‘Focus on the workforce’: New AHA president outlines goals for improving research, CV care
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The American Heart Association in July installed Michelle A. Albert, MD, MPH, FACC, FAHA, as its 86th president, the first woman of color and Black woman to serve as its highest volunteer medical officer.
Albert, also immediate past president of the Association of Black Cardiologists, is the Walter A. Haas-Lucie Stern Endowed Chair in Cardiology, professor of medicine at the University of California, San Francisco (UCSF) and admissions dean for UCSF Medical School. She specializes in research related to health disparities, adversity and cumulative toxic stress, with a focus on CV risk among women and diverse racial and ethnic populations. She has been a volunteer with the AHA for more than 20 years.
Healio spoke with Albert about her goals for the AHA moving forward, including improving workforce development throughout the pipeline, addressing economic adversity as a CV health issue and removing barriers to health care.
Healio: You have been a longtime volunteer with the AHA. How does it feel to assume the role of president?
Albert: It is an honor and it is exciting, especially on the precipice of the organization moving into its second century. I am honored to carry on the tradition of action-oriented, exceptional work that the organization does. I am particularly honored to be the first woman of color serving this organization. I certainly do not want to be the last.
Healio: The new board represents one of the most diverse volunteer leadership teams in the AHA’s nearly 100-year history. What does that mean both for the AHA and for cardiologists?
Albert: I want to take a step back and reflect on that. During the last 2 years, boards of directors have scrambled to make sure they double down on diversity, equity and inclusion initiatives. For an organization like the AHA, these processes have been in place for years. Certainly, I have been a 20-year volunteer and involved different levels within the organization from local to regional and national; other board members that represent a broad swath of diversity have been involved with the board for years. That matters because this is not just about window dressing for this organization. This organization set out to remove barriers to health care and assemble an outstanding team to lead that effort.
Healio: You have mentioned your hope to address economic adversity as a root driver of poor health, especially CV health. How do you plan to do that?
Albert: This is overarching. I cannot get into the details for some initiatives at this juncture. I will say the pillar in which this organization can be most consequential are within the science arena. There are multiple ways to do that, including having and funding science reflecting the tenets of economic adversity as well as supporting science around the latter issue as it pertains to health and wellness, especially cardiovascular health. Other ways are through advocacy. The AHA is very involved in issues around social determinants of health. We must ensure there are standards set for social determinants of health that are collected and can be harmonized across systems. Having a focus on economics as part of that will be important.
Healio: How does economic adversity impact CV health?
Albert: Economic adversity is fundamentally a life course stressor and perhaps the major driver of health and educational inequities rooted in structural racism. Recent research suggests for example that differences in outcomes between younger and older women and men with heart attacks relates in part to psychosocial stress, and in particular financial stress. Also, research from our research team at UCSF shows that financial strain is associated with poor cardiovascular health.
Healio: How do researchers and clinicians begin to address such a tough issue?
Albert: It is challenging, but we have to and there are ways to address it. I recently wrote an article for the president’s page in Circulation, titled “Adversity and CVD: The time has come.” It gets at this very issue we are talking about here. I would say that 30 or 40 years ago, when people were staring down the issue of how to treat a heart attack by doing angioplasty and stenting, that was hard to tackle also. But people rallied around it. This is where workforce is important, too. Medicine has a lot of people who are from upper-middle class and upper-class socioeconomic status backgrounds. The perspectives that they bring to what gets researched in medicine and how issues are approached can be very different from the insights put forward by persons from diverse socioeconomic and racial/ethnic perspectives. Education around topics like economic adversity is not prioritized. If you focus on workforce, and you have more people with that lived experience involved in the work, we can bring reasonable science-based solutions that leverage academic, community and clinical perspectives to address these issues. A key need is to ensure that medical education and research initiatives incorporate social determinants of health principles early on in medical training.
Healio: What are some of your other goals for the AHA in the coming year?
Albert: Representing the organization on a global stage in the scientific arena and highlighting resource challenged settings, particularly pertaining to the role of economics in health outcomes. Another goal is continuing my work around workforce. At UCSF, I serve as the dean of admissions for the school of medicine. Workforce is something I care very deeply about. I want to work collaboratively with AHA on their work they are doing with historically Black colleges and universities in addition to other outreach to young people. The hope is, for me personally, to see workforce goals extended to the deep pipeline such as to middle and high school levels.
For more information:
Michelle A. Albert, MD, MPH, FACC, FAHA, can be reached at michelle.albert@ucsf.edu.
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