A vision for the future: Q&A with Dr. April P. Carson, Director of the Jackson Heart Study

INTRODUCTION:

April P. Carson, Ph.D., was recently named director of the Jackson Heart Study (JHS), the largest and longest running study of cardiovascular disease in African Americans. With this appointment, Dr. Carson becomes the first woman to be named director of the study, which is now in its 22nd year.

In addition to holding the title of JHS Director, Carson is currently a professor of medicine and population health science at the University of Mississippi Medical Center in Jackson. She brings a wealth of experience in epidemiology as well as a life-long passion about the historic study, which is credited with saving lives in the Black community, which is disproportionately affected by heart disease. Here, in this Q&A, we talk with her about current research, COVID, and vision for the study.

Q: How do you think the Jackson Heart Study will change under your leadership?   

A: There are a couple of ways this study will change, while still building upon the storied history and strong foundation of the Jackson Heart Study. First, we have an excellent opportunity to leverage all the data and information we have collected so far and explore emerging areas of science – whether it's aging, cognition, or the environment – and look at how these factors relate to cardiovascular disease.

We also can help inform advances in genetic studies, like TOPMed, which stands for Trans-Omics for Precision Medicine. In TOPMed, genetic data from many different studies is combined for analysis in order to shed light on health differences among populations, including biomarkers that increase or decrease the risk of heart disease. Because African Americans have been typically underrepresented in genetic studies on heart disease, it is important to have the Jackson Heart Study as part of this new wave of research to understand how genes and the environment affect health.    

I hope to provide more training opportunities for students and early career faculty. One of the goals of the Jackson Heart Study is to increase the number of African American health professionals.  Through our partnerships with Tougaloo College, Jackson State University, and the University of Mississippi Medical Center, we have been able to provide undergraduate and graduate-level training programs and high school science and math enrichment programs to prepare and encourage underrepresented minority students to pursue careers in the biomedical sciences. I would like to see these programs continue to grow and provide opportunities for students to experience the entire scientific process—from the planning phase to data collection and management, to research conduct, and to communicating results—so that the students can gain research skills and see different career paths available to them.

Q: Are you looking at any new areas of focus?  

A: Scientifically, one area that I want to see JHS advance more in is implementation science.  This will help us to understand how to better translate interventions into different community settings where people live as well as within the healthcare systems that serve them.  The whole idea around implementation science is that we know there are health interventions or evidence-based practices that work very well in research settings. But once we try to apply them broadly, they don’t work as well as they did when they were in a research setting. 

A good example of this is diabetes prevention. We know that following an evidence-based lifestyle modification program can prevent diabetes—a risk factor for heart disease—but it is often challenging for some people in the community to participate in a program like this. So, while the program may be available, there are barriers that limit a person’s ability to access or participate in the program. Implementation science can help address these barriers so that these programs have greater reach. 

Q: How has the Jackson Heart Study pivoted during the COVID-19 pandemic?  

A: The Jackson Heart Study was deeply affected by the COVID-19 pandemic, but we managed to pivot and help racial-ethnic minority communities through this crisis. This is thanks in part to our collaborations with the Mississippi State Department of Health, NHLBI-funded CEAL program (Community Engagement Alliance Against COVID-19 Disparities), as well as local groups such as barbershops and churches.

Before vaccines were available, we distributed face masks—printed with the Jackson Heart logo—to local community members as part of an effort to raise awareness about COVID-19 preventive measures and maintain engagement. Later, we hosted a drive-through event in the parking lot of a local shopping mall, where we distributed health education materials and had vaccines available for community members.

In-person medical exams, which are a key part of the Jackson Heart Study, were delayed significantly during COVID. We did telephone interviews to gather some health information during this time, but we were unable to conduct in-person medical exams for our cohort members until this past summer. Since then, our study participants have been very excited about being able to come back in for their in-person medical exam so that they can help us learn more about how to prevent heart disease.  

During this time, we have also been able to help conduct COVID research. Through the NIH-supported Collaborative Cohort of Cohorts for COVID-19 Research, or C4R, the Jackson Heart Study is part of a nationwide effort to determine factors that predict disease severity and long-term health impacts of COVID-19.  We are collecting data on COVID exposures, symptoms, and hospitalizations from our community members, which will help us learn about the lasting health effects of this pandemic.  

Q: What are some of the newer health challenges or emerging health issues facing the Jackson Heart Study?

A: As a large portion of the Jackson Heart cohort is older, aging is one of the emerging issues we face.  When our study participants started coming for their in-person medical exam last year, it was wonderful to see many of them thriving in their 80s and 90s and being active, and independent, and you want to know how they were able to achieve that.  We now have more than 20 years’ worth of research data that will help us learn more about healthy aging in addition to what we will continue to learn about cardiovascular disease. I am very excited and optimistic about the future of the Jackson Heart Study as it continues to have a positive impact on the community and across the country.