Category Archives: Diversity

Dear Senator . . .

Plea from a cancer survivor and scientist to save the ACA and science funding

 

Dear Senator,

My name is Kiran Dhillon and I live in Seattle, WA (98102). I am writing to ask you to help save the Affordable Care Act and to strongly support increased funding for scientific research.

In March 2015, I was diagnosed with breast cancer. The news was devastating but I powered through surgery, chemotherapy and radiation. I even met you at a fundraiser for you in West Seattle soon after I had lost my hair to chemotherapy. At the time, I was a scientist at the Fred Hutch, studying chemotherapy resistance in breast and ovarian cancers of all things. I had excellent insurance and acquired only a few thousand dollars in debt from medical bills. Now as I wait for my 2 year mammogram on March 10, I find myself filled with an enormous amount of anxiety. My cancer was found early so the prognosis is very good but I still can’t help being nervous before the big test. This time around, the prospect of repeal of the Affordable Care Act has added another dimension to the anxiety. I have insurance now but if I ever had a recurrence, would I be denied coverage due to preexisting conditions if President Trump and Republicans had their way with the repeal of the ACA? This thought terrifies me. Would I have to make decisions based on my financial ability instead of my medical needs? Would I become a burden for my family?

As a scientist and someone who now promotes scientific research as the Director of Scientific Programs for the Rivkin Center for Ovarian Cancer, I’m also alarmed at the prospect of reduced funding for scientific research. Men and women who are currently battling or have survived the horrible ordeal of cancer are depending on scientists across the nation to continue to work hard until we have a cure for these deadly diseases.

The United States has been the leader of research and innovation since the time of Benjamin Franklin—a tradition that continues today. I believe there are (at least) two major factors that have contributed to our success and both are under threat with the new administration. First, we invest more at the federal level on research and development than any other country. Second, our immigrant past and present ensure a diversity of ideas and approaches that are required to solve difficult scientific, medical and engineering challenges. The policies and tweets of the current White House administration threaten both federal funding for research and development and immigration and diversity. We will surely not remain leaders in innovation and research if these trends continue.

Senator, we need you and your colleagues in both the Senate and the House to fight for us. Fight for cancer survivors like me. Fight for the ACA. Fight for science. Fight for immigrants. We also promise to do our part. As you have seen we have organized ourselves. You and your colleagues will hear from us. We will provide you the public support you need to help defend our freedoms and rights to equality, healthcare and a healthy environment. Fight for America.

I appreciate your help and ask that you please send me a response with a commitment to protecting the ACA and funding for research. Thank you for your time and considering my request.

Sincerely,

KD Signature

Kiran Dhillon, PhD

Hutch United Fellowships Awarded!

I’m excited to announce that the first Hutch United Predoctoral and Postdoctoral Fellowships have been awarded to Vasundhara Sridharan and Dr. Athea Vichas! The Fellowship is the result of efforts by a large team of dedicated volunteers, the Fred Hutch Development team and senior Fred Hutch Leadership. The awards signify a very important step towards increasing scientific diversity at the Fred Hutch.

Read more about the awardees in the Fred Hutch News Service piece written by Bill Briggs:

http://www.fredhutch.org/en/news/center-news/2016/07/hutch-united-fellowships-diversity-aml-grant-research-genomic-sequencing.html

Hutch United Fellowship Program Launched!

Fellowship team
Hutch United members who have contributed to the fellowship include, left to right, Laura Martinez, Dr. Laura Gaydos, Dr. Tony Abeyta (founding core board member and former co-chair), Bish Paul (member), Dr. Kiran Dhillon (founding core board member), Heather Noble (member), Jackie Lang (current core board co-chair), Andrea Casasola (former core board member), and Erin dela Cruz (current core board co-chair). Photo by Bill Wright / Fred Hutch News Service

Two years ago, four of us – founders of Hutch United – started work on a dream project to develop and acquire funding for fellowships that would fund scientists from backgrounds typically underrepresented in science to bolster their chances of success in their chosen path and, in turn, increase diversity in the scientific pool. We wanted this to be an inclusive fellowship that would support traditionally underrepresented , women, LGBTQ and international scientists. Due to the efforts of a large team of Hutch United members and support from Fred Hutch Development and Fred Hutch CEO Gary Gilliland, the dream has finally become a reality! We’re proud to announce two fellowships, each for $100,000/year, that will support 1 postdoc/medical scientist and 1 graduate student for two years each. Funds can be used for salary/stipend, tuition (grad students), benefits, conference travel and research. The first round of Hutch United Fellows are expected to be announced this summer.

