“These strategies will move us past band-aid fixes and empower us to truly improve people’s health,” says Cheryl Clark, who was recently appointed executive director of a new, statewide health equity research institute.

Community health centers play a pivotal role in providing affordable, accessible care to underserved populations, many of whom experience poorer health outcomes due to systemic factors such as racism, poverty and other barriers. And yet, for the same reasons, these same patients are often excluded from medical research that could improve their health and well-being.

Brigham hospitalist and health equity researcher Cheryl Clark, MD, ScD, associate chief of the Division of General Internal Medicine and Primary Care, has spent her career working to change that narrative. Now, she seeks to advance that work further as the inaugural executive director of the Massachusetts League of Community Health Centers’ new Institute for Health Equity Research, Evaluation and Policy — a role she will maintain alongside her appointments at the Brigham and Harvard Medical School.

“Cheryl is an amazing health equity investigator. Her deep expertise in diversity, equity and inclusion, ground-level understanding of the needs of the community, and background in social science research make her an inspired choice for this role,” said Elsie Taveras, MD, MPH, chief community health equity officer for Mass General Brigham, which contributed a $1.5 million seed-funding grant to help establish the institute.

The Mass League of Community Health Centers serves as the unifying body for the state’s 52 federally qualified health centers and community health centers, which collectively serve 1 million patients in Massachusetts. Under Clark’s leadership, this new institute will advance what she calls an “emancipatory research approach” to ensure that science benefits communities who bear the greatest human costs of longstanding health inequities.

Clark recently spoke with Brigham Bulletin about her vision for building a healthier society for all.

There are many research institutes out there studying health equity. What is unique about this endeavor?

Cheryl Clark: This is the first time that an institute would be centered on community health centers statewide in Massachusetts to understand the research questions that matter most to them and provide the infrastructure to investigate those questions. That’s important for several reasons. In Massachusetts and across the country, community health centers are the primary place that people of color and people of different socioeconomic status groups receive primary care and dental care — and they get it regardless of ability to pay. When we focus our attention and energy on those populations, it reveals unmet needs that reflect structural racism and inequities.

We are going to be completely focused on ensuring the way we conduct research happens in partnership with people who are experiencing those inequities and prioritizes their experiences. That is unusual even in this field, and it’s what we’re trying to do differently.

You have described your approach as “emancipatory research.” What does that mean?

Clark: Part of what we are boldly doing is calling out and centering structural racism. We know that this is the root of many inequities we see because a lot of what challenges health status is unnecessary and unfair. Why do some of us have to go through so much to get assigned a primary care provider or get medications? Why is it that neighborhood safety and good schools aren’t part of everyone’s life? All of these things are choices that we’ve made socially, so part of what we say when we talk about an emancipatory process is establishing an equitable foundation for everybody.

The word emancipation, in many ways, evokes the experience of African Americans who were enslaved in the United States and what it looked like to change that fundamental relationship with people whose well-being and humanity were harnessed and exploited for the enrichment of some in society at their expense.

How does that translate into a research approach?

Clark: Emancipatory research is a process with a couple of pillars. One is that we really want to address and solve problems that are root causes of health inequities. The second is that people who have lived experience should be the ones prioritizing the topics of research. An important feature of community health centers is that their boards have patient representatives. Understanding the issues that influence health status and health care from the perspective of people who are living that experience is a critical part of being emancipatory. These strategies will move us past band-aid fixes and empower us to truly improve people’s health.

How do you think your career at the Brigham has prepared you for this expanded role?

Clark: I have had tremendous mentorship at the Brigham from folks in the history of our institution like Paula Johnson and JudyAnn Bigby, from phenomenal educators like Joel Katz and outstanding mentors like David Bates and Elizabeth Karlson. Having great mentors and educators has been a critically important part of my own development.

The openness and rigor of the work we do at the Brigham has also been an important part of my growth. We do strong science, and we are committed to seeing good actions come from that science. One tremendous example of this was the work we did during the COVID pandemic. I was part of the equity response leadership team during that time, and it really gave me a sense of the challenges that we face and just how capable we are rising to meet them.

You have been in the health equity field for a while. I’m sure you’ve witnessed hopeful moments of progress but also disappointments. What keeps engaged in this work and optimistic about its future?

Clark: It is important to recognize that this is a long journey. This is something that we’ve been grappling with even before the inception of the country, and we’ve seen change.

In terms of historic bright spots, I have gained a lot of inspiration and hope from health equity leaders who came before us. I have another project where we’re hearing the histories and stories of leaders who launched community health centers, including Dr. Aaron Shirley and Dr. Robert Smith in Mississippi, and other folks who were involved in the movement, even in Massachusetts, like Dr. John Hatch.

So, part of what keeps me going is just knowing the history — staying close to the narratives of activists who have come before us and knowing that you’re standing on their shoulders. I also take so much hope from everyday folks who are committing everyday acts of bravery as they live their lives, raise children, go to work and support each other.

People and our perseverance give me so much joy and hope. One of the really exciting things about the institute is that it’s going be a convening space — a place for people who share this passion so we can come together, talk, think and make things happen.