Helping patients know their risks of health issues

This week on Health Matters, guest host Kelly Albert speaks with Valerie Aitken about volunteering and donating in support of Dr. Lucy Gilbert and the DOvEEgene Project. Eric St-Pierre describes why the Trottier Family Foundation made a donation to reduce the environmental impact of anesthetic gasses. Dr. Patricia Tonin explains her role in helping discover the BRCA1 & BRCA2 genes and how they signal an elevated risk of breast, ovarian and prostate cancers. Women from racialized communities are at a higher risk of dying from heart disease. Dr. Judy Luu shares how POWER Hub wants to reduce the barriers to accessing care.

Cette semaine à Questions de santé, l’animatrice invitée Kelly Albert discute avec Valerie Aitken de l’importance de faire du bénévolat et de donner pour appuyer la Dre Lucy Gilbert et le projet DOvEEgene. Eric St-Pierre raconte pourquoi la Fondation familiale Trottier a fait un don pour réduire l’impact environnemental des gaz d’anesthésie. La Dre Patricia Tonin précise son rôle dans la découverte de la façon dont les gènes BRCA1 et BRCA2 peuvent révéler un risque accru de cancers du sein, de l’ovaire et de la prostate. Les femmes issues de communautés racisées courent un risque plus important de mourir d’une maladie cardiaque. La Dre Judy Luu explique comment le POWER Hub réduira les obstacles à l’accès aux soins.

Transcript

Kelly Albert: 0:00

Good afternoon. Thank you for joining us. Tarah Schwartz is off this week. I'm Kelly Albert, and this is Health Matters on CJAD 800. On today's show women from racialized communities are at a higher risk of dying from heart disease. Later in the show, we speak with the cardiologist from the MUHC about her initiative to reduce barriers to accessing health care. And the Trottier Family Foundation has made a significant donation to help champion a more environmentally-friendly hospital. But first, this past Monday was World Ovarian Cancer Day. The MUHC Foundation is proud to support many doctors, researchers and clinician scientists at the MUHC and RI-MUHC who are working to find a way to diagnose ovarian cancer at an earlier stage when it is more treatable and find better treatments for patients. On World Ovarian Cancer Day, a team of dedicated volunteers joined us for a thank-a-than; a time where we could thank our community for their support of ovarian cancer research and patient care. Valerie Aitken is one of those dedicated volunteers. She has been an incredible supporter of the MUHC Foundation, and she joins me now. Hello, Valerie.

Valerie Aitken: 1:05

Hello, Kelly. Speak to us this morning.

Kelly Albert: 1:08

Nice to speak with you too. We see each other at events every once in a while. And I just would love to know how long have you been volunteering with the MUHC Foundation?

Valerie Aitken: 1:18

My diagnosis with ovarian cancer was in 2015 and I went through the chemo, the surgery. Actually in April the next year, I said, how do I give back? And I asked to speak to somebody at the MUHC Foundation to inquire as to how that could happen.

Kelly Albert: 1:45

That's incredible. And it's been ever since. So ever since 2016, you've been volunteering with us?

Valerie Aitken: 1:51

Yes. And I think also I was invited to the breakfasts, which explained how people can not only give money in cash, but give shares, and all the all the pros and cons of that. So it was besides living with ovarian cancer, I always call it my journey. I don't call it a struggle, whatever; it's a journey. I learned more, I became more financially literate, which I thought was for me, I always have to look at the positive side. If something happens, where are we going to go. And for me, it's been able to support Dr. Gilbert with the award. So that is one of the things I have been doing.

Kelly Albert: 2:37

I really do admire that because I think oftentimes when we're faced with a diagnosis, it can be very scary. It can be a very overwhelming time. But I feel that you have really made it your mission to look at it in a bright way and know that you can change the world by making these steps to make your life more positive.

Valerie Aitken: 3:01

Yes, and also, of course the people. The first award I gave was given to a biomedical engineer, and she is still my friend. She is responsible for part of the little brush that's used in the clinical trial. And then my second award went to help a nurse. She'd always already registered nurse, but it helped her get her master's degree in epidemiology. And this is somebody else who I've been in touch with. And that also is wonderful for me to see how these people have contributed towards Dr. Gilbert's trial.

