UofL News: How was the idea for the Health Equity Innovation Hub developed?��

Monica Wendel: The Hub is a collaboration between UofL, The Humana Foundation, and Humana Inc. aimed at closing health equity gaps. It became clear that health equity was a shared goal between the organizations. Realizing this shared goal, UofL Executive Vice President of Research & Innovation Kevin Gardner invited me to lead the development of the collaboration. Not long after, Humana’s inaugural Chief Health Equity Officer, Nwando Olayiwola, was named and both Humana and The Humana Foundation deepened their existing commitment to working towards equitable health systems for each person and community.

UofL News: Break down for us, please, the main mission of the Hub.��

Wendel: The mission of the Hub is to advance social and health equity for structurally marginalized communities. In recognizing that health outcomes and inequities are driven by social determinants, which in turn are shaped by structural determinants, the Hub is committed to working across multiple levels of social ecology in ways that provide communities made vulnerable equitable access to the resources they need to be healthy and whole. We are doing this by integrating the research power of the university, the resources of industry, the expertise of the community in these issues, and the ingenuity and creativity of innovators and entrepreneurs — especially those who hold minoritized identities — in solving health equity issues.

UofL News: Why is this work so important at this time?��

Wendel: Everyone wants to be healthy, but the choices people make are the choices people have. And we don’t all have the same choices – our health care, housing, food and other systems offer more choice and accessibility to some people than others. For Black and brown populations, LGBTQ+ populations, foreign-born populations, rural populations and populations living in poverty, the structures and systems enact and reinforce marginalization that produces health inequities.

It’s important here to differentiate between ‘disparities’ and ‘inequities.’ Health disparities refer to differences in risk, incidence, morbidity, disability and mortality in various conditions between different groups. Health inequities more specifically identify differences between groups that are unjust, unnecessary and preventable. The structures and systems we create and maintain produce inequities — we as a society are responsible for that. But that also means it can be changed. If it’s going to change, we have to change it.��Equity will not happen organically.

UofL News: Please describe the research aspect of the Hub.��

Wendel: A key aspect of the Hub is the integration of research, community engagement, innovation, entrepreneurship, strategic relationships and talent development to achieve specific outcomes toward advancing health equity. This integration is both the most innovative and the most challenging facet of the work; because of it, people in Louisville and beyond will thrive.

I have had the privilege of assembling a team of individuals who are rock stars in their respective areas of expertise. But doing things the way they’ve been done is going to continue to get us what we’ve got – which is inequity. So, our team is intentionally doing the hard work of not operating in silos of individual areas of expertise, and bringing all areas of expertise to the strategies and activities in each of our workstreams. In that way, we are advancing health equity at multiple levels of social ecology and interconnecting community sectors that likely would not otherwise be connected. Those cross-sector network relationships will transform systems to advance health equity and will endure long past all of us.��

Thanks to the Humana Foundation’s gift, the Hub is able to support minoritized researchers and novel health equity research. We put out our first call for research proposals in March, and through a rigorous review process, awarded over $1 million to fund 10 health equity research projects.

UofL News:��As a public health researcher, you’ve worked over 20 years addressing aspects of health inequity and factors related to social determinants of health. How does the Hub build upon what you’ve learned through your own research?

Wendel:��My vision and design for the Hub is grounded in several things I’ve learned over the course of my career. First, people have a right to self-determination. For minoritized populations, our systems have historically stripped away this right.��The people most impacted by health inequities of any kind are the most expert in those inequities, and often have valuable insights and innovative ideas for how to solve them. We must listen and engage the communities affected. Solutions brought in from outside those communities rarely have the intended magnitude of effects.

Second, we must work upstream and downstream at the same time and across sectors — advancing health equity requires organization and strategy. Although the United States has made some gains in health equity efforts, there is still much work to be done in addressing inequities and ensuring everyone has access to resources that support good health. Our downstream interventions must address immediate needs and advance health equity at that level.

But we cannot achieve sustainable gains in health equity unless we also work upstream, with communities that have historically experienced these inequities. For example, inequities in maternal health outcomes for people of color may result from lower quality of care, but they may also result from experience of racism within the health care system. Improving quality of care downstream only addresses part of the problem; if people do not seek care because of distrust of the health care system, they will not benefit from improved quality of care. There must be simultaneous work addressing systemic racism in the health care system. Thus, our upstream interventions must transform systems to reduce health inequities, while downstream, we work to ensure equitable access to health resources. Both of these efforts are necessary, and neither on its own is sufficient.

Third, our interventions must be planned for way beyond the term of a grant. Initiatives intended to advance health equity must not bring needed resources to a marginalized community that then disappear at the end of the grant; this results in real harm to real humans. Any kind of equity work requires intellectual and cultural humility and a conscious intent on doing no harm. There is no substitute.

