Harkness Project Title:    Cross-National Study of Racial Minorities’ Access to Renal Transplantation

Mentor: John Ayanian, M.D.

Placement: Harvard Medical School

Biography at time of Harkness Fellowship: Alan Cass, a 2002-03 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is head of the Renal Program at the George Institute for International Health. His research program spans from global, multi-centre clinical trials generating evidence regarding the effectiveness of interventions in chronic disease, through health systems research exploring barriers to equitable health outcomes, to participatory action research aiming to improve cross-cultural competence in health care. Cass was co-organizer of a Health Policy Roundtable held in Beijing in April 2005, organized in conjunction with the Chinese Ministry of Health, to address safety and quality of health care in China. He is a lead researcher within an Indigenous Health Research Network across Australia, New Zealand and Canada, which includes four Harkness Fellows. The research collaboration aims to reduce disparities in chronic diseases and has a strong focus on research translation. Cass is the chair of the Royal Australasian College of Physicians Taskforce on Equity and Health and Inaugural chair of the Scientific Committee of the Australasian Kidney Trials Network.

Project: Cass used national datasets available in Australia, New Zealand, Canada, and the U.S. to determine disparities in access to renal transplantation for indigenous and ethnic minorities.  He also interviewed key health service providers, policymakers, patients, and family members to investigate barriers to accessing renal transplantation services.  He used the findings to develop strategies for reducing these barriers. 

Career Activity Since Fellowship

• Senior Director, George Institute for International Health, University of Sydney, 2009
• Professor and Director, Poche Centre for Indigenous Health, University of Sydney, 2009
• Kidney Health Australia Award for Best Clinical Nephrology Research, 45^th Annual Scientific Meeting of the Australia and New Zealand Society of Nephrology, 2009
• Associate Professor, Renal Medicine, University of Sydney, 2008
• National Health and Medical Research Council Senior Research Fellowship, 2007-2011
• Don and Lorraine Jacquot Research Establishment Award, Royal Australasian College of Physicians, 2005
• John Chalmers Post-Doctoral Award, George Institute for International Health, 2005
• Senior Lecturer in Medicine and Public Health, University of Sydney, 2004
• Director Policy and Practice Division, The George Institute for International Health, 2004
• Senior Research Fellow, The George Institute for International Health, 2003
• Medical Journal of Australia/Wyeth Award for best research paper published in the Medical Journal of Australia, 2002

E-Mail: acass@thegeorgeinstitute.org

Harkness-Related Publications

Jamieson LM, Paradies YC, Eades S, Chong A, Maple-Brown L, Morris P, Bailie R, Cass A, Roberts-Thomson K, and Brown A. "Ten principles relevant to health research among Indigenous Australian Populations." Medical Journal of Australia. 2012; 197 (1): 16-18.

Anderson K, Yeates K, Cunningham J, Devitt J, Cass A. “They really want to go back home, they hate it here: The importance of place in Canadian health professionals’ views on the barriers facing Aboriginal patients accessing kidney transplants.” Health and Place 2009; 15(1): 390-3.

Yeates KE, Cass A, Sequist TS, McDonald SP, Jardine MJ, Trpeski L, Ayanian JZ. “Renal Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation.” Kidney International 2009; 76(6): 659-64

White S, McGeechan K, Jones M, Cass A, Chadban S, Polkinghorne K, Perkovic V, Roderick P. “Disadvantage and kidney disease: population-representative data from Thailand, Australia and the United States.” American Journal of Public Health 2008; 98(7): 1306-13.

White S, Chadban SJ, Jan S, Chapman J, Cass A. “How Can We Achieve Global Equity in Provision of Renal Replacement Therapy?” World Health Organisation Bulletin, 2008; 86(3): 229-37.

Cunningham J, Cass A, Anderson K, Snelling P, Devitt J, Preece C, Eris J. “Australian Nephrologists’ Attitudes Towards Living Kidney Donation,” Nephrology Dialysis Transplantation 2006; 21:1178-1183.

Cass A. “Health Outcomes in Aboriginal Populations,” Canadian Medical Association Journal 2004; 171(6):9-10.

Cass A, Cunningham J, Snelling P, Wang Z, Hoy W. “Exploring the Pathways Leading from Disadvantage to End-Stage Renal Disease for Indigenous Australians,” Social Science and Medicine 2004; 58(4):767-785.

 Yeates KE, Schaubel DE, Cass A, Sequist TD, Ayanian JZ. “Access to renal transplantation for minority patients with end-stage renal disease in Canada.” American Journal of Kidney Diseases 2004; 44(6): 1083-9.

Sequist TD, Narva AS, Stiles SK, Karp SK, Cass A, Ayanian JZ. “Access to renal transplantation among American Indians and Hispanics.” American Journal of Kidney Diseases 2004; 44(2): 344-52.

Cass A, Devitt J, Preece C, Cunningham J, Anderson K, Snelling P, Eris J, Ayanian JZ. “Barriers to access by Indigenous Australians to kidney transplantation – the IMPAKT study” Nephrology 2004; 9: S144-6.

Cass A, Cunningham J, Snelling P, Wang Z, Hoy W. “Renal Transplantation for Indigenous Australians: Identifying the Barriers to Equitable Access,” Ethnicity and Health 2003; 8(2):111-119

Cass A, Cunningham J, Snelling P, Ayanian JZ. “Late referral to a nephrologist reduces access to renal transplantation.” American Journal of Kidney Diseases 2003; 42(5): 1043-9.