In elementary school, Latrice Goosby Landry, A02, N04, N09, M12, thought pills were a normal part of any adult’s dinner, like mashed potatoes or buttered cornbread.
"Everyone in my family had some sort of low-level chronic illness–mainly high blood pressure–that they were treating with medication," she recalls. "They accepted it as inevitable. So I did, too. I just figured that one day I’d probably have the same thing."
Her family’s experience isn’t unusual. Forty percent of black Americans suffer from hypertension, a condition that can lead to more severe health problems, especially if untreated. Consequently, African Americans suffer heart attacks, strokes, kidney failure, vision problems, poor birth outcomes and premature death in far higher numbers than any other racial or ethnic group.
While researchers have been aware of the race-related disparity in heart disease figures for decades, isolating the cause is a politically sensitive and scientifically complex task. It is precise and painstaking work, but Landry welcomes the challenge. With a Ph.D. in nutritional epidemiology from the Friedman School and the first year of Tufts Medical School under her belt, she is involved in new research that may reveal why African Americans are more prone to heart disease than other Americans.
For the last four years, her thesis has required her to shuttle back and forth from the laboratory in Boston’s bustling Chinatown neighborhood to a converted strip-mall in Jackson, Miss., where she has joined the staff of the Jackson Heart Study, the largest ever single-site investigation of cardiovascular disease in African Americans. Landry’s specific research examines the interactions between genes and nutrients and a variety of fatty acids, from "good" monounsaturated fats like the kind found in olive oil to "bad" trans-fats once common in margarine and vegetable shortening and now banned from many restaurant menus.
"We’ve found that depending on what genetic inheritance you have, fatty acids have a different impact on your health," Landry explains. "So, you might be more likely to get cardiovascular disease if you have some genetic traits rather than others. Some drugs might work on you, and some may not."
As a pre-med major at Tufts, Landry enrolled in a graduate class in primary care at the Friedman School. The class taught nutrition students the basic clinical knowledge needed to deal with famine and HIV in refugee camps and international crisis situations.
Landry was fascinated by how many health problems could be prevented with proper nutrition. In 2002, she was accepted to the Friedman School’s Food Policy and Applied Nutrition master’s program, specializing in nutritional intervention.
Though Tufts offered no formal program that coupled a Ph.D. at the Friedman School with an M.D. at Tufts Medical School, Landry convinced deans at both schools that if anyone could meet such an ambitious goal, she could.
"That’s one of the remarkable things about Tufts. If you have a good idea, they’ll help you make it happen," says Landry.
The Jackson Heart Study focuses on the complex interplay of nutritional, genetic and socio-economic factors in a sizeable African-American population. Structurally, it is similar to the Framingham Heart Study, which surveyed three generations of mostly white Americans. But the Jackson study also monitors social stresses that may be unique in their degree and effect on the black, southern population, including perceived discrimination, cultural differences such as religious faith or regional factors like high unemployment rates.
The Jackson data has revealed some interesting differences from the Framingham study. For example, a person who is likely to develop heart disease is also likely to have multiple risk factors–he might not only suffer from high blood pressure, but be overweight, a smoker or diabetic. In African Americans, however, the prevalence of multiple risk factors is extraordinarily high, and the factors themselves are slightly different from those seen in the white population. While whites at risk for cardiovascular disease typically have high triglyceride levels, African Americans tend to have a combination of truncal obesity, hypertension and low HDL, the "good" cholesterol.
Landry is committed to get to the heart of the matter. While her colleagues say her leadership skills will bring her far in the field, Landry says it is simple stubbornness.
"You remember Ashley’s wife, Melanie, in Gone with the Wind?" she says, laughing. "When I was young, I wanted to be just like her, because she was so sweet and unselfish and gracious with everyone. But I realized I had a lot more in common with Scarlett. When someone tells me I can’t do something, I become twice as determined to do it."