NIAMS Scientists Diverse Backgrounds, Shared Goals

January 31, 2011 (historical)

Photo of Dr. Said Ibrahim
Dr. Said Ibrahim

A Conversation with NIAMS Grantee Dr. Said Ibrahim

February is Black History Month. To celebrate African American contributions to science, we are highlighting the accomplishments of Dr. Said Ibrahim, a NIAMS grantee. Dr. Ibrahim is a tenured professor of medicine and Vice Chair, Department of Medicine, at the University of Pennsylvania School of Medicine. He is also the Associate Chief of Staff for Medicine at the Philadelphia VA Medical Center. In this interview, Dr. Ibrahim discusses his innovative research on health care for minorities, what led to his interest in health disparities and his passion for mentoring young scientists.

What led you to become involved in scientific research and medicine?

I grew up in East Africa. It was there that I was exposed to a whole host of diseases and social issues related to access to health care. But it was my experience as a medical student in inner city Cleveland, and later as a resident in inner city Boston, that made me aware of the link between social status and access to health care. It became apparent to me that the poverty in East Africa is not the sole determinant of who gets the right health care at the right time: even within the most developed country of the world, the USA, inequities in health care exist.

What is the focus of your research?

Although the theme of my scientific interest is on health care equity and quality, the focus of my research has been on health care for minorities and socio-economically disenfranchised communities. My NIAMS-funded research aims to understand and ultimately intervene on racial/ethnic variations in access and outcomes regarding knee and hip replacement in the management of end-stage osteoarthritis (OA). OA, sometimes called degenerative joint disease, is the most common type of arthritis and is seen especially among older people. It most often occurs in the hands, spine, knees and hips, and causes joint pain and stiffness. The use of elective joint replacement varies by race/ethnicity. This provides a unique research model for understanding how issues of race, income, and education shape health care access and decision-making. I have used the health disparities research organizational framework to pursue this line of research. I started with first-generation health disparities research where the objective is to document the existence of racial variations in health care. Specifically, we examined whether there were differences by race/ethnicity in the likelihood of undergoing knee and hip replacement in the Veterans Affairs Health Care System.

In one of the first research studies to look at preferences and expectations on joint replacement, we studied African American and white patients with OA of the knee and hip in Cleveland, Philadelphia and Pittsburgh. We found that African Americans have concerns about surgical outcomes, which might explain the well-documented racial differences in preference for this treatment. NIAMS funded my work to act on these findings by designing studies to assess the effectiveness of various educational interventions to reduce racial variations in access to joint replacement, when clinically indicated.

What do you find is unique about research of musculoskeletal diseases?

Arthritis is an extremely common condition that cuts across all demographic groups. Sometimes some diseases are more prevalent in one community, but generally arthritis is an equal opportunity condition that affects all demographic groups. It also crosses medical disciplines and subspecialties, such as primary care, rheumatology and orthopaedics. Therefore, the treatment of OA requires the collective care of primary care doctors, rheumatologists and, ultimately, orthopaedic surgeons.

Are you involved in mentoring future scientists?

NIAMS supports me to mentor early career scientists who are interested in health equity research, specifically in musculoskeletal diseases. I believe strongly that in order to address disparities in health care, we need to expand research capacity. I make myself available to help train the next generation of researchers who want to pursue musculoskeletal health disparities. Currently, I am mentoring a young rheumatologist who is interested in racial variations in arthritis care. One mentee of mine is a young orthopaedic surgeon who is establishing a career in orthopaedic research focusing on quality of care and patient outcomes. Another one is a social psychologist who is interested in understanding how perceived discrimination impacts health care behavior. For example, we just completed a study looking at how patients who have experienced discrimination in the health care setting communicate with their orthopaedic surgeons about knee OA.

Why is it important for African Americans to participate in the research process, both as scientific investigators and as patients?

As an investigator, it's important for the research community to include diverse perspectives. This helps us establish a diverse set of priorities and creates a sense of trust in the health care system. There is a history of minorities being suspicious of research. They need to see minority researchers to alleviate concerns they may have. The effectiveness of certain treatments may vary depending on the patient's ethnic background. Therefore, it is important to research subjects who are well-represented across racial and ethnic populations so that the findings are generalizable to all communities.

What activities do you enjoy outside of work?

In my younger days, I used to play basketball. I'm a strong believer in movement to sustain life, so I walk, sometimes swim and play ping pong. I also have two daughters, ages 15 and 12, who keep me going.

What is your advice for African Americans and other people from communities of color who wish to pursue a career in science?

I encourage high school and college students to spend time in the summer at scientific labs to get exposed to careers in research.

What do you enjoy about your career?

I enjoy most the ability to generate the kind of work that contributes to the scientific knowledge base and improves life for all human beings. That's why I do what I do. The collective effort of like-minded people to improve the human condition is really what's most gratifying about research.