A Johns Hopkins physician who studies the effect of racial differences in the examining room and an environmental geographer at the University of Maryland who uses satellites to map tropical deforestation are among the latest recipients of MacArthur "genius" grants.
Dr. Lisa A. Cooper of Columbia and Ruth DeFries of Washington will receive $500,000 each over the next five years to use however they see fit - no strings attached.
They are among 24 winners of this year's MacArthur Fellows Program grants - chosen for their creativity, the originality of their work and their potential to make important contributions in their fields.
Other recipients include a forensic anthropologist investigating crimes against humanity in Argentina, a short-story author in Illinois, a water-quality engineer at Virginia Tech, a spider silk biologist in California and an explosives engineer in New Mexico.
MacArthur nominations are supposed to be secret. But the 44-year-old Cooper, an internist, epidemiologist and professor of general internal medicine, got wind of hers well in advance. "Somebody leaked word to me last year that I'd been nominated," she said.
Although she was the sixth MacArthur recipient to win while working at Hopkins, she said she had never heard of the grants before learning about the nomination.
"I looked it up, and said, 'Wow!'" she recalled, but when months passed with no more news, she forgot about the whole thing. "When I got the phone call this week, I thought someone was trying to play a joke on me," she said.
Although research on racial disparities in medical care have traditionally focused on access to doctors, Cooper found additional reasons for the problem: black patients are less likely to trust their doctors and less likely to challenge authority and ask questions than white patients.
They're also more likely than whites to worry about personal privacy, addiction to antidepressant drugs and the potential for harmful experimentation.
Cooper said the MacArthur Fellows grants speak directly to a persistent problem academic researchers face obtaining funding. "Sometimes you have ideas that are just not in the mainstream. People think you're kind of crazy, and say, 'Why would you want to study that kind of population? It's too hard,'" she said.
The "no-strings" grants, she said, "mean somebody is willing to take a chance on you ... based on what you've done in the past; that you are promising enough that you'll deliver something on it. ... It's really exciting."
Dr. Edward D. Miller, dean and CEO of Johns Hopkins Medicine, said Cooper's work is "absolutely critical to the mission of delivering the benefits and advances in health care to all who need them."
Cooper grew up in Liberia, the daughter of a surgeon and a reference librarian. Schooled in Switzerland, she fled violence in Liberia in 1980 with her family.
She earned a bachelor's degree in chemistry from Emory University in Atlanta, and her M.D. from the University of North Carolina at Chapel Hill. She completed her internship and residency at the University of Maryland, and earned a master's in public health at Hopkins.
Cooper's research at Hopkins has focused on the cultural and social roots of disparities in health care outcomes among minorities.
"What we've shown is that there are differences in the communication process between minorities and whites" that appear to have an impact on medical outcomes, she explained. "Minority patients talk less, ask fewer questions and basically sound less assertive and interested when they're seeing [white] doctors."
For their part, the doctors and other providers "talk to the patient, but maybe in a way where the patient doesn't get a chance to express ... why they're there, and what's worrying them. We don't know whether they [patients] have understood when they leave," Cooper said.
A study she published in 2003 showed same-race patient visits are 2 1/2 minutes longer than different-race visits. Patients also reported being more satisfied and more involved in their treatment when their doctor was of the same race.
Other work is attempting to determine what changes in their approach to examining room conversations might improve how white providers relate to minority patients, and patients' adherence to treatment.
With support from her MacArthur grant, Cooper hopes to remain at Hopkins, but take time to extend her work into the developing world, perhaps to Liberia and even to Europe, where minority groups receive poorer health care. "This is a global problem," she said.
Ruth DeFries, 50, works in College Park's Earth System Science Interdisciplinary Center and Department of Geography, using satellites to research the rapid changes humans are making to the environment.
Officials believe she's the first College Park faculty member to win a MacArthur grant, although five graduates have won the awards later in their careers.
Working with NASA satellite imagery, DeFries uses light and heat reflected from the Earth's surface to build maps of the tropical forests. "It's a perspective we can't get any other way," said DeFries. "It allows us to understand how humans are transforming the landscape and how those changes are transforming the planet."
Her work has improved the precision of satellite maps of tropical deforestation, a key measurement in predicting global warming. Forest depletion reduces the planet's ability to absorb carbon dioxide from the atmosphere.
She has focused on central Africa, Southeast Asia and the Brazilian Amazon. She has recently expanded her research to look at how wood is used by people in India.
John Townshend, chair of Maryland's Department of Geography, hired DeFries in 1991. "Her [calculations] are becoming the baseline by which people are exploring changes to the earth's surfaces," he said.
Using computer maps, DeFries and other scientists can cross-reference deforestation with information about the diet, health, livelihood, energy consumption, transportation and agricultural methods of people in the region to discern how such factors influence the environment.
DeFries earned a bachelor's degree from Washington University in St. Louis in 1976 and a doctorate from the Johns Hopkins University in 1980. She worked as a research scientist at the India Institute of Technology in Bombay from 1980 to 1983 and then as a senior project officer at the National Research Council from 1987 to 1991.
Earlier this year she received a Fulbright award and last year she was elected to the National Academy of Sciences, an elite group of 2,100 leading American researchers.
Townshend said DeFries worked part time for several years so that she could spend more time with her two children. "She's a very good example of how a woman can combine having a family and an extremely successful career."
"She provides guidance, but she allows her students a lot of freedom to develop their own ideas," said Jan Dempewolf, a student of DeFries who just received his doctorate from Maryland.
DeFries said she learned of the award by phone last week. "I was sure shocked," she said. "I had the idea that someone was playing a practical joke on me."
The MacArthur Fellows Program has made 20 to 25 grants annually since 1981. The awards are funded by income from the $6.4 billion endowment of the John D. and Catherine T. MacArthur Foundation. The program has given out 756 fellowships to date.