University of Michigan researchers receive Javits Award for work on stroke health disparities in Mexican Americans

Two University of Michigan researchers have received the Javits Neuroscience Investigator Award from the National Institute of Neurological Disorders and Stroke for their work on stroke health disparities in Mexican Americans.

Lewis Morgenstern, professor of neurology, neurosurgery and emergency medicine at U-M Medical School and professor of epidemiology at the School of Public Health, and Lynda Lisabeth, professor of epidemiology at the School of Public Health and research professor of neurology at the Medical School, received the award in recognition of their distinguished record of substantial contributions to the field of neurological science. 

This is only the second time in its 39-year history that the Javits Award has gone to a pair of epidemiological principal investigators.

The award from NINDS, which is part of the National Institutes of Health, comes with a $5 million grant that will provide additional funding to support the researchers' BASIC Study (Brain Attack Surveillance in Corpus Christi), as well as the potential for a three-year extension and additional funding after the initial four-year period. 

Started by Morgenstern in the mid-1990s, BASIC was established as a health equity study using stroke as a common model of severe illness to look at health inequities between Hispanic and non-Hispanic white populations in Corpus Christi, Texas. Every person in Nueces County who has a stroke becomes part of the BASIC cohort, and the researchers and their team follow the patients over time to better understand outcomes, recurrence, deaths and more. 

BASIC has enrolled more than 15,000 participants

"Having written 146 manuscripts together, Lynda and I have had an incredibly successful research partnership," Morgenstern said. "It's special to win the award with her, and a good statement of our collaboration. 

"We also accept this award on behalf of our team and the project, which has been going on for 25 years, and will go on for at least 32 with the funding from this award. More than 15,000 participants have trusted us and allowed us to provide the data that has gone into all these publications and made a real impact on health equity."

Lisabeth and Morgenstern have a team of about 30 U-M researchers and staff, including several based in Corpus Christi, who manage the day-to-day operations of the study, going into hospitals to meet with patients and obtain data. 

"Epidemiology is the foundation by which we understand disease burden in a population, evaluate emerging trends including disparities, and design impactful interventions," said Lisabeth, who is also senior associate dean for faculty affairs at Michigan Public Health. 

"The significance of this award for an epidemiologic study such as ours signals the critical importance of acquiring a deep understanding of stroke within and between subgroups of the population. Our longstanding work in a diverse, biethnic community allows us to explore the many facets impacting stroke risk and recovery in Mexican American persons, including social determinants of health and other risk and resilience factors such as aspects of Mexican American culture."

The project has gone through many cycles 

Early on, the researchers documented clear disparities. Mexican Americans had higher rates of stroke and worse outcomes than their non-Hispanic white counterparts. More recently, they have shown that some of those disparities have disappeared. Incidence of stroke, recurrence rates and all-cause mortality have become roughly equal between Mexican Americans and whites. However, outcome disparities— such as worse neurological or cognitive outcomes following a stroke — remain. 

With the help of this new funding, Morgenstern and Lisabeth will kick off the sixth five-year cycle of BASIC. While they had previously only enrolled patients 45 and older, they will now expand their study to include people ages 35 to 44. Having seen a recent uptick in the number of people having strokes in midlife, the researchers wanted to look more carefully at a younger population.

In addition, the researchers will explore resilience mechanisms within the Mexican American population. 

"We've always made comparisons between Mexican American and non-Hispanic white populations," Morgenstern said. "Now we're going to look more closely within the Mexican American population to understand why some people get better after a stroke and others don't. We'll look at psychosocial, medical, cultural, spiritual and other factors that may explain these differences."

The Javits Awards were established by the U.S. Congress to honor the late Sen. Jacob Javits of New York, who for several years battled amyotrophic lateral sclerosis (ALS), a degenerative neurological disorder also known as Lou Gehrig's disease. Javits was a strong advocate for support of research in a wide variety of disorders of the brain and nervous system. 

The Javits Neuroscience Investigator Award is a conditional seven-year research grant given to scientists selected by staff and the National Advisory Neurological Disorders and Stroke Council from among the pool of competing applicants during a given grants cycle. Awardees must have demonstrated exceptional scientific excellence and productivity in one of the areas of neurological research supported by the NINDS, have proposals of the highest scientific merit, and be judged highly likely to be able to continue to do research on the cutting edge of their science.

This article was written by Andrea LaFerle.