The Hub was launched earlier this year as a collaboration between UofL, The Humana Foundation, and Humana Inc. aimed at closing health equity gaps facing vulnerable populations. The 10 projects awarded in this initial round of funding furthers this goal by tackling inequities in areas such as access to mental and physical health care and healthy food. Projects were eligible for up to $100,000 per year for up to three years.

Monica Wendel, who leads the Hub, said finding solutions for these challenges will create more choices for people in making decisions that affect their health.��

“These factors play a huge role in our health outcomes,” said Wendel,��a professor��in the UofL School of Public Health��and��Information Sciences.��“We all want to be healthy and whole. But��the choices people make are the choices people have. For communities that have been marginalized, their choices are greatly limited by structural and social barriers. Our goal with the Hub and with this research is to dismantle these barriers, create more choices and thus empower people and communities.”

The funded projects include:��

• • The Pharmacy Accessibility Index (PAI) Project (Lihui Bai, J.B. Speed School of Engineering);
  • Healing-Centered Capacity Building: Social Justice Youth Development Certificate (Aishia Brown, School of Public Health and Information Sciences);
  • An Examination of the Feasibility and Acceptability of a Racial Trauma Processing for Family Health Intervention (Emma Sterrett‐Hong, Kent School of Social Work);
  • Exploring Workforce Development, Well‐Being, and Organizational Readiness to Recruit, Retain Black American Adults Living in Low Resource Communities (Meera Alagaraja, College of ����ֱ�� and Human Development);
  • A Community-Engaged Feasibility Study of hrHPV Self‐Sampling for Primary Cervical Cancer Screening in Sexual and Gender Minorities (Mollie Aleshire, School of Nursing);
  • A Community‐based, Knowledge Translation Approach to Address Neighborhood Factors that Impact HIV Care Continuum Participation (Jelani Kerr, School of Public Health and Information Sciences);
  • Assessing risk factors associated with childhood lead poisoning in Jefferson County: Structural racism and a legacy of lead (Brian Guinn, School of Public Health and Information Sciences);
  • “Getting the Listening” in Louisville: Environmental Health Literacy and Justice in and around Rubbertown (Megan Poole, College of Arts and Sciences);
  • Empowered by the Sun: Exploring the Intersections of Housing Justice and Green Technologies in Louisville (David Johnson, School of Public Health and Information Sciences); and
  • Equity‐Centered, Trauma‐informed Teacher Preparation: Development and Study of a Teacher Residency Curriculum (Shelley Thomas, College of ����ֱ�� and Human Development).

Wendel said the Hub will work closely with researchers and their community partners throughout the projects and plans to open a new round of research funding in 2023. Many projects will be conducted in collaboration with Louisville-based Humana Inc., which will share anonymized data for research purposes.��

“We’re proud to back both research and underrepresented minority researchers to help communities achieve greater health equity and improved outcomes,” said Keni Winchester, director, strategy & community engagement at The Humana Foundation.��“Through the collective efforts of researchers, community partners and the University of Louisville’s Health Equity Innovation Hub, people in Louisville and beyond will thrive.”��

The Hub launched with a potential total investment of $25 million from the Humana Foundation, Humana Inc., and UofL, representing one of the largest single donations in the history of the university. Humana also recently announced it would donate a fully furnished eight-story building, located at 515 W. Market St., to house the Hub’s administrative team and programming.��

“This research is an important facet of the great collaboration we have with The Humana Foundation and Humana Inc.,” Wendel said. “These projects are designed to lead to scalable solutions to health equity issues here in Louisville and beyond.”��

The event, hosted by the , honored UofL faculty and staff nominated by their colleagues or self-nominated for outstanding research and scholarship accomplishments in fiscal year 2021.

“I often say that UofL is a true research engine, continuously blazing new trails and seeking answers to important questions,” said Interim President Lori Stewart Gonzalez, speaking at the event. “Our researchers, scholars and research administrators are the very backbone of that work and they deserve this celebration and recognition.”��

In addition to the roughly 90 recognized, six major awards were presented to:��

• • Kenneth Palmer, of the School of Medicine, who won Researcher of the Year, in part, for work to address the global COVID-19 pandemic, securing $8.5 million from the Department of Defense to adapt a novel broad-spectrum antiviral as a coronovirus-fighting nasal spray;
  • Hui Wang, of the J.B. Speed School of Engineering, who won Emerging Researcher of the Year for work to advance solid ion conductors and electrochemical energy storage;��
  • Becky Antle, of the Kent School of Social Work, who won Collaborator of the Year for serving as an evaluator on numerous groundbreaking projects with principal investigators across the university;
  • Monica Wendel, of the School of Public Health and Information Sciences, who won the Grand Challenger Award in Empowering our Communities in part for work to launch a new Health Equity Innovation Hub at UofL, backed by Humana Inc. and the Humana Foundation;
  • Shirish Barve, of the School of Medicine, who won the Grand Challenger Award in Advancing our Health for work to uncover the connections and impacts of alcohol on the body and organ injury and studying the gut/brain axis in HIV and aging; and
  • Joshua Spurgeon, of the J.B. Speed School of Engineering, who won the Grand Challenger Award in Engineering our Future Economy for work to create clean fuels using just water, carbon dioxide and sunlight, paving the way for more low-carbon power.

