Though clinicians are tasked with doing their very best to extend the same level of care to all patients, the fact remains that disparities exist in care and health outcomes, especially in pediatric patients. A new center at The Children’s Hospital of Philadelphia Research Institute will seek to support these most vulnerable patients by conducting research to better understand the root of disparities — be they racial, gender-based, or caused by geography.
The Center for Perinatal and Pediatric Health Disparities Research (CPHD) will work, according to its mission, to “identify, describe, and understand disparities in care and care practices among perinatal and pediatric patients.”
The new Center will be led by Scott Lorch, MD, MSCE, the Harriet and Ronald Lassin Endowed Chair in Pediatric Neonatology. Dr. Lorch is also director of the Neonatal-Perinatal Medicine Fellowship Program in the Division of Neonatology and Deputy Director of the Center for Outcomes Research at CHOP, as well as an associate professor of Pediatrics in the Perelman School of Medicine at the University of Pennsylvania.
“Research in adult patients has shown that there are extensive disparities in the care received by minority patients, particularly Hispanic and African-American patients,” said Dr. Lorch. “CPHD, through multidisciplinary academic and clinical research, aims to understand how these same disparities apply to the perinatal population, where the mother-fetal interaction is of primary importance, and the pediatric population, where family/mother-child interaction is of primary importance.”
Dr. Lorch is an ideal choice to lead the new Center, because his years of work — focused on health disparities, the economics and geography of healthcare, and perinatal epidemiology — dovetails nicely with the Center’s mission. In addition to currently overseeing several federally funded investigations, Dr. Lorch has contributed to recent papers in the American Journal of Obstetrics and Gynecology, Pediatrics, JAMA Pediatrics, and The American Journal of Public Health.
Other faculty associated with the new Center include Nadia Dowshen, MD; Kristin Feemster, MD, MPH, MSHP; Chén Kenyon, MD, MSHP; and Saba Khan, MD. The Center’s Associate Director is Ashley E. Martin, MPH, while Molly Passarella, MS, will perform statistical programming for the CPHD. Both Martin and Passarella, as well several other CPHD faculty and staff, also play roles in the Center for Outcomes Research and PolicyLab, among other CHOP centers.
Hitting the Ground Running
13 faculty members and four CHOP fellows — experts in a number of topics including but not limited to emergency care, food insecurity, HIV/AIDS, and pediatric injuries — have committed to working with the Center and moving health disparities research forward.
And though it was only recently established, the CPHD has already announced its first round of pilot project funding. Designed to support pediatric and perinatal health disparities projects for a year, the CPHD Pilot Grant Program “aims to engage fellows and junior faculty in HD research and to assist established faculty in developing new lines of research in this area,” said Martin.
Geared toward junior faculty, the pilot program is open to all regardless of rank or discipline, so long as one member of the team is from Children’s Hospital. Grant proposals should be submitted by May 30, and awards will be announced in June, Martin noted.
The CPHD has also partnered with a number of community organizations and outside partners to advance its goals of identifying and addressing pediatric and perinatal disparities. They range from the governmental — in the case of the Philadelphia Department of Public Health — to those in higher education, such as the University of Pennsylvania’s Netter Center for Community Partnerships, and nonprofit organizations like Public Citizens for Children and Youth. The CPHD will also work with Children’s Hospital’s Family Relations Department and Family Advisory Council on a variety of projects.
Indeed, one of Dr. Lorch’s current investigations, on obstetric (OB) unit closures in Philadelphia, has involved working with obstetric department chairs, leaders of private obstetric groups, obstetricians, nurses, nurse managers, and midwives to understand the impact OB unit closures can have on patients and hospital. Funded by the Agency for Healthcare Research and Quality, in late 2014 Dr. Lorch and colleagues published a paper in Health Affairs that showed better planning and communication are needed to reduce stress on health systems and the patients they serve.
All of the CPHD’s work — be it research conducted by Center faculty, or that supported by Center grants — seeks to better understand and confront disparities. Ultimately, Dr. Lorch said, with its work the Center hopes to inspire the next generation of pediatric medical researchers to conduct health disparities research, and to start a dialogue about pediatric and perinatal health disparities, with the ultimate goal of improving outcomes for patients.
Investigators interested in working with the Center for Perinatal and Pediatric Health Disparities Research should contact Ashley E. Martin directly at MartinA3@email.chop.edu or 215-590-0902, or via the Center’s email, CPHD@email.chop.edu.