Addressing Health Disparities in Rural Areas: New PhD Graduate Uses Health Economics to Study Patient Choices

Street view of New Kensington, PA. Cropped from an original photo by Jon Dawson (CC BY-ND 2.0).

Marquita Decker-Palmer, MD, PhD, MPH, earned her PhD in Clinical Investigation in 2017 with a dissertation titled Modeling Health Preferences and Cost-Effectiveness of Current Breast Cancer Screening Technologies to Inform Policy, Practice, and Prevention Strategies.

In her new position as Research Assistant Professor in the Jefferson College of Population Health at Thomas Jefferson University, and Associate Director of the 1889 Jefferson Center for Population Health in Johnstown, Pennsylvania, she engages small town and rural community stakeholders in research aimed at improving population health.

These communities in rural Western Pennsylvania reside in a formerly wealthy area impoverished after the decline of the coal and steel industries. In working with them, Decker-Palmer will apply the multidisciplinary education she has obtained through the ICTR PhD in Clinical Investigation, including skills in health intervention design and implementation, econometric analysis, outcomes assessment, and measurement of health preferences.

Marquita Decker-Palmer, MD, PhD, MPHAs part of the Center for Population Health in Johnstown, PA, I will be working with community groups and local health systems to engage members of the public in making decisions about how to address key public health issues in the region – diabetes, obesity, addiction, tobacco use, depression, and suicide.

We hope to find innovative ways of improving population health in a way that is tailored to the needs of small towns and rural communities, which may differ from the ways we approach health at major academic medical centers. It will be fascinating and informative to see how best practices in population health may differ from urban to rural settings.

She began her work with ICTR through the Certificate program in the Fundamentals of Clinical Research as a post-doctoral research fellow in Surgical Oncology  (NCI T32 CA090217) in the UW-Madison Department of Surgery. After earning the certificate, Decker-Palmer was awarded a US Fulbright Scholarship grant to pursue health economics research on breast cancer screening at Erasmus University in the Netherlands. She found that academic experience so rewarding that she decided to pursue further research education as a doctoral trainee in health economics (NIMH T32 MH018029) with John Mullahy and David Vanness at the UW Department of Population Health Sciences.

Her PhD included an academic minor in Population Health. Vanness, her major advisor, notes,

David Vanness, PhDMarquita’s dissertation embodies the multidisciplinary team science approach that ICTR promotes. Her research breaks new ground by applying Bayesian statistical methods not just to the analysis of clinical outcomes, but also to the fundamental question of how patients think of their own quality of life during different phases of breast cancer screening and treatment.

Marquita’s work will help patients, clinicians, and policy-makers make better informed decisions about their health care. I am excited to follow her research career as she applies and extends her dissertation research into community-based projects.

Her dissertation committee consisted of two health economists (Vanness and Mullahy), a cancer epidemiologist (Amy Trentham-Dietz), a clinical radiologist (Elizabeth Burnside), and a philosopher (Daniel Hausman). The flexibility of the PhD program in Clinical Investigation allowed Decker-Palmer and  Vanness, to design a rigorous, multidisciplinary curriculum that prepared her for the next stage in her career.