Chapter 11: The Intercultural Council; the Biennial Symposium, The Center for Research on Minority Health

Title

Chapter 11: The Intercultural Council; the Biennial Symposium, The Center for Research on Minority Health

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Description

Dr. Jones begins with stories to demonstrate the positive impact of the Biennial and how it advanced awareness of the health disparities movement. Next, he tells how he met with Arlan Specter (Senator, Pennsylvania) and eventually convinced him to appropriate money for a study that showed the lack of focus on health disparities, a precursor to the creation of a new NIH institute, the Office on Research on Minority Health. Dr. Jones next tells the story of forming the Center for Research on Minority Health. He describes how the Center was set up and positioned within MD Anderson. He explains its mission and initiatives directed at closing the gap in health disparities through science and education. Dr. Jones explains difficulties in sustaining his connection to the Department of Health Disparities Research after his retirement.

Identifier

JonesLA_02_20140116_C11

Publication Date

1-16-2014

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - An Institutional Unit; The Leader; The Professional at Work; MD Anderson and Government; Beyond the Institution; Inspirations to Practice Science/Medicine; Experiences re: Gender, Race, Ethnicity; MD Anderson Impact; MD Anderson History; Gender, Race, Ethnicity, Religion; Diversity at MD Anderson; Women and Minorities at Work; Institutional Mission and Values; Personal Reflections, Memories of MD Anderson

Transcript

Tacey Ann Rosolowski, PhD:

But let's return to those activities that were kind of linked with the Biennial, and then we were talking about the Research Center, because you told the story about the Biennial. What about the founding of the Research Center, which came on the heels of that?

Lovell A. Jones, PhD:

Well, actually, it came on the heels of the Intercultural Cancer Council.

Tacey Ann Rosolowski, PhD:

Oh, okay. Well, let's talk about that first.

Lovell A. Jones, PhD:

The Biennial, at the end of the fourth Biennial, several individuals approached me and said, "You know, we have this meeting every two years, and we sang all these "˜Kumbaya,' but we have no way of really formally implementing all the good things that are coming out of it, and so we need to form some sort of organization." And it was Pam Jackson [phonetic], who worked for me, who was a staff assistant. Actually, even if she worked for me, her title was staff assistant to the president. Because of her pay grade and what she was coming from, that was the only thing that really fit, and her salary was paid by the NCI grant to create the National Black Leadership Initiative on Cancer.

Tacey Ann Rosolowski, PhD:

Which we also have not talked about. (laughs)

Lovell A. Jones, PhD:

So she said, "Why don't we call it Intercultural Cancer Council," and that's how it got the name. And then there was another woman, Bobbi de Córdova-Hanks, who said, "Well, we all speak with one voice," and that's why the tagline ended up with ICC of "Speaking With One Voice."

Tacey Ann Rosolowski, PhD:

How interesting. Now, let me back up for sec, because you said one of the main reasons you were approached was that the Biennial was producing a lot of positive effect, but I'd like to get a sense of what those positive products were.

Lovell A. Jones, PhD:

Well, this was the first time that all communities had met together. By the fourth biennial, it was poor whites, people of color, Pacific Islanders, even had some foreigners coming in for the meeting, just to see how we were doing-actually had a couple people from Russia come in-to see how we were doing and how all of these different diverse communities were actually under one roof. It was a sharing of knowledge, a sharing of scientific knowledge. We had leaders in the field come in to talk about major breakthroughs in cancer, and I told them to put their presentations in short snippets on prevention, treatment, and education, and do it in a way that if they were asked by CNN to give a short snippet, to do it the same way so that people would walk away with not an hour-long presentation, but very short snippets so we could get a lot in. In fact, that has consistently been rated as one of the highest sessions of any of the meetings. And then we focused on different issues that were the topic of the day. In terms of bringing in leaders, we've had people attend, all the way from the vice president down to the little old lady sitting on the stoop, to speak, and so it's probably one of the most diverse meetings you would ever attend. And I think it allows-I'll never forget, one woman said, coming back, said how that meeting had not only impacted her, but her family, specifically her son, who was not listening to her and doing certain things. And she made the comment how she had met Harold Freeman and had talked to him about his efforts, and he said, "Oh, Mom." And Harold had given her his personal number, and so she got on the phone and called. She says, "Son, I have somebody here who wants to talk to you." And it so impressed him that she had climbed above where she was and was moving on to doing different things, that it changed his whole outlook on life.

