Conversation with Dr. Francine Gachupin, University of Arizona

Working with Tribal Communities to Inform Community Programming and Advance Research

NIMHD’s Conversations with Researchers Advancing Health Equity

November is Native American Heritage Month. As we celebrate the significant contributions to America—from its history through present day—by people who represent Native communities, we recognize researchers who are promoting health equity through their work to advance the science of minority health and health disparities.

Meet Francine C. Gachupin, Ph.D., MPH, principal investigator in minority health and health disparities research.

Dr. Francine Gachupin

Dr. Gachupin is an associate professor and member of the graduate faculty at the University of Arizona (UA). She is the principal investigator on a number of NIH-funded grants, including an NIMHD-funded R01 focused on primary obesity-related chronic disease prevention and healthy lifestyle promotion among youth (1R01MD014127-01A1).

Dr. Gachupin is a tribal member of the Pueblo of Jemez, New Mexico. A prominent researcher in the field of chronic disease epidemiology and a noted expert in protection of human research participants, specific to American Indian biospecimen use, she has served as founding director to Tribal Epidemiology Centers, chaired several institutional review boards (IRBs), and is committed to education and research founded in the unique needs and strengths of American Indian and Alaska Native (AI/AN) communities.

The complex and multifaceted exposures that inform disparities experienced by AI/AN communities form the backdrop of Dr. Gachupin’s research, service, and teaching. American Indian and Alaska Native individuals comprise 1.7% of all people in the United States. AI/AN communities experience significant health disparities compared to all other racial and ethnic population groups in the U.S. These disparities have become more pronounced through the COVID-19 pandemic.

In her research efforts, Dr. Gachupin works to gain the trust and respect of tribes by providing data and reports they can use and involving tribes as equal partners in preparing manuscripts, research project design and implementation. These collaborations adhere to community-based participatory research (CBPR) methods and the University of Arizona Tribal Consultation Policy.

Dr. Gachupin received her doctorate from the University of New Mexico and her Master of Public Health in epidemiology from the University of Washington.

Q&A with Dr. Gachupin

What inspired you to become a researcher in minority health, health disparities, and health equity?
During the pandemic, COVID-19 infection rates were over 3.5 times higher in AI/AN populations than in non-Hispanic White populations. AI/AN populations were four times more likely to be hospitalized and experience higher rates of mortality at younger ages. On August 31, 2022, the New York Times published an article, How the Pandemic Shortened Life Expectancy in Indigenous Communities, and reported that life expectancy for AI/AN communities fell by six and a half years. The article also reported on the ongoing issues related to access to health care, lack of transportation, and access to basic utilities like running water.

Although the pandemic exacerbated these health disparities, as Native people, we have known of these inequities throughout our lives, and that has inspired me to become a researcher in AI/AN health topic areas. As a Native woman, I feel a personal responsibility to do what I can to further understand and address the root causes of these health disparities and to design respectful research that benefits AI/AN communities.

What is your research goal, purpose and aim?
As a chronic disease epidemiologist, I have spent my entire career designing research and public health practice projects that address priority areas as identified by tribes. The objectives of these projects have been to provide tribes with timely and accurate information to inform decision making. Much of my career was spent at Tribal Epidemiology Centers (the Pacific Northwest, Great Plains, Albuquerque Area and Navajo) where tribal health priorities include sudden infant death syndrome, suicide, motor vehicle related injuries, cancer, diabetes, heart disease, dental caries, diabetic retinopathy and glaucoma.

In 2012, I transitioned into academia and brought to UA my experience working with diverse American Indian tribal communities, as well as my commitment to improve the lives and health of American Indians. I’ve worked extensively to inform community programming and to advance research with American Indian tribes.

How is your work advancing health equity? Are you seeing specific changes in the health disparities experienced by particular communities or groups?
Through my work, I’m addressing high priority health areas as identified by tribes; grants include opportunities for advancing training and scholarship. For example, the long-standing NCI Partnership for Native American Cancer Prevention grant, partnering with Arizona tribes and Northern Arizona University, of which I am current contact MPI, has successfully funded 33 research projects (9 full, 20 pilot, 4 planning), trained 332 students, received 5 supplements and 3 NIH F-mechanism awards, and published 117 peer reviewed manuscripts. This has increased our understanding of American Indian cancer health disparities and is working to build a cadre of investigators trained in research specifically involving American Indians.

From the research you are doing, what has surprised you about the discoveries from your lab and its impact?
The research I am doing has not surprised me per se; rather, it has validated the existence of American Indian health disparities and emphasized the need for more interventions. For example, through our work on kidney cancer, led by Dr. Ken Batai, we have quantified Arizona cancer disparities, renal cell carcinoma (RCC) disparities, RCC histologic subtype variations, disparities in RCC stage and mortality, disparities in preoperative RCC surgical wait time, and American Indian RCC treatment and mortality disparities.

How do we encourage the next generation of scientists?
I strongly believe in hands-on practical training of our scientists by providing opportunities to work on the front lines of research. This allows early career scientists to fully appreciate the spectrum of research, building partnerships, forming hypotheses, and designing research, as well as managing, analyzing, interpreting, and reporting data.

I believe it is vital for our scientists, existing and incoming, to remember that the data represents the experiences and human conditions of real people. Its purpose is to allow us to more fully understand and, hopefully, to treat and/or prevent disease.

What do you envision as the future of minority health, health disparities, and health equity research?
Through the various diversity, equity and inclusion initiatives being undertaken at so many different levels right now, I am hopeful that important conversations about the determinants of health disparities will be addressed with strategic attention, resources, follow-through and evaluation.

Page updated November 15, 2022