Q&A With Health Equity Committee Member, Dr. Rachel Issaka

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Resources and Research Blog
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We interviewed Health Equity Committee member, Dr. Rachel Issaka, to find out what inspires her and how she’s fighting for health equity.

Rachel Issaka, MD, MAS is a gastroenterologist and medical researcher with expertise in colorectal cancer prevention, quality improvement, and health equity. As an Assistant Professor at the Fred Hutchinson Cancer Research Center and the University of Washington, her research focuses on  decreasing colorectal cancer mortality in medically underserved populations. Her research has been funded by the National Institutes of Health and the Centers for Medicare and Medicaid Services.

Dr. Issaka has contributed to national medical practice guidelines for the National Comprehensive Cancer Network (NCCN), the National Colorectal Cancer Roundtable (NCCRT), and the Centers for Disease Control (CDC).

Dr. Issaka completed her gastroenterology fellowship at the University of California, San Francisco where she also earned a Master’s in clinical research. She completed her internal medicine residency at Northwestern University Feinberg School of Medicine, where she served as chief resident and obtained her medical degree from the University of Michigan Medical School.

Dr. Issaka is a member of Fight CRC’s Health Equity Committee.

What led you to become a doctor?

I announced that I wanted to be a doctor at the age of five. My mom still tells the story of me picking up a newspaper, seeing a story about a doctor, and saying that’s what I wanted to do. As a child, when people asked me what I wanted to do when I grew up, I said I wanted to be a doctor and my answer remained consistent.

That decision was reinforced by several experiences navigating health care systems as a Black woman, a first-generational African-American, and a first-generation college graduate.

What inspired you to start working in GI and focus on colorectal cancer research?

I went to the University of Michigan Medical School and at the time, it was one of the few places with an inpatient gastroenterology service. I was fortunate to rotate on the service during my third year and was immediately drawn to the full spectrum of disease—from inflammatory bowel diseases in really young people to cancers in older adults – and the ability to complete procedures. I completed another gastroenterology rotation in my final year and I was sold!

During my residency at Northwestern, I had the opportunity to serve at two primary care clinics. One in downtown Chicago and the other, a Federally Qualified Health Center (FQHC), on the city’s south side. I noticed striking differences in response to conversations about colon cancer screening. In my downtown clinic, mostly White, middle-to-upper class patients uniformly agreed to complete screening. In my south-side clinic, my mostly Black and Latino, low-income patients, often declined screening. I left residency wanting to improve colorectal cancer outcomes in racial/ethnic minorities and medically underserved populations through my clinical practice, thoughtful research, and community engaged service. I am privileged to do all of those things today.

What is the impact of having a Black physician for Black patients?

A patient recently came in for their colonoscopy and I was their physician. In fact, my entire team that day was Black. They were floored and said, “I’ve never seen this happen before.” The patient was just ecstatic and said they wanted to stay with us all day. There are patients who actively seek me out because they want a Black physician. These experiences are always really heartwarming. But there are also people who look for Black physicians and never find them, this is unacceptable and needs to change.

In summer 2020, you published a personal piece about the struggle of racism. What led you to write the piece and speak out?

My research focuses on colorectal cancer. In the U.S., Black people are more likely to be diagnosed with and die from colorectal cancer than any other group. Hispanic people are one of the least likely groups to complete a colonoscopy for screening. The impact of race and racism is always present. During the pandemic, it became clear that Black people were dying from an unjust criminal and police system, from COVID-19, and from a multitude of other diseases, including colorectal cancer. This is due to the impact of structural racism in medicine. As a Black woman, physician, and researcher, I wanted to bring attention to this topic.

What role do you see researchers playing in terms of health equity?

I think everybody who conducts research, whether it’s clinical or bench, approaches the work with a lens. That lens influences questions asked, the manner in which those questions are asked, how research is conducted, and ultimately, shared . Health equity is important is because it frames all of the above. This means that if research is not considered from the perspective of the least privileged, they may never see the benefit. For this reason, it is so important that all research is conducted through a health equity lens.

What are some steps you hope to see Fight CRC’s Health Equity Committee take?

For a long time, the face of cancer has not been that of a Black, Latino, or Native American person. It’s really important that when we talk about a disease that disproportionately affects racial, ethnic, minority groups, that there’s representation across the spectrum. Hopefully, our committee’s work will inspire groups that did not consider themselves to be at risk to become more engaged and increase partnerships with Black, Latino, & Native American survivors.

What role do you see policy playing in this committee’s work?

Preventative care should be accessible to everyone, regardless of insurance or immigration status. I hope this group is able to impact policy and legislation that moves the needle in those spaces.

You’ve emphasized the importance of being explicit in the language when working with certain communities. Can you explain what you mean?

I’ve seen the term “Black and Brown communities” a lot lately. Brown in particular could mean different things to different communities. If we’re talking about Black people and colon cancer, let’s say that. If we’re saying Native Americans and colon cancer, let’s say that. If we mean Hispanic people and colon cancer, let’s say that. Explicit language should create clarity and hopefully that will lead to interventions or programs, tailored for the specific communities we wish to engage. 

What gives you hope when looking at conversations around health equity?

2020 was a year of loss. But 2020 also elevated important issues and forced everyone to engage in difficult conversations. For example, the impact of racism on health outcomes can no longer be denied. I’m encouraged by people awakening to this fact. I am also encouraged by President Biden’s executive order that mandates prioritizing equity across the whole government. I look forward to what will result from these realizations and laws. 

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