Our Research: Equity in Action

Health equity is the idea that everyone should have all the resources needed to be healthy: nutritious food, stable housing, safe places to play and exercise, good education, fair-paying jobs, clean air and water, quality health care, and freedom from exploitation and racism. Our health equity researchers study these issues within their naturally occurring social and structural contexts and allow the development of strategies, programs, and policies to eliminate barriers to health.

Our research is comprised of four core areas: community engagement, data science and research, health care delivery science, and research workforce. This allows us to understand and address the myriad causes of health and health care disparities. Together, these four cores enable our Institute to generate evidence, develop interventions, shift policy, and train new leaders to create meaningful and sustainable change. Our cores collaborate closely while providing targeted expertise, creativity, and dedication to ensure health equity reaches all communities. In addition to our cores, the Institute has research groups with specific areas of focus to drive health equity research related to particular health issues. The work of these research groups employs multidisciplinary methods to examine and address inequities.

The Community Engagement Core works toward optimizing the health and lives of groups most significantly and unjustly impacted by systemic oppressions and inequities (e.g., racism, poverty, and barriers to care) through representative and durable community partnerships. We believe that authentic and meaningful community engagement is critical to addressing the most pressing health disparities. Our recent work includes:

Community-Based Participatory Research
Community-based participatory research is a process that involves diverse community members in all phases of the research process. We offer training for community members and leaders to learn how to conduct community-based participatory research that matters to them and link participants with researchers for continued learning and collaboration. Our community-based Participatory Research Hub includes community-identified and vetted resources to support community-engaged research projects.

RiseBoro Storytelling Event “Hope Bodega”
The Institute hosted an intergenerational storytelling event at RiseBoro, a nonprofit organization in Brooklyn. Dubbed as "Hope Bodega", the innovative participatory project is an assemblage of shared experiences, designed to kindle a sense of connection and resiliency among community members. At its heart lies a simple yet powerful concept: inviting individuals to bring forth cherished objects and mementos from their personal spaces carrying a unique significance that embody joy, hope, strength, and love. Bodegas are special to New York City, and to those of us who call New York home. To showcase and more widely share the profound impact of the experiences, places, and wisdom shared during the event, an upcoming exhibit is being planned. “Hope Bodega” will travel to other neighborhoods and spaces across New York City.

The Data Science and Research Core investigates and addresses how biological, social, financial, neighborhood, and health care factors have contributed to poor health outcomes for racial, ethnic, and gender minorities, as well as socioeconomically and physically disadvantaged groups, across a wide range of diseases and conditions. Key initiatives include using data on millions of people to understand the impact of mass incarceration on community health; the association between genes and air pollution in the well-known disparities in chronic kidney disease; and the different impacts of COVID-19 on different communities, racial, and ethnic groups. Our recent work includes:

Interventions to Eliminate Disparities
Many factors determine how long and how well people live. The Institute for Health Equity Research at the Icahn School of Medicine at Mount Sinai is shattering the traditional silos researchers operate in to elucidate reasons for, and address, disparities. By building, using, and sharing user-friendly and reliable datasets, we are learning and addressing how these factors influence health.

Transforming Clinical Trials to Address Disparities
Too often, the populations most impacted by poor health are not included either as intellectual partners in, or as participants of, interventions to improve health. The Institute for Health Equity Research is changing that. We are leading several national and international efforts in which diverse community members and advocates help select interventions that address root causes of disparities. With community, industry, academic leaders, and funders, we are ensuring the populations we enroll in studies are fully representative populations.

 

The Health Care Delivery Science Core works toward eliminating disparities in how diseases are diagnosed and treated while embedding equity in all measurements of health care quality across the health system. Our recent work includes the following initiatives.

Developing Equity Dashboards
Lynne Richardson, MD and Nina Bickell, MD of the Institute for Health Equity Research are founding members of the Mount Sinai Health System Health Equity Data Assessment. Working with equity experts from Mount Sinai’s Digital and Technology Partners and the Office for Diversity and Inclusion, the Health Equity Data Assessment provides oversight, guidance and technical support to design dashboards to monitor the quality of care received by patients of every race, ethnicity, language preference, gender identity, and ability across the Mount Sinai Health System and to implement interventions to assure equitable outcomes for all patients.

