February 16, 2022, 9:03 a.m. Michael Devitt — In 2018, the Academy, in collaboration with the Association of Family Medicine Residency Directors, launched a Health Equity Fellowship for family physicians. The goal of the program, which provides fellows with mentorship opportunities and support from AAFP staff, is to develop FPs into leaders who are subject matter experts on the social, institutional and cultural influences that impact patient health, and who can use that expertise to implement changes in primary care and their local communities.
The program started accepting applications from family physicians interested in becoming Health Equity Fellows for the latest fellowship period last summer. After an extensive application and review process, the program has selected three FPs for the 2021-2022 class of Health Equity Fellows.
Eda Akyar, M.D., M.P.H., a PGY1 family medicine resident at New York-Presbyterian Hospital-Columbia University Irving Medical Center, first learned about the Health Equity Fellowship while searching for resources on community health research and advocacy.
“I was thrilled to come across this fellowship, which directly connects fellows to resources and field leaders to promote change in health equity and policy,” Akyar said, adding, “This fellowship will allow me to interact with other family medicine practitioners and advocates to help me forge a career dedicated to social justice and health equity.”
Akyar’s research will focus on understanding the mental health needs of the residents of Washington Heights, a predominantly Latinx neighborhood in New York City, with an emphasis on the needs of adolescents. Akyar noted previous research that has identified several contributing factors to disparities in mental health care for Latinx individuals as an impetus for her project.
“I plan to work directly with community members through community-based organizations and the local government to design program proposals and policy reform that will improve the mental health of the community,” she said. “This project will allow me to interact directly with community members to promote improvements that are tailored to the specific needs of Washington Heights.”
Ultimately, Akyar wants her research to put a spotlight on mental health disparities that affect marginalized populations and create a greater understanding of these patients’ needs.
“As family medicine practitioners, we have the unique privilege to care for patients longitudinally, allowing us to build a patient-physician relationship that is rooted in trust,” said Akyar. “With increased awareness, I hope family physicians will feel empowered to incorporate more attention to mental health in their practices.”
Safiya McNeese-Ruffin, M.D., an assistant professor in the Department of Family and Community Medicine and associate program director and director of obstetrics and women’s health at the Southern Illinois University School of Medicine Family Medicine Residency Program-Alton, learned about the Health Equity Fellowship via an announcement from the Academy.
“I believe the overarching heart of the family medicine physician is caring for the whole patient in that we are concerned about how all aspects of our patient’s existence affects their health,” McNeese-Ruffin said. “I am particularly concerned about the maternal/fetal health of the African American population, which, although improving, continues to have distinct inequities.”
Using her experience at SIU, McNeese-Ruffin’s research project will focus on making improvements to the routine course of prenatal care in African American women, such as adding appointments or in-home visits with behavioral health specialists or doulas, and having a doula or provider mentor present during active labor. She also plans on developing a patient satisfaction survey and using other tools to measure outcomes, such as the number of triage visits, labor complications and overall maternal/infant mortality rates. She added that the project’s scope and goals are likely to evolve as her work progresses.
“My desire is to help create a model for perinatal care that decreases inequities and disparities between classes and ethnicities of women,” McNeese-Ruffin explained. “Many times, family physicians serve as the ‘gatekeeper’ or ‘case manager’ for their patients’ health. Patients trust us with their health and value the advice we give. They trust that we will direct them to the best services and best practices. This is an extraordinary opportunity to capture the attention of this population and help decrease the three-times increase in adverse events in this population.”
Yogesh Shah, M.D., M.P.H., C.M.P., chief medical officer and vice president of medical affairs at Broadlawns Medical Center, a public hospital in Des Moines, Iowa, decided to apply for the fellowship after seeing mentions of the program in American Family Physician and on AAFP.org.
“Broadlawns is Polk County’s public hospital,” Shah said. “We are in one of the poorest ZIP codes of Polk County. Our mission is to build a healthy community through the delivery of accessible, cost-effective and high-quality patient care.”
Shah’s research is aimed at addressing health care barriers in central Iowa by developing and strengthening collaborative efforts between healthcare communities and faith-based communities. Shah’s work will take a three-pronged approach focused on three areas:
Shah expanded on these approaches for AAFP News. Part of his research, he explained, will include creating a health ambassador certification program. This program will train members of the community who belong to minoritized groups to provide health information to their communities, build support for vaccinations, and address issues related to behavioral health and social determinants of health that have been exacerbated by the COVID-19 pandemic.
Another component will include building networks to support the use and acceptance of telehealth. This will be achieved through the purchase and deployment of mobile clinics and web-connected tablets that will allow for patient enrollment of vaccinations and physician visits, provide on-demand translation services, improve digital literacy, and expand health knowledge and access to wellness services in underserved communities.
“Family physicians provide the majority of healthcare for underserved populations in the United States,” said Shah. “As the only county hospital, we treat a more diverse population of patients at Broadlawns than any other hospital in Polk County. As leaders, family physicians have an essential role in raising awareness about health disparities and helping communities address social determinants of health through appropriate education and resources.”
In addition to their research, all Health Equity Fellows are required to fulfill a number of objectives during the course of their fellowship, including
The application period for the 2022-2023 class of Health Equity Fellows will open later this year and posted on AAFP.org. FPs interested in learning more about the fellowship or the application process are encouraged to contact Danielle Jones, Ph.D., the Academy’s director of diversity and health equity, at email@example.com.