Read more about the fellowship in this Fred Hutch News Service piece written by Bill Briggs:
http://www.fredhutch.org/en/news/center-news/2016/05/hutch-united-fellowship-program-seeks-applicants.html

 

THE BLACK AND WHITE OF BREAST CANCER (Reblog)

Here’s a piece I co-wrote with my colleague Kathy Briant on the disparities in survival from breast cancer. Next week, Hutch United hosts two Diversity Seminars that will include discussion on efforts of cancer research centers to decrease such disparities. The post was originally posted on the Hutch United Blog.

Photo credit to Wally Gobetz.  This picture has a creative commons attribute license.
Photo credit to Wally Gobetz. This picture has a creative commons attribute license.

The color of your skin may impact your risk as well as your prognosis for breast and other types of cancers. It sounds absurd, but it is true.  For example, last year, a study published by the Sinai Urban Health Institute and the Avon Foundation for women reported that black women are 40% more likely to die from breast cancer than are white women, even though mortality rates from the disease are decreasing overall. In some cities in the US, they’re up to 70% more likely to die. What’s worse is that this disparity in mortality is growing in a majority of the cities analyzed.

Disparities in cancer incidence and mortality rates are not a new phenomenon and they exist for a number of reasons—and the problem isn’t exclusive among black women. In fact, regardless of race or ethnicity, disparities are often seen among people of low socioeconomic status and people who live in areas with limited or no access to effective health care (e.g. Native American women living on Indian reservations and Hispanic women living in rural Yakima Valley).  These medically underserved populations tend to suffer from a disproportionate burden of cancer when compared to the general population (NCI Center to Reduce Cancer Health Disparities).

Why does such disparity in breast cancer mortality exist?

Reports from Avon and the Fred Hutch highlight some of the underlying socio-economic and biological causes of this disparity. Differences in both access and the quality of cancer screenings may explain some of the disparity. Medically underserved women may have less access to “cutting edge” screening technologies. Additionally, there may be differences in both the access and quality of cancer treatment for them because they may seek treatment at local hospitals as opposed to cancer centers that not only offer treatment, but conduct research and can offer access to novel therapies. Further, distrust of the healthcare system due to historical injustices may keep black and other minority women away from traditional sources of healthcare for longer, which delays diagnosis and treatment and negatively impacts survival.

It’s also possible that genetic differences, however slight, may also contribute to differences in survival. For example, higher obesity rates known to occur among black and Hispanic women may place them at higher risk for breast cancer. It’s important to note however that this doesn’t explain differences in treatment once a diagnosis has been made. Another reason for worse outcomes is that black and Hispanic women tend to get a more aggressive, and less treatable, type of breast cancer.

Increasing trust and removing barriers to access

thompson
Photo credit: Bo Jungmayer

Dr. Beti Thompson, Director of the Health Disparities Research Center at Fred Hutch offers some solutions to reduce the existing disparities. One much needed solution is ‘connecting with the community’ and building trust. Historical abuses, such as the Tuskegee syphilis study, continue to have repercussions in the present day.  These types of cases laid the foundation for distrust and fear of the medical establishment by minority populations.

In addition to building trust, Dr. Thompson and others suggest education to dispel cancer myths and empower community members to make informed decisions about cancer prevention and screening.  Equally important is increasing access to screening by offering appointments outside of normal business hours for the working class, bringing mobile mammography units to communities with limited access, or partnering with the Breast, Cervical and Colorectal Cancer Early Detection Program to offer low-cost or no-cost mammograms for those who are uninsured or underinsured. In addition to lowering screening costs, bringing screenings to communities can result in increasing access to early diagnosis for even the most isolated communities.

Addressing the critical need for increased participation of minorities in clinical trials

Though major advances have been made to understand the genetic basis and treatment of breast and other kinds of cancers, most of these studies have been conducted in white women (and men). It is critical to understand if findings from these studies are broadly applicable to patients across all ethnic groups. There has been a push in recent years to expand studies to other minority populations but progress has been slow.