Advancing Maternal Health Equity
In partnership with experts from the Institute for Health Equity Research and Digital and Technology Partners, Tori Stern, MD, Vice Chair of Icahn Mount Sinai’s Department of Obstetrics and Gynecology, has done seminal work to improve maternal outcomes for Black patients including replacement of the race-based Vaginal Birth after Cesarean calculator with one that does not use race.

Eliminating Bias from Physician and Nursing Notes
Institute leaders Carol Horowitz, MD, MPH, and Lynne Richardson, MD, have partnered with the Quality Leadership Council on the Factual, Affirming, Informative and Respectful (FAIR) Documentation initiative, which will eliminate negative descriptors and stigmatizing language from provider notes in electronic health records and educate clinicians on how to use FAIR language when writing about patients. This effort incorporates the latest technology, including artificial intelligence to identify inappropriate language, and engages patients to implement solutions.

Improving Linguistic Equity
Researchers from the Institute for Health Equity Research are partnering with the office of the Chief Medical Officer of the Mount Sinai Health System to identify and eliminate disparities in outcomes for patients with a language preference other than English and to implement improvements in language interpreter services.  

Eliminating Harmful Racially Biased Clinical Algorithms
Competently caring for diverse populations requires knowledge of group-specific data on risks and outcomes; evidence-based clinical decision tools based on the best available data can facilitate equitable care. However, inappropriately using race in clinical algorithms based on flawed evidence has caused harm to certain racial groups. Institute leaders, Nina Bickell, MD, and Lynne Richardson, MD, convened a system-wide multidisciplinary task force that has completed a comprehensive review of all clinical algorithms across the Mount Sinai Health System to identify and eliminate those that are not based on valid evidence.

Eliminating Cancer Disparities
Researchers are leading a systematic investigation of racial, ethnic, and language disparities in the care received by cancer patients. Through a citywide collaborative of academic institutions and community advocates, funded by Stand Up to Cancer!, we are working to achieve equity in cancer clinical trials by increasing the proportion of Black and Latine participants in cancer clinical trials.

Investigating Practice Segregation in Ambulatory Care
Institute for Health Equity Research investigators have been funded by the NIH/National Institute for Minority Health and Health Disparities (1R01MD017508) to do a retrospective investigation of ambulatory visit data for 12 million patients from five medical centers in New York City to assess the level of segregation of ambulatory practices and its impact on processes of care and care outcomes.

The Interdisciplinary Collaborative Research (iCORE) Training Program is a nine-week summer program that provides hands-on and classroom research training for undergraduate, post-baccalaureate, medical, nursing, and graduate students. The iCORE program is a collaborative effort between the Institute for Health Equity Research, the Department of Emergency Medicine, and the Center for Nursing Research and Innovation. The program runs from June to early August and offers a unique opportunity for students to gain valuable research skills and clinical experience in a collaborative and interdisciplinary environment.

The Research Workforce Core works toward transforming the composition and focus of Icahn Mount Sinai’s research workforce to reflect the diversity of our society and ensure that all research is conducted through an equity lens. Our recent work includes the following initiatives.

Center for Scientific Diversity
Led by Emma Benn, PhD, MPH, the primary objective of the Center for Scientific Diversity at Icahn Mount Sinai is to increase the research success and equitable advancement of underrepresented faculty researchers in academic medical centers, both investigators and trainees. The team developed an eight-week summer mentored research training initiative for underrepresented undergraduate students from New York City who are interested in pursuing a career as a physician or physician-scientist. In addition, the team co-leads the National Institutes of Health Faculty Institutional Recruitment for Sustainable Transformation (FIRST) Cohort Cluster Hiring Initiative.

