NIMHD’s Conversations with NIH Loan Repayment Program Recipient
Meet Dr. Brad Wright to Learn How the NIH Loan Repayment Program Transforms the Career of a Health Disparities Researcher
The NIMHD Loan Repayment Program (LRP) is a congressionally established program that offers loan repayment awards of up to $50,000 per year for up to two years of a recipient’s qualified educational debt annually, in return for a commitment to engage in NIMHD mission–relevant research for at least two years. One of the major goals of the LRP is to increase the pool of highly qualified researchers who conduct health disparities research. The 2021 LRP award application cycle is from September 1 through November 20, 2020.
We are featuring past LRP awardee, Brad Wright, Ph.D., associate professor and director of Health Services and Outcomes Research, Department of Family Medicine at the University of North Carolina at Chapel Hill School of Medicine. Dr. Wright is also an NIMHD R01 grant recipient. In his words, “My research generally focuses on disparities in health and health care among marginalized populations who use safety-net facilities and are publicly insured.” Dr. Wright brings his expertise on minority health and health disparities as co-director of the Program on Healthcare Economics and Finance at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. We talked with Dr. Wright about his motivations to pursue health disparities research, the people that showed him the way forward, his work, and the larger experiences of being an LRP award recipient. Read on!
Describe the beginning of your interest in science. At what age did you start becoming interested? Where were you living? Who were the people that influenced you?
I remember being interested in science from the age of 5 or 6. I was really into dinosaurs and spent the summer attending a science day camp at a local college. That love for science continued throughout school. As I got older, I decided that a career in medicine would unite my love for science and my desire to help others. So, I enrolled at the University of Georgia and majored in biology. While there, I wrote an honors thesis comparing the U.S. and Swedish health care systems, which ignited my interest in addressing the issues with our existing health care system through policy change, rather than direct care provision. Several people influenced and encouraged me throughout my academic journey. Among them are Dr. Larry Nackerud, a professor at the University of Georgia School of Social Work, who encouraged me to pursue graduate studies in health policy; Dr. Jeanne Lambrew from George Washington University, who introduced me to the field of health services research and suggested that I apply to UNC-Chapel Hill for my doctoral research; Drs. Jonathan Oberlander and Thomas Ricketts, two incredible mentors at UNC, who guided me as I studied health centers for my dissertation work; and finally, Drs. Vincent Mor and Amal Trivedi, with whom I worked as a postdoctoral fellow at Brown University.
Fast forward to present day, talk about your work with NIMHD and the LRP.
As I was completing my postdoctoral fellowship, I decided to apply for the LRP, because I had considerable loan debt and I was already planning on a career in health equity research. I focused on a project using claims data to study the relationship between receipt of primary care at health centers and the use of potentially avoidable hospital care among individuals dually enrolled in Medicare and Medicaid. Writing my LRP application forced me to solidify my research ideas and think about my career objectives. The exercise positioned me well to secure funding from the Retirement Research Foundation, which then provided the preliminary data that I needed to prepare a strong R01 application for submission to the NIMHD.
I used the two-year competitive renewal of my LRP award to develop ideas for an R21 grant application on disparities in hospital observation stays, which was funded by the National Institute on Aging. Suffice it to say that the LRP application process is beneficial in helping new and early-stage investigators formulate and execute their research agenda.
Why are you interested in minority/diverse population study, and how has this award helped you grow in your career?
My specific interest in health equity research developed from growing up in southeast Georgia and observing disparities all around me by race, ethnicity, income, education, and rurality. As an adult, I now recognize that the forces at work were (and are) structural racism, discrimination, poverty, inadequate public education, and geographic barriers in access to care, among others. Receiving the LRP award did not steer me in the direction of health equity research, but it certainly confirmed for me that this was a viable career path, and it helped me to advance my research agenda.
Any interesting anecdote that spurred your interest in minority health research or relating to the LRP award or your work with the award?
Like I mentioned, while growing up, I observed disparate health outcomes, and inherently knew that it was wrong and needed to be addressed. This awareness of injustice was reinforced by my lived experiences as a child whose extended family on my father’s and mother’s sides were quite different socioeconomically. It did not make sense to me that one side of my family should have better access to care than the other side, based on things outside of their control. Finally, all of this was informed by my Christian faith, which instilled in me a strong sense of social justice and the inherent worth of all people. Thus, health services research became my calling, and a way to ensure a more just and equitable world through the lens of health and health care.
How has the LRP award helped, or empowered you to help others?
The work I have been able to conduct as an LRP awardee has enhanced our understanding of racial and ethnic disparities in both primary care and the use of hospital-based care among the populations dually enrolled in Medicare and Medicaid. This early work has also led to additional ongoing studies that will help us identify the specific causes of existing disparities, as well as methods for combatting—and hopefully eliminating—them. I also think that my participation in the LRP has empowered me to help others, because it helped me to establish a successful research career, which allows me to be able to teach and mentor a diverse group of graduate students and junior faculty, which is one of my favorite parts of the job.
What would you say to encourage someone who might be thinking of applying to the LRP or considering a career in minority health and health disparities research?
My advice to someone considering a career in minority health and health disparities research is simple: Pursue your passion, partner with others, and persevere. I say that because in my experience, research careers can be incredibly difficult—and there is emerging evidence that health disparities research is funded even less often than other topics, particularly if the principal investigator belongs to a marginalized population. Amid such intense competition, failure is common, and it can make even the best and brightest question whether they belong in the field or have ideas worth pursuing.
But make no mistake: The field needs you and your ideas. Pursuing a research topic that you are passionate about will attract others to your work (because enthusiasm is contagious). Among those colleagues, identify advocates, mentors, and collaborators to partner with (because going at it alone does not make you a hero). In turn, both of these will fuel perseverance (because having a support network makes you more resilient). And, if you’re thinking about applying to the LRP, my advice is similar: Pick a topic you are passionate about, reach out to successful applicants for guidance (I am an official “LRP Ambassador” so please feel free to contact me!), and if you are not successful initially, do not give up!
Is there an interesting fact (not related to science) that you are willing to share with our readers?
I think it is important for researchers to remember that they need other outlets to maintain their balance and wellbeing. I once heard someone say that the word recreation can literally be broken down to mean “something you do to create yourself again.” I try to remember that. As passionate as I can be about my work, I need other ways to renew myself. In that spirit, I enjoy music (both listening to it and playing it on my guitar), gardening, cooking, painting, and outdoor activities like camping and fishing. The point is: Make sure you are regularly doing something that restores you so that you can return to your work with the energy of one who has been created anew!
Is there anything else you’d like to add about yourself, your work, or the award?
I am just so grateful for having received the LRP award and being free of my education debt in a relatively short period of time. And I am a firm believer in the idea that we are blessed by being helpful to others. I try to be helpful through the research questions I ask, the teaching and mentoring I do, and the ways I serve and lead within my institution, the field of health services research, and the larger community. But for several years now, I have felt the need to do more; to pursue something much bigger. Thus, I have started the MEMPHIS Project (Making Everyone Mentally and Physically Healthy In the South)—a network of collaborators from multiple sectors with the shared goal of combatting health inequity across the southern United States. I would encourage anyone who is interested in learning more about my work, the MEMPHIS Project, the LRP application process, or who would like some mentoring or guidance as they embark upon their own research career, to reach out to me directly. I have benefited greatly from others who have been willing to serve in those roles, and it is a joy and a privilege for me to pay it forward!
Posted October 1, 2020