Tacey Ann Rosolowski, PhD:

Wow.

Lovell A. Jones, PhD:

There was one woman who I met here, was a cancer patient here, was one of the few minorities that at the time worked in the Patient Assistance Center here, and I met her when I walked past her in the hallway and she pulled me in, and she saw me with my lab coat on and she said, "You work here?" And I said, "Yes, I do. She said, "What do you do here?" And I told her, and she says, "Are you really a faculty member?" She said, "You're the first black faculty member I've seen, and I've been here for five years." I said, "Yep, I am." Anyway, she came to the Biennial. She actually was one of the founding members of the Intercultural Cancer Council on its board. But the reason I mentioned her is that she had not finished high school, but prior to her death, she got a GED, she went back and got a bachelor's and she got a master's. And I used to say, "What are you going to do with these?" And she says, "It's not what I'm going to do. It's the example I'm going to show to the kids in my neighborhood. If I'm at the age where the gray matter is not functioning as well as it should be functioning, and I can go back and make things happen, then they, too, can go back and make things happen. So instead of just seeing me sit on the stoop, they're seeing me doing something about my life." So the Biennial led to really, in my mind, the whole movement in terms of health disparities on a national level, simply because it educated policymakers. It triggered National Minority Cancer Awareness Week across the nation, which is still held in different places. It led to the revitalization of National Minority Health Month, which is April, which is now celebrated. So it led to, as I said, the creation of the Intercultural Cancer Council, which has led to major policy changes. A lot of the IOM studies initially in the nineties, early 2000s, were either initiated or pushed by the Intercultural Cancer Council. The unequal burden was a direct result of the Intercultural Cancer Council. Then I met with Arlen Specter and invited to meet with the chief of staff of-Arlen Specter was a friend of a friend, who arranged for me to meet with him. I met with him the first time, laid out what I thought needed to be done. Then I told him that the data he was using in Pennsylvania was not [unclear] data and that his Cancer Registry was probably very poor in terms of data and that sort of thing. And he kind of looked at me and thought I was speaking heresy, but then when he invited me back, he started off and he said, "The reason I'm inviting you back is that everything you said to me was true. And secondly, but most importantly, you don't need to be here. We've looked you up, and you're well funded and you're a premier scientist in your own right, so you're not here just because you can't do anything. You're here because you're really concerned." And so he appropriated money for the IOM to do the study. It took two years, because the first year NIH refused to spend the money on the study.

Tacey Ann Rosolowski, PhD:

And I'm sorry, the organization that ran the study was?

Lovell A. Jones, PhD:

The Institute of Medicine. But Harold Varmus refused to spend the money. As director of NIH, he said there wasn't a need. Then we went back to Arlen Specter and said, "Hey, they're not doing it." So he then tagged the money going to the NIH budget with the proviso that if they didn't spend it, they couldn't spend the other. (laughs) And so they did the study, but then they hired a team to investigate each of the members, more so than they normally would, because they didn't want any, as they said, "ICC infiltrators" to be a part of the report.

Tacey Ann Rosolowski, PhD:

Interesting.

Lovell A. Jones, PhD:

But the report came out the way we thought [unclear]. (laughs) I mean, the evidence that we knew was there, and if they looked at it in the appropriate way, would indicate that they weren't doing what they should be doing.

Tacey Ann Rosolowski, PhD:

Now, the scope of this study was?

Lovell A. Jones, PhD:

Well, I had asked Arlen Specter to investigate the entire NIH for racial discrimination, and he looked and laughed and basically said, "Are you crazy?" (laughs) And his response was-and that's how it ended up being NCI-he said, "If you investigate the top dog, then the rest of the dogs will follow, and we can't look at it as discrimination. We just say that we're looking at the proportion of dollars that they are focusing on in terms of investigating these disparities and seeing if the gaps match the dollar figures that they are placing to address the issue." I said, "Good. I'm satisfied with that."

