Understanding the Role of Trust

With Dr. Altaf Saadi and Dr. Consuelo H. Wilkins

Racial differences in Parkinson’s treatment and mortality exist. When it comes to addressing these disparities, the concept of trust comes up in nearly every conversation. But what do we really mean when we talk about trust? In this conversation, Dr. Altaf Saadi and Dr. Consuelo H. Wilkins examined the concept of trust, what we mean when we talk about trust, and how trust is necessary to address health disparities. A few of the questions our panelists answered included:

  • What do we mean when we talk about trust?
  • How can trust be built?
  • What causes trust to break down?
  • How can we measure trust?
  • How can communities use existing, trusted relationships to address health disparities?
  • How can health care providers and health care institutions be more trustworthy?


Altaf Saadi, MD, MSc

Altaf Saadi, MD, MSc is a general academic neurologist at Massachusetts General Hospital (MGH) and assistant professor of neurology at Harvard Medical School. She is also associate director of the MGH Asylum Clinic. Her research is focused on health disparities and social and structural determinants of health among racial/ethnic minorities, immigrants, and refugees.

Dr. Saadi completed her neurology training at the Partners Neurology Program at MGH and Brigham and Women’s Hospital in Boston, where she also served as chief resident. During her residency, Dr. Saadi’s interest in health equity led her to work in resource-limited settings in the Navajo Nation, Tanzania, Zambia, with Boston Healthcare for the Homeless, and with the Doctors Without Borders telemedicine program.

Her research training includes a fellowship with the National Clinician Scholars Program at UCLA, where she conducted several health services research projects and received a master’s degree in health policy and management at the UCLA Fielding School of Public Health. One of her projects focused on understanding how hospitals and health care facilities can ensure that all patients feel safe when accessing health care, regardless of their immigration status, exploring the concept of “sanctuary” and “safe spaces” in the clinical setting.

Consuelo H. Wilkins, MD, MCSI

Consuelo H. Wilkins, MD, MCSI, is a nationally recognized physician-scientist leader in health equity research focused on integrating social, cultural, and environmental factors into clinical and translational research. Dr. Wilkins is a Professor of Medicine in the Division of Geriatric Medicine within the Department of Medicine at Vanderbilt University Medical Center. She is Senior Vice President, Health Equity and Inclusive Excellence, VUMC; and Senior Associate Dean, Health Equity and Inclusive Excellence, Vanderbilt University School of Medicine.

Among Dr. Wilkins’ many contributions to science is her prescient focus on engaging racial and ethnic minority communities, using implementation science methodologies in the design and conduct of clinical research. She has pioneered efforts to move the academic and clinical research enterprise to transform approaches to clinical research design by embedding participant and community engagement in every aspect of biomedical discovery. An elected member of the National Academy of Medicine, she has published over 100 papers on her research. 

Dr. Wilkins’ impact is evident in the diversity of her research funding, which includes being PI of multiple, large NIH research center awards: the Vanderbilt-Miami-Meharry Center of Excellence in Precision Medicine and Population Health; the Vanderbilt Institute for Clinical and Translational Research; the Center for Improving Clinical Trial Education Recruitment and Enrollment at CTSA Hubs. As Director of the Engagement Core of the All of Us Research Program (a component of the Precision Medicine Initiative), Dr. Wilkins oversees initiatives that meaningfully engage research participants in the governance, oversight, implementation, and dissemination of the program. She has also been PI of a Robert Wood Johnson Foundation Award on measuring and engendering trust in healthcare among African American men and a Patient-Centered Outcomes Research Award on Improving Patient Engagement and Understanding Its Impact on Research.  

Prior to joining the faculty at Vanderbilt University Medical Center in 2012, Dr. Wilkins was an Associate Professor in the Department of Medicine, Division of Geriatrics, with secondary appointments in Psychiatry and Surgery (Public Health Sciences) at Washington University School of Medicine in St. Louis. She served as the founding Director of the Center for Community Health and Partnerships in the Institute for Public Health, the Co-Director of the Center for Community-Engaged Research in the Clinical and Translational Science Awards Program, and the Director of “Our Community, Our Health,” a collaborative program with St. Louis University to disseminate culturally relevant health information and facilitate community–academic partnerships to address health disparities.