For health disparities researcher Dr. Jason “Jay” Mendoza, it all started with the kids. The ones who were hungry. The ones who didn’t know if there would be a meal on the table when they got home. Or if there would even be a home.
“It was during my training as a pediatrician at Seattle Children’s and Harborview Medical Center that I really began to take to heart the disparities within the health care system,” he said. “Kids living in poverty were worried about basic things: food, shelter, their parents’ mental health, their parents’ jobs. Some of them were bouncing around a lot because of housing instability.”
“The things these kids worried about were beyond their years,” he said. “They were things that no kid should have to worry about.”
For Mendoza, it was a moment of clarity. No matter what kind of care they got from a clinician, “these issues were much broader than the snippet of time we had with them.”
And he wanted to do more. So, after finishing his residency, he went on to pursue a master’s in public health. It was the perfect training for someone who longed to identify and dismantle the health inequities that led to such little kids having to deal with such big woes.
Health disparities dream job
Today, Mendoza is director of the Office of Community Outreach & Engagement, or OCOE, housed at Fred Hutchinson Cancer Research Center.
He first began working with the group, originally launched by Fred Hutch as the Health Disparities Research Center, when he came back to Seattle in 2013. Established in 2017, the OCOE is a larger research and programmatic collaboration between the Hutch, the University of Washington, Seattle Children's and Seattle Cancer Care Alliance.
In many ways, it’s his dream job.
“Our health system and society itself are steeped in structural inequities such as structural racism,” he said. “This job gives me an opportunity to tackle some of the most longstanding and difficult health inequities in this region. And the fact that Hutch leadership and the [Fred Hutch / University of Washington Cancer] Consortium were willing to put resources behind the slogans and the policies, that sealed the deal for me.”
Not surprisingly, Mendoza is incredibly busy.
He designs and conducts research aimed at keeping kids eating right and getting enough exercise, via interventions like “Walking School Bus,” “Fit Five” and “Bike Train.” He manages the OCOE’s roster of community health educators and patient navigators who provide education and resources to Black, Latino, Indigenous and other communities who frequently lack access to care. He zips back and forth across the Cascade Mountains to hear from community advisory boards around Washington share their local health care needs.
In his “spare” time, he teaches at UW, sees young patients at Harborview and is associate program head of the Hutch’s Cancer Prevention Program.
“Cancer prevention is at the heart of all my research,” he said. “Getting enough physical activity, eating a healthy diet with enough fruits and vegetables. Getting vaccinated.”
But the people he works with and helps are right at the heart of it, too.
“The people make it all worthwhile,” Mendoza said. “The faculty, the health educators, the team out in lower Yakima Valley who have been doing incredible work for decades. The community partners, the ones in the trenches day in and day out, who let us know what’s going on and give frank advice. My team which is always pushing back on inequities. They’re incredible. They get me all fired up.”
The COVID-19 pandemic and public health
As with other diseases, the people the OCOE serves have been especially hard hit by the COVID-19 pandemic, Mendoza said.
“Health care inequities have been magnified by this fast-moving pandemic,” he said. “It’s jumping from population to population, area to area, disproportionately affecting people of color. Our health system has predisposed us for this. There are glaring inequities with regard to who is at risk for infection and mortality.”
Mendoza said the high number of Black, Latino and Indigenous people being infected — and dying from those infections — is heartbreaking.
Tragically, it’s also not surprising.
“Families of color often live in multigenerational households, and in places like the Lower Yakima Valley, you’ll have some farmworkers living in dorms with 10, 15, 20 adults all in one area,” he said. “It’s hard to socially distance in a bunkhouse. There are many factors that lead to higher infections in these communities. Many of these people are essential workers. Many don’t have personal protective equipment, like masks, or the capacity — or resources — to work at home.”
As Washington state began to quarantine, Mendoza and his team had to redesign their research to align with a new socially distanced reality.
“We’ve had to re-envision how to conduct science,” he said. “We’re working on remote data collection, online surveys and other ways to do research without having participants come in.”
The OCOE’s health educators, for instance, have moved most of their programming over to “the interwebs,” he said.
“They bravely pivoted from doing in-person events to doing it all online,” he said. “They’re doing events on Facebook, Zoom, Instagram — all the different platforms. They’re still able to make connections and provide education. We’re all making the most of what we can do.”
Despite the turmoil and uncertainty of the times, Mendoza said he is optimistic about what the future brings for the communities he serves and the children he cares for, including the little ones with worries beyond their years.
“I feel like there’s a lot of momentum and we’re making progress,” he said. “It certainly feels like there’s a lot of grassroots organizing around equity — in the work force, in our research, in health care and in ending health inequities. If we can keep that interest up, we’ll make great strides.”
— By Diane Mapes, Sept. 10, 2020