Health Disparities Research Consultation Service
The Health Disparities Research Consultation Service offers support to Icahn Mount Sinai researchers who are currently working on or are planning to conduct research involving diverse populations or research with a health equity focus, and who lack formal training in disparities research. Researchers receive expert advice from experienced disparities researchers or from community members, who can provide insight and guide inquiries, strategies, study design, analysis, and research methods. This service is designed to encourage and enhance health equity science across the Mount Sinai Health System, and to foster long-term collaborations across departments, institutions, and community partners.

Research Supplements to Promote Diversity in Health-Related Research
The Institute for Health Equity Research provides information to principal investigators who have eligible awards from the National Institutes of Health and are considering preparation of an application for a Diversity Research Supplement.

NIH FIRST at Mount Sinai
The NIH Faculty Institutional Recruitment for Sustainable Transformation (FIRST) program aims to transform academic culture by building a self-reinforcing community of scientists committed to diversity and inclusive excellence. Each of the participating research institutes: The Friedman Brain Institute, the Tisch Cancer Institute, the Global Health and Emerging Pathogens Institute, and the Institute for Health Equity Research has hired a cluster of three outstanding early-stage investigators from diverse backgrounds and scientific disciplines, who are committed to research careers. The NIH FIRST program provides support to these 12 FIRST faculty scholars with inclusive and equitable mentorship and a broad range of programs designed to foster their success as independent investigators and to build and sustain a culture of inclusive excellence at Mount Sinai.

The NIH FIRST Cohort Cluster Hiring Initiative at Icahn Mount Sinai is supported through the National Cancer Institute of the National Institutes of Health under Award Number U54CA267776. This award is supported by the NIH Common Fund, through the Office of Strategic Coordination/Office of the NIH Director.

Mental Health Equity Research Group
The Mental Health Equity Research group is focused on promoting equitable access to culturally relevant mental health treatment. This research group, led by Sidney Hankerson, MD, MBA, specializes in meeting people where they are through partnerships with churches, barbershops, youth sports leagues, and other community-based agencies. They integrate principles of community engagement, implementation science, and social justice.

Geospatial Health Research Lab
Directed by Andrew Maroko, PhD, the Geospatial Health Research Lab’s primary goal is to provide Institute researchers, and the broader Mount Sinai community, access to methodological and theoretical expertise in health geography, spatial analysis, and geographic information science for the study of population health in general, and health equity in particular. These services include simple map making and geo-visualization, neighborhood characterization using robust spatial approaches such as dasymetric disaggregation and expert systems, exposure and accessibility estimates, spatial statistics such as cluster detection, and the formulation of “spatial” or “geographic” hypotheses to be tested.

In a study funded by National Institute of Allergy and Infectious Diseases, we are collaborating with The City University of New York; the University of California, Santa Barbara; and the University of California, San Francisco to examine the effects of extreme weather events, such as heavy rainfall, hurricanes, and drought, on short- and long-term outcomes of people living with HIV across the world.

We are also collaborating with the Mount Sinai Scientific Computing and Data Group to advise them on best practices for including neighborhood-level social detriments of health in Electronic Health Record (EHR) data. Including these types of data into EHRs can help researchers more easily incorporate contextual social determinants into their work and projects.

Immigrant, Cultural, and Linguistics Studies Research Group
This research group focuses on investigating language equity. The Mount Sinai Health System serves one of the most diverse patient populations in the world, making the consistent use of appropriate language interpreter services (LIS) imperative. Dr. Ngai is leading a novel study examining the correlation between LIS usage records and patients with a preferred language other than English. Findings will inform interventions to assure that all patients have access to qualified interpreter services when receiving care at Mount Sinai.

Core and Research Group Leads

Nina A Bickell, MD
Nina A Bickell, MD

Professor and Director, Health Care Delivery Science Care

Nita Vangeepuram, MD
Nita Vangeepuram, MD

Associate Director, Community Engagement Core

Sidney Hankerson, MD, MBA
Sidney Hankerson, MD, MBA

Director of Mental Health Equity

ANDREW MAROKO
ANDREW MAROKO

Director,  Geospatial Health Research Group

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