Francisco Barrera, SM ’22, delves into thorny questions on racial variations in well being outcomes
Could 24, 2022 – Do sufferers of shade face increased danger of most cancers after a coronary heart transplant than white sufferers? Do Hispanic individuals who stop smoking have decrease charges of cognitive decline than those that don’t stop?
These are the kinds of analysis questions that excite Francisco Barrera, who’s set to earn his grasp of science in epidemiology from Harvard T.H. Chan Faculty of Public Well being in Could. He desires to uncover racial, ethnic, and gender variations in illness prevalence.
“Social injustices are significantly vital to me,” stated Barrera, who goes by Frank. “On this world, it seems we will have all the pieces, however not everybody has entry to the identical alternatives. That is my method of making extra data and consciousness round points, to indicate people who they exist. And hopefully this information can result in coverage interventions that would finally lower the consequences of the social injustices we face.”
An analyst at coronary heart
Rising up in Monterrey, Mexico, Barrera was intensely observant. “I’ve at all times paid loads of consideration to element and been very analytical by nature,” he stated. “I like to look at issues, particularly folks.” That inquisitiveness led him towards analysis whereas attending medical college on the College of Nuevo Leon, the place he acquired a analysis fellowship and discovered the fundamentals of methodology, statistics, and scientific writing.
Over the subsequent few years, Barrera took on each analysis matter that got here his method, together with prosthetic joints, most cancers on the base of the cranium, and metabolic syndrome amongst soccer gamers. “The alternatives the place I come from are diverse, and it’s tough for a medical scholar to search out the right match,” he stated. “My curiosity was in studying the right way to analysis. However many instances I requested myself after I was going to have the ability to deal with one thing that I might be enthusiastic about.”
He’s begun to search out the subjects that curiosity him at Harvard Chan Faculty. Over the previous 12 months, he’s been engaged on a analysis venture with Murray Mittleman, professor of epidemiology, to have a look at the prevalence of most cancers amongst coronary heart transplant recipients by race. Transplant recipients obtain immunosuppressants to cut back the possibilities of organ rejection, however these drugs can even improve the danger of many sorts of most cancers, together with pores and skin most cancers and malignancies in blood and bone marrow.
Utilizing about 30 years of data from a nationwide transplant registry—greater than 60,000 in all—Barrera has examined the chance of sufferers each creating and dying from most cancers. Preliminary outcomes present that Black, Asian, or Hispanic recipients are much less prone to be recognized with most cancers than white sufferers and usually tend to die from the illness. “There are various components which may clarify these disparities, together with entry to high-quality medical care, insurance coverage standing, location, socioeconomic standing, and even racism throughout the medical career,” he stated.
So as to draw conclusions from the analysis, Barrera stated it was vital to investigate the information rigorously, taking into consideration racial variations within the improvement of most cancers over time, moderately than merely a person’s propensity to develop or die from most cancers following transplant surgical procedure.
Barrera first grew to become conscious of the subtleties of knowledge evaluation close to the top of his medical coaching in Mexico, when he carried out a number of meta-analyses that mixed quite a few research on a selected matter. “In assessing the standard of the strategies of the research I used to be synthesized, I began studying about all the various kinds of bias that may be created from measurement errors,” he stated.
Persevering with schooling
That have drew him to Harvard Chan Faculty in hopes of higher studying the right way to carry out correct analyses of knowledge. “The lessons right here have reshaped the way in which I see strategies and analysis, and cleared up many misconceptions I had,” he stated. For instance, he has gained a a lot higher appreciation for the difficulties in assigning causality in observational research. “I’ve gained loads of humility and respect for strategies, however I additionally really feel assured with what I do know now—and really feel empowered to design and conduct these sorts of research,” he stated.
Barrera will stay on the Faculty for a 12 months as a postdoctoral researcher, working with Mittleman on a brand new venture to look at how quitting smoking impacts cognitive decline amongst Hispanic sufferers. “They’ve a excessive prevalence of smoking and a better danger of creating dementia in comparison with non-Hispanic whites,” Barrera stated. “This relationship has not been studied earlier than on this inhabitants.”
On the similar time, he’s making use of for residencies in psychiatry, pursuing his lifelong fascination with analyzing and observing human habits. His objective is to make use of his coaching in analysis strategies to additional conduct research which may higher determine and clarify variations in psychological well being between folks in several demographic teams, to assist design higher particular person therapy.
“There’s a false impression in drugs that we will all slot in the identical field,” he stated. “However we aren’t all the identical, and we don’t reply the identical to therapy. There are loads of variations in gender, race, and ethnicity that may be analyzed by means of analysis in ways in which might have affect on prognosis and the medical care we will present to sufferers.”
