When Health and Nutrition Sciences Assistant Professor Margrethe Horlyck-Romanovsky started teaching at Brooklyn College just over a decade ago, she taught a course on community nutrition. In it, students learned to conduct local community health assessments by gathering information from residents and supplementing that with publicly available data from published research. “I would assign them to cultural enclaves that I knew existed at the time,” says Horlyck-Romanovsky, “and tell them to focus on this particular population in this particular area.” Most of these enclaves were immigrant communities. The students’ findings were significant and instructive. Consistently, particularly from the Black Caribbean community, students identified concerns about Type 2 diabetes. They documented people being diagnosed with diabetes in their thirties and forties, as well as diabetes-related kidney disease and amputations in older relatives. These findings were surprising, says Horlyck-Romanovsky, because Black immigrants historically have been “generally healthier than the rest of the U.S. population.” In addition, many of the people diagnosed with the disease did not fit the typical risk profile. They did not have obesity and were relatively young. Diabetes is more often expected among those who either have obesity, are older, or both. When Horlyck-Romanovsky and her researchers went to the scholarly literature seeking explanations for what they had found, she was surprised again. They found no published research about the epidemiology, pathology, or risk factors for Type 2 diabetes in Caribbean populations in the United States. “Given that an estimated two-thirds of the Black population in New York City is Black Caribbean, that was truly concerning.” This “embarrassing” lack of scholarly attention confirmed what Horlyck-Romanovsky suspected about public health evidence. “It demonstrates that epidemiological data is presented in ways that perpetuate racist perceptions of people,” she says. “How can we defend grouping people by color first, essentially saying that they are the same, and thereby negate everything else about them?” She decided to take a better approach. Documenting the differences in risk of, and prevention strategies for, Type 2 diabetes among New York City residents of African descent (African American, African immigrant, and Black Caribbean people) became her dissertation topic. After graduating with a Doctor of Public Health from the CUNY Graduate School of Public Health and Health Policy in 2018, Horlyck-Romanovsky completed a postdoctoral fellowship at the National Institutes of Health, returning to Brooklyn College as an assistant professor in 2019. She has continued to examine intraethnic health variation in populations of African descent, which is a focus of the Immigrant Health Lab she runs at Brooklyn College. The lab is currently piloting a diabetes prevention program for Black Caribbean communities for which Horlyck-Romanovsky received a CUNY Interdisciplinary Research Grant in 2022. She collaborates on the project with her mentor, Hunter Professor Ming-Chin Yeh. Horlyck-Romanovsky and her team of student researchers are also in the initial stages of a related initiative to assess the role Caribbean restaurants may play in preventing type 2 diabetes. In 2023, she received a PSC-CUNY Research Award enhanced grant to support a feasibility study for this project. Diabetes Prevention Program Research Coordinator Abena Dinizulu, a Brooklyn College health and nutrition sciences major with a concentration in public health, has been working on the project since last June. The first phase involved reworking the CDC’s diabetes prevention curriculum “so that it is culturally relevant for Caribbean people living in New York City,” says Dinizulu. The second phase, recently begun, is a 16-week online program that aims to help at-risk people from Black Caribbean communities avoid diabetes. Dinizulu is one of six undergraduate students of Caribbean descent who have been trained as lifestyle coaches, certified by the CDC, to support participants in the program. She works with two experts in biostatistics and epidemiology to collect, manage, and visualize the data collected. Horlyck-Romanovsky is clear about the importance of the student researchers’ role, and her own goals. “My students come from the underrepresented communities we work with [on projects], which motivates them to be involved and builds trust and credibility within the communities,” she says. While serving those communities through research, Horlyck-Romanovsky is also steering her students toward and preparing them for research careers. “We [faculty and mentors] have a huge responsibility to give them a preview of what it can look like when they get out there as researchers in their fields.” The Immigrant Health Lab has also received a recent $1.1 million contract from the National Institute for Minority Health and Health Disparities, part of the NIH, to conduct research for the New York City Ghanaian Immigrant Mental Health and Well-Being Project.