Recruitment of minorities in clinical trials still lags due to a number of issues including recruitment problems and fear among patients due to past abuses discussed above. Perhaps recruitment can be improved by developing culturally relevant communication tools that are tailored for communities. Minority community members may not be aware of the importance of participating in trials—treatment may benefit them individually, but it also helps advance research to develop cutting edge therapies.

Additionally, different tools or approaches may be needed for the recruitment of patients of different ethnicities. An increase in the diversity among the clinicians and other caregivers who are attempting to serve patients from different communities may ameliorate the recruitment and trust issues. This paired with more cultural training for non-minority clinicians may decrease potential biases that interfere with recruitment of minority patients in clinical trials.

As scientists and clinicians, we help provide solutions to the myriad of health problems that plague humanity. However, it is also imperative that we strive to bring equitable access to those solutions among people from different socio-economic and cultural walks of life. The problems are grand and the solutions are not simple. Building trust has to occur at the level of the community and that is slow work, but we can do it.


 

Kiran Dhillon is a postdoctoral scientist working to identify mechanisms of chemotherapy resistance in BRCA-associated breast and ovarian cancers at Fred Hutch. In addition to being a breast cancer researcher, Kiran is also a recent breast cancer survivor. She is a founding member of Hutch United and a member of the Fred Hutch Diversity Council. 

Katherine (Kathy) Briant is a bilingual (English/Spanish) and bicultural community health educator with the National Cancer Institute’s (NCI) National Outreach Network.  She works with Dr. Beti Thompson of the Health Disparities Research Center at Fred Hutch using a community-based participatory research approach to implement and evaluate community interventions that address issues around health disparities. Kathy is also a member of the Fred Hutch Diversity Council.

Fifty Nifty United States: A Citizenship Story

As of September 3, 2015, I am officially an American! Laila Kazmi, a producer at the local PBS station KCTS9 asked me to write about my citizenship experience for their Borders & Heritage: Stories of Immigration project. I’m sharing the piece with you here. You can read the original post on the KCTS9 website. You can also listen to my reading of a version of this piece as part of KUOW 94.9 (NPR)’s Storywallas, a storytelling event inspired by the Moth. The recording also has other stories shared that night, with mine appearing in the last 15 minutes of the recording.

Fifty nifty United States from the 13 original colonies ….

This is the song that was stuck in my head as I stood in the FedEx office putting together all the required materials for my United States Naturalization application. The giddiness and excitement had caught me completely by surprise. I had resided in the country for 28 years and had felt like an American for at least half of that time, despite being a green card holder. I had viewed getting my citizenship as a formality for “officially” becoming an American, and of course, gaining the right to vote. Yet I felt so excited that day that I sang the 50 states song all the way to work from the FedEx office. Perhaps getting my citizenship was more than just a formality and I couldn’t wait to get my U.S. passport. Reflecting back, it was a long journey getting to this point though.

I was born in India and moved to Cleveland, Ohio when I was 9 years old. I had known for about a year that my family was going to move to “Amreeka” but I had no idea what that actually meant. I knew that my grandfather was worried about the political climate in Punjab, India at the time. The fallout from Indian Prime Minister Indira Gandhi’s assassination in 1984 by her Sikh bodyguards and the ongoing separatist movement in Punjab had made India unsafe for Sikhs in the 80s. My father’s farm was on the other side of the city from our house, and I remember we would all wait by the window until we saw him pull up in the tractor and breathe a sigh of relief, especially on days when curfew had been enforced due to shootings or other unrest.

My family a few years before our move to the US

My dad’s sister had been living in the United States since the mid-70s and had filed paperwork for us to immigrate since the early 80s. After anxiously waiting for the better part of a decade to receive our invitation to the U.S., it took only a few months for us to leave the only home we had ever known. Despite the dangers in India, I know it was an incredibly difficult decision for my parents to leave everything familiar for a new country with very different customs and ways of life.

Within a few days, I went from being one of the popular kids in my grade and school to being a complete outsider with a strange accent and strange way of doing things. Over time, my accent slowly disappeared and I made lots of American friends, but those changes didn’t alter that feeling of not belonging.

