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ECU researchers studying premature deaths

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ECU researchers in The Lincoln Project are focused on reducing the impact of out-of-hospital premature natural death in eastern North Carolina counties.

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By Michael Abramowitz
The Daily Reflector

Wednesday, July 18, 2018

Each year, more than 900,000 Americans die prematurely from the five leading causes of death: Heart disease, cancer, chronic respiratory disease, stroke and accidental injuries.

In 2016, a total of 3,678 Pitt County residents died from those top causes. According to a study from the U.S. Centers for Disease Control and Prevention, as many as 40 percent of these deaths could be prevented.

On a mission to reduce premature mortality in eastern North Carolina, East Carolina University researchers involved in a multi-disciplinary effort dubbed “The Lincoln Project” conducted a community health needs assessment survey in Pitt and Onslow counties.

“Pitt and Onslow counties were chosen because of their rates of premature natural death,” said Jessica Ford, an associate professor of psychology and cardiology who is working on the project. 

The Lincoln Project is focused on reducing the effect of out-of-hospital premature natural death in eastern North Carolina counties. The research team is identifying medical and social drivers of health and well-being in the region.

Research findings will support community-specific interventions, inform federal, state and local policy decisions and assist clinicians to develop medical “best practices” to prevent out-of-hospital premature natural death.

Researchers have scoured many data sources for relevant information, including decedents, Ford said.

“We’ve accumulated death certificates for all people in 29 counties east of Interstate 95, identifying those who appeared to have a high risk for premature natural death,” she said.

The researchers also have enlisted professionals from ECU’s Geography Department who use Geographic Information System mapping technology.

“Our focus is on individual census block groups and neighborhoods, trying to understand each community’s unique characteristics so we can develop tailored interventions,” Ford said. “We will rely on the geographers to develop maps that help us focus in and understand where we’re going and what we’re doing in each place.”

Researchers in the cardiovascular sciences and psychology departments, in collaboration with nurses and public health professionals, will use data collected from the survey to better understand participants’ health care needs and access to care, and to inform community-based intervention efforts to improve cardiovascular health and longevity among the region’s residents.

“The project was conceived from work done in cardiology because of our data in premature death sudden cardiac death is the top cause,” Ford said. “We’re looking back from the end state of cardiac disease toward all the factors that might have led to it.”

Clinical psychologist Sam Sears works with Ford, looking at the science of behavior change, particularly those who have chronic health conditions.

“Chronic disease develops from lots of trajectories, some psychological,” Ford said. “Mental health conditions and emotional states are factors, as perhaps are medical mistrust and histories of stressful experiences in a health care setting.”

The research team also is paying attention to access-to-care issues — structural barriers and lack of knowledge about available treatments and practices, including distance care — that act as major obstacles to healthier living and more natural deaths, Ford said. 

There are some deeply ingrained perceptions among low-income people living for generations in isolated parts of the state that poor health is an expected fate, Ford said. 

“Many people see poor health as part of their identity, the norms of their community,” she said. “These are issues we definitely want to tackle. We’re going to ask people in our survey about their willingness to be interviewed to understand some of the more qualitative aspects of life in their communities. What is it like living there, and what would it mean to feel like you deserve better health care?”

Digging into the roots of people’s personal views and expectations about their health can be challenging, but challenges make the work more meaningful for Ford and her colleagues, she said.

“There is a good research foundation laid for a lot of these concepts,” Ford said. “A lot of people know that mistrust is a barrier to medical care. They know that fatalism is also a barrier.

“One of the ways The Lincoln Project is a little different is that while we know (many) things affect people’s health, we want to talk to a community about the three things that mean the most to them.” she said. “Taking a more individualized tailored approach will help us meet the challenge.”

Community members received an introductory letter followed by the needs assessment survey with a self-addressed return envelope. Participants also had the option to complete the survey online or by phone. All information collected will be held in strict confidence, research officials said.

Funding for the Lincoln Project was provided by through startup program funding from ECU’s Division of Research, Economic Development and Engagement. The research team also is seeking additional support.

Contact Michael Abramowitz at mabramowitz@reflector.com or 252-329-9507.

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