Alejandro Diaz Shines Light on Respiratory Conditions Among Understudied Populations
Alejandro Diaz
Long before his career in clinical research began, Alejandro Diaz, MD, MPH, was drawn to the world of medicine. Growing up in a small town in Chile, he was no stranger to hospitals, regularly accompanying his younger brother to receive treatments for a severe seizure disorder or helping friends go to get treated for minor soccer-related injuries. Physicians were dinner guests at his home and these experiences, along with his father’s encouragement, eventually shaped Diaz’s decision to become a doctor.
During his medical residency at the Hospital de Clínicas in Argentina, he became interested in respiratory health. His work on pneumonia and its effect on the elderly drew the attention of Carlos Luna, MD, PhD, a senior member of the hospital. Luna’s mentorship and guidance helped cement Diaz’s interest in pulmonary health research.
“It is very stimulating to have someone tell you that your work is important,” Diaz said. “From that point on, I never lost interest in research. That was the start of my career.”
Community at the Brigham
Now, Diaz is an associate professor of Medicine at the Harvard Medical School and lead investigator in the Division of Pulmonary and Critical Care Medicine at the Brigham. When he first came to the Brigham, he joined a small group of people who were just starting an imaging lab to study disorders like chronic obstructive pulmonary disease (COPD) and bronchiectasis. Today, he works with the same group at what is now the Applied Chest Imaging Laboratory.
“I consider myself lucky,” Diaz said. “I’ve had incredibly productive interactions with many scientists who are interested in working together. And resources are always made available quickly for any kind of work. It’s really incredible.”
Diaz’s research interests include the use of lung imaging to characterize airway diseases and develop imaging biomarkers. His work has earned him several accolades, including the 2013 Brigham and Women’s Minority Career Development Award and Principal Investigator of National Heart, Lung, and Blood Institute awards.
New Avenues for Research
His recent work on the respiratory health of Latino and Hispanic populations has helped identify risk factors for early COPD. Earlier studies examining risk of COPD have focused primarily on older and white populations, leaving younger and minority groups understudied. Diaz and his colleagues found that Latino/Hispanic immigrants have a lower chance of developing early COPD (i.e., before the age of 50) in comparison to U.S.-born individuals. They also found that asthma and smoking can increase chances of developing early COPD, despite the fact that U.S. Latinos and Hispanics tend to smoke less on average than other groups.
To Diaz, these differences in susceptibility offer new and interesting avenues for research to look into possible underlying genetic influences. He also points out the importance of environmental factors that can affect the respiratory system.
“Approximately 39% of all workers in the ‘building, grounds cleaning and maintenance sector’ are Hispanic,” he said. “They are regularly exposed to cleaning and disinfecting products that increase their risk of developing other respiratory diseases like chronic bronchitis.s”, .
Diaz and colleagues recently studied and documented this increased risk using data from the National Institutes of Health-funded Study of Latinos.
Diaz explains that understanding the influence of such environmental factors on disease risk factors is important for the bigger picture of healthcare in the U.S. and could help influence policy decisions on what types of products are allowed for frequent use.
Making Healthcare Accessible
To Diaz, ensuring treatment is as important as uncovering causes of disease. The difficulty of navigating a complex healthcare system can be a barrier to people who are not proficient in English. Diaz stresses the importance of making these systems more accessible.
“Making an appointment online can be hard for people who are fluent in English,” he said. “Now imagine trying to navigate an appointment application as someone with limited English proficiency.”
Although the U.S. has no official language and is home to over 300 spoken languages, English is the default language almost everywhere in the U.S. healthcare system. Those who identify as having Limited English Proficiency (LEP) have a right to request medical interpreters to help bridge this gap, but this service is not always available at all healthcare providers.
Diaz is also concerned that, in addition to language, immigration status may also be a deterrent to those seeking medical care. Undocumented individuals may avoid the healthcare system altogether out of a fear of deportation. Latinos under the age of 65 are also the most likely group in the U.S. to be uninsured, adding yet another layer of difficulty to the problem.
Bridging the Gap
Dr. Elsie Taveras (second from left), MGB Chief Community Health and Health Equity Officer, and Dr. Priya Sarin Gupta (third from left), MGB Medical Director for Mobile Health Initiatives, stand in front of one of the Mass General Brigham Community Care Vans with members of the mobile health team. The Community Care Vans are designed to expand access to health care services across diverse communities in the Greater Boston area
“There’s a lot of work to be done to counter these issues,” Diaz said. “Mass General Brigham has had some great initiatives in this area, especially with the mobile clinic to get people vaccinated.” One initiative that comes to mind for Diaz is the Community Care Vans program, which started during the pandemic. When it launched in 2021, the program provided COVID-19 vaccines to underserved and minority populations in the Boston area, more than half of whom self-identified as Hispanic. Since then, the program has expanded to include screening and treatment options for diabetes, hypertension and substance abuse disorder.
Diaz believes education can bridge gaps in health care. He teaches Medical Spanish at Harvard Medical School to a diverse group including local medical students and often international participants in non-profit programs like those run by Partners in Health.
“It’s a pleasure to see how interested these students are in improving their communication skills,” Diaz said. “They do this because they want to serve their patients better and that’s really what motivates me to teach. There’s a lot you can learn from them and their experiences.”