Kelly Albert: 3:41

Absolutely. So the awards that we're speaking about is the Valerie Jasset and Gary Aitken Cancer Research Award, and this goes towards the DOvEE Project. We have spoken about the DOvEE Project before on the show. But for those who don't know, it's a project from Dr. Lucy Gilbert, which the goal is to be like a Pap test for ovarian and endometrial cancer. The struggle with these cancers is they're diagnosed usually at a later stage, when it is very difficult to treat. And the DOvEEgene test, which was created right here in Montreal, the goal is to have a test so we can detect these cancers earlier and treat them at an earlier stage. And this research awards that you created, the amount goes directly to Dr. Gilbert who helps select a health care worker who wants to make a difference and is helping to make a difference. Is that correct?

Valerie Aitken: 4:31

That's correct. Yes, if she has a need, then she can use the money. So it's held with the MUHC Foundation. I think last year's award has not been given yet because she's looking for the right person to give that money to.

Kelly Albert: 4:50

Incredible. We're in conversation with Valerie Aitken, who is one of the dedicated volunteers at MUHC Foundation. She's a really important part of our community. And so you mentioned you are one of Dr. Gilbert's patients. You mentioned that you've been working with the MUHC Foundation quite a bit. Why is it important for you to support both Dr. Gilbert in the DOvEE Project, and also just support excellence in health care?

Valerie Aitken: 5:19

Obviously, I spend quite a lot of time back and forth between the hospital, the clinics and the various things. I think for me supporting specifically the research into ovarian cancer, and to look and see how it can be found before it becomes stage two, stage three, stage four. As you mentioned, are so more difficult to treat. And with the treatment, I have side effects. So I am reminded every day, that if it hadn't been for Lucy Gilbert and her team, then I may not be having this conversation with you today. But I think this is what I want to do. I want to have women, particularly younger women, this disease can be caught nipped in the bud, and then they would have a much better quality of life. Quality of life is what I see. The little things that all these treatments leave one with. Myself, I want to live my life as positively and as actively as I can, but there are certain things that slow you down, because of the treatments. So that's why my first donations. Mind you, I am followed in two other particular clinics, and I do give money as well towards that particular area of medicine.

Kelly Albert: 7:17

It's important to give back for sure. In conversation with Valerie Aitken, who is a donor in our community, she's a valued volunteer of our community. We're running short on time, Valerie, but I did want to ask you, we talk quite a bit about giving back. We talk quite a bit about philanthropy. What message would you have for our listeners about the importance of giving back; particularly to a cause as important as yours, as important as the DOvEE Project, and why you feel so connected to it?

Valerie Aitken: 7:47

Yeah, I think people will say to me, I can't give very much and perhaps, giving $5 a month. Maybe you're going to give up that $5 coffee. And that's a way of saying, I can do this and it's only a little amount. But if everybody gives a little amount, then I see that as a way. It makes me feel good when I'm giving whether giving of myself or even being able to give the award. So at that would be my message.

Kelly Albert: 8:20

That's a lovely message. And as you mentioned, you know, we have a lot of information on our website about the financial benefits that come from it. There's taxable benefits that come from this. You can become more financially literate when you know about the different ways to give. And I think you're right, any amount, no matter the size of the amount is an important demonstration that you believe in the cause and you believe in our community. So thank you so much for everything that you do for us, Valerie. I really appreciate your time today. That is Valerie Aitken, one of our dedicated volunteers and wonderful supporters at the MUHC Foundation. Next on Health Matters, a donation in support of making the many surgeries at the MUHC more environmentally-friendly. Tarah Schwartz is off this week. I'm Kelly Albert, welcome back to Health Matters on CJAD 800. The MUHC Foundation is proud to work with a number of other foundations who support our Dream Big campaign and our goal to provide excellent patient care and push the boundaries forward for innovative research to find better treatments. The Trottier Family Foundation has been an important partner and has recently donated $280,000 in support of a project to reduce the environmental impact of anesthetic gases. You might know that most surgeries are performed with anesthetic gases. Eric St-Pierre is the Executive Director of the Trottier Family Foundation and he joins me now to talk about this wonderful project. Hello, Eric.

Eric St-Pierre: 9:43

Hi, Kelly. How are you?

Kelly Albert: 9:44

I'm very well, thank you so much for being here. For those who don't know, can you tell me a little bit about the Trottier Family Foundation?