Tacey Ann Rosolowski, PhD:

And the findings?

Lovell A. Jones, PhD:

The findings were they weren't focusing on issues and that they needed to redirect their efforts. A lot of that report helped to shape the creation of and the advancement of what started off as Office of Research on Minority Health. It helped push it to a national center, and then it provided the basis for it to be moved to an institute. So part of the efforts of the ICC, although not entirely, but a good part of it led to the creation of the National Institute for Minority Health and Health Disparities.

Tacey Ann Rosolowski, PhD:

And that's here.

Lovell A. Jones, PhD:

No, that's at NIH. That's one of the institutes at NIH.

Tacey Ann Rosolowski, PhD:

Okay. Okay.

Lovell A. Jones, PhD:

But it also led to-well, one of the things, in forming the ICC, I got a chance to interact, and I had met Ken Benson through his uncle, Lloyd Benson, because Ken served as an intern at one time in the office, and got to know Ken and his wife, Tamarind Benson, pretty well and had talked to them about my vision of the three-legged stool, the education, policy, and research, and that in research I wanted to create a center and a holistic kind of approach to addressing health differently than any other center, that it was a center that would not be funded through the normal NIH mechanisms. And I first attempted it through Patton Boggs, which is a major lobbying firm in D.C.

Tacey Ann Rosolowski, PhD:

Can I ask you why you wanted to avoid the normal funding mechanisms?

Lovell A. Jones, PhD:

Because they wouldn't fund it. I mean, even after NIH and NCI, I mean, and the institutes, although they are changing and changes have [unclear], are in boxes. Either you're going to submit it for research or you're going to submit it for community engagement, but never the twain meet. And although the Center grants that they are now funding are kind of a hybrid of moving that direction, they still don't do it in the way that they should be doing it, but they are moving in that direction. How fast they get to where they should be is debatable. So I knew that the only way of getting the Center funded was through this mechanism and to demonstrate that it is a functioning mechanism that will lead to results, and so Patton Boggs, working with some of the congressmen on the Hill, was able to get me $5 million to begin the development of the Center. Anderson turned the money down.

Tacey Ann Rosolowski, PhD:

Why?

Lovell A. Jones, PhD:

They said they weren't ready to deal with minorities at that time.

Tacey Ann Rosolowski, PhD:

And what year was this?

Lovell A. Jones, PhD:

Let's see. That was '97.

Tacey Ann Rosolowski, PhD:

Gosh. Now, what is your evaluation of that? Did you feel the institution could have handled it? What did it mean to not be ready to handle minorities?

Lovell A. Jones, PhD:

I think they weren't ready for me.

Tacey Ann Rosolowski, PhD:

Okay.

Lovell A. Jones, PhD:

It wasn't their idea. And so I remember I was at a dinner party in '99-a dinner party. It was a banquet, actually, that was honoring me for my efforts in terms of helping Sisters Network get started. When Sisters Network was in its infancy, I was the scientific director and supported it, and then actually trained one of my mentees to take it over, and she's done a fantastic job; Lisa Newman [phonetic] out of Michigan. But Tamarind turned and she said, "How is your Center coming?" I said, "It's not." She said, "What do you mean, it's not? What did you do with all the money?" I said, "We didn't get any of the money," and I explained to her what had happened. And then she turned to Ken and she said, "Well, Ken, I think we can do something about it." And he looked at me, and it's like, "You know what happens to people who ask for money from Congress and have to give it back." I said, "I know," because you do not ask Congress for money and not spend it, because it goes back to the Treasury. And in going back to the Treasury, if you ask for 5 million and didn't spend the 5 million, that means that they lose 10 million the next year in that budget. And people do not like to lose money.

Tacey Ann Rosolowski, PhD:

Right, right.

