Research to Increase Health Care Equity for Children
Charlotte Gilson '25
Sociology
Commonwealth Honors College
Marshfield, MA
What drew you to this field of study?
I come from a big family of physicians and have wanted to be a doctor for as long as I can remember. I’m also passionate about social justice. Growing up, my grandmother told me about her career as a Black physician before and after the Civil Rights Movement. She made me aware of persistent disparities in the accessibility of healthcare for systemically oppressed groups in the United States. I believe that physicians bear some responsibility in advocating for and ensuring that all people receive high-quality healthcare with minimized cultural bias or oppression.
At UMass, I am studying sociology to deepen my understanding of social justice issues while pursuing a pre-med track. Working in the Quality for All (Q4A) lab under Dr. Sarah Goff at the UMass Amherst School of Public Health and Health Sciences has allowed me to combine my passions and research ways to increase equity in the American healthcare system.
How do you conduct your research?
Since joining the Q4A lab as a first-year student, I have been heavily involved in a four-year, National Institutes of Health (NIH)-funded project [that] examines pediatric fluoride varnish (FV) application patterns in Massachusetts. FV is a concentrated form of fluoride applied topically to the teeth by a dental or medical professional. Studies have found that, when applied regularly, it is an effective measure to prevent dental carries (also known as cavities), one of the most prevalent childhood diseases in the world that disproportionately affects low-income, Black, and Latinx populations in America. Despite the effectiveness and safety of FV, very few children receive this treatment in pediatric primary care settings. In our study, we’re assessing the factors preventing and facilitating the widespread application of FV in Massachusetts in hopes of improving oral health access and equity for all children.
I became the student lead on this project in May 2022, working under Dr. Goff’s leadership and supervision to collect and analyze qualitative data to address our research questions. Our research primarily involves conducting semi-structured interviews with healthcare providers—including pediatricians, nurses, nurse practitioners, dentists, and dental hygienists—in Massachusetts to learn about the factors that make it easier [or] harder to apply FV in a medical setting. In a second study, we conducted interviews to learn about care coordination with pediatricians and factors that make it easier or harder for dental practices to accept children insured by MassHealth or Medicaid.
I’ve been involved in two other studies in the Q4A lab, including one on the online propagation of COVID-19 misinformation by physicians and the other focused on the experiences of parents of children with asthma with Massachusetts Medicaid Accountable Care Organizations.
What do you see as the impact—or potential impact—of your work?
I believe that medicine is largely focused on treatment, yet there should be a much greater emphasis on prevention. I hope my research helps spread awareness of the importance of fluoride varnish as an effective preventative measure to avoid caries. Children who develop caries sometimes have to undergo surgery and go under general anesthesia, which can have longer-term health consequences. This could be prevented if all pediatric primary care practices applied fluoride varnish and educated parents on proper dental health care for their children.
Research really provided me with education on health equity and how to fight for it.
How does your faculty mentor support your research?
I feel like the luckiest person in the world to be able to work with Dr. Goff. She does such a brilliant job of giving her research assistants opportunities to take on leadership roles in the lab. She gives us independence while letting us know she’s there to provide any support we need. I’m so grateful for her generosity and guidance. Thanks to her, I’ve been able to co-author two published papers as an undergraduate, and now am the first author on another forthcoming paper.
What do you find most exciting about conducting research?
As an aspiring doctor, I’m passionate about making a difference in people’s lives. With my research, I think that if even one pediatrician reads one of our papers and decides to start using fluoride varnish in their practice, that could prevent caries and unnecessary medical treatment for so many children.
What are you most proud of?
I’m really proud of the leadership skills I’ve acquired doing research, and of being part of such an amazing team of people in our lab—all of whom are passionate about health equity and want to make a difference. I’m also proud that I’ve been able to take a non-traditional approach to the pre-med curriculum at UMass by majoring in sociology, and that I’ve found success by following my passion.
How has your research enhanced your overall educational experience at UMass?
Research has enhanced my learning so much. I came to UMass knowing I was passionate about social justice and wanted to go to medical school, but I didn’t know much about health inequity beyond its existence. I knew that when I went to the pharmacy, I would see people who couldn’t afford their prescriptions, and I didn’t like it and wanted to change it, but I didn’t know how to go about it or where to start. Research really provided me with education on health equity and how to fight for it. Combined with my sociology studies, it helped motivate me and steer me in the right direction for my future career.
I believe that my experiences in research are helping me gain a better understanding of society, culture, and justice so I can be the most understanding, empathetic, and compassionate physician and researcher possible in the future.
What are your plans for the future?
I plan to apply to medical school, and [I] dream of being an implementation scientist doing research and implementing it in my own medical practice.
Why would you recommend UMass to a friend?
I’ve really been able to flourish at UMass. I came from a small community with limited diversity, and being at UMass with such a wide diversity of people has been really healing for me. I’ve met some of my best friends here—people I consider my family. I also chose UMass because of its reputation in research. Thanks to UMass’s commitment to promoting undergraduate participation in research, I was able to get involved as a first-year student when I was only 18. I feel so fortunate for this opportunity.