Eric St-Pierre: 9:53

Absolutely. So the Trottier Family Foundation was established by Lorne Trottier and Louise Rousselle Trottier back in 2006. It was created to create a meaningful impact to improve the lives of Canadians. And so we've had about four main programs. So we've been focusing a lot on science, a lot on education, climate change and health sectors. For example, we're currently at the Climate Summit, which has been hosted in the Old Port; in partnership with the Montreal Climate Partnership. And we're currently trying to mobilize diverse stakeholders around climate change. So I would say Trottier Foundation has become one of the largest Quebec or Canadian funders, and one of the biggest funders on climate change.

Kelly Albert: 10:35

Absolutely. And so, why was it important for you to support this project at the MUHC- the hospital is already eco-friendly, but to make it even more eco-friendly?

Eric St-Pierre: 10:45

Yeah, that's a great question. So we started analyzing what we could do with our health program that might be a little bit more proactive, and a little bit more innovative, and how can we address systemic issues. We started realizing that often health care is treated separately from climate change, or climate change is treated separately from health. But we realized they're actually interconnected. They intersect and overlap. For example, about 5% of emissions come from the health and hospital sector. So this might include buildings that are heated on fossil fuels. It might include large fleets of vehicles, or think of ambulances. But it also might include things like food waste, material supplies, or even different gases. Hospitals and the health sector is actually a very significant emitter of CO2. And last year, at the Climate Summit, we had that Dr. Steven Williams, who's a doctor at the CHUM. And the CHUM announced that they would go carbon neutral by 2040. And this doctor had announced a new method for reducing emissions from anesthetic gases by over 80%. So it was sort of an innovative first time that Quebec hospital was doing something innovative and reducing emissions and gases. And so we quickly had a conversation with the MUHC and we thought, wouldn't this be great if the MUHC was to become the second hospital in Quebec to also reduce emissions, and anesthetic gases. We had the MUHC very willingly contribute.

Kelly Albert: 12:19

We're in conversation with Eric St-Pierre, who's the Executive Director of the Trottier Family Foundation, the foundation has made a donation to the MUHC Foundation for $280,000 to support a make the MUHC greener initiative. And this project, particularly, as Eric mentioned, pertains to anesthetic gases. So I'll give a bit of background on anesthetic gases; about 5% of the gases used during surgical procedures are the ones that are absorbed into the body. So 95% of the gases are released through ventilation systems into the environment. So this project will help recuperate these gases that are released into the environment, and then use them again, in a way that... I don't know the science behind it, but I know that they're able to recuperate it to make them usable again. So it's really special, that it's so innovative. And it really shows forward thinking. Is that important to have this forward-thinking, innovative, outside the box approach to finding solutions?

Eric St-Pierre: 13:23

Yeah, absolutely. I think the challenge is that the health sector is so preoccupied with significant health issues. We just came out of COVID, or we're still coming out of COVID. So there's very significant issues. And it's hard to make connections to the climate change, whether how we're adapting to climate change, what the impact of heat waves or flooding on Montreal's vulnerable populations. But also how do we start reducing emissions. So we're actually starting to see some leadership amongst some health institutions that are really starting to think about those innovative ways to directly reduce emissions. We're quite inspired by this. And we actually think that we should be trying to scale this across the province. We've got now a second hospital that's reducing its gases. But we'd love to see this spread throughout the rest of the province, ideally,

Kelly Albert: 14:15

How does that happen? Because I think it's really difficult. I mean, there's so many hospitals in Montreal, of varying ages as well. We're fortunate that the MUHC is a relatively new hospital as is the CHUM. And so is it conversations? Is it going to government officials? Is it a little bit of everything?

Eric St-Pierre: 14:35

Yeah, it's a little bit of everything. So what we're seeing is leadership. We're seeing some hospitals, being bold and acting as those pilot projects and being the early adopters, if you will. And but what we really need to do now is we need to take that leadership and we need to start putting it to scale. And that will actually involve conversations with the Quebec government and other stakeholders as well, potentially City of Montreal, health officials. We really need to start having some higher-level conversations with the governments and public policymakers to really advance the discussion of the intersection of health and climate.

Kelly Albert: 15:17

We're in conversation with Eric St-Pierre, who is the Executive Director of the Trottier Family Foundation. What I really admire about foundation supporting other foundations is it shows that we have one goal in mind. It's to improve our community improve our province, our city, our country. And when we support each other, I think it just shows how important our impact can be. And so I love asking the guests that come on the show with a philanthropic mind; what is your message to listeners about the importance of the impact of philanthropy and giving back? Regardless of the size of donation, how important is giving back?