Lovell A. Jones, PhD:

And so I didn't have a lot of friends. I had former friends at CDC, because that's where the money was being appropriated through. And he looked and he says-and then he looked at Tamarind and he realized he was going to have to do something. To make a long story short, November 19th, 1999, I got a phone call from Bradley Edgel [phonetic], who was Ken's chief of staff. She says, "I have good news and bad news." I said, "Tell me the bad news." "Well, the bad news is you're getting some money." "What's the good news?" "The good news is you're getting some money." I said, "Huh?" "Well, let me explain. You asked for 5 million. They're giving you 500,000. The discussion was that they could tolerate 500,000 coming back. They could not tolerate 5 million coming back for a second time. And what Ken is asking you is to say nothing to no one and let him come and do a major press conference in the middle of the Medical Center and let's see if they give it back then."

Tacey Ann Rosolowski, PhD:

Yeah.

Lovell A. Jones, PhD:

The rest is history.

Tacey Ann Rosolowski, PhD:

Wow. Hmm. So who was involved in setting up the Center? How did all that work? How was it designed? (end of first audio file for January 16, 2014) (beginning of second audio file for January 16, 2014)

Lovell A. Jones, PhD:

There were some close-Angelina Esposa [phonetic], who's now head of Health Equity and Patient Navigation at American Cancer Society, was chiefly involved. She had been the young college student that worked with me on the Tri-Ethnic [unclear] in terms of getting it done before she left to go work for industry and earn big bucks. Janice Jolson [phonetic], who was a staffer with me, and Richard Heyjack [phonetic], who was my graduate student and ended up working as head of my research group, I think those were the key individuals that sat down. But the overarching idea and the components and that sort of thing came from just years of seeing what worked and what didn't work, and that was in the proposal that went to-and that was reviewed by a number of people across the country: Mun Chin [phonetic] and Frank Pendegrass [phonetic], Marjorie [unclear]. There was a whole slew of about ten scientists and activists who I circulated and said, "This is what I want to do. What do you think? Is it feasible?"

Tacey Ann Rosolowski, PhD:

And what did you say the mission was?

Lovell A. Jones, PhD:

The mission was to close the gap through science and education. And what I wanted to do, although I was never able-well, I was for a short period of time-was I said to Congress, the main hub, the main focus, the main center of this, would be the community, and that I wanted a community representative for each of the major populations: Hispanic, African American, Asian American, Native American, and poor white. Never was able to get the poor-white one funded. Nobody wanted it. [unclear]. But I was able to get, through various means, the other four, and we had four at one time, and, in fact, those four individuals-actually, the first individual who did all four was Angelina Esposa. She went and worked with Hispanics, Native Americans, African Americans, Asian Americans, and put that together. And then we laid the basis and was able to get money to hire all the other coordinators for a period of time, and those coordinators actually helped firm up or establish each of the minority health organizations in the city of Houston: the African American, Hispanic, Asian American, and Native American. One of the conditions of getting the money came from Senator Inouye, who was chair of Senate Appropriations Committee, and he put a rider on the money, and that rider-and became an extremely good supporter of what we were doing-was that we needed to do a health survey of the Asian American community here in Houston in the southeast part of the state. And I definitely told people I thought it was going to be very easy. I figured I'd go to [unclear] and [unclear] and get all the data. And then when I started to look at that, I realized their data was rubbish because, for instance, for a behavioral risk factor survey, one year they did 110, another year they did 112, and they all had to speak English. That means they're all acculturated [unclear], so the answers they gave were answers they were asked to give. So we spent two and a half years developing a survey and implementing it to determine the health status of Asian Americans, Vietnamese, Chinese were the first group. We were going to do others, but couldn't get support to do that. But we did two of the three largest. The second largest is Asian Americans, and what we're doing is Indian Americans. And one of my faculty that is still here is doing it outside the institution in terms of that survey, because we promised them, and they came up with the money for us to do it. So at the end of this year, we will have the top three done in terms of health needs.

Tacey Ann Rosolowski, PhD:

Where is the Center located in terms of the structure? I mean, is it related to a division at MD Anderson?