In addition to presenting awards, the event also highlighted the Office of Research and Innovation’s recently launched Ascending Star Fellowship program, which provides mentorship, funding and other support to high-performing associate professors. The inaugural class includes Cheri Levinson, Brandon McCormack and Kaila Story, all from the College of Arts and Sciences.��

Kevin Gardner, UofL’s Executive Vice President for Research and Innovation, said his office launched this inaugural awards event to recognize faculty and staff for their contributions to UofL’s research and scholarship.��

In the past fiscal year, their work helped bring in record $201.5 million to support groundbreaking work that saves and improves lives and shapes our society and culture.��And, UofL recently received another consecutive Research-1 designation from the , placing it among just 4% of schools considered.��

“What we celebrate and recognize reflects our values as an organization and as a community of scholars,” Gardner said. “Each researcher, scholar and administrator being celebrated is absolutely critical to our important work here at UofL, and we want you to know your efforts are appreciated.”

The Hub is funded by a potential total investment of $25 million, including $10 million from UofL, $1.5 million from Humana and up to $13.5 million from The Humana Foundation. The investment by The Humana Foundation represents one of the largest single donations in UofL’s history and is contingent upon progress against the collaboration’s objectives and achievement of established milestones.

The Health Equity Innovation Hub is an integrated, multi-disciplinary collaboration among Humana, The Humana Foundation and UofL. The Hub will focus on groundbreaking research, talent development, entrepreneurship and innovation, with a deliberate focus on health equity, social determinants of health and digital health and analytics.

“Humana is committed to improving health equity and we will be intentional about addressing the underlying societal and structural factors that impede good and fair health, especially for people in communities that have been historically marginalized and made vulnerable,” said Dr. Nwando Olayiwola, chief health equity officer and senior vice president at Humana. “This unique collaboration with the University of Louisville and The Humana Foundation to create the Health Equity Innovation Hub is an exciting opportunity for Humana to partner with a leading research institution in our founding city where so many health disparities exist, establish shared goals and drive positive change beginning in local communities.”

Enabled by Humana and The Humana Foundation’s investment and support, the Hub will seek to develop solutions for health inequities in Louisville and globally. This includes the up-skilling and re-skilling of community members who have been underserved to provide a talent pipeline for Louisville’s significant concentration of major health care companies, thereby creating a pathway for family-sustaining jobs. The Hub will also conduct dedicated outcomes-based research on population and social health issues to derive a wide range of insights on how to mitigate health inequities and the adverse impacts of health-related social needs. In addition, the Hub will support diverse creators, innovators and entrepreneurs whose ideas can positively impact populations around the world that have historically been marginalized and underserved.

“UofL is a research powerhouse dedicated to making a positive impact on our world and addressing the challenges affecting the human condition,” said UofL Interim President Lori Gonzalez. “We are proud to work with Humana and The Humana Foundation to further health equity for all through this new Hub. Together, we can have a tangible impact that benefits our shared community and far, far beyond.”

UofL is among the top U.S. research institutions, holding the ’s��“Research 1” designation for doctoral universities with��very high research activity. In addition to being a Research 1 institution, UofL also holds the Carnegie community-engaged designation, which recognizes institutions that work with community partners to exchange knowledge and resources for public benefit. UofL is one of just 79 U.S. institutions to hold both designations.��

At UofL, the Hub is led by Dr. Monica Wendel, a renowned public health researcher with significant expertise in health equity. A national search is currently underway to fill the role of executive director. The Hub’s leadership team also includes Deputy Director Ben Reno-Weber, a seasoned tech entrepreneur who previously led the Microsoft Future of Work Initiative; Director of Community Engagement Ivory Rollins Cross, a Louisville native and community champion; and Director of Innovation and Social Entrepreneurship Natalia Bishop, who founded prominent Louisville co-working brand, Story Louisville.

“Everything affects our health, our health affects everything,” said Wendel,��professor��and��chair��of Health Promotion & Behavioral Sciences in the UofL School of Public Health��and��Information Sciences.��“We all want to be healthy, but��the choices people make are the choices people have. In seeking to advance health equity, then, we have to change the choices people have. And we have that opportunity.”

