Black History Month: Spotlight on Marwah Abdalla, MD
During the first week of March 2020 as the first patient with COVID-19 was hospitalized at NYP/CUIMC, cardiologist Marwah Abdalla, MD, MPH, assistant professor of medicine at VP&S, learned that one of her intensive care unit patients may have had contact with the index COVID patient.
She spent hours trying to get her patient tested for COVID-19 by the state—the only option available at the time—while also tracing contacts and reaching out to over 60 people, telling people she didn’t know to stay put, don’t get on the subway, don’t go to work.
“It was a very stressful day, and for the very first time in our lives, being in health care had public health and personal implications simultaneously: What am I doing right now to protect my patient, their family, my colleagues, their social networks, my family, and myself?” she says.
Abdalla was chief medical resident on call at Brigham and Women's Hospital in 2013 when bombs exploded on the streets during the Boston Marathon. Based on the effects of those events on her colleagues, “I thought that the pandemic was probably going to become a psychological crisis for many health care workers.”
She quickly organized a survey of over 1,200 physicians, nurses, and other clinicians to document their levels of stress, anxiety, coping mechanisms, and wellness resources desired. “In academia, it can take years to get a survey off the ground, but our research team wanted to do this quickly and get it in the hands of administrators so we could help mitigate the crisis.”
Abdalla, who is also a cardiac intensivist and a researcher in the Center for Behavioral Cardiovascular Health, became interested in medicine while living abroad and witnessing health care disparities globally.
“Just seeing the scarcity of resources, particularly around health care, was always disturbing for me,” she says. “People with means could leave a country if they needed health care that wasn’t available at home, and those who didn't have the means just didn't get the care.”
After medical school at Yale, she went to Brigham and Women's for internal medicine training. “Cardiovascular disease kept popping up, even in my primary care clinics,” she says. As one of the few Black Muslim physicians, she attracted patients from historically excluded communities, including Somali refugees and immigrants.
“Compared to some of my other patients, they were having advanced cardiovascular disease at relatively young ages,” she says. “And it bothered me that they may end up dying earlier because of structural issues such as racism and health inequities that they have to face.”
In her research, Abdalla looks for ways to counteract the health effects of structural racism. “We know that there are people who are not going to have access to care. Are there also things at the individual level that can potentially be used as an intervention?” she says.
Much of her work involves the Jackson Heart Study, the largest cohort of African Americans being studied for cardiovascular disease, which has followed participants for 20 years.
One of her studies found that one in five African Americans have high blood pressure at night, when blood pressure should dip below its daytime level. (Other researchers have found a link between high nighttime blood pressure and a person’s encounters with racism.)
“We know there’s a link between sleep—how long you sleep and the quality of your sleep—and cardiovascular disease outcomes,” Abdalla says. “I'm interested in learning the mechanisms behind why people have high blood pressure at night, but also if one can manipulate the sleep period to potentially decrease blood pressure.
“My goal as a researcher is to do the research, but also translate these findings into policies that help tackle the problems with health equity, build a more antiracist society, and transform health care. To me, that's my passion.”