Lovell A. Jones, PhD:

Well, the Center originally was freestanding and under the Office of the President. That's how it was originally established. And then they moved it to the Office of Institutional [unclear], so I was under Harry Gibbs [phonetic] for a while. Then, good or bad, I made a push to make the Center a department, and I made that push because David Gershenson, who ended up being quite supportive of what I was doing after the run-in we had over my promotion, came to me and said, "Lovell, you know I'm supportive of you," he said, "but, you know, performance of the clinical departments are based on income from the clinical faculty. I have all these basic people that you've hired through your Center. It seems to me that-and I can't hire any more, because hiring some more would mean impacting my ratio. Unless you hire clinicians, which I know you aren't, you need to do something about that." And the only way that one could do that was create a department. So I approached administration, wrote up a proposal, met with some of the people I knew who had put together proposals for departments here at the institution, and worked with them over a period of time to put together a proposal. And then I was met with strong resistance and then told, "Well, if we're going to create a department, we're going to have to create it in the School of Allied Health Sciences." And I said, "Well, that would be a department of unequals, because the guys in the School of Allied Health Sciences don't have tenure-track positions like they do in the regular institutions." And they said, "Well, we don't see the value of creating a department in the institution, but you're free to put it together, put a proposal together." So I put the proposal together, and I thought it was a very good proposal. Then one day I was called in and I was told that, "Well, we've decided to create a Department of Health Disparities Research." "Okay. Well, what about the Center?" "Well, the Center will be a part and under the new department." I said, "Interesting." And then when they showed me the proposal, it's the proposal I had put together.

Tacey Ann Rosolowski, PhD:

Okay. That's how that connected.

Lovell A. Jones, PhD:

And so in the end- (laughter)

Tacey Ann Rosolowski, PhD:

Ai-yi-yi.

Lovell A. Jones, PhD:

And then I was told that I was better off serving on the search committee than applying for the position, and I said, "No, I'm going to apply for the position." And then after the position was selected, a group met with me and said, "You know, you were the most qualified candidate, but we knew the institution wouldn't appoint you." And I said, "Well, you're doing the institution's role for them, because, hey, you let them make the decision, not you."

Tacey Ann Rosolowski, PhD:

Right. Who was selected as chair, director of that department?

Lovell A. Jones, PhD:

Well, the first person that was selected was Emily Ramirez [phonetic]. She turned it down. She said, "I can't be your boss." She called me up and said, "I can't be your boss." Then the second person was a guy out of National Mental Health Institute, and he said, "You know, I just don't see it." Then the third person that was on the list was David Wetter [phonetic], who's now the current chair.

Tacey Ann Rosolowski, PhD:

Okay. Yeah.

Lovell A. Jones, PhD:

And so my issues continue and I said that, "You have a department where the majority of individuals-." Well, the original department, when it originally started, the majority of the faculty were white and female, and I said to the institution, which didn't go over well, I said, "So let me create a Department of Women's Health and I be chair and I hire all black males. Then it would be equal." (laughter) "Well, Lovell, you just don't see [unclear]." "No, I see it very clearly," I said. And as I constantly say, I said, "Who you are determines the solutions to the problem." And I said, "You may end up with a department that gets a lot of money, gets a lot of grants, publishes a lot of papers, and everybody's happy, but the results in terms of output may not be where you want it to be." And that's where we are today.

Tacey Ann Rosolowski, PhD:

Wow.

Lovell A. Jones, PhD:

So with me, I don't know that the Center will remain. The staff, all the faculty that I recruited have left, with the exception of Beverly Gore [phonetic], who's still here. Angelina-no, Isabel Torres [phonetic] is now in another department here at the institution, but she's looking. The only other African American male basic scientist who I recruited, who was my fellow, is now at the University of North Texas at the School of Public Health. He's gone. There was no attempt made keep him when he announced that he was looking.

Tacey Ann Rosolowski, PhD:

Interesting.

Lovell A. Jones, PhD:

And my chief administrator, her last day is going to be February 13th, and my former secretary, her last day is February 13th as well, and the head of my research group, his last day is August 31st.

Tacey Ann Rosolowski, PhD:

So did the Center continue to be free or was it absorbed into this department?

