Salud America! Promotes Research, Advocacy, and Policy to Reduce Childhood Obesity among Latino Children

    • January 14, 2014

The challenge. Latinos suffer disproportionately from diabetes, cancer, obesity, and other health problems that affect Americans of all races and economic groups. Some population groups, however, struggle more than others. Because of disparities in the health care they receive—due to language barriers, less education and income, and a lack of access to care or insurance—Latinos are more likely than Whites to forego or delay seeking care.

These disparities are especially alarming as Latinos are the nation's largest minority group, and by 2050 will account for about 30 percent of the population of the United States.

Amelie G. Ramirez, DrPH, MPH, has devoted a career to changing this picture.

A strong identity and an early interest in health. “I grew up in Laredo, Texas,” Ramirez says. "My parents were here and my grandparents were here. It was a unique community because Latinos were the majority there and we interfaced a lot with Mexico."

Ramirez' interest in health developed early. Seeing her father struggle with health problems and accompanying him on doctor visits exposed her to the helping professions. "When I went to school, I knew I was interested in working with people," she recalls. "So my undergraduate degree is in psychology and then I moved into public health."

Ramirez earned a masters degree in public health in 1977 and a doctorate in public health in 1992, both from the University of Texas in Houston. From the start, she focused on integrating research and communication aimed at reducing health disparities.

Ramirez' early work focused on cancer, including a stint as associate director of the Center for Cancer Control Research at Baylor College of Medicine in Houston, and later as director of Baylor’s Office of Health Disparities Research at the Dan L. Duncan Cancer Center.

In 2006, Ramirez founded and became director of the Institute for Health Promotion Research at the University of Texas Health Science Center at San Antonio. "I was recruited by the National Cancer Institute to form the institute, but it builds on my prior work as a principal investigator here in San Antonio and at Baylor College of Medicine."

The institute studies the causes of and solutions to the unequal impact of cancer, chronic disease, and obesity among Latinos in South Texas and beyond. By the time she founded the institute, Ramirez had a national reputation for creating and engaging a network of researchers, policy-makers, practitioners, and others—and for using research findings to promote changes in policy and practice.

The institute has received four cycles of funding from the National Cancer Institute for its national Latino cancer research network, called Redes En Acción. As of 2013, the institute includes 50 faculty and staff engaged in studies on topics such as breast cancer, exercise and cardiovascular disease, acculturation, cervical cancer, and strategies to get parents to vaccinate their children with the HPV (human papilloma virus) vaccine.

Making the connection with RWJF. Ramirez' work caught the eye of RWJF staff as the institute was launching its ambitious plan to reverse the epidemic of childhood obesity by 2015. RWJF's multi-program effort aims to find policy and environmental solutions to the epidemic. RWJF is especially concerned about groups most at risk, including Latinos. "Amelie had a history of some of the best work and was very well-known," recalls James S. Marks, MD, a senior vice president at RWJF.

From mid-November 2006 through mid-September 2007, Ramirez was a senior fellow in residence at RWJF. "There had not been a lot of Latino-based research, and the fellowship was instrumental in helping me understand what was going on [at RWJF] and in giving me a chance to share with them what we were doing."

Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children. In July 2007, RWJF tapped Ramirez to design and direct Salud America!, a new national program to address childhood obesity among Latinos by integrating research and communication with a goal of promoting action, advocacy, and policy changes.

Ramirez was a natural to direct the new program, says Laura C. Leviton, PhD, special adviser for evaluation at RWJF and Salud program officer. "Amelie was probably the premier person in the country. She already had terrific stature with NIH and had been involved with behavior change to help Latinos in highly effective ways."

Ramirez has guided Salud in creating the first National Latino Childhood Obesity Research Agenda, funding 20 pilot research projects totaling $1.5 million that researchers leveraged into more than $30 million in additional support and establishing a 2,200-member network of stakeholders. Salud is known for its engaging website that creatively integrates research, case studies, stories, and videos. Its video "Did You Know?/¿Sabia Usted?” won several awards from the television and film industry. Watch the English version or the Spanish version of the video online. Recently it has created six new animated videos on Latino childhood obesity that correspond with the six RWJF target areas on obesity: school foods and beverages; healthy affordable food, physical activity at school; pricing strategies; physical activity in communities; and marketing to kids. Link to the playlists of the English language version or the playlists of the Spanish language version.

Recognition and appreciation. In June 2012, Ramirez was honored as a First Lady of the Intercultural Cancer Council, an award given to "a distinguished group of women who have shown outstanding commitment and support to the Intercultural Cancer Council."

In September 2011, she was named a Champion of Change by the White House for Latina breast cancer. She was nominated by Susan G. Komen for the Cure. It was her second award related to cancer. In April 2010, Ramirez received the American Association for Cancer Research-Minorities in Cancer Research-Jane Cooke Wright Lectureship Award, which "acknowledges outstanding scientific contributions to the field of cancer research and contributions, through leadership and example, to further the careers of minority scientists."

In 2007, Ramirez was elected to the Institute of Medicine.

Spending time with family and colleagues. Ramirez says she realizes that “exercise is important.” She enjoys yoga, working out with a personal trainer, and walking. She especially values spending time with her three children and two young grandchildren and weekends at a family getaway. "Recently my husband and I purchased a little country place, and we enjoy working with our sheep and our longhorns. As a young child, I grew up on a ranch. I enjoyed the outdoors and went horseback riding when I was younger."

Her colleagues at the institute are also very important to her. "I am very much one of those who really enjoy working as part of a team and working to put forth our agenda, and it takes a talented group of people to make that happen. I'm just proud to be their director."

RWJF perspective. Salud America! is part of RWJF's efforts to reverse the childhood obesity epidemic by 2015. RWJF places special importance on reducing childhood obesity among groups most at risk who are often overlooked and underserved: African Americans, Latinos, American Indians, Asian/Pacific Islanders, and children living in low-income areas. "Salud represents a really important point of entry to the Latino community that I don't think anyone else has," says RWJF’s Marks.

RWJF's Leviton reflects on Salud's contribution. "Amelie had developed extensive networks of health researchers and community leaders across the country. In preparing for the Salud request for proposals, she did some careful planning with her network, consulting with them about which aspects of the epidemic the program should focus on, and which possibilities for prevention should take priority."

When RWJF shifted its childhood obesity funding priorities away from research and toward supporting an action, advocacy, and policy agenda in 2012, it authorized Salud to turn that way as well. Going forward, Salud is creating an online platform where researchers, policy-makers, advocates, and practitioners can find information, tools, and resources; contribute their own stories, data, and insights; and communicate with each other in finding solutions.

"I think Salud has a lot of potential to be a platform for Latino health generally. They know what they are doing in this area and could do it for any number of issues that plague Latinos," says Leviton.

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