Dalio Center for Health Justice

Srilaxmi Bearelly, MD, MHS; Ronald Wapner, MD; Andrew Laine, DSc

In the US, racial and ethnic minority women face much higher rates of pregnancy-related complications and pregnancy-related deaths. Preeclampsia complicates up to 4-7% of pregnancies and is a leading cause of maternal morbidity and mortality. In addition, women with adverse pregnancy outcomes, in particular preeclampsia, have a significantly higher risk of cardiovascular disorders later in life. Progress towards improving maternal health equity has been limited by the lack of available rigorously collected data from prospective longitudinal cohorts, and lack of interdisciplinary teams committed to such research. The vasculature of the eye is a far more accessible target for non-invasive imaging than the placenta. Recent advancements in ocular imaging now provide high-resolution, widefield imaging of the retina. In a collaborative effort between Departments of Ophthalmology, Obstetrics and Gynecology, and Biomedical Engineering, the team will utilize deep learning to identify the retinal vascular alterations occurring prior to the onset of preeclampsia to develop and validate predictive algorithms.

Arnab K Ghosh, MD, MSc, MA; Cecilia Sorensen, MD; Fei Wang, PhD; Donald Edmondson, PhD, MPH

Since the 1980s, extreme heat events (EHEs) have drastically increased, resulting in over 11,000 excess heat-related deaths in the United States. Of particular concern are those most vulnerable to heat, including older adults, infants and toddlers, patients with multiple comorbidities, patients with low socioeconomic status (SES) and/or minoritized race/ethnicity, and outdoor workers. Thus, the purpose of the team’s project is to build a stakeholder-informed, Heat-Related Risk Prediction Tool (HRRPT) to model EHE-related morbidity risk across the NewYork-Presbyterian system, ultimately to reduce the adverse health impacts of EHEs in vulnerable populations.

In preparation for beginning the 2023 Health Justice Research Grant, the team has been working with the Architecture for Research Computing in Health (ARCH) team at Weill Cornell Medicine to merge electronic health record data with heat data and SES variables across the NewYork-Presbyterian system. This was done to help their team identify who is presenting with EHE-related illnesses so they can quantify disparities in emergency room presentation and hospitalization within the NewYork-Presbyterian patient community.

Anaïs Rameau, MDCM, MPhil, MS, FACS; Jerel Ezell, PhD MPH; Dustin Duncan, ScD; Asa Radix, MD PhD; Mary Pitti, MS; Keith Chadwick, MD MS; Rachel Coleman, MS-CCC/SLP; Katerina Andreadis, PhD Candidate

Transgender and gender diverse individuals often perceive their voice as a component of their identity. Congruence between voice and experienced gender has been correlated with greater quality of life, and conversely, incongruence may lead to dysphoria. Voice and communication modification training (VCMT) is the current standard of care for voice modification. Unfortunately, VCMT is not readily accessible, especially for racial/ethnic minorities, those facing socio-economic challenges, and/or those located in rural communities. Dr. Rameau’s transdisciplinary team has been developing an open-access VCMT app, Attuned, using evidence-based standard of care practices in speech language pathology with the participation and feedback of transgender and gender diverse individuals. With the support of the Dalio Center’s Health Justice Research Grant, they are improving the app user interface and prospectively assessing the outcomes of Attuned versus those of traditional VCMT in collaboration with the Callen-Lorde Community Health Center, the global leader in LGBTQ care.

Kalliope Tsirilakis, MD; Perdita Permaul, MD, FAAAAI, FAAP; Maria D’Urso, MSN, MBA, RN, FACHE; Rachel Schwartz, RN ,MSW, MPH; Zenna Solomon, MD

Asthma affects 12-15% of children in United States cities, accounts for over 14 million missed school days per year, and costs billions of dollars in healthcare utilization, disproportionately affecting low income, Black, and Hispanic populations. Research shows that home healthcare visits and self-management education can reduce environmental asthma triggers and improve patient outcomes.

The Homebased Asthma Nurse Directed Youth Home Environment and Learning Program (HANDY HELP) partners a Public Health Solutions Home Asthma Specialist with a NewYork-Presbyterian Asthma Nurse Practitioner to create a homebased asthma team. These providers will provide SDoH screening, environmental interventions, asthma self-management education, and clinical asthma management to patients in their homes. Dr. Tsirilakis’ team will evaluate the impact of this program by monitoring symptom control, healthcare utilization, quality of life, and school absenteeism. The intervention targets culturally and racially diverse populations throughout New York City who are vulnerable to poorly controlled asthma, with a focus on high disease burden and low resource neighborhoods served by NewYork-Presbyterian Queens and NewYork-Presbyterian/Weill Cornell.

This unique program allows providers to create tailored interventions to decrease environmental asthma triggers in the patient’s home and provide individualized asthma self-management education to patients and their families.