UC Merced students investigate health disparities in Central Valley

November 21, 2011

By Tim Moran

A select group of undergraduates and graduate students at the University of California Merced are researching health topics in a unique but “unfortunate” laboratory.

The students are studying an array of topics related to health disparities, and the lab is the community of Merced. It is an unfortunate laboratory, UC professors say, because of the prevalence of diseases and chronic conditions such as diabetes, high blood pressure, obesity and asthma. That and the unique ethnic and racial profile of Merced makes the community ideal for studying health disparities.

The study is part of the university’s Center of Excellence for the Study of Health Disparities in Rural and Ethnic Underserved Populations, funded by the National Institutes of Health.

The NIH grant gave the center $1.3 million over two years, which funds the training of students in research methods, according to Jan Wallander, principal investigator for the center and a professor in the School of Social Sciences, Humanities and Arts.

“They get a full year of research training and experience. They spend it in the faculty lab, and they get paid for it. It makes them more competitive for future education opportunities like medical school,” Wallander said.

The students are selected in a competitive process, and work with a mentor on the faculty.

Study topics have ranged from the effectiveness of public policies to curb tobacco smoking to how home foreclosures are affecting the city of Planada.

An example is the study underway by students under the mentorship of Associate Professor Rudy M. Ortiz, a professor of physiology and endocrinology in the university’s School of Natural Sciences.

The students are looking at the problem of obesity in adolescents in Merced, and how it relates to high blood pressure. With cooperation from Merced Union High School District and area doctors and nurses, the students collected data on the height, weight and blood pressure of more than 1,700 area high schoolers.

They sorted the results into categories: normal, overweight and obese based on the Body Mass Index, and normal, pre-elevated and elevated for blood pressure. They then looked for correlations in the data.

One of the findings was that obese adolescent girls are at higher risk for high blood pressure than obese adolescent boys. Both genders showed an elevated risk for high blood pressure, but the correlation was much stronger for girls, the study showed.

“It’s not a cause and effect relationship,” Ortiz said. “We are not saying if you become obese you will have a blood pressure problem.” But the risks increase with body mass, he said.

For example, among normal weight white male teens in the study, 12 percent had pre-elevated systolic blood pressure. That increased to 20 percent in overweight males and 40 percent for obese males.

The trend was the same across ethnic groups, with the exception of African-American males, Ortiz said. That may reflect the small sample of African Americans in the study, just 6 percent, he added.

The disparity between males and females in the study may be a reflection of differences in physical activity, according to Ortiz. Obese females are half as likely to participate in physical activity as normal females, he said.

The study is in its infancy, but ultimately the goal is to design interventions to try and prevent the problems. That’s at least a few years off, Ortiz said.

“Before you can jump in, you need to better categorize the situation we are dealing with in the community. We have to tailor the intervention to the needs,” he said.

“We definitely see a problem here. We need to find out more. It’s primarily a Hispanic population, migrant farm workers. We don’t know the impact of their lifestyles. We would need to go out in the harvest season to study that.

“We have poor air quality, and it’s rural, with not a lot of resources for medical care… There are still a lot of variables we haven’t addressed or quantified,” Ortiz said.

Most of the studies done on the topic have been in urban areas or the rural southeast with a predominantly African-American population, Otiz said. That makes the Merced community unique and an ideal laboratory for the students.

“It’s an unfortunate laboratory with the prevalence of the overweight and obese much greater than you see in other areas,” he said. “It’s pretty exciting to be here, it’s a natural laboratory, but also unfortunate.”

Wallander agreed. The San Joaquin Valley has been compared to Appalachia, and is one of the poorest regions in the country, he noted. “If the valley were a state, it would rank 48th in per capita income,” he said.

The elevated levels of various health problems offers the university a test bed for study and potential solutions, Wallander said.

“It’s an opportunity for us as a university to contribute to the reduction of these health disparities,” he said.

At the same time, university students benefit, Ortiz added. His research on obesity and blood pressure was done primarily by undergraduate students.

“I love mentioning that point. This is pretty cool research, very profound findings. For undergrads to be involved in research – they wrote the papers, I helped them, but they did all the legwork, the data gathering,” Ortiz said.

Many of the students on campus, and those doing the research, come from the same backgrounds as the population the center is studying. “That’s one of the things we look to in selecting undergrads – the experience in these backgrounds, low economic and minority,” Wallander said.

“It’s not surprising. We are in an area where more than 50 percent are in a home where English is not the native language, and 50 percent of students are the first college students in the family,” Wallander said. “The campus is populated by students with those backgrounds.”

Ortiz himself is a first generation Mexican-American, and he noted that he grew up in a community outside of California but very similar to Merced.

The university is working to form partnerships in the community, including holding meetings for community members to help decide what research projects to pursue. A number of collaborations have occurred, and are developing, Wallander said.

“Merced Union High School District was better than I could have imagined,” Ortiz said. “Without their cooperation this couldn’t have happened. A lot of doctors and nurses helped, donating time for free. Overwhelmingly yes, we couldn’t have had better partnerships.”

“Oh my God, it’s wonderful,” said Kelly J. Bentz, Ph.D., of the research partnership with UC Merced program. Bentz is administrator for the Child Welfare, Attendance and Safety Program for Merced Union High School District.

Bentz said she is working with the university on a followup study comparing attendance figures with the rest of the data.The district had over 88,000 days of absence in the past year, which she noted hurts school revenue as well as taking away educational opportunities.

“It makes sense for us to look at health issues,” she said.

The UC Merced research has a real potential for making changes in student health, she said, because the data is more relevant to the parents. It’s not just numbers on a page, “It’s their kids,” she said. The district is looking for more ways they can partner with the university, Bentz said.

The biggest challenge facing the Center is finding continuing funding , Wallander said. The NIH money will run out, and it’s up to the center to find grants and private donations to keep the research going.

It costs $8,000 to $10,000 a year to support an undergraduate in the program, Wallander said, and $30,000 to $35,000 for a graduate student. There are currently 10 undergraduates and seven graduate students in the program.

Ortiz said the ultimate goal is for the center to become an administrative entity, overseeing grants for specific research. If new funding isn’t found, the center could wind up dissolving, he said.

The Center should have a clearer idea about future funding by early next year, Wallander said.

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