Melissa Simon, MD, MPH, assistant professor in obstetrics and gynecology, preventive medicine and medical social sciences, doesn’t need a translator to understand hopelessness. Whether in Detroit or the Dominican Republic, China or Chicago, the predominance of health disparities among low-income, medically underserved women acts as the impetus for her role as clinician, scientist and humanitarian.
Growing up in an impoverished neighborhood in Michigan’s largest city, Simon saw firsthand what it was like not to have one’s needs met, particularly with respect to health and disease. She’s seen it in Mexico and Zimbabwe, too; the issue is as much a national concern as a global problem.
A report in 2009 showed that low-income American women not yet old enough for Medicare are four times more likely to be in poor or fair health, according to the Center for Health Policy Research.
Simon, who came to Northwestern to complete a fellowship, in family planning and reproductive health before joining the Feinberg faculty in 2006, received her doctorate at Rush Medical College, completed an obstetrics and gynecology residency at Yale-New Haven Hospital, and a mini-fellowship in geriatric medicine at Johns Hopkins.
The goal of my research is to not only help those who are underserved across the lifespan, but to integrate the findings into a larger, impactful level of policy,” she said.
What is your professional focus?
My career has been centered on promoting health equity through true community engagement among low-income women across the lifespan.
I grew up in a very poor part of Detroit, and from those powerful experiences stem my sincere desire to work with and expand research on populations, especially women, who are considered disenfranchised and medically underserved. I have led many student organizations focusing on community organizing, women’s and immigrant’s rights, and cultural barriers to obtaining health care.
Aiming to approach health care research from a broad public health perspective, I worked at the Chicago Department of Public Health and published several white papers and community reports on a variety of topics essential to minority health in Chicago. As an Albert Schweitzer Fellow, I focused on stress and depression among patients in a free Chicago clinic. I have also worked around the world in Mexico, Dominican Republic, Zimbabwe, and China delivering health care and researching locally relevant topics to improve the health of the underserved.
What are your research interests?
Having worked in many developing countries and in many impoverished communities in the U.S., I am an ardent advocate of partnering with my patients and their communities to achieve optimal health. I hold a strong interest in leveraging research to empower, improve the health, and advocate for low-income, medically underserved women.
My research aims to merge social epidemiology principles with health services research to reduce health disparities through a community-based participatory research framework. I am the principal investigator for several federal and foundation grants on barriers low-income women face in obtaining cancer treatment across the care continuum and on patient navigation-based interventions to overcome these barriers. My research also seeks to mitigate the health related poverty trap among family caregivers through inbuilt economic resilience options.
Why have you chosen to work with underserved communities?
Health and education are transformative and are essential human rights. Community engagement is an essential vehicle through which health and education can be optimally achieved. To this end, my research approach is rooted in community engagement, and I firmly believe engaging the community is an essential component of translational research and one of the most optimal approaches with which to conduct dissemination and implementation research.
Research that is performed on the bench and that subsequently makes it to the bedside, does not always apply to all individuals. Many minority and underserved communities, in particular, are often not included in cutting-edge, basic science, clinical trial, and behavioral intervention research for a variety of reasons, including access to participation, not fitting the study inclusion criteria, and personal fear or mistrust of participation in research.
I truly believe that community research enterprise is an essential component of all research, and without it, all of the high tech research projects with millions of dollars of funding, remain in the ivory tower and do not concur benefit on the populations that are most in need. My research approach and expertise act as a broad-band connector and aims to facilitate the dissemination, tailoring, and implementation of such research studied in majority populations to minority and harder to reach populations.
Who inspires you?
I obtain deep inspiration from a wide range of people, especially those who have faced and overcome adversity like my own personal and family experiences. All of the patients and community members with whom I have worked around the world have deeply touched my life and provide inspiration. Given where I started and where I am now, I am very fortunate to have had so many mentors and supporters throughout my life. I have been especially privileged to have received mentorship and guidance from several faculty members here at Northwestern. Of greatest importance, though, is the support and love from my husband, four children, and family.
You were recently selected as the Institute of Medicine Fellow; on what will your work focus?
The Institute of Medicine (IOM) nominated me as the 2011-2013 Norman F. Gant/American Board of Obstetrics and Gynecology/IOM Anniversary Fellow in recognition of my work toward health equity for uninsured and publicly-insured women. I am the second national recipient of this award.
As a fellow, I am working with the IOM’s eminent researchers, policy experts, and clinicians from across the country as they collaborate on initiatives convened by the IOM to provide nonpartisan, evidence-based guidance to national, state, and local policymakers, academic leaders, health care administrators, and the public. The fellowship program provides an exceptional learning and professional development opportunity for my career. As an IOM Anniversary Fellow, I continue with my main academic responsibilities while engaging part time over a two-year period in IOM’s health and science policy work.
What is your most recent project?
My work focused on patient navigation and community health worker (CHW) models has grown substantially since I started at Feinberg. My lab has been successful in garnering continuous NIH funding to adapt my career development award work on cancer patient navigation to four different levels. We started with clinic- and hospital-focused patient navigation and then moved to a model of a unit of free-standing navigators/CHWs that move fluidly throughout DuPage County, focused on uninsured women with breast or cervical cancer.
Second, we were awarded an NCI R01 focused on the cultural adaptation, application and dissemination of patient navigation across the cancer care continuum among Chinese women in Chicago. This work will be connected to my visiting professorship at Peking Union Medical College in Beijing this summer.
Third, this body of navigation research has progressed beyond cancer to uninsured patients with diabetes and hypertension.
Fourth, our navigation expertise has recently been recognized by the governor with an appointment to the body charged with implementing the statewide breast cancer screening and treatment quality law, and we are now leading the statewide implementation and evaluation of breast cancer patient navigation.