African-American men suffer from prostate cancer at a much higher rate than white men. And M. Norman Oliver, M.D., wants to know why.
Oliver, who holds the Spencer P. Bass, M.D., Twenty-First Century Professorship in Family Medicine at the University of Virginia School of Medicine, has studied health disparities in prostate cancer since 2001. He has found that the incidence among African-American men is 60 percent higher than among white men, and their mortality from the disease is two to three times higher. Oliver doesn’t believe the disparities are due to biology, so he’s seeking other factors.
At Case Western Reserve University School of Medicine, Oliver studied medical anthropology as well as medicine. He earned a master’s degree in medical anthropology at the end of his second year, and graduated from medical school in 1994.
To repay his school loans, he accepted a position as a family doctor in Bethel, Alaska, a small town four hundred miles northwest of Anchorage, reachable only by sea and air. Most of the town’s six thousand residents are Yup’ik Eskimos.
“It was an incredible learning experience, both from a clinical and a cultural point of view,” Oliver said. “The pediatric population had rampant infectious disease, so I saw infections and exposures to toxins, such as botulism, that I wouldn’t expect to see elsewhere. Among the adults, I saw a lot of trauma related to alcohol, things like snowmobile accidents and homicides.” He also witnessed depression and a high suicide rate, a result of the breakdown of Yup’ik society and way of life through contact with modern white culture.
After two years in Bethel, Oliver was recruited by Sim S. Galazka, M.D., chair of UVA’s Department of Family Medicine. Since 1998, Oliver has held joint appointments at UVA in family medicine, anthropology, and public health.
Shortly after his arrival in Charlottesville, he sought out other University faculty who were interested in health disparities – racial, ethnic, geographic – and organized the Center on Health Disparities, which he now directs. In addition, Oliver conducts research, sees patients, and teaches residents and medical students on rounds.
In 2008, when Oliver’s five-year National Cancer Institute Career Development Award ended, Galazka nominated him for the Bass professorship.
The Spencer P. Bass, M.D., Twenty-First Century Professorship in Family Medicine was established in 2007 with a bequest from Spencer P. Bass, Jr., M.D. (Medicine ’49), in honor of his father, Spencer P. Bass, M.D. (Medicine 1906), who was a life-long practitioner of family medicine. Bass’s generous gift to the School of Medicine included a $2 million endowment to establish the professorship in addition to a significant unrestricted gift. The professorship was designed to help recruit or retain a physician specializing in family medicine who excels in three ways – as a researcher, as a clinician, and as a teacher.
In addition to his work on prostate cancer, Oliver studies a range of factors – such as poverty, income, and education – that influence public health.
Oliver knows that physicians can’t be experts on all their patients’ cultures. “But if we are curious and nonjudgmental, we can learn about our patients and have them feel comfortable enough to talk about their problems,” he said. “You can develop a relationship that allows you to work together to improve that person’s health.”