Charles Agyemang: The challenge, especially with minority populations, is building trust

Some communities may seem hard to reach, but the real issue is that we don’t know how to connect with them, says Charles Agyemang, professor of Global Migration, Ethnicity and Health at the University of Amsterdam. As a member of JACARDI’s Scientific Advisory Board and an expert on ethnic inequalities in health and non-communicable diseases, he shares his experiences in working to connect with and empower minority communities. We also discussed the importance of addressing diversity in Europe and how JACARDI is leading the way.

What significance does JACARDI hold for you and your organisation in terms of its mission and values?

JACARDI is bringing a new dimension and aims to change the way things are done at the European level. The extensive network provides an excellent opportunity to interact with people, re-evaluate existing practices, and learn from other countries. It is quite exciting that JACARDI places inequalities at the center of its focus.

For me and my team, this is an opportunity to learn about what is happening across Europe and to contribute to ensuring that care and services related to cardiovascular disease are delivered equitably across Europe, taking into account people from diverse backgrounds such as migrant and ethnic minority groups.

How do you see JACARDI’s role in tackling the increasing prevalence of CVDs and diabetes in Europe?

Over the years, many countries have been working on cardiovascular diseases, but often in silos. When it comes to diversity and its various aspects, such as ethnicity and gender, many countries have been addressing these issues in their own ways and often with limited attention.

Now JACARDI provides an opportunity to raise awareness, share best practices among countries, and develop excellent ideas that can be implemented locally. It also allows countries to assess how far they have progressed, and engage with others in the process. More importantly, it ensures that countries are not working alone in silos. They have a network of people to rely on and seek input from when needed, fostering a collective responsibility to address this issue at the European level.

What is our role in promoting equity in healthcare?

Diversity cuts across the entire project, which is what makes it unique. In other words, regardless of what you are working on in your country, it is essential to apply a vested lens to it. I believe that adopting diversity as a horizontal approach should be the approach that is taken across the world. 

This is the flagship element of the project. Everyone involved is expected to take it seriously and actively work on it. Having a dedicated work package focused on this ensures a constant reminder and provides a source of support for those seeking help. Some countries are more advanced in addressing these themes, and this project creates an opportunity to support countries that are less developed in their approach to diversity.

One important issue is the sustainability of the project’s results. There should be a plan and funding to enable the implementation of the diversity lens across all of Europe and ensure equitable healthcare for everyone regardless of ethnic background, gender, sexual orientation and so forth after JACARDI.

How do you see the significance of considering cultural diversity in the development of treatment for diabetes and cardiovascular disease and what is the most critical aspect of this?

The fact of the matter is that Europe today is very diverse, especially in urban centers. This is a reality, and we must address it. Diversity plays a crucial role in cardiovascular diseases, and understanding it is key to addressing inequalities in health and healthcare.

It also makes economic sense to address these gaps. For example, if we know that a specific group is affected by hypertension and we ignore this, individuals may eventually end up in the hospital with strokes, and society will bear a heavy cost of treating and caring for stroke patients. We should focus on the individuals or groups most affected and implement effective interventions to support them in living healthier lives.

Many of these inequalities are tied to social determinants of health and access to resources. For example, not everyone has the privilege of living a healthy life because of financial constraints, which may prevent them from buying healthy food. No matter how much health information you provide to specific communities, it is not going to be effective if their social and economic circumstances are not right. There must be a plan backed by resources to simultaneously promote healthy life and improve social and economic circumstances among a culturally diverse population.

Do you have any tips or valuable experiences on how to implement research findings in healthcare to benefit both the system and the patients?

It is crucial to involve the communities that matter from the very beginning of the implementation process. Their voices, especially those that are often unheard, must be included. We need to empower these communities, ensuring they are not just recipients but co-creators of the initiatives. By working together with communities from the start, we can ensure that the program is meaningful and sustainable. 

Often, there is a tendency to go into communities and tell them what they should do. Instead, we should focus on ensuring that people are actively engaged in decisions, so that they take ownership of the program. When communities take ownership, they are more likely to ensure the program’s continued success after its initial implementation.

It’s crucial to recognize that long-term commitment is necessary for the success of a program. Governments must invest in supporting communities, especially those from lower economic groups and minorities, as it offers long-term benefits.

Do you have advice on how we can reach different communities?

People often say some communities are “hard to reach,” but the real issue is that we don’t know how to connect with or reach them. In fact, these communities are quite accessible if we approach them the right way and through proper channels.

The challenge, especially with minority populations, is building trust. To truly connect with people, we need to focus on establishing trust and building bridges. It’s about making people feel comfortable and valued. We need to invest time, establish relationships, and co-create with them.

Many times, researchers only engage when they need something, but we should connect even when we don’t need anything. By forming relationships and spending time with communities, it becomes easier to reach out when the need arises.

Charles Agyemang is a professor of Global Migration, Ethnicity and Health at Amsterdam University Medical Centres, University of Amsterdam. He is currently the Vice President of the EUPHA Migrant health section, Secretary of EUPHA’s Governing Board and Scientific Chair of the Global Society of Migration, Ethnicity, Race and Health. He is also a member of the prestigious US National Academy of Medicine and The European Academy. His work focuses on migration and health, particularly in relation to cardiovascular diseases. One of his most notable projects is the RODAM study, which investigates obesity and type 2 diabetes among African migrants.

Learn more about Charles Agyemang and his work here and connect on Linkedin here