UMN working to include Asian Americans in medical studies

CATHY WURZER: More than 100,000 people around the country are part of a study that aims to look at child health from pregnancy through adolescence. The program looks at how environmental factors like chemicals, pollution, and stress, affects kids' minds and bodies.

About 800 pregnant Asian-Americans in the Twin Cities now have the opportunity to join the study. A recent story by the Sahan Journal looks at efforts by a University of Minnesota research team to make sure Asian-Americans are well represented in this research. They just won a $13.6 million grant to recruit participants. Ruby Nguyen leads the project. She's a professor of public health at the University of Minnesota. Professor, welcome to the program.

RUBY NGUYEN: Thank you so much for sharing our story, Cathy.

CATHY WURZER: Absolutely. Can you give us some context, if you would please? How well are people of Asian descent represented in most medical research?

RUBY NGUYEN: There's been a call nationwide to increase the participation of Asians, and not only Asians as one monolithic group, but multiple Asian groups within our communities. And the reason is, we see so much disparity throughout our classification. And each of us and each of our groups experience many different types of social, as well as biological, determinants that may affect our health.

CATHY WURZER: Do you know why Asian people tend to be underrepresented in medical studies?

RUBY NGUYEN: Well, one of these reasons is exactly what we're addressing today. So it is a naive understanding of what we do in research, and really, a lack of researchers reaching out to communities. And that's exactly what we're trying to do.

So we are building bridges within our Asian-American communities here in the metropolitan area to better understand this collaborative approach toward research, and to understand what it would take for Asian families to trust us enough with their health information and their time and their resources to better understand these early environmental exposures on their children.

CATHY WURZER: I've learned over the years, professor, that there's always a personal story, almost always a personal story, behind why a researcher gets involved in something. What motivated you to pursue the grant to broaden this study?

RUBY NGUYEN: OK, I think this is definitely a passion project for me. I have been researching environmental influences for more than a decade, but really, the fact that I had seen over and over again that especially in these large national studies, that Asians were underrepresented, and therefore unable to be accounted for in some of the analyses, was really hitting home.

So I came to Minnesota in 1975. My family fled Vietnam at the end of the war, and we were sponsored by a group of South Minneapolis churches. And it was through that experience that I realized that Asian-Americans not only had unique barriers to achieving good health, but we also have some very unique buffers that have prevented us from chronic conditions as well. So this study allows us to understand both the barriers to health, as well as the buffers to those barriers.

CATHY WURZER: So I'm betting, then, the kinds of questions you can answer with a more inclusive study would be pretty interesting.

RUBY NGUYEN: So we have some preliminary data already. Some of that comes from our colleagues. I don't know if your listeners know, but the Minnesota legislature had mandated that we have a biomonitoring group at the Minnesota Department of Health. And my colleagues there have done a fabulous study that's looked at heavy metal exposure in a large group of individuals, pregnant women in the Twin Cities.

And they found, for example, that the group that had the highest level of mercury exposure in both the women during pregnancy, as well as in the umbilical cord, so that's an exposure that we assume that the fetus has had. The largest exposed to mercury were the Asian-American group.

And there were several reasons that were defined as those source exposures. One was an increase or higher than recommended intake of lake fish. So the wonderful walleye that we have here in Minnesota tend to be carriers of mercury. And then another exposure that was unique to the Asian-American population was skin whitening cream. And those tended to have high levels of mercury as well.

So we have evidence within our communities itself that more inclusive recruitment and retention of participants in these types of studies will be able to unmask some of the health inequalities that we see in our communities.

CATHY WURZER: Yet, as you know, there are people who listen to this and say, oh, I don't know if I want to get involved in this. There's some great hesitancy sometimes. There's some fear, right, to have so much data collected. And what do you, as a researcher, get out of it? There's so many questions. So what would you say to folks who are a little worried about maybe joining you with this research project?

RUBY NGUYEN: Yeah, thank you for asking. So we are a very experienced group. Like I said, we've been doing something similar to this for over a decade, but we haven't been doing it with this population. And what's unique about this study is that we are in the stages of it in that we can partner and collaborate and meet the needs of the participants to have them better understand and have them feel more comfortable with participation.

We believe that community members will share our enthusiasm. And we've seen that so far. After the Sahan Journal article came out, we had a wonderful response because I believe that the passion and the intent for research is there within our communities. So now it's at the phase where we are working with community members to make sure that all of the questions and concerns about this research can be met. And therefore, participants feel safe in collaborating with us.

CATHY WURZER: And just to be clear for folks listening, your research is focusing on the kinds of environmental exposures, their impacts on childhood development. Is that correct?

RUBY NGUYEN: That's exactly it. And the reason is we believe that these early environmental exposures can set trajectories into later health, both in adulthood and potentially into the next generation.

CATHY WURZER: So how are you going about recruiting people to participate? And do you need more individuals?

RUBY NGUYEN: We are just starting recruitment now. And so that's another novel aspect to our study, and again, another way that this study is different and really trying to meet the needs of our community. And that is, we're combining three of the largest health care systems in the Twin Cities, which we don't believe has ever been done for pregnancy studies before. So we're working with Allina, the University of Minnesota Fairview system, and Health Partners.

And so the way that participants would be approached is through their normal provider visit in the beginning of their pregnancy. These three health care systems will be able to identify potential participants for us. And then someone from that health care organization will introduce the study. And then after that, the study participant, once they have agreed, will be working with the University of Minnesota and my team.

CATHY WURZER: All right. It sounds like you have a ways to go yet to recruit some more individuals into this study, but you also sound like you're very excited about this.

RUBY NGUYEN: We are incredibly excited. And I think we're hitting the ground running. And we are looking forward to meeting potential participants.

CATHY WURZER: All right. Professor, thank you so much for your time today.

RUBY NGUYEN: Thank you.

CATHY WURZER: We've been talking to Ruby Nguyen, who's an associate professor in the University of Minnesota's School of Public Health. By the way, you can read the full story on this research project at sahanjournal.org. We'll have a link to it on our website, mprnews.org.