It wasn’t until my first (and only) trip back to India 11 years later that the feeling would change. I had just finished college and decided to go on a trip with my dad. I was so excited! We spent the first two days in the hustle and bustle of New Delhi before going “home” to Punjab.

Though reconnecting with family we hadn’t seen for years was great, the experience was far from the homecoming I had expected. The place that I had expected to feel so familiar, didn’t feel like home at all. And though I dressed in a traditional Punjabi salwar-kameez, people treated me like a foreigner. Sadly, my once fluent Punjabi now resembled that of my ABCD, or American-Born-Confused-Desi (“Desi” is a slang term referring to people from South Asian countries) friends, with a healthy interjection of “Okay” and “Yeah.”

Once again I was an outsider with a strange accent and a strange way of doing things. When I questioned customs pertaining to religion or the roles of women in the household, I was seen as rude or disrespectful. On the opposite spectrum, people thought the questions I was asking were cute or funny — I just couldn’t say the right thing. I missed the openness with which we can talk about almost anything in America. Though I enjoyed the trip, the culture shock I experienced was completely unexpected!

After returning home to the U.S., I went through a sort of identity crisis — confused about where I belonged and how I saw myself.

It took me a while to understand, but I finally realized that accepting a place as home was more about a decision I needed to make and less about others accepting me or making me feel at home. I had spent my youth hanging on to India as home — I hadn’t realized how much of an American I had become. And despite its imperfections, I couldn’t imagine living anywhere else in the world.

My need for holding on to my Indian identity was borne out of living in a close-knit family, and as is the case for many immigrants, a fear of losing integral aspects of a cultural heritage.

The turning point for me was moving away from home to Seattle for graduate school soon after that impressionable visit to India. It was the first time I only had to worry about myself, which felt selfish at first, but I soon learned to call it “self-loving.“ I loved the taste of American independence that accompanied a focus on individuality! I wasn’t afraid of being labeled “too American” anymore. I was proud of it. I soon learned that I didn’t have to choose to be one or the other — I was a good mix, loving my American individuality with a healthy appreciation for the close familial bonds of my Indian culture. I finally could stop questioning who I was or where I belonged.

As I sat in the auditorium along with people from 15 other countries at the Seattle Office of Homeland Security, waiting to take the oath to officially become an American, I felt an enormous tide of emotion well up inside me. President Obama came on the screen and talked about the hard work and sacrifice it took for us to be there and how we should feel not only pride but a sense of duty to our new country. It might sound overly sentimental, but I felt it. I also registered some sadness at not being an Indian anymore, but most of the emotion I was feeling was indeed pride! I couldn’t wait to pull out the small American flag in the packet I had been handed and wave it at the end of the ceremony. The official told us that the only office higher in the land than President was that of citizen. “We the people,” begins the Constitution. We the people, indeed! I had finally come home.

Diversity Series: Solutions for the STEM diversity problem at the University level (reblog)

Lack of hispanics, blacks and other minorities in the sciences is a well-documented problem. What is at the root of this problem? At what level of training or education should the solutions be targeted at? These are some of the questions individuals working in this area grapple with constantly. Here is an interesting piece from the Huffington Post that discusses the problem and possible solutions at the level of higher education.

As a side note, we’re excited to host Dr. Maggie Werner-Washburne, one of the contributors to this piece, in February 2015 for a seminar for Hutch United, a group committed to fostering diversity in science at Fred Hutch.

http://www.huffingtonpost.com/george-sanchez/crisis-opportunity_b_6181290.html

 

Hutch United Logo 4

Sharing Our Stories – Diversity Series

This is the second post in the Diversity in Science Series where I reflect on some of my own early experiences as a person of color and the first in my family to enter a PhD program.

The first time I noticed the lack of diversity in the sciences was as a young graduate student as I listened to a seminar and noticed that I was one of only a few people of color in a full auditorium. I distinctly remember feeling both intimidated and conspicuous. I’m sure I wasn’t the only new graduate student who felt intimidated. It was common feeling among everyone in our class, regardless of color. We had even learned there was a name for what we were feeling, ‘impostor syndrome.’ The thing for me was that the feeling of being an impostor wasn’t just because I’m brown—Indians aren’t underrepresented in the sciences.