The Hub also will create and collaborate with advisory boards, including national thought leaders, community organizations and local community residents who are passionate about improving social and health equity in their neighborhoods, as well as local business leaders and mentors from a diverse cross-section of the health equity ecosystem.��

The launch of the Hub will further UofL’s three strategic research priorities identified and launched in 2020, which include: Empowering our Communities, Advancing our Health and Engineering our Future Economy. The investment from Humana will advance the first challenge, Empowering our Communities, with a focus on promoting equity by engaging partners and strategically integrating research, innovation and training to address complex social and structural issues driving health inequity.

“These are huge challenges that will impact our world for years to come,” said UofL’s Executive Vice President for Research and Innovation Kevin Gardner. “Through this Hub and work with our partners at Humana and The Humana Foundation, UofL research and innovation will help empower those in our community — promoting equity, eliminating disparities and strengthening the ability of all individuals to achieve well-being and prosperity.”

The Hub’s mission also is well-aligned with Humana’s of advancing the health of the communities it serves by addressing social determinants of health and the health-related social needs for its members and communities.

SPHIS received a grant from the Centers for Disease Control and Prevention in 2015 to��, led by Monica Wendel, DrPH, MA, associate dean for public health practice.

Through this center,����were hired to help create and test the media/social media campaign aimed at reducing violence by opposing the perception that violence is normal, accepted and expected, particularly among African American youth. The campaign aims to combat violence by making youth aware of their own pride and history. It also seeks to foster community dialogue around difficult issues such as racial and social injustices. In doing so, the YVPRC hopes to raise critical consciousness in an effort to promote racial justice and reduce youth violence.

The media campaign features the youth fellows in YouTube videos, television commercials, radio ads, neighborhood billboards, bus shelters, print ads,��,��and social media platforms using #YVPRC. This particular media effort concludes at the end of December 2017; the overall����campaign continues through spring 2020.

from the campaign kick-off held at the Louisville Central Community Centers on Saturday, May 20.

This is one of more than 80 photographs taken by members of the West Louisville and St. Louis communities as part of a Photovoice project designed to provide an opportunity for expression and discussion about community concerns. The University of Louisville School of Public Health and Information Sciences’ (SPHIS) Office of Public Health Practice led the project, and about half the pictures are on display in a new exhibit, at the , a collaborator on the project.

“Communities struggle to address issues because we collectively lack the patience and humility to listen and to acknowledge that people have lived experiences that are different than ours,” said Monica Wendel, DrPH, MA, SPHIS associate dean of public health practice. “This exhibit creates space for people who aren’t usually heard to tell their stories, talk about their experiences – and if we invest our time in listening, we can learn things that help us know how to create meaningful change in our community.”

The UofL SPHIS Office of Public Health Practice invited various community groups to take photographs representing aspects of justice, safety, hope, and racial equity. Office staff then asked the participants to discuss the meaning of the photos, and propose action associated with identified problems.

Trinidad Jackson, MS, MPH, SPHIS senior researcher, wanted to launch the local Photovoice project after collecting images and stories from his hometown of St. Louis, Mo., during the week of the Ferguson protests triggered by the grand jury decision to not indict police officer Darren Wilson for crimes in the killing of 18-year-old Michael Brown.

“The images in this exhibit characterize real-life situations that impact all of us in some way, but some of us cannot easily escape the real consequences attached to certain social phenomena such as having dark skin or living in a certain zip code,” Jackson said. “Data generated from places like police departments and hospital emergency departments often project damaging narratives of populations that have, for centuries, been inequitably impacted by Eurocentric systems that facilitate community destruction.”

Jackson says he hopes the exhibit will provide a means for the local community to create its own narrative about historical and contemporary positives and negatives to present “a more comprehensive context — one that includes the community’s truth and power.”

“‘Yet We Live, Strive, and Succeed’ is a brilliant exhibit of photography from community members sharing their lived experiences,” said Aukram Burton, executive director, Kentucky Center for African American Heritage. “It is my hope that this exhibition will facilitate productive conversations and dialogue that will lead to new ideas and partnerships in solving community issues like��excessive force by police and the��unacceptable level of gun violence.”

Originally developed by Caroline Wang, DrPH, at the University of Michigan School of Public Health, the goal of Photovoice is to use photographs as a tool to reflect on community strengths and weaknesses, serve as a platform to discuss important community issues and act as a catalyst to reach policymakers.

UofL’s Office of Public Health Practice Photovoice project exemplifies one of multiple community-based participatory research efforts facilitated by the office. Their research team plans to analyze data from the Photovoice project and other community forums to provide actionable information to local leaders and mobilize local residents for community improvement. On Sept. 18, the office plans to invite the community to learn about their findings and engage participants in developing solutions to identified problems.

The Kentucky Center for African-American Heritage is providing the space and IDEAS xLab is curating the exhibit. “Yet We Live, Strive and Succeed,” is open Monday through��Friday from 10 a.m. to��4 p.m. and runs through Sept. 23. Admission is free. More information is .��

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