University of Colorado Department of Medicine faculty member Lilia Cervantes, MD, MSCS, has been elected to membership in the American Society for Clinical Investigation (ASCI), a 116-year-old medical honor society of physician-scientists. She's one of just 100 new members elected for 2024 out of 302 nominations.
It’s the latest of many national and regional honors for Cervantes, who is devoting her career to research and activism that seeks to advance health equity and justice, as well as to community outreach and mentorship of junior colleagues.
Cervantes, a professor in the Division of Hospital Medicine and director of immigrant health for the CU School of Medicine, will be inducted into ASCI at a ceremony and dinner April 5 in Chicago.
ASCI, which has more than 3,000 members representing all medical specialties, says it is “dedicated to the advancement of research that extends understanding of diseases and improves treatment, and members are committed to mentoring future generations of physician-scientists.”
“I am truly honored,” Cervantes says. She recalls her transition several years ago from being a full-time clinician at Denver Health to “a research career to build evidence to change policy and eliminate structural racism. Now I can’t imagine doing anything else. It just feels too important.”
Focus on kidney outcomes
Cervantes says that the bulk of her research “is focused on building community-based interventions specifically utilizing community health workers to improve person-centered and clinical outcomes for the Latino community with kidney disease. Racial and ethnic minorities make up over 50% of patients with kidney failure in the country. Latinos specifically are disproportionately burdened by social challenges, and so those with kidney failure end up really struggling with health disparities.”
Cervantes cites her Latina heritage and growing up in poverty in Denver’s Valverde and Westwood neighborhoods as informing her commitment to research and advocacy on behalf of underserved communities, including immigrants.
She completed her medical degree and residency at the University of Colorado Anschutz Medical Campus, and served for 13 years as an internal-medicine hospitalist at Denver Health. There she encountered marginalized patients, including undocumented and uninsured immigrants with failing kidneys who lacked access to standard maintenance hemodialysis under then-current Medicaid policy and could only obtain emergency dialysis once their symptoms reached a critical level – a situation that, according to Cervantes’ research, means higher mortality rates.
A key change
Cervantes talks and writes often about one such patient: Hilda, an undocumented-immigrant mother of two in her 30s who became a close friend. She had end-stage kidney disease (ESKD) but could not access maintenance dialysis three times a week in Colorado, so she had to rely on repeated emergency dialysis. Hilda died in 2014.
“Two years of caring for Hilda as an internal medicine hospitalist changed me,” Cervantes wrote in a 2020 article in the Journal of Hospital Medicine. “Grief gave way to anger, anger to determination. I found it morally distressing to continue to provide this type of care. Something had to change and there was little research in this area.”
The experience led Cervantes to shift from clinical work to research aimed at promoting health justice – in the 2020 paper, she called it “driving policy change with data.” She produced a string of studies and helped lead a collaborative research and advocacy effort that, in 2019, spurred a change in Colorado Medicaid’s policy on maintenance dialysis, extending it to those with ESKD.
“This meant that any individual who was uninsured or undocumented who qualifies for Medicaid could receive standard dialysis instead of having to wait until they’re at death’s door,” Cervantes says.
Her research showed that with standard dialysis, “patients’ quality of life improved, their symptom burden improved, and they felt they could be employed again and participate more in their family because they felt better. We have not assessed mortality since the policy change, but people are likely living longer lives because they now have access to standard dialysis. And one study that I published demonstrated a significant cost saving to the state by making the change.”
Creating change
Hilda’s journey, she says, “inspired all this work. All the people who knew her were inspired to change this, a large coalition of people, including community-based organizations.” The research leading to the changes was supported by Denver Health, the CU School of Medicine, and the Robert Wood Johnson Foundation.
Cervantes says she is gratified that interest in and support for health-disparities research “is growing, and I am personally gratified to mentor several junior faculty who are similarly passionate about this kind of work.”
In September 2023 she received a UO1 grant from the National Institutes of Health to fund further research into addressing structural racism as a way to reduce kidney-health disparities, focused on intervention by community health workers supporting Latino people with advanced kidney disease.
“The intersection of research and policy is critically important,” Cervantes says. “You want to be able to do something with that research. You want to fill a gap that's going to create change.”
April 24, 2024