Eric St-Pierre: 16:00

Yeah, getting back is crucial. For foundations like us, philanthropic dollars are still very meaningful. The grants we're providing are helping benefit hospitals in the health sector. But it's actually very small compared to what governments have. And so our support from the Trottier Foundation, and I would encourage other foundations in the Montreal area, to really look at their funding as being catalytic, being bold and innovative. So our hope is actually that we may mobilize other like-minded foundations to start thinking about the links between climate and health, whether that's reducing emissions in the health sector, or helping vulnerable communities adapt to the impacts of climate change. I think it's a call to action, if you will; for funders to start thinking a little bit differently.

Kelly Albert: 16:52

For the average person to, I think there might be a sort of misconception that I don't have a lot of money. We all experience financial insecurity sometimes, and it can be difficult to give back. But truly, the impact of every dollar is really, really significant, isn't it?

Eric St-Pierre: 17:10

Yeah, absolutely. Every dollar works and has an impact. But everybody has also a voice, right? So everybody could put pressure on their local hospital or if they have elected officials, they can they can contact their local MP or local politicians to really ask them- what are you doing for climate? And what are you doing for decarbonizing the health sector, for example? There's a lot of tools and toolbox for everybody.

Kelly Albert: 17:36

Yeah, I love that idea. I think we don't necessarily always associate giving back with time, like volunteering or making calls or really using your voice to push forward to cause it is important to you. So I think that's a really excellent point.

Eric St-Pierre: 17:50

We all have to try our best and all hands on deck, as they say.

Kelly Albert: 17:54

Well, Eric, thank you so much for coming on the show. We really appreciate it. And as I mentioned, this donation is really going to help push forward a more eco-friendly hospital and really continue to make the MUHC as green as possible.

Eric St-Pierre: 18:06

Thank you, Kelly. I really appreciate being on.

Kelly Albert: 18:08

That is Eric St. Pierre, the executive director of the Trottier Family Foundation, the foundation made a $280,000 donation to a project that will help recuperate anesthetic gases and make a less environmental impact. Coming up on Health Matters, an historic discovery that changed how to know who is more at risk for breast cancer and the local researcher who helped make it happen. Tarah Schwartz is off this week. I'm Kelly Albert, and this is Health Matters. The BRCA1 and BRCA2 are two genes that impact a person's chances of developing breast cancer. You might have heard of the BRCA gene from celebrity news, Angelina Jolie decided to have a preventative double mastectomy after finding she was a carrier of the BRCA1 gene. This discovery was first reported in 1994, and one of the scientists at the RI-MUHC was part of the team that discovered these genes and has helped push forward research to whom it impacts. Dr. Patricia Tonin is a senior scientist in the Cancer Research Program at the RI-MUHC, she was part of the team who discovered the gene and joins me now. Hello, Dr. Tonin. Hello, thank you so much for being here.

Dr. Patricia Tonin: 19:15

Thank you for having me.

Kelly Albert: 19:17

In very general terms, for those who may not know what the BRCA1 and BRCA2 genes are, can you describe them to me?

Dr. Patricia Tonin: 19:26

Yes. So these are genes that code for proteins that are involved in the normal functioning of our cells. All of our cells in our body have this, we all inherit these genes from our parents. We have two copies of them, one that we inherit from our mothers when we inherit from our fathers. And what they produce are proteins that are important to maintain what we call the integrity of DNA in the cells.

Kelly Albert: 19:59

Okay, so sometimes the cells change or aren't the way that they're supposed to be, and that impacts your health?

Dr. Patricia Tonin: 20:10

Yes. So what's interesting about these two genes is that if you inherit a very variant in these genes, which we call pathogenic. In other words, if you inherited a variant that's not a normal variant, that would have no consequence. But it's something that would change the functioning of the protein that it makes. This results in one of two things, either the protein that's made is not functioning properly, or it's just simply not making a protein at all. So what happens is that you can inherit this variant from either parent. And if you do inherit it, it significantly increases a woman's chance of developing breast cancer and ovarian cancer. For men, it increases could increase your risk for developing breast cancer and prostate cancer. Depending on what gene is involved.

Kelly Albert: 21:14

Wow. And so this is a historic discovery, for many reasons, but because it really helps pinpoint who's more at risk of developing these cancers.

