TMC PULSE

t m c » p u l s e | d e c e m b e r 2 0 1 6 18 18 As a core component of the UT Center for Clinical and Translational Sciences (CCTS), a region-specific clinical research unit was created to gather data for a first-of-its-kind long-term study of this population. Participants in the cohort are asked to follow up every five years and are invited to join in other research being set up. If disease or risk factors are found, researchers connect them with appropriate medical care. "We can't do intervention because it's a cohort and it's for understanding what it is we need to do," explained Fisher-Hoch, a professor in the Department of Epidemiology, Human Genetics & Environmental Sciences at the cam- pus who also oversees the clinical research unit. "If you use the data we generate to figure out who it is, what they've got, where they are and what the risk factors are, then you know what you're doing." Since its creation in 2004, the clinical research unit has published more than 40 papers defining the burden of disease in the area. The statistics are sobering. "We have the highest amputation rates in the country," Fisher-Hoch said. "We have the highest rates of liver cancer. We have the high- est rates of a lot of things, including diabetes, of course. These all go together." Based on the data collected and analyzed, more than 50 percent of the adult population is obese, and another 30 percent is overweight. Twenty-eight percent has Type 2 diabetes, though 43 percent don't know it. Of those who know, only half are under treatment. More than 33 percent of the population has hyper- tension, but 40 percent of that group goes untreated. All this is compounded by the fact that nearly 70 percent of the population is uninsured. "This is what poverty looks like," McCormick said. Salud y Vida The team's initial efforts to collect health data from the local population were simultaneously supported by the creation of a community advisory board and outreach program. In McCormick's words, they are not just sitting there in an ivory tower, writing papers. "We want to work with you, try to empower you to be able to take matters in your own hands, change your community and do better," McCormick said in an interview on campus, where buildings are lined with ceramic Mexican tiles and surrounded by lush landscaping dot- ted with palm trees. McCormick emphasized the multifaceted approach of their mission and the importance of pulling every corner of the city and surround- ing areas into one large support network. "Everything that we've tried to put into place has been through partnerships," said Belinda Reininger, Dr.P.H., the lead researcher for UTHealth's community-wide health initia- tive and co-director of the CCTS Community Engagement Core. "It's not like the school of public health came in and we have done all this stuff—it's not that at all. It's actually the exact opposite of that. Everything we've done has been in partnership and through collaboration. It's about integration of research and teaching and community outreach." Because diabetes affects more than 25 per- cent of the population, much of the program's work is linked to its detection and management, with a focus on education, access to healthier foods, exercise classes and medication, if necessary. The Salud y Vida (Health and Life) pro- gram is made up of local organizations ded- icated to helping community members with Veronica Rosenbaum, director of the Brownsville Wellness Coalition, works in a community garden. We have the highest amputation rates in the country. We have the highest rates of liver cancer. We have the highest rates of a lot of things, including diabetes, of course. These all go together. — SUSAN FISHER-HOCH, M.D. Professor in the Department of Epidemiology, Human Genetics & Environmental Sciences at the UTHealth School of Public Health in Brownsville

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