Tell us about your research into health disparities and substance abuse. What first drew you to these areas of inquiry and what are you learning?
I grew up in Baltimore, MD, so I was aware of many of the health challenges that the city faced. Baltimore was known for its high prevalence of residents addicted to heroin and other drugs as well as being plagued with violence. This was also reflected in the TV shows, ‘The Corner’ and ‘The Wire.’
During my undergraduate studies I majored in public health and joined a research study that examined characteristics of the built and social environment in every neighborhood in Baltimore City. The study sought to understand the features of the built and social environment that may contribute to youth exposure to violence, alcohol, tobacco, and other drugs with the goal of developing interventions and policies that would reduce youth exposure to these hazardous aspects of the environment. I continued this line of research because I thought it would have a significant impact on the health and well-being of youth in Baltimore and similar areas. This research helped inform legislation and was used in Baltimore’s zoning rewrite. I have continued to study risk factors and preventive strategies for substance use in adolescent populations.
Similarly, my interest in studying health disparities started with after volunteering in the community and observing the stark difference in health and access to healthcare by race and income. I later worked with the health department and helped develop neighborhood health profiles that found a 20-year gap in life expectancy in two communities less than five miles apart. My goal since then has been to bring attention to racial disparities in health and the lack of access to quality healthcare in minority and impoverished populations.
You were just finishing up your residency at Cedars-Sinai Medical Center in Los Angeles when COVID-19 hit. What was your experience during the early days of the pandemic, both personally and professionally?
The early days of the pandemic were tough, both personally and professionally. Similar to everyone across the globe, the social distancing completely altered my life. I loved living in Los Angeles because of all the outdoor activities - going to the beach or a quick hike with amazing views at Runyon Canyon. Suddenly, I could not do any of these activities; it was a huge adjustment! Additionally, not being able to visit family and friends was equally frustrating.
Professionally, the pandemic brought another set of problems and obstacles. While elective cases at the hospital were cancelled, the ICU and OB floors remained busy and we had to adjust to the new normal to manage patients at the hospital with constantly changing guidelines.
My public health background and my work in the area or health disparities also thrust me into additional responsibilities - I worked with several national organizations to develop strategies to address the racial disparities in COVID-19 testing, cases, and mortality. My evenings were consumed with Zoom meetings and conference calls which I did not mind because the work was important and meaningful.
By April, Los Angeles had established two dozen or so emergency shelters to reduce the spread of virus. Several health centers were asked to provide medical services at these emergency shelter. I had the opportunity to serve as the medical lead from the Cedars-Sinai team, providing medical care at four emergency shelter. The team included two nurse practitioners, three nurses, two social workers, and a dental hygienist. This was one of my most rewarding experiences during residency - assisting this often-overlooked community access care and connecting them to medical homes. At the same time, it was frustrating reminder that segments of our population are unable to fulfill basic needs or access necessary medical and dental services.
You’ve been very active in the California Society of Anesthesiologists, serving as Director of their In-Training Practice Forum, among other leadership roles. Why do you think it’s important to get involved with your state component society at such an early stage in your medical career?
I’ve always been interested in the intersection of policy and health. The CSA devotes resources and time to advocating for policies and legislation that protects our patients. I got involved in CSA and subsequently ASA to help advocate for our patients and learn more about challenges facing our specialty. I was able to meet with legislators in Sacramento and Washington DC to advocate for my patients and our specialty.
I also had the opportunity to be mentored by leaders in anesthesiology through my involvement with CSA; this was a welcomed surprise. The support I received from the organization especially while applying for fellowship and faculty positions was invaluable. Working with the CSA and state component societies also helps with professional development and provides another networking opportunity; many of the leaders that I look up to became involved in their state societies and ASA early in their career and I believe that early involvement was one of the keys to their success.
Is there anything else you’d like to discuss that we haven’t yet touched on?
No, great questions!
Adam Milam, MD, PhD, completed residency at Cedars-Sinai Medical Center and is now an attending at Mayo Clinic Arizona. He was recently appointed Professor of Practice within the College of Health Solutions at Arizona State University. Dr. Milam holds a MHS as well as a PhD in Public Health from the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health. His research is rooted in practices, policies, and interventions to address health disparities and health inequities.