Dr. Patricia Tonin: 21:25

Absolutely. So they can be used as what we call biomarkers. So we knew that carriers of either of these variants, they develop breast cancer on average at a younger age. Before the age of 50, sometimes as young as in their mid-30s. They can develop ovarian cancer; perhaps not as young but still ovarian cancer is quite a deadly disease. The risk for developing ovarian cancer is lower than the risk for breast cancer, but it's still a real risk. And because the ways in which to treat ovarian cancer are not as sophisticated as they are for breast cancer, it's possible that it can be lethal. We now know, through years of research that men who carry mutations in BRCA1 or BRCA2 are at an increased risk for breast cancer as well. The risk is not the same as for women, but it's there. And for BRCA2, the most important observation is that if they carry mutation and they develop prostate cancer, it can be quite lethal. So the management is quite different now for men who have prostate cancer, and it's known that they carry a mutation in one of these genes.

Kelly Albert: 22:48

It's really, really fascinating. We're in conversation with Dr. Patricia Tonin, a senior scientist in the Cancer Research Program at the RI-MUHC. So you are one of the scientists who was part of the team that made this discovery in 1994. If you could take us back to those years. Did you know that what you were working on was going to be as transformative- I guess is the word- as it was?

Dr. Patricia Tonin: 23:13

Yes, yes, definitely. Because the way in which we found both BRCA1 and reported it in the scientific literature into the world in 1994. And then BRCA2, about a year later, it was just after the holidays, in December of 1995. We knew then, that it would be impactful. What we studied were families that had a large number of breast cancer cases in them, or ovarian cancers and breast cancers. We knew that the ages of diagnosis of breast cancer were young. It's the genetic study of these families, which led us to pinpoint exactly where in the human genome these two genes are located. So we had genetic markers that we knew we're tracking in the families, but we couldn't find a gene. Until we performed some genetic tests, which allowed us to pinpoint exactly where these genes were. And that's the role that I played it for BRCA1 and then for BRCA2. By pinpointing where to look for the genes, it allowed our colleagues elsewhere to physically clone the genes. Then through DNA sequencing, we're able to show the link between having a variant in one of these genes and the gene itself. Then itself becomes a marker which then can be used to identify all the members of the family. Do they contain the same variant or not? Because everything is hereditary, if it is passed from one generation to the next. It's not what we called de novo, it's not something new. It's something that's in your family and your family history; it could be there for hundreds of years. And that reveals itself when cancer presents itself. Perhaps at an unusually younger age, or when you have a lot of siblings, or close family members that have the disease. That's how it reveals itself. And it becomes a marker for family history of disease and for the risk.

Kelly Albert: 25:28

Absolutely. And that's how your research is continuing. You started examining the French Canadian population

Dr. Patricia Tonin: 25:33

yes...

Kelly Albert: 25:34

For these markers as well. And we're short on time. But can you tell us very briefly about what your findings were in the French Canadian population?

Dr. Patricia Tonin: 25:42

Yes, we published a paper in 1998, showing that women who had family histories of breast and ovarian cancer had very specific mutations in either BRCA1 or BRCA2 that were tracked in individual families. And the significance of this at that time, was that it provided a way to specifically use these as genetic markers for finding women and men in the population who carry these variants, which can then be used for genetic counseling purposes. So these genes, both genes are very, very large. They're very complex mutations or variants that can occur anywhere in the gene. And it made it very difficult to find the underlying causal variant. In specific populations, like the French Canadians, which can trace their ancestors back to common founders. They could have inherited the same variant in their families for generations, tracing back to the 1600s. So we were able to find those specific variants. And at the time the discovery was made was important, because it allowed us to provide a more precise genetic counseling advice to individuals who may carry these mutations. Because sometimes the precision was just not there with sequencing. Now we have sophisticated sequencing methods where we can look at the entire gene, but back then it was costly, it was not necessarily available to everyone. And this was one way to be able to reach a much larger population, as we did with the Ashkenazi Jewish population, we offered that as well. Now we offer genetic testing to everyone who is eligible for testing.

Kelly Albert: 27:38

It's incredible the advances that have been able to be made as a part of this discovering, because of improvements in technology. We just have 45 seconds left, Dr. Tonin. But you recently were part of the team recognized for the BRCA1 and 2 gene discovery. You received a plaque in London at the Cancer Research Institute in London. There's a plaque with your name as part of the team that made this discovery. How special is that honor?

