Ronny Bell, Fred Eshelman Distinguished Professor in the UNC Eshelman School of Pharmacy and associate director of cancer care access and excellence at UNC Lineberger, on the health disparities affecting American Indian communities.
As a Lumbee Indian growing up in Robeson County, North Carolina, Ronny Bell has always been aware of health concerns facing his tribal community. Now, as an expert in public health and pharmacy, he knows how little health research is done in American Indian communities.
He’s spent his career trying to fill that gap and create evidence-based interventions that can address these health disparities. Currently, American Indian populations face higher rates of most chronic diseases and many cancers, and they are significantly more likely to die from diabetes (2.5 times more likely) or heart disease (30-40% more likely) than white North Carolinians. Bell has studied a number of different health concerns, including chronic diseases, mental health and cancer; but his work now is primarily focused on cancer disparities among rural and American Indian populations.
Bell co-leads the Southeastern American Indian Cancer Health Equity Partnership. The partnership is a collaboration between UNC Lineberger Comprehensive Cancer Center, Duke Health and Atrium Health Wake Forest Baptist, in which the cancer centers come together to work with tribal communities throughout the state. The group provides community outreach and seeks to understand which cancers pose the biggest threat to American Indians.
How can the state’s health systems best partner with tribal communities to address health disparities in American Indian communities and improve health equity?
BELL: We need more research to understand which interventions will work in American Indian communities. We can’t take cookie-cutter approaches and expect them to work in every community.
We also have to recognize that academic institutions have a long history of flying into tribal communities, doing the research they want to do, then publishing and leaving the community behind. That’s not what’s needed. Many tribes have their own institutional review boards now that have to approve research before it’s done in the community. I’m also working on one study right now where the tribe itself received the grant and is working with me as a subcontractor on the study. It’s important that the tribe and its leaders are involved in the planning of research, not just as the subjects of the research. This improves the quality of the research and makes sure it will actually be helpful to the community.
Trust-building and putting some investment into the community is also important. There needs to be more support for tribal communities, whether it be financial, educational, or training and hiring from within American Indian communities.
Fall is powwow season, so our team at Southeastern American Indian Cancer Health Equity Partnership has been traveling across the state to the powwows. We set up booths to distribute educational material and talk about the importance of getting screened for cancer. At each event we may talk to 150-200 people, many of whom live two hours away from the closest cancer center. We’re sharing information like where they can go for a colonoscopy, or who is eligible for a lung cancer screening. This type of outreach takes time and work, but working closely with the tribal communities is always more successful in improving health outcomes.
Distinguished and named professorships support renowned scholars and propel research at Carolina. These privately funded endowments help attract and retain the academic leaders of today, ensuring a state-of-the-art education for all Tar Heels.
As told to Audrey Smith
Pictured above: The bolo Professor Ronny Bell is wearing was a gift from a Lumbee friend. The turtle in the center of the emblem is an important animal in the Lumbee tribe, representing strength, wisdom and longevity. Bell’s son made him the UNC medallion necklace. (Photo by Danny Alexander / UNC Eshelman School of Pharmacy)
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