Our Communications Manager, Katie M. Kanagawa, interviewed Epidemiology and Population Health Postdoctoral Research Fellow, Hoda S. Abdel Magid, about her research on spatial disparities and health inequalities, and her significant contributions to justice, diversity, equity and inclusion (JEDI) efforts on and off campus.

Can you start by telling us a bit about yourself? How did you get here (to Stanford Epidemiology and Population Health)? Was there something in particular that attracted you to the fields of science, health and disease? 

I was born in Cairo, Egypt, where I lived until the age of five, before my family and I immigrated to the United States. As a first-generation Muslim Egyptian-American, raised in the Bay Area in a lower middle-class family, I saw first-hand how complex socioeconomic factors impacted the health of my family and community. It is precisely because of my upbringing and background as a Muslim Egyptian-American woman that I am committed to conducting research that elucidates the impact of contextual factors on the health of racial/ethnic minorities and socioeconomically marginalized populations. As a member of a minority group that is underrepresented in Epidemiology, I am also committed to contributing to efforts to diversify our field and our academic communities.

I am the first in my family, and one of the first women in my local Egyptian community here in the Bay Area, to pursue a doctoral degree. I started out in academia at community college and was afforded many opportunities to work my way up into my graduate training. After transferring from a local community college to Santa Clara University (SCU) on a scholarship, I discovered my passion for public health during my first Epidemiology course. Like many, I too had thought that Epidemiology had something to do with skin!

SCU—a Jesuit university in California’s Bay Area with a long history of social justice-focused pedagogy—ignited my passion for health disparities research. Courses in sociology, anthropology, economics, and ethics helped me understand some of the underlying societal structures that shape individual health. As part of my undergraduate public health training, I interned at the California Family Health Council, where I worked with members of various socially marginalized risk groups in adolescent sexual health. I discovered a passion for quantitative data analysis and scientific writing, especially with collaborative mentors and teams. As a Masters of Health Science student at Johns Hopkins University's Bloomberg School of Public Health (JHSPH), I pursued research among multiple racial/ethnic and socioeconomic risk groups, and worked jointly in the Departments of Epidemiology and Environmental Health Sciences and the Institute for Global Tobacco Control. As a doctoral student at the UC Berkeley School of Public Health, I developed an interest in utilizing spatial analysis methods to study the social and behavioral context of health.

These experiences – and the guidance and support of my mentors – brought me to Stanford E&PH. I would have never imagined that I would conduct research at Stanford. This truly has been my dream job, and I am grateful for the unique opportunities afforded to me everyday!

Let’s turn to your current research on spatial, racial/ethnic, and socioeconomic disparities. Can you start by telling us about this work? What particular problems are you seeking to address and what are some key takeaways from this research? 

I am interested in examining how place affects health. Specifically, I examine how social determinants of health impact health disparities among socially marginalized groups and communities. To understand why this is both interesting and important, you need to know:

1. Place matters for health. Where you live, work, and go to school shapes your individual health.
2. Social determinants of health impact chronic disease risk behaviors such as your ability to exercise, access to nutritious food, or access to mental health resources.
3. Social determinants of health impact chronic disease outcomes such as an individual’s cardiovascular disease status, obesity outcomes, or mental health outcomes.
4. Socially marginalized communities—including individuals of low socioeconomic status living in rural or urban communities, or racial and ethnic minorities such as Black/African American, Indigenous, and Latinx individuals—are at the highest risk for many chronic disease risk behaviors and outcomes.

Health outcomes I have examined in this context include subclinical cardiovascular disease, alternative tobacco product use, multiple sclerosis, ALS, and most recently COVID-19 testing and test positivity.

Methodologically, I am currently working to develop a specific epidemiologic framework for simultaneously utilizing electronic health record (EHR) data, Geographic Information Systems (GIS) and spatial analysis methods to monitor and reduce health inequities. This approach would inform our use of rich EHR data and provide opportunities to merge it with geographic social determinants of health data. This newly enriched data will inform how we ask and answer questions about how place affects health. 

Can you tell us a bit about your postdoctoral work as a fellow in the Big Data Scientist Training Enhancement (BD-STEP) Program, and how it is allowing you to continue to examine health inequities? 

I am currently a Postdoctoral Fellow in E&PH and the Center for Population Health Sciences at Stanford, and also in the joint U.S. Department of Veterans Affairs (VA) Health Economics Resource Center and National Cancer Institute Big Data-Scientist Training Enhancement Program (BD-STEP). I am working under the mentorship of Dr. Lorene Nelson and Dr. Michelle Odden, furthering my research interests in spatial, racial/ethnic, and socioeconomic health disparities and methodological barriers in spatial analyses of chronic disease.

The BD-STEP program has afforded me several opportunities to learn from amazing mentors at the VA, Stanford, and several research institutions and governmental organizations around the country. For example, I have been able to learn from mentors at the VA’s Multiple Sclerosis Centers for Excellence, and utilize over 12 years of longitudinal data to examine telemedicine utilization in the VA among patients with MS. This project aims to identify disparities in telemedicine utilization among cases and controls with MS in the VA, and ultimately inform telemedicine programs for Veterans and patients in the VA.

