MIT Sloan Health Systems Initiative
MLK Scholar Charles Senteio’s Research Shines a Light on Health Inequity
Charles Senteio, (PhD, MBA, LCSW) is one of MIT’s current 10 MLK Scholars. His community-based health informatics research focuses on addressing health inequities, by examining how to use information to support health behavior to improve health equity. The drivers of health inequities, Senteio says, emanate in large part because of structural drivers, like racism and inequality. To help identify and mitigate the negative effect of these drivers, he continues, “health equity work must inform health policy, rather than continuing to design individual programs”, which may not adequately consider broader factors necessary to effect sustainable change.
Social Determinants of Health Drive Health Inequity
HSI spoke to Senteio in January 2021 to discuss his research while at MIT. Health equity informatics research is about addressing the causes of difference in disease incidence, prevalence, mortality and impact (such as disease complications) between groups. Central to health equity research is that inequalities are driven by social determinants of health. “The research is clear that racially disparate health outcomes are primarily influenced by social factors”, says Senteio.
Vaccines Don’t Make Us Safe. Vaccinations Do
Mistrust is among the social factors that has received much attention recently, especially as COVID-19 vaccines are being rolled out. In fact, institutional credibility has been “front page” news since the beginning of the pandemic. Senteio is looking to improve upon the construct, because it tends to focus on changing patients’ behavior. The assumption is that participants must be changed in order to trust institutions and individuals. To Senteio, this appears misguided because institutions are responsible for the existence of mistrust, certainly more so than marginalized individuals. Senteio’s current informatics research flips the script. He is focusing on credibility – of researchers, providers, care teams, and institutions. With this lens, the focus is on the people and institutions most responsible for causing and perpetuating mistrust Perceived credibility of health advisors, researchers and providers is a salient factor to investigate concerning decisions to get a COVID-19 vaccine.
Senteio discusses disparate COVID-19 vaccine uptake as an illustration of larger health inequity issues. Racial disparities in vaccination rates simply reflect persistent racial disparities driven by social determinants, which include perceptions. In a January 2021 presentation, Senteio quoted Pew Research statistics that despite rising confidence in vaccines across the U.S., fewer than half of Black Americans intend to be vaccinated. And this is among the lowest of any group measured. At the same time, Black Americans have higher incidence, infection and mortality rates from COVID-19 than any other group. While at MIT, Senteio continues to pursue how to measure the effect of credibility on health behaviors – from COVID vaccination to cancer screenings.
Collaboration is a Highlight at MIT
During his time at MIT, Senteio has advanced his efforts in some particularly MIT ways. Senteio advised a team that included post-docs, PhD students and representatives from community groups to hold a hackathon, MIT Hacking Racism in Healthcare last year from October 16th - 18th. The event was co-hosted with the nonprofit organization Black Tech Matters. Just before the event, MIT News published an interview with the organizers in which they discussed how the collaborative nature of hackathons may be well suited to addressing such a complex problem.
In our January conversation, Senteio emphasized the ease of collaboration with MIT Sloan faculty, which includes HSI. He and HSI researcher David Rand, along with Rand’s colleagues from the University of Regina (Canada) and Senteio’s colleagues from Rutgers and Emory, are working on a project to understand intragroup perceptions of Blacks concerning COVID-19 vaccines. The team will use findings to design interventions that target specific Black groups most at risk for vaccine hesitancy. The project website, www.CovidAndRace.com explains, “Just as race and ethnicity are associated with COVID-19 risk of infection, hospitalization, and death, we are investigating how they may be associated with perceptions of COVID-19 and intentions”. Given disparities in vaccination rates for people of color and of other groups, Senteio and Rand’s work population-level work is of paramount importance. It may impact all of our health.