TALLAHASSEE, Fla. — A team of Florida State University researchers has received a National Institutes of Health Director’s Transformative Research Award worth $3.1 million to investigate racial inequities in the nation’s health-care system.

The award is the first of its kind to be administered by the National Institute of Minority Health and Health Disparities, part of the NIH.

“We are very pleased to receive this transformative research grant,” said FSU President Richard McCullough. “The NIH is putting considerable resources behind this extraordinary FSU research team to address a critical societal problem. This is a great example of what can happen when interdisciplinary researchers coalesce around a common goal.”

FSU College of Medicine Distinguished Endowed Professor Sylvie Naar is principal investigator for the five-year grant, along with Assistant Vice President for Research and Academic Affairs Norman Anderson and College of Social Work Associate Professor Carrie Pettus. 

“The science put forward by this cohort is exceptionally novel and creative and is sure to push at the boundaries of what is known,” said NIH Director Francis S. Collins. “These visionary investigators come from a wide breadth of career stages and show that groundbreaking science can happen at any career level given the right opportunity.”

With this interdisciplinary award to FSU, led by the College of Medicine, the NIH signals they are moving in a new direction, providing funding specifically to investigate behavioral and social issues leading to racial inequities in the health-care system.

The NIH announced its High Risk-High Reward grants Tuesday with most of the 106 grants supporting biomedical – rather than behavioral – research.

“With everything that’s been going on in the world, it’s a recognition of the effects of racism on health and mortality, which is an affront to the social structure of our society,” Naar said. “Being awarded a grant to transform health equity research by addressing racism was just overwhelming to me from the standpoint of recognizing we are taking meaningful steps as a society to actually do something about it.”

The FSU proposal is one of the first NIH-funded research projects using an established model of translational and behavioral social science – traditionally utilized to change patient behavior – to address racism in health care.

The project maps out the impact of racism in primary care that leads to significant health disparities in prevalence, diagnosis and treatment of associated physical and mental health conditions and the resulting poor outcomes. The goal is to develop new organizational- and policy-level interventions meant to reduce and ultimately eliminate race-related health disparities and move away from focusing on intervention with individual health-care providers.

“The scientific literature has clearly established the existence of racial bias within the health-care system, so much so that it has recently been declared a public health emergency,” said Anderson, a member of the National Academy of Medicine. “Yet, there are few if any successful approaches to addressing this bias. Our project will be among the first to design, from the ground up, interventions that might reduce racial bias in health care, especially at the system level.”

The team will collaborate directly with patients, community members, health administrators, health-care providers and experts in the field to identify innovations and increase the likelihood of existing health systems and community partners adopting new evidence-based practices that could change the way care is delivered.

“The benefits and outcomes of this unique approach to developing antiracism innovations extend beyond traditional health-care settings,” Pettus said. “We can apply this model throughout our nation’s other critical systems of care, including the educational, criminal justice and mental health systems.”

Their approach allows them the time to truly understand areas of bias within the health system from a wide variety of perspectives, Anderson added.

“Using this qualitative information, coupled with sophisticated quantitative approaches, we can find leverage points within the systems where anti-racism interventions might be effective,” he said. “We also have the opportunity to determine exactly which interventions might work best.”

Patients will be recruited with collaboration from the Florida Department of Health and through some of Florida’s more than 3,000 patient-centered medical homes, many of which are affiliates of the FSU College of Medicine and its primary care network, stretching from the Panhandle to South Florida.

“We’ll be looking not just for currently active patients; for example, we are going to really want patients that maybe showed up once and then didn’t show up again, so that’s part of the challenge,” Naar said. “But that’s what we do (at the Center for Translational Behavioral Science) — we aim to improve health outcomes among people who are marginalized and don’t really show up for care.

“We’re going to build off FSU’s history of community engagement and leverage that. I think that with the medical school and the university’s mission, this grant really puts us at the forefront of health disparities research.”

TALLAHASSEE, Fla. — New research from the Florida State University College of Medicine found that changes in the brain associated with Alzheimer’s disease are often visible early on in individuals with personality traits associated with the condition.

The study focused on two traits previously linked to the risk of dementia: neuroticism, which measures a predisposition for negative emotions, and conscientiousness, which measures the tendency to be careful, organized, goal-directed and responsible.

“We have done studies showing who’s at risk of developing dementia, but those other studies were looking at the clinical diagnosis,” said Antonio Terracciano, professor of geriatrics at the College of Medicine. “Here, we are looking at the neuropathology; that is, the lesions in the brain that tell us about the underlying pathological change. This study shows that even before clinical dementia, personality predicts the accumulation of pathology associated with dementia.”

The findings, published as an article-in-press online with Biological Psychiatry, combine data from the Baltimore Longitudinal Study of Aging (BLSA) and previously published work in a meta-analysis that summarized 12 studies on personality and Alzheimer’s neuropathology. The studies combined included more than 3,000 participants. Combining results across studies provides more robust estimates of the associations between personality and neuropathology than a single individual study can typically provide.

In both the BLSA and meta-analysis, the researchers found more amyloid and tau deposits (the proteins responsible for the plaques and tangles that characterize Alzheimer’s disease) in participants who scored higher in neuroticism and lower in conscientiousness.

The team also found associations to be stronger in studies of cognitively normal people compared to studies that included people with cognitive problems.

The study suggests that personality can help protect against Alzheimer’s and other neurological diseases by delaying or preventing the emergence of neuropathology for those strong in conscientiousness and low in neuroticism.

“Such protection against neuropathology may derive from a lifetime difference in people’s emotions and behaviors,” Terracciano said. “For example, past research has shown that low neuroticism helps with managing stress and reduces the risk of common mental health disorders. Similarly, high conscientiousness is consistently related to healthy lifestyles, like physical activity. Over time, more adaptive personality traits can better support metabolic and immunological functions, and ultimately prevent or delay the neurodegeneration process”.

The BLSA is a scientific study of human aging conducted by the National Institute on Aging (NIA), part of the National Institutes of Health, that began in 1958. Personality was measured using a five-factor personality test, the most common personality assessment tool. At the time of their enrollment in the BLSA neuroimaging sub-study, all participants were free of dementia or other severe medical conditions.

Advances in brain scan technology used to assess in vivo amyloid and tau neuropathology made it possible for researchers to complete this work.

“Until recently, researchers measured amyloid and tau in the brain through autopsy — after people died,” Terracciano said. “In recent years, advances in medical imaging have made it possible to assess neuropathology when people are still alive, even before they show any symptoms.”

This research was supported by NIA Intramural Research Program and by the NIA/NIH award numbers R01AG068093 and R01AG053297. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional authors include FSU College of Medicine Professor Angelina Sutin, Assistant Professor Martina Luchetti and postdoctoral researcher Damaris Aschwanden. Other co-authors are from the NIA, Johns Hopkins University, Washington University School of Medicine and the University of Montpellier.