The BD-STEP program has also afforded me the opportunity to work with several types of health data sources and, as an epidemiologist, this is probably one of the best things! I am able to learn about different types of data sources, including geodata, claims data, case control data, etc. Although I have encountered several challenges working with these data sources – many of which I have not used before – I have truly enjoyed learning from and working through these challenges. This is one of the many unique features of the BD-STEP fellowship, and I would encourage anyone who is interested in big data projects in the public health space to apply!

You have done a lot of work, at Stanford, the Society of Epidemiologic Research (SER), and the National Cancer Institute (NCI), in the area of diversity, equity and inclusion. Can you tell us a bit about these efforts, and why it is vitally important that we tackle these subjects at this particular point in time? 

I firmly believe scientific advancement depends on diverse perspectives and experiences.

Dr. Manu Platt, a key leader in justice, equity, diversity, and inclusion (JEDI) training in academia, states the following in his recent Nature Reviews Materials commentary: “We must all ask ourselves critical questions about our role in the persistence of racism in academia, its effects on our colleagues and intentional actions to improve equity for all.” Dr. Platt eloquently describes our role as academics and scientists in a democratic society. In order to improve academia, we must all work together and be intentional about our commitments to JEDI in our respective academic communities.

I have been intentional about my commitment and contributions to JEDI in academia through the following projects: 

• At the Society for Epidemiologic Research (SER), we are working hard to survey members of this leading organization in epidemiology to identify ways that SER can contribute to engagement of all members from diverse backgrounds and career stages in the Society’s activities – all with the intent of enhancing discovery in epidemiology and public health. I have been a member of SER since my first year as a graduate student in 2013. I love the opportunities SER provides for epidemiologists, and I am grateful to represent our growing E&PH Department in this scientific space.
• At the National Cancer Institute (NCI), I am working on a joint committee of CSBC/PS-ON/BD-STEP of junior investigators, including graduate students and postdocs, from around the country. We worked together to organize the annual NCI Junior Investigators’ Meeting (August 27th - 28th, 2020), which brings together graduate students and postdocs from across the nation. One of the highlights of this meeting for me was that we were able to bring Dr. Manu Platt to lead an interactive session on diversity in science for all conference attendees. 
• At the Stanford Grant Writing Academy (GWA), Crystal Botham (GWA Director) and I worked together to organize a few workshops on applying for NIH diversity funding. These workshops featured NIH program officers and Stanford awardees discussing funding opportunities at the NIH, including the PRIDE and MOSAIC funding mechanisms.
• At Stanford, our own department’s JEDI committee, led by Dr. Michelle Odden and Dr. Lisa Goldman Rosas, works to: improve the recruitment of BIPOC faculty, staff, and students; incorporate JEDI into the curriculum for MS/PhD students, providing training in anti-racism, allyship, and implicit bias; and contribute to community-building and wellness — both on and off campus. We  are looking forward to hosting our first department-wide JEDI Town Hall on November 11th, featuring Stanford Medicine’s newest Associate Dean for Equity and Strategic Initiatives, Dr. Terrence Mayes.

I am grateful to be a part of these initiatives as I believe training in JEDI is important now more than ever. I am committed to JEDI work and I hope that together our field and respective academic communities will remain committed to this work. Plus, who doesn’t want to be a JEDI!

Is there anything else you would like to cover before we end this interview? Anything we missed in our discussion that you want to make sure our readers know or things in the pipeline you would like to tease? 

At SER, I worked with Justin Feldman (Harvard University) to put together an upcoming panel discussion as part of SER’s Experts webinar series for a timely discussion on police violence, brutality, and reform. This webinar is part of the SER Experts series, which is a career development event series featuring experts in the field on a specific topic area. I am privileged to be the organizer for this webinar, titled "SER Takes Action on Police Violence: A Vision for Public Health Scholarship," and to hold space for this important discussion. 

I was motivated to organize this session because I wanted to learn more about opportunities to contribute to public health scholarship on police violence and to motivate others to engage in this area of research and advocacy. We know too well that we are grappling with many losses from COVID-19 while simultaneously wrestling with the persistent pandemic of white supremacy and related losses enacted by law enforcement that disproportionately harm, assault, and murder Black, LatinX, and indigenous people, and, in that vein, I want to acknowledge some of the lives we lost this year due to injustice. In this session, we will acknowledge and remember these individuals, including Breonna Taylor, George Floyd, and all of the names that we know and all of the names that we don’t know that have been erased due to social injustice.

Additionally, I want to take a moment to acknowledge the importance of this issue. Police violence is not just something that happens, it is a form of state sponsored terrorism. It happens to people that we love and it may be something that you worry about. I think it is important to recognize the personal dimension of this state-sponsored violence. I encourage you to check in with yourself during these conversations, including the upcoming session as SER, as they can be very difficult conversations to have. I am grateful to spend time with attendees and panelists in discussing police violence, the nature of police violence, and what we know about its impacts on individual and population health. Ultimately, I hope that these conversations may inspire you and/or provide direction for your research and work.