Our Communications Manager, Katie M. Kanagawa, interviewed Associate Professor of Epidemiology & Population Health (E&PH), Michelle Odden, about her previous research on the safety of cardioprotective medications for older adults, her current Jackson Heart Study- funded research on mobility limitation and minority health, and her love of mentoring and teaching.
Can you start by telling us a bit about yourself? How did you get here (to Stanford Epidemiology)? Was there something in particular that attracted you to the fields of science, health and disease?
You might be surprised to know that I actually learned about the field of epidemiology on Craigslist! I had graduated from Northwestern University with a degree in biomedical engineering and was interested in securing a research assistant position at an academic medical center to enhance my chances of getting into medical school. I saw a posting to work as a research assistant for a cardiovascular epidemiologist and I had to look up “epidemiology” on the internet to figure out what it meant. I ended up getting the job for then Assistant Professor at UCSF, Michael (Mike) Shlipak, and fell in love with epidemiology and changed my career track. Mike and I are still good friends and collaborators.
I understand you have worked for the last 10 years on the safety and effectiveness of cardioprotective medications (statins and antihypertensives) for older adults. Can you please give us an overview of this research? What is the important problem you are working to solve and how have you approached solving it?
After completing my PhD in epidemiology at UC Berkeley, I entered a postdoctoral fellowship in Primary Care Research at UCSF. I was the only non-clinician in my program, so I learned a lot about the challenges that clinicians face in their practices. A common challenge I heard was how to care for older adults whom often were not represented in clinical trials. Although the clinical trial evidence has shown clear benefit of statins and blood pressure lowering, my colleagues were concerned that their patients were more frail and susceptible to adverse side effects than trial participants. My research uses statistical and epidemiologic methods to estimate treatment benefits and harms in patients who have not been included in clinical trials.
What has driven you to pursue this research for a decade? What have you loved most, or found the most rewarding, about it?
Epidemiology is about solving puzzles, which often have no clear or easy answer. You have to love the process. I love thinking about scientific questions from different angles, and using different methods to triangulate evidence. My husband recently asked me, “How do you know when you have the right answer?” And, of course, you never do with certainty. You just keep developing your hypotheses, building evidence, and being critical of your work. Science is a process, not a “point A-to-B”.
Over the last three years, you have been exploring your emerging interest in the area of minority health, and you recently received a grant to study mobility limitation in the Jackson Heart Study, which is a cohort study of >5K African Americans in Jackson, MS. Can you please tell us a bit about that new research project and what is drawing you in this new direction?
In addition to my work on medication effects, my research has focused on the aging process, with the goal of helping people age successfully. Many older adults tell us that the most important things to them are to remain physically able and cognitively healthy, so my work has focused on these outcomes. We have learned a lot about the link between vascular disease and physical and cognitive function, which has informed interventions to prevent disability and dementia. Unfortunately, the majority of aging studies have been conducted in predominantly White populations. Limitations in physical function, cognitive impairment, and vascular disease all disproportionately affect African Americans, so we need more research in these communities. Our grant will add measures of physical function to an existing study of cardiovascular health in African Americans residing in the tri-county area of Jackson, Mississippi. Our goal is to better understand the determinants of preserved mobility (i.e. the ability to walk and move about) in this community, with the purpose of being able to inform culturally sensitive interventions.
Why is this an important area of research to study at this particular point in time?
The recent acts of violence against people of color as well as the disproportionate burden of COVID-19 in minority communities have highlighted long-standing inequities by race/ethnicity. Unfortunately these are not new inequities, but I do feel like we are at a time as a country where we are poised for change. I hope that we can capitalize on some of the energy that we are seeing across the U.S. to make meaningful changes that will reduce disparities.
What do you hope to accomplish with this new line of research? What larger impacts do you hope to make, scientifically and perhaps socially speaking?
There is a wealth of research that has demonstrated that African Americans have worse health outcomes across nearly all health indicators. Throughout my career, I’ve seen a lot of work attempt to explain these disparities through differences in behavior and even biology. But people are coming to realize that disparities in health outcomes across race/ethnicity are most often a result of structural racism. This is not a new idea, but it is one that is finally gaining well-deserved traction. Any potential biologic differences between racial/ethnic groups are miniscule compared to the social inequities. And a lot of behavioral differences are driven by these same unequal conditions. I hope that my research can inform health interventions through a social justice lens.
Is there advice you would like to offer to students or other researchers interested in learning more about the field of minority health? How would you suggest they get started?
Listen more than talk. As a White person working in minority health, it is my job to do the work to learn to be culturally sensitive and ask meaningful questions. I have found Twitter to be a great platform for me to sit back and listen. I follow a lot of Black scholars and it has been really insightful to learn from them. I have also had a lot of generous friends and colleagues from diverse backgrounds who have taken the time to have conversations with me and help me learn.