Conversation with Julie A. Baldwin, Ph.D., Northern Arizona University

Applying Cross-Cutting Themes of Prevention Science and Community-Based, Participatory Research to Address Health Disparities

Meet Dr. Julie Baldwin, a Regents’ Professor in the Department of Health Sciences and the Director of the Center for Health Equity Research at Northern Arizona University.

Go to the Q&A with Dr. Baldwin

She earned her B.A. in molecular, cellular, and developmental biology from the University of Colorado (Boulder) in 1984 and her doctorate in behavioral sciences and health education from the Johns Hopkins Bloomberg School of Public Health in 1991. As a citizen of the Cherokee Nation of Oklahoma, she has made a lifelong commitment to serving diverse communities and to advocating for health promotion programs for children, adolescents, and families. Dr. Baldwin’s research interests include both infectious and chronic disease prevention, often by utilizing community-based participatory research approaches, working with underserved and/or marginalized populations, and addressing health disparities by developing, implementing, and evaluating culturally centered public health interventions.

One example of this work is her longstanding program of applied research addressing HIV/AIDS and substance abuse prevention in youth, with a special emphasis on working with American Indian youth and their families. She currently co-directs a 5-year National Institute on Drug Abuse-funded research education (R25) grant titled, the “Culturally Centered Addictions Research Training” Program.

Since 2017, she has served as the principal investigator of the Southwest Health Equity Research Collaborative (SHERC), an NIMHD-funded RCMI. She oversees a team of over 80 investigators, staff, and students conducting 5 main research projects, 19 pilot projects, and multiple core activities for the center. She also oversees 8 supplements awarded to SHERC, several of which focus on addressing COVID-19 in American Indian and other rural communities.

Q & A with Dr. Julie A. Baldwin

What is your research goal, purpose, and aim?
For more than 32 years, I have had a consistent program of research addressing HIV/AIDS and substance abuse prevention in youth, with a special emphasis on serving American Indian adolescents and their families. I have also overseen chronic disease prevention studies (i.e., diabetes, cancer, obesity, and oral health) and worked with other underserved populations.

Important cross-cutting themes which have characterized my work include prevention science, community-based, participatory research (CBPR), and addressing health disparities by developing, implementing, and evaluating culturally centered, theory-based public health interventions. After many years of implementing independent research projects, I now devote most of my time to mentoring other scholars and building teams of researchers to address health disparities. Since 2016, I have been the founding director of the Center for Health Equity Research (CHER) at Northern Arizona University (NAU) and since 2017, I have been the PI of the U54 RCMI Southwest Health Equity Research Collaborative (SHERC).

How is your work advancing the health of particular minority populations and which ones? Are you seeing specific changes in particular communities or groups?
Although my primary passion and focus has been working with American Indian populations, I have also led studies in collaboration with other underserved, diverse populations including migrant farm workers, LGTBQ populations, African American and Latinx communities, rural communities, people with alcohol and drug use disorders, incarcerated populations, and people living with disabilities.

Certainly, we have seen success in some of our intervention studies, especially using CBPR approaches. But to see sustainable change, we must embrace traditional knowledge and cultural worldviews and actively engage community members in research partnerships to help empower people to take action and to build lasting change. In my work today as the Director of CHER and SHERC at NAU, I strive to ensure that these approaches are utilized.

From the research you’re doing, what has surprised you about the discoveries you have made and their impact?
Although not surprised, I have been in awe of the resilience I have witnessed among community members participating in our projects. A recent example involves one of our NIMHD-funded COVID-19 supplements entitled, “Understanding Resilience and Mental Wellbeing: Southwest Indigenous Nations and the Impact of COVID-19.”

This study integrates two key concepts: resilience and Indigenous determinants of health (IDOH). Resilience is the observable process identified as helpful to individuals, families, communities and nations to overcome adversity. IDOH recognize that colonialism, racism, marginalization, dislocation and social exclusion crosscut and influence all other social determinants of health for Indigenous Peoples.

When IDOH and resilience are integrated, achieving health becomes a holistic journey guided by Indigenous cultural values, social practices and ways of knowing and being, including concepts of spirituality, connectedness and reciprocity to the land and all life. Through this study, we are learning of strategies our participants are using to overcome adversity related to COVID-19.

What inspired you to become a researcher in minority health and health disparities?
Early in my career, I was inspired to become a researcher focused on behavioral health disparities because of my own experience watching family members struggle with substance use disorders. It was heartbreaking not to be able to help my loved ones more, but I felt that I could have the most impact by developing community-based interventions that focused on the root causes of these health disparities.

The factors that influence health include many social, cultural, and structural issues. By focusing on these social determinants of health, such as access to medical and behavioral health care, quality education and well-paying jobs, reliable transportation, and a clean, safe environment, and by respecting and embracing cultural beliefs regarding health and medicine, we can achieve lasting change by working across sectors and partnering closely with communities. Developing and nurturing partnerships and trusting relationships with community members is a cornerstone upon which I have built my research for the past 32 years.

How do we encourage the next generation of scientists?
As a citizen of the Cherokee Nation of Oklahoma, I am especially dedicated to mentoring minority and underrepresented students and faculty. I currently mentor several early-stage investigators through CHER and SHERC. In addition, I have mentored dozens of students (especially American Indian and Latinx students), through research assistantships and/or internships, as part of research and service projects that I direct.

I am a strong advocate that one of the best ways to “arm” communities to address public health issues and disparities is to build a cadre of scholars and practitioners with the knowledge, skills, and confidence to address public health concerns in their home communities. Striving to be a democratic teacher/mentor, as Paulo Freire exemplified, requires facilitating critical dialogue about social conditions and motivating students/mentees to reflect on their lives and to take action. This requires being introspective and recognizing our strengths as well as our weaknesses.

What do you envision as the future of minority health and health disparities research?
From very early in my academic career, I realized the value of interdisciplinary research and building teams to address health inequities. Public health research has been transitioning from research dominated by a small number of disciplines to transdisciplinary and translational research.

In 2003, the Institute of Medicine (IOM), now known as the National Academy of Medicine, predicted a shift toward more intervention-oriented research, which in turn dictates a greater emphasis on community participation. The IOM also advocated that public health professionals must be able to understand and incorporate the needs and perspectives of culturally diverse communities in public health interventions and research.

Approaches to research that involve practitioners, researchers, and the community in collaborative efforts in order to improve health have become imperative as we recognize the importance of multiple social determinants of health. Thus, health disparities research requires the development of interactive practices that involve both academic researchers and the community as equal partners in all phases of the research process.

Page updated November 24, 2021