An Inside Look

A new study on hypertension gives students a personal glimpse of a public health dilemma

By Barbara Snyder Stambaugh

Just in case there is anyone left on the planet who thinks a Dickinson education means four quiet years inside a limestone building, consider this: Laurel Peterson ’06 spent the summer after her freshman year in downtown Philadelphia doing graduate-level research on a project that could save lives.

Her reaction when she came back to campus in the fall?

“I feel like my life was ripped off the shelf, thrown down and reshaped,” Peterson says. “I re-evaluated ‘privilege’ in American society. I want to tell everyone about it.”

Peterson went to Philly with fellow psychology majors Ally Meloni ’04 and Kristyn DiDominick ’04 as part of the Community Studies Center’s Healthcare Disparities project, led by professors Kjell Enge, Marie Helweg-Larsen, Lonna Malmsheimer and Susan Rose ’77. Dickinson’s students and faculty are collaborating with the University of Pennsylvania Medical School and Cheney University, with the support of a $4.8 million state grant from Pennsylvania’s share of the national tobacco settlement.

Nicknamed CHORD—Collaboration to Reduce Disparities in Hypertension—the project’s four-year mission is to investigate why treatment follow-through for high blood pressure has not been as effective in low-income and African-American communities and, then, figure out how to solve the problem.

To determine why some people don’t take their prescribed high-blood pressure medications, the students spent six weeks this summer conducting elaborate surveys in the Philadelphia Veterans Affairs (VA) Medical Center.

Working in teams with Penn and Cheney students, Peterson, Meloni and DiDominick were posted inside the VA, where they interviewed outpatients.

“They seemed glad to talk to us,” Meloni says of the veterans. “Their life stories are amazing. Because some of them have been through so much, we had to be careful. We were taught during our training sessions that certain words or actions could set up bad reactions. We had to be open and on guard at the same time.”

The training Meloni refers to included two weeks of role playing and lectures on high blood pressure, the health care system and the mechanics of field research.

“The lectures were awesome,” Peterson says. “I was ignorant about so much injustice in our nation’s health care. The professors and doctors were fantastic. Since everything we were doing in this research was new, they were learning, too. They cared about our opinions, and we had a lot of input into the survey itself.”

Though the students were prepared for worst-case scenarios, the research proceeded without incident—for the most part.

Some days, tension seemed a little higher in the hospital because it was hot outside or because the patients endured incredibly long waiting lines. One day, a patient yelled at Peterson and swung his cane very close to a student from Cheney.

“The man shouted, ‘Not all that glitters is gold. Not every cloud has a silver lining.’ It was a little scary,” Peterson says, “but I think he was instilling some reality. I think what he meant was, ‘Don’t just sit there and be happy.’ He had this cane. He didn’t have full use of his leg. He had two daughters with him. I think his life was hard.”

Kjell Enge, associate professor of anthropology and leader of the CHORD project, says the students’ experiences this summer were intense. In addition to their time spent inside the hospital, the students performed “externships,” during which they volunteered at Philadelphia agencies and homeless shelters, and they completed group projects to present their work to the professors and medical professionals involved in the research.

In the next phases of the study, there will be more observation of the interaction between doctors and patients.

“So far, we’ve just been observing the patients,” Enge says. “That’s half the picture. Anthropologists look at everything as being a part of a larger system.

“The most important thing is that, at all stages of this study, the students are involved,” Enge adds, pointing out that the students also will help to create intervention strategies for the next phases of the project. The interventions, which will test ways that hypertension disparities might be eliminated, could be life saving.

“This isn’t just theoretical,” says Marie Helweg-Larsen, associate professor of psychology and student supervisor for the study. “These are real people who are going to die from a real stroke because they aren’t taking their medications.” (See sidebar, page 25 of the Magazine, for more.)

Meanwhile, the Dickinson participants are waiting for the summer’s data to come in. The professors and students will evaluate it and, they hope, submit collaborative academic papers on their findings.

DiDominick, who is interested in becoming a clinical psychiatrist, says the summer research made her more aware of health care discrepancies.

“I’ll be more aware because of what I did this summer,” she says. “It will make me a better person and a better practitioner.” •

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