Feeling like an impostor came more from my personal background. Everyone seemed so familiar with the research scene. I didn’t even know what a ‘PI’ was when I first arrived since I had never done research in a lab. (FYI, PI stands for Principal Investigator—in other words the boss of the lab.) My classmates seemed to be so comfortable socializing with other students and faculty. The only PhD’s I knew before grad school were my professors from undergrad. And, it seemed like everyone else’s parents were professors or doctors or other types of academics. I came from a blue collar family. My dad was a farmer in India and worked as landscaper in the US before becoming a real estate agent. My mom was a house wife in India and then worked at a farmer’s market and a macaroni factory in the US.

I felt out of place—and I didn’t want anyone else to know. So, I faked it.

I didn’t ask questions but instead paid attention and stayed quiet until I learned what I needed to without letting anyone in on my secret, for a while anyway. It took me about a year to start to make friends—who eventually became really good friends and got to know the real me, and my family. As time went on, I realized that I wasn’t alone in feeling this way. A lot of folks had come from different backgrounds, and I don’t just mean color. But nobody ever talked about it so we went around thinking we were alone in feeling out of place.

We were all faking it!

Why was there the need for secrecy? The thing about being different in any environment is that it can make you feel very conspicuous. No one has to say a single word to you for you to feel this way, you just do. I didn’t want to seem to others like the outsider I felt I was, so I kept my little secret. And so did everybody else.

Would things have been different for me in those early years had I met someone who came from a similar background? Definitely!

I am so proud (and always have been) of my family’s ‘blue collar’ background and how hard my parents worked in a country that was foreign to them so my siblings and I would have the best opportunities available to us. I’m ashamed I didn’t talk about it openly, or even hid it in an effort to fit in. Maybe if we share our stories more openly, we can help reduce the pressure of fitting in and being different for aspiring young scientists from even the most humble backgrounds.

It’s been many years since that day in the auditorium, and I still find myself thinking about diversity in science. The difference is that now I openly talk about my ‘different’ background, especially to the younger scientists. It’s time to celebrate the diverse backgrounds we all come from and use this diversity to launch us forward, and not hold us back. As a few friends and I endeavor to find solutions to the diversity problem at our own institution, we’re starting by sharing our own stories. Everyone has one. What’s yours?

Why is diversity in the workplace so important?

Diversity in the sciences is a topic that is close to my heart and something I keep coming back to over and over. It’s not something we strive for just in the sciences but probably all work places. I’ve always taken it as a given that diversity is a good thing without feeling the need to justify it. But, why is diversity so important in the workplace?

What diversity means to me

For me, diversity refers to cultivation and celebration of ideas from and individuals from different ethnic, national, social, economic, political, physical, mental and sexual (orientation and identification) backgrounds and ways of thinking. Yeah, it’s a cumbersome definition but it’s inclusive, just like the word it defines. And notice, I didn’t write ‘tolerance.’ For me, true diversity means respecting and celebrating differences, not just tolerating them.

Getting back to why diversity is important

An obvious reason is that cultivating a diverse work force allows ‘equal’ opportunity for folks from different backgrounds, some of which come with challenges that can be roadblocks to success. But I think the strongest argument for diversity is that we ALL benefit from working in an environment with people from diverse backgrounds, ideas and experiences. Working with folks with different experiences, different sets of assumptions and approaches to problems not only has the potential to lead to more creative solutions but also forces us to challenge our own assumptions and ideas.

Lack of diversity in the sciences is a problem

Despite the potential benefits, the sciences still struggle to be sufficiently diverse. We have a really nice representation of international scientists (which is great!). However, there’s a glaring and well-documented under-representation of African-Americans, Native Americans, Mexican-Americans, mainland Puerto Ricans and Pacific Islanders across academic and research institutions nationally. The problem gets worse the higher you go up the ladder, from undergrads, grad students, postdocs, faculty, and all the way up to higher administration. The reasons behind this are complex-involving circumstances that have basis in history, economics, social and racial conditions and politics-and we won’t explore them here.

What we can explore here are some possible solutions. Through a series of posts I’ll conveniently call ‘The Diversity Series’, I’ll explore different solutions some of us are implementing locally to foster diversity. The next post in the series will be ‘Sharing Our Stories.’