Dr. Patricia Tonin: 28:08

Just to clarify that plaque specifically for BRCA2 and not for BRCA1 because those are two separate discoveries, same people. So the question is, how does it make me feel?

Kelly Albert: 28:20

Yes, how is it to be recognized that way?

Dr. Patricia Tonin: 28:23

Fantastic, because the purpose behind this plaque is what it contains is the order of all the authors that published the seminal paper on the discovery of BRCA2. The purpose behind these plaques, that are that are on the buildings of these Cancer Institute's is to recognize team science. In other words, is to recognize how many people are involved to get to the point where we can answer a question. Rarely are teams recognized. Usually, these are individuals. It could be the lead author of paper or the leader of the team. But in reality, when you pull the curtain back and you look at what's happening in a lab, there's a large number of people from graduate student trainees, undergraduate students, all the way up to the team leaders. And then this is replicated across many, many labs. To be able to achieve the successes that we were able to achieve as a group with the discoveries of these two genes is an example of this. It required the study of geneticists, molecular biologists, biologists, breast cancer and ovarian cancer and prostate cancer specialists from around the world to come together to be able to do this. I could not have been done with one particular group or one particular team or one particular method, it required interdisciplinary effort to be able to come to this point. And the field that I'm in, also continues to operate in that way and operates quite successfully. I mean, there are other genes that have been discovered over the past 20 years that are also known to increased risk for breast and ovarian cancer. So it's not just those two genes. There's now up to 13 different genes that have been identified, that will allow us to provide advice for carriers and what to do.

Kelly Albert: 30:30

It's really remarkable, and we're so excited to have you at the RI-MUHC continuing to push the needle forward with your research. Dr. Tonin, congratulations on this recognition. And thank you so much for joining us on the show.

Dr. Patricia Tonin: 30:42

Thank you. Thank you.

Kelly Albert: 30:43

That's Dr. Patricia Tonin, a senior scientist in the Cancer Research Program at the RI-MUHC. Coming up next on Health Matters, women from racialized communities are at a higher risk of dying from heart disease. Learn how a team of doctors at the MUHC want to reduce the barriers to accessing care. Tarah Schwartz is off this week. I'm Kelly Albert and you're listening to Health Matters. The leading cause of death for women in Canada is heart disease and cases are rising every year. For women in racialized communities, the rates are even higher. There are many reasons why this is happening from limited access to cardiovascular specialists to risks of being overlooked. But Dr. Judy Luu hopes to correct this with the creation of POWER Hub. It's an initiative at the MUHC. Cardiologist Dr. Judy Luu joins me now to discuss Good afternoon, Dr. Luu.

Dr. Judy Luu: 31:27

Hi, good afternoon, Kelly, thank you for having me.

Kelly Albert: 31:30

Thank you so much for being here. So do you think the average person; and in particular, the average woman knows their risks of heart disease?

Dr. Judy Luu: 31:39

That's an excellent question. So we have contemporary research to show that the average woman actually doesn't recognize that heart disease is the number one killer. So research from the United States, which is our close neighbor shows that only about half a woman recognize this very fact. So it definitely suggests that there's a lack of awareness among a significant proportion of women about the risk of heart disease. There's lots of reasons why this may be. I mean, on top of having traditional cardiovascular risk factors like high blood pressure, high cholesterol, diabetes, and obesity, a lot of women don't know that these risk factors impact them much more than they do a man. So for instance, a woman with diabetes is three times more likely to die from heart disease when compared to a man. So this information is currently not that fully obvious in the public. And so a lot of women do underestimate the risk when it comes to heart disease.

Kelly Albert: 32:34

Those are really big numbers. And, you know, we're speaking more specifically about women in racialized communities. So how much higher is that that risk for women in racialized communities?

