NIH Grants Rita Hamad a K08 and Four Years of Support

Over the past three years, the NIH has funded between 13 and 16% of new investigators’ grant proposals. For young researchers, such funding has become rare and precious.

Months after learning that her NIH grant proposal had received a competitive score, Rita Hamad, MD, MPH (instructor, General Medical Disciplines), was officially notified that her K08 would be funded. This covers 75% of her salary for four years, reducing her clinical responsibilities in order to develop her research career.

Hamad, who began her baccalaureate education at Harvard expecting to end up an economist, is most interested in the relationship between social and economic circumstances during childhood and the effects they have on one’s education, job prospects, access to food and medical care and, ultimately, health outcomes.

The topic is timely, Hamad says. “Especially today with all the dialogue about inequality, and how wealth is increasingly concentrated among the top 1%, a lot more people are beginning to notice the connection between poverty and inequality and health.  My goal is to study them more rigorously so that we can come up with solutions.”

The title of Hamad’s grant proposal is “Assessing the Impact of Educational Interventions in Reducing Disparities in Hypertension and Other Related Biomarkers.” Put simply, her hypothesis is that people who grew up in areas where there is better school quality are going to have lower levels of cardiovascular disease later in life.

To begin to dig into the topic, she will look at educational policies, seeing how they have affected different kinds of disease outcomes. In more detail, she says, “I am looking at how different markers of school quality and educational policy affect cardiovascular outcomes decades later by following these people over time.  For example, how much money are we spending per student, how many students are assigned to each teacher, what is the length of the school term?”

There are many ways to imagine that better education is better for health, Hamad explains: “The theory is that those who are exposed to a higher quality education are more likely to have a better job, have more money to buy better food, have access to better health care, eat healthier, be less likely to smoke, and so on.” But how do you prove it? Here is where other Stanford resources play a significant role in answering the question and, in the process, developing a research career.

“Mark Cullen [MD (professor, General Medical Disciplines and director, Center for Population Health Sciences)] is my primary mentor on the K08 grant. My research proposal has a couple of different aims that rely on some of the data sources that are either at the Center for Population Health Sciences or that the Center has connected me with. That is a huge resource from which I’ve gotten to benefit.”

One of Cullen’s goals when he became the inaugural director of the CPHS last year was to acquire databases that researchers all over the Stanford campus could study from different vantage points. He describes the range of them in these words: “Databases include such things as health claims records on large populations, electronic health records, genetic and ‘omics’ data, and large administrative sets that capture snapshots of peoples' lives such as their housing, occupational activities, and the like.”

Hamad’s research capitalizes on several of those databases as well as others.  “One of the advantages of these big databases is that I get to follow the same people for several decades. Some of them I only see at one point in time when they are older. But because I know where and when they were born, I can figure out what educational policies they were exposed to when they were younger and see how that has affected their health later in time."

People are beginning to notice the connection between poverty and inequality and health. My goal is to study them more rigorously so that we can come up with solutions.

The K08 grant funds additional aspects of a young investigator’s research career. Hamad explains that “the point of the K08 is not just to pay your salary but to give you time to conduct research, to get out publications, to get additional training to learn more statistical methods or other content areas, and most importantly to be a better health researcher.” Hamad’s earlier funding through “a Baby K” award, a KL2 through Spectrum, would have underwritten a master’s degree.  Because she already had a master’s, she was able to transfer that benefit to studying for a PhD in Stanford’s Division of Epidemiology, which was serendipitously recruiting its first class when she was casting about for a source of additional training.

What are the next steps for someone like Hamad who has received early NIH funding? In addition to beginning to uncover some results of her research, which she hopes to publish in the next few years, she plans to take the next step up the NIH ladder. As she says, “After K level grants, the next level of NIH-funding would be the R01, often for 5 years. Those are getting increasingly competitive these days. In the same way that the KL2 helped me become more competitive for the K08, the hope is that the K08 will help me prepare well for the R01.”

There is also the hope that her research findings will stimulate some focus on developing educational policies that will lead to a better-educated citizenry with better health outcomes.