Member Profile: Amelie Ramirez, Dr.P.H., M.P.H. (NAM)

Advocate for Improving the Health of Latinos in Texas

Amelie Ramirez, Dr.P.H., M.P.H. (NAM) of UT Health San Antonio has built her career on efforts to improve the lives of others. Her research on organizational and human communication to reduce chronic disease and cancer health disparities has led to improved health outcomes for Hispanics/Latinos and other populations. She is the current vice president on the TAMEST Board of Directors.

What inspired you to pursue your area of study and why do your work in Texas?

I was born and raised in Laredo, Texas. I grew up seeing health disparities first-hand in my community and often felt powerless to help. That’s why I have spent a number of years understanding the health issues that disproportionately impact the South Texas population.

I earned my B.S. in psychology, an M.P.H. in health services and a Dr.P.H. in Health Promotion and have spent my entire career in Texas. I’ve stayed in Texas because this is always where I thought I could make the most difference in our growing Latino population. Yet my research also has taken me on a national level to learn about similarities and differences among our Latino communities, and to create innovative approaches and methodologies to help change behaviors and improve their health.

What research have you been involved in throughout your career?

Throughout my career, I’ve worked on hundreds of research projects on health disparities and communication to reduce disparities affecting Latinos, including:

• Helping plan heart disease educational campaigns for Latinos at the DeBakey Heart Institute during a time when most research focused on “white, black or other” populations.
• Collaborating with Dr. Alfred McAlister to pioneer the Diffusion Acceleration Model, based on the Social Cognitive and Diffusion of Innovation theories, to deliver and reinforce positive health messages, and empower individuals and families to make healthy choices promoting cancer prevention and control. Together we led several studies using this model to accelerate behavioral and policy changes among Latinos for many health issues, including improving cancer screening rates, reducing tobacco use and increasing healthy lifestyles.

More recently, I’ve been involved in:

• Developing community- and individual-level research and innovations to reduce Latino health disparities in cancer, obesity and chronic diseases as part of the Institute for Health Promotion Research (IHPR) at UT Health San Antonio. This has included dozens of large-scale collaborative research studies and randomized controlled trials targeting positive behavior changes and risk factor identification in cancer, clinical trial recruitment, genetic testing, chronic disease, obesity prevention and healthy lifestyles among underserved minority populations, especially Latinos.
• Establishing a program—Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children—that creates culturally relevant multimedia research, tools and case studies to empower a national online network of 250,000 Latino childhood health-focused parents, academics and health care providers to start policy and environmental changes in schools and communities to improve Latino child health, reduce disparities and promote lifelong well-being.

What’s been the biggest surprise of your field? The biggest breakthroughs?

In Latino health, the biggest breakthrough was perhaps when my collaborators and I launched the first comprehensive assessment of cancer risk factors in 1992–99 (National Hispanic Leadership Initiative on Cancer: En Acción).

This 18,000-person study was the first of its kind to identify levels of risk, adherence to cancer screening recommendations and healthy behaviors (i.e., not smoking) among different Latino population groups: Mexican Americans in San Diego, California, and San Antonio and Brownsville, Texas; Cuban Americans in Miami; Puerto Ricans in New York City; and Central and South Americans in San Francisco.

Since then, more research has focused on the diversity within the diversity in the Latino population, which is critical if we are going to successfully unlock the vast potential for precision medicine and precision prevention.

What’s next? Where do you see your research going?

U.S. Latinos are the new majority minority. For the future health of the nation, we need to find ways to reduce healthcare disparities and ensure good access to health care for this population. We are trying new and innovative approaches to reach Latinos.

For example, because Latinos are among the heaviest users of mobile Internet, texting and social media, we’re utilizing the latest mobile technologies—mobile phone apps, text messaging programs and social media innovations, etc.—to reach Latinos where they are, in real time, to improve their health.

We’ve created Quitxt, a bilingual tobacco-cessation smartphone service for young Latino adults using text messages and mobile media. For those in South Texas who enrolled, the service yielded a strong 21% quit rate at a seven-month follow-up.

We are about to beta-test a new bilingual app to educate, support and promote adherence to prescribed treatment among San Antonio cancer patients.

What advice would you give to young scientists in your field?

Our young researchers, scientists and public health professionals are people who care, want to make a difference, and are leaders now and will be into the future.

But no matter how passionate you are, there is one immutable fact: You can’t do it alone.

My advice is to:

• Cultivate mentors. We all need someone we can turn to for advice, collaboration on a project, writing a letter of support and who won’t be afraid to give you the feedback you may need to enable good decisions. I encourage young scientists to have multiple mentors. Don’t be shy or afraid to ask for help.
• Nurture yourself. Make time for reflection. Go on vacation. Sleep more. Recognize burnout in yourself and in others. Develop resilience.
• Pay it forward. Being a professional ally and a mentor to others can seem like adding more responsibility to an already full plate. Instead, I have found it to be energizing and recharging. Listening to understand, helping others find their own solutions and allowing someone to be heard are powerful gifts for both sides.

Paying it forward to the next generation of researchers is the reason I started

My team and I also recently conducted the Advancing the Science of Cancer in Latinos conference, which united 225 cancer experts from 23 states and Puerto Rico—and featured dignitaries like U.S. Rep Joaquin Castro—to tackle Latino cancer on all fronts in February 2018 in San Antonio. We will soon publish a scientific article on the conference proceedings.

What do you like to do in your free time?

I like staying active, and particularly enjoy Yoga. I enjoy ranching, raising sheep and tending to my new lavender garden.

I also spend a lot of time with my family, including grandchildren. At the end of the day, family is what matters most. My work—and everyone’s work—takes time and effort. We couldn’t do it without the support of our families.

Anything else you’d like to share?

Always think about how your work—whether public health, research or clinical trials—affects our communities of color, and seek out ways you can advocate for positive healthy changes in your schools and communities that can make the right healthy choice the easy choice.