Dr. Judy Luu: 32:46

For Canadian data, we don't have an exact number, per se. But we do now recognize that, racial and ethnic disparities do exist when it comes to the occurrence of heart disease and the outcomes of heart disease. And so what do I mean by that? For example, from the Heart and Stroke Foundation of Canada, we know that indigenous women do face a higher risk of heart disease and stroke. And this is due to a number of things that are very complex. And I want to caveat that there's a lot of factors like socio-economic factors, employment, education, access to health services, nutritious foods, adequate housing, so all of these can impact racialized communities and heart disease. Indigenous people are just one of them. But there's also other examples across the multi ethnic spectrum. South Asian populations in Canada, also have higher proportions of heart disease. They've shown again, in Heart and Stroke, that South Asian people oftentimes have up to 10 years earlier, chances of having heart disease compared to their white counterparts. So all in all, I say there, again, I want to caveat that there's a lot of health disparities. And the situation is very complex and multifaceted. And what I mean by multifaceted is there's like systemic reasons, societal, and health-related reasons. And we're only really beginning to understand that we're at the very tip of this iceberg in trying to help resolve this current situation.

Kelly Albert: 34:17

Of course, I mean, whether it be socio-economic factors, as you mentioned, it could there could be a variety of reasons why this is happening. But it's important to know that it is happening and that it's a problem that we can try to help with. We're in conversation with Dr. Judy Luu, a cardiologist at the MUHC, so you want to start an initiative called POWER. So it's Pathway to Cardiovascular Care for Women in Ethnic, Racialized and Remote Communities. POWER- I really liked that acronym. So tell us about the POWER Hub and your idea behind it.

Dr. Judy Luu: 34:49

Yes. Thank you so much for this opportunity to talk about the POWER Hub. It really came as a call to action as a national initiative for some research funding. When I conceptualize the idea; as a team of clinicians, researchers, women who have lived experience, and other community members, we definitely recognize that there are several deep layers of barriers that exist when we come to providing equitable care for a woman, especially in our province in Quebec. And what I mean by these barriers are things that are including, access to specialists, even just cultural awareness and sensitivities about heart disease. There's also a physician-patient language discordance, especially someone doesn't speak English, or if they don't speak French in our province. And then importantly, really systematically we're poorly underestimating the risk profile of a woman. And so that's how the POWER Hub came to be. As a new clinician-scientist, physician, a woman's heart health cardiologist at MUHC, I wanted to form this network of powerhouse team members to really bridge the gap between the French and the English health care system. And to find a way how we can redefine how cardiovascular care is delivered for women in Quebec. So, very briefly to the podcast is limited. But briefly, the POWER Hub is a virtual network that comprises of multiple sites throughout Quebec. It includes the CHUM that includes like physician numbers and researchers from the CHUM; as well as, Laval. And our other international collaborators from the US including Cedar Sinai in Los Angeles. And this POWER Hub is designed to co-develop and create with our community members. So we have the Jamaica Association in Montreal, too. And the vision really is to create a platform where all key stakeholders can really work together to understand what the disparities and health disparities are, and to find meaningful and effective ways to improve those disparities and better deliver access to care for a woman in Quebec.

Kelly Albert: 37:16

I find it so important and inspiring that you're working with the community stakeholders. Because there's so many different groups in Montreal that maybe don't feel represented in health care and for a variety of reasons. But I think it's really, really wonderful that you're working together with these different groups to make sure that everyone feels supported.

Dr. Judy Luu: 37:36

100%, and one of our main tripartite leadership members is like I said is the Jamaica Association but they have access to all the other black communities in the City of Montreal. I think it's very important for us to reach out to. We're in our infancy and trying to really garner those relationships with these cultural and ethnic community associations. So eventually, we will reach out to, let's say, the Iranian community, the Greek communities, and so many other the Chinese, Vietnamese etc. And so it's important for us to really build those relationships as they help us in the fundamental creation of all these deliverables of the POWER Hub.

Kelly Albert: 38:16

It's really inspiring to hear and I know that the foundation is supporting you through this initiative, and we want to get you funding to help expand this program and get this program off the ground. So I'm really grateful to have a cardiologist like you who's working so diligently to help make sure that we have full representation and equity in health care. Thank you so much, Dr. Luu.

Dr. Judy Luu: 38:35

Thank you.

Kelly Albert: 38:36

That is Dr. Judy Luu, a cardiologist and one of the team members behind the POWER Hub and initiative here at the MUHC that hopes to bring cardiovascular care to women in racialized communities. I'm Kelly Albert, thank you for tuning in. What would you like to hear about on the show? Write to me at healthmatters at MUHCFoundation.com. You can also follow the MUHC Foundation on social media or sign up for our newsletter at our website, MUHCFoundation.com. Tarah will be back next Sunday. Thank you for listening to Health Matters and stay healthy.