Environmental Factor, November 2007, National Institute of Environmental Health Sciences
Success in Health Disparities Research
By Robin Arnette
November 2007
In one of several activities held to celebrate Hispanic Heritage Month, NIEHS welcomed Gloria Coronado, Ph.D. who shared a few of her success stories during a seminar, titled “Health Disparities Research in Agricultural Communities in Washington State,” held in Rodbell Auditorium on October 3. Coronado is an assistant professor in the Department of Epidemiology at the University of Washington and an Assistant Member in the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center (FHCRC) 
in Seattle, Washington.
Rosemarie Ramos, Ph.D., a postdoctoral fellow in the Laboratory of Molecular Carcinogenesis and a member of the NIEHS Diversity Council, hosted the seminar. Ramos was pleased that Coronado was able to make the cross-country trip and said, “Dr. Coronado’s research helps to fill the void of what we still do not understand about health disparities within the U.S. migrant worker population.”
Under the mentorship of Beti Thompson, Ph.D., at FHCRC, Coronado worked on a cancer prevention program that focused on understanding different cancer screening behaviors and lifestyle practices in the Yakima Valley in southeastern Washington State. She and colleagues hired and trained bilingual/bicultural individuals to conduct in-person surveys in 20 communities in 1998. They selected 1800 households for interviews and asked whether adults had received a colonoscopy, mammogram or Pap test.
The results determined that a majority of the respondents had not received any of these tests, even if they had the resources to pay for them. Respondents listed a variety of reasons for not participating in preventive care, but one of the prevailing thoughts was that Hispanics don’t want to know if they have cancer. According to Coronado, one of the respondents said, “The doctor is often asked to talk about the diagnosis of the disease [only] with the patient’s relatives.”
To combat these beliefs, Coronado’s team decided to take a community approach. By forming an advisory board that included individuals from 18 different organizations, the team was able to receive funding for a Special Populations Network. The Network funded community activities, such as the Student Cervical Health Program, Smart Nutrition Choices and the Prostate Cancer Radio Outreach Program.
In the next portion of the talk, Coronado discussed the For Healthy Kids! project. Its goal was to reduce pesticide exposure, specifically in children, by developing a culturally appropriate intervention to break the take-home pesticide pathway. The team formed a community advisory board, identified about 600 families in the area, and collected urine and dust samples from families in 24 labor camp communities in the spring of 1999.
The team looked at non-pome fruit (grapes, cherries and asparagus) workers and pome fruit (apples and pears) workers and found that the most common urinary metabolite was DMTP (0,0-dimethyl-s-(2-methoxy-1,3,4-thiadiazol-5(4H)-onyl-(4)-m ethyl)- dithiophosphate). DMTP is a breakdown product of azinphos-methyl, the most used organophosphate in Yakima Valley.
The most interesting finding was that pome fruit workers had a higher percentage of detection and higher concentrations of DMTP than non-pome fruit workers. Also, pome fruit workers who worked with both apples and pears had slightly higher exposure levels than those who worked with either apples or pears. The data for the children of pome fruit workers was similar to the adult values, which suggested the children were being exposed to pesticides via their parents. The results provided a stimulus for farm workers to employ good safety practices such as removing work boots before entering the home.
Coronado and her colleagues received recognition in a local Washington newspaper and as a result, donors contributed an additional $120,000 to expand the research. The researchers used the money to collect blood, saliva and buccal cell samples, and they added cholinesterase monitoring. They also provided the families with their study results and additional education materials in regard to pesticides.
Coronado said that one of the most fulfilling aspects of the unexpected financial windfall was the establishment of a summer interns program. “[This money] allows us to train underrepresented [minority] students in cancer research and pesticide research, and it really has an impact on encouraging them to go to college,” she said. “It gives me joy to participate in their training.”
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