Public Health Messaging in Minority Communities and COVID-19’s Neurological Effects With Hiral Shah7/22/2020
By: Hannah Lin (CC '23)
Could you talk a bit about the work that you do? I work in the Department of Neurology and in the Division of Movement Disorders, so I mostly focus on seeing patients who have degenerative diseases such as Parkinson’s Disease, Huntington’s Disease, and others. My research focus is centered around public health approaches to improving access and treatment for neurological disorders. In that capacity, I also work as a consultant for the World Health Organization. How did you get started in public health research and neurology?
little serendipitous that I had the opportunity during my training to work at the World Health Organization and really observe firsthand how public health initiatives can transform care delivery in a variety of ways.
From what I saw, your COVID-related research focuses on health disparities for Black and African American New Yorkers. Could you talk a bit about that? Here in New York, the initial epicenter of the COVID-19 pandemic, we observed firsthand the egregious health disparities which were further highlighted in the context of the pandemic. Though we suspect that social determinants of health and a multitude of factors such as issues related to education, housing, insurance, health literacy, and structural racism all have played into the more severe outcomes and the brunt of the burden of the illness being borne by our minority communities, I still think that there is a lot left to be learned in terms of what the modifiable risk factors or modifiable barriers are that, as clinicians or as public health experts, we could try to leverage to improve our response to the pandemic, both now and in the future.
and related myths surrounding the disease that could shed some light on ways that we could improve the health of these communities.
How is your progress on these surveys? Are you still collecting responses?
Where do you see your research going in the near and far future? I know you talked about the broader goals of having your work reflected in public policy as well as community and institution-level strategies. I think in the near term, within our department, we may be able to modify our messaging and the way that we educate the public in terms of safety and coming back to the medical center. In the era of the COVID-19 pandemic, we’ve also observed that many are reluctant to come seek routine care because of fears related to COVID, so I think if we can better understand what those fears are, which is part of the survey, then we can better address those concerns to ensure that there aren’t unnecessary delays to care that further cause negative health consequences for our communities. In the long term, I think that we simply don’t know enough about the effective strategies to reach minority communities. Sometimes, simply translation of messaging is used to communicate with Hispanic communities, but I think that we need to think more creatively and out of the box in terms of how we get these public health messages out to the community, whether it means relying on local faith leaders that are based in the community or using mass media or alternative approaches. I think we need to think outside of the box in the future because clearly, public health messaging has been a little inconsistent throughout the pandemic, which has led to more confusion for the public on how to respond and what guidelines to follow. I think we need to think of novel ways to reach minority communities and provide messaging that’s a little more tailored and culturally appropriate. Switching gears to your clinical work: obviously, you not only do research, you’re a neurologist as well. Could you talk about your experience as a neurologist during the pandemic?
challenges with using the technology and positioning themselves to allow for an appropriate examination. And, many of our patients are older adults; I think we all know family members or friends ourselves who struggle with these new technologies and how to implement them. So though I believe it’s been an exciting time in which we’ve been able to take advantage of and leverage telemedicine and information technologies, I think it’s also exposed a lot of the barriers to its implementation universally.
In terms of COVID-19 infection, we’ve heard a lot about the respiratory and cardiac effects. Could you talk about the neurological effects? Absolutely. The neurological manifestations of COVID-19 have been of great interest. I think at the onset of the pandemic when it became obvious that anosmia, or lack of sense of smell, was a feature of the disease, that got a lot of people’s attention. It’s thought that the virus likely gains access or entry into the neurological system by the mucosal membrane in the nose and that maybe travels to the brain in that way, but this has not been confirmed.
For students out there who want to pursue a career in neurology or public health research, do you have any advice or life lessons you’d like to impart? I would just say follow your passions and your interests. Always look for ways that you can get involved. I think learning on the job or on the ground, so to speak, is one of the best ways to figure out whether it’s really something that interests you and something that you want to pursue as a lifelong career. I would encourage students to try to find opportunities and get involved. Both regarding science and research as well as society at large, what is your perspective on the future, and what do you want the future to look like? That’s a big question. I think that this period of time has really opened a lot of eyes for folks in terms of the egregiousness of health disparities and how that impacts some communities more than others. I just hope that it leads to more awareness and activity to try to tackle those problems, because I think that these problems have existed long before the pandemic and will continue long after. Perhaps with additional attention and interest, we can really have some more momentum to solve some of these issues, because I think if they are prioritized and recognized for the terrible consequences that result, we can all really work together to make a change and improve the health of our minority communities in particular. I think that that knowledge will translate to improving the health of our communities at large. Thanks, Hannah, for taking the time to speak to me!
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