Q & A with Kimberly Johnson: “We all have a role to play”

Monday, June 15, 2015

Kimberly Johnson, MD, associate professor of medicine (Geriatrics), is driven to reduce racial disparities in end-of-life care.

“I have always been deeply moved by the experiences of patients who are near the end of life,” Dr. Johnson said. “At some point, it became clear to me that this experience was different for African Americans.”

Johnson is creating a new research program, which she will direct, on health disparities in palliative care among underserved populations.

What is the focus of your current research?
African Americans use hospice at significantly lower rates than whites, which is a problem because hospice care is associated with better communication, symptom management, caregiver support, and overall satisfaction for terminally ill patients and their families. My research shows that a number of factors may explain lower rates: patient knowledge about hospice care, treatment preferences, trust in the healthcare system, and cultural and spiritual beliefs. I am examining how hospice providers work to increase enrollment of eligible African Americans through such efforts as partnerships with faith communities, engagement of African American staff and volunteers, and community education and outreach to organizations important to the African American community.

How did you get interested in health disparities research?
I can’t imagine studying anything else. In fact, I didn’t first become a clinical investigator and then to decide to study health disparities. I first decided that reducing health disparities was important so I became a clinical investigator. When I started medical school, my plan was to return to my hometown of Winstonville, Mississippi, as a primary care physician at the community health center, which serves primarily uninsured or underinsured African Americans. While my career has taken a very different path, my commitment to improving access to care for underserved groups, particularly African Americans, has remained steadfast.

How can your colleagues at Duke get involved in addressing health disparities?
We held a one-day Health Disparities Research Colloquium on April 17 and at the end, Judy Seidenstein, chief diversity officer at Duke, invited faculty and staff to join the new Duke Health Disparities Consortium. The Consortium will help to facilitate collaborations across the institution among those engaged in health disparities work across all missions and will highlight current efforts. I encourage folks to join the consortium at:  http://dukehealthdisparities.medschool.duke.edu/

You are the associate director for Duke’s CTSA KL2 program. How does that program support diversity and disparities research?
Our KL2 program aims to diversify the research workforce by funding at least 50% underrepresented minority junior investigators. Another major initiative is our health disparities research curriculum, directed by Laura Svetkey, Kevin Thomas, and myself. Curriculum participants include a multidisciplinary group of Duke CTSA KL2 scholars, fellows, and junior faculty engaged in research across the campus.

How can providers help reduce disparities in their clinics?
We all have a role to play. Healthcare providers need to be aware of the existence of health disparities and the many contributing factors, including provider communication. We need to be aware of our own implicit biases and how these may contribute to disparities, as well as how patient factors such as health literacy, socioeconomic status, and beliefs about health and healthcare affect treatment adherence. Providers also have an opportunity to examine disparities in their own patient populations or clinical practice and make quality improvements.