or "for" the community, it will be done "with" the community." To help facilitate this shift, the community action core will create a planning council composed of community-based organizations and academic researchers who will collectively develop, evaluate and modify approaches to community-based activities in each of the grant's other's cores.
Training: The need to address the under-representation of ethnic minorities in the health professions has been identified as an important mechanism of addressing health disparities. This CHUM training core provides MD/MPH students from Columbia and elsewhere with opportunities to carry out research on minority health and health disparities under the mentorship of a CHUM investigator. Students will also take part in a novel curriculum developed under a National Institute of General Medical Sciences funded Initiative for Minority Student Development.
Minority Health and Health Disparity Education: Cross-cultural communication offers a tool to improve health care professionals' ability to provide quality care for diverse populations and thereby reduce health disparities. This core will use the expertise gained from a highly successful pediatric house staff cultural competence initiative, to upgrade the current cultural competency of medical students through service learning methodology. Utilizing community experiences and community members as part of the educational process, students will explore the four cornerstones of cultural competency training: community asset mapping, developing communication and language skills, exploring provider and patient culture, and analyzing disparities in health outcomes. Once implemented the core will expand cultural competency training to all four years of the medical school curriculum and develop a parallel curriculum for all other Health Sciences students.
Primary Barriers: Researchers will examine disparities in access to care due to lack of health insurance as well as other monetary barriers. In collaboration with the planning council, researchers will work to better delineate these barriers and develop appropriate mechanisms to overcome such financial barriers.
Cardiovascular: Incorporating input from northern Manhattan community groups, researchers will examine the contribution of neighborhood level socioeconomic characteristics in the development of cardiovascular disease in minority populations.
Mental Health: Based at the New York Psychiatric Institute, researchers will facilitate the development and research evaluation of mental health interventions for low-income minority populations who have limited access to specialized mental health services.
Diabetes: Researchers will address the growing problem of diabetes in northern Manhattan. By collaborating with community groups, they will increase minority representation in ongoing diabetes clinical trials and embed diabetes prevention, education, and outreach as a core component of their services in Northern Manhattan. This research core will be based at Columbia University's Naomi Berrie Diabetes Center, one of three "Diabetes Centers of Excellence" in New York State.
Injury Prevention: With unintentional injuries being the third leading cause of death in Hispanic populations and the fourth leading cause of death in African-American populations, researchers at the Harlem Injury Prevention Center will examine injury patterns and disability prevention programs among minority populations which a focus on children and the elderly. They will also identify community-based interventions to reduce injuries and disabilities within northern Manhattan.
Other Health Disparity Programs at CHUM