Lovell A. Jones, PhD:

It was absorbed.

Tacey Ann Rosolowski, PhD:

It was absorbed. Okay. Okay. Because you are an emeritus professor in that department. So you became part of that officially?

Lovell A. Jones, PhD:

No, no.

Tacey Ann Rosolowski, PhD:

No?

Lovell A. Jones, PhD:

Nuh-uh.

Tacey Ann Rosolowski, PhD:

Huh.

Lovell A. Jones, PhD:

No. System [University of Texas System] gave me the title, but this institution does not recognize it.

Tacey Ann Rosolowski, PhD:

How interesting. Huh.

Lovell A. Jones, PhD:

So when I got the title, I made the wrong assumption. I said, "Hmm. Okay, I'll get email, and if I can generate funds, I'll get an office and the whole bit." So on the week before I was leaving, I got a note from-what's his name? The vice president for academic affairs here. It'll come to me. Anyway, he sent me a note and he says-I sent a note and I said, "Thank you. In terms of maintaining my email, I have these grants coming. It will maintain part of my salary. What can I expect from the institution in terms of support going forward?" And he wrote back and he says, "There must be some mistake here. Your email will stop on August 31st, you will have no office, and as far as grants are concerned, we're transferring those to other people." So a couple of my friends on the East Coast sent me a-I decided to wear it today. I said, "I'm going to wear it." They sent me a set of t-shirts that says "Professor Emeritus, University of Texas MD Anderson Cancer Center, and the only thing I got is this t-shirt." (laughs)

Tacey Ann Rosolowski, PhD:

And we're talking about Oliver Bogler [Oral History Interview]?

Lovell A. Jones, PhD:

Mm-hmm.

Tacey Ann Rosolowski, PhD:

Yes. Okay. Yep.

Lovell A. Jones, PhD:

And then my exit interview, I said, "It's interesting that you treat-it sends a message, a very strong message, and maybe it's the message you want to send, but your first African American basic science faculty, first to be promoted to full professor, first to hold administrative title here, and the first to become professor emeritus, you have no relationship." So I said, "Well, maybe they want to separate some distance." So I wrote to-and maybe this is the reason [unclear]. So I wrote to the system and I wrote to the new executive vice chancellor for Health Affairs, who I've known tangentially, Greenberg, Richard Greenberg [phonetic], and I said, "Richard, I just want to see what your opinion is. I have these two new grants that I'm getting that will easily pay part-time status, 20 percent. It won't pay any more than that. So I could still maintain my retirement. Is there any reason that MD Anderson can't do that?" He says, "Why are you asking me this? That's not an issue." I said, "Okay." I said, "Well, I'm just asking." He said, "Ask. Send a note and ask." So I wrote up an email, copied him on it, didn't get a response. No, I wrote it and just sent it from me. Didn't get a response, so I sent it again and I copied him on it. And then the response that came back was, "We entertained your suggestion and we are regretful in that we have to decline." I said, "Well, okay." And what I didn't realize is that they had asked one of the grantees to replace me with another person here at the institution, and they refused. They said, "No."

Tacey Ann Rosolowski, PhD:

Interesting.

Lovell A. Jones, PhD:

So Anderson and the graduate school is no longer involved in that grant, and that grant actually is to mentor minority kids. (laughs) So I guess they still aren't ready.

Tacey Ann Rosolowski, PhD:

Yeah. Yeah. I need to stop for today.

Lovell A. Jones, PhD:

Sure.

Tacey Ann Rosolowski, PhD:

But I would like to take a little time after we turn off the recorder, find another time next week or the week after. That would be great. Okay?

Lovell A. Jones, PhD:

Sure.

Tacey Ann Rosolowski, PhD:

Thanks very much for your time today.

Lovell A. Jones, PhD:

Oh, sure. My pleasure.

Tacey Ann Rosolowski, PhD:

Very interesting to talk to you. And I'm turning off the recorder at 12:37. (end of session two)

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Chapter 11: The Intercultural Council; the Biennial Symposium, The Center for Research on Minority Health

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