Milestone Gift Funds Geisel Student Scholarships

A particularly powerful research method Lewinson uses is Photovoice—giving tenants cameras to document their lives. The photos then serve as springboards for conversation. One study participant photographed a busy highway next to their home and told Lewinson, “I can’t cross this street.” Another showed her a picture of an iron and said, “My husband hit me with this iron.” The first photo led to a conversation about neighborhood walkability, and the second, a discussion about domestic abuse. Lewinson’s research interests continue to evolve. In 2017, she served as a Health and Aging Policy Fellow in the Washington, D.C., office of the late civil rights icon and Georgia Congressman John Lewis. Her portfolio included environmental issues. “It opened my eyes to the inequities, not only arising from affordability and quality, but larger environmental issues,” she says. The siting of low-income housing often exposes residents to industrial emissions, unclean water, and noise pollution. Drawing on the expertise of her new colleagues at The Dartmouth Institute, Lewinson aims to expand her research to explore the intersection of housing and environmental issues—and ultimately inform better public policies and community programs that will enable more low-income people to live healthier lives.

What a Patient Wants

Like Lewinson, Christine Marie Gunn, MA, PhD, works to include the voices and perceptions of individuals, but her focus is on cancer and the decisions people make. Physicians and patients tend to view decision-making differently, Gunn explains. Physicians look at likely benefits and harms, while patients focus on what’s important to them. Gunn recalls a woman with kidney cancer who declined a drug because it would have made her hair turn white. In another study, she found that women chose not to take a medicine to prevent breast cancer despite being at high risk because they feared the rare side effect of stroke and were concerned about possible menopause-like side effects. Gunn, who earned a doctorate in health services research at the Boston University School of Public Health and taught at Boston University School of Medicine, will bring to Dartmouth her expertise in health literacy and working with ethnically and linguistically diverse patients. For instance, in a study completed in 2016, she analyzed breast density notifications (after mammograms) in 24 states and found that in most cases the notifications were difficult to understand and contained language whose complexity surpassed the average reading level of state residents. At The Dartmouth Institute, Gunn will have access to unparalleled health care data sets and colleagues who are world leaders in patient decision making, health systems research, and in co-designing care with patients and families. With those resources, she plans to expand her work to include socioeconomic disparities. Most importantly, she will continue to center patients, as she has done throughout her career. For a current study, she is hiring male prostate cancer survivors to interview men who had also completed prostate cancer treatment. “Talking to someone who’s been through a similar experience and can relate in different ways to study participants can sometimes generate a more open conversation,” says Gunn. And that could make all the difference.

Research—and Action

New Hampshire and Vermont may not seem to have much in common with Haiti, Indonesia, Kosovo, Mexico, Bangladesh, and India. But for Alka Dev, MHS, DrPH, who has worked to improve maternal and newborn health in all of those places, she sees a similar story of health inequity. People

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