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Health care is focus of Keefe’s work
New social work faculty member studies health-care disparities, access
By JESSICA KELTZ
Reporter Contributor
Robert Keefe thought he'd retire from Syracuse University.
"When I got recruited and came here for the interview, I wasn't ready to leave Syracuse, so I said 'no,'" Keefe, who joined the faculty of the UB School of Social Work in August as an associate professor, recalled during a recent interview in his Baldy Hall office. But UB administrators "kept the dialogue going," and ultimately he decided to make the switch, mainly because UB offered a more research-oriented environment.
Robert Keefe says he expected to retire
from Syracuse University, but made the switch to the UB School of Social
Work because the university offered a more research-oriented
environment.
PHOTO: NANCY J. PARISI
Keefe, who specializes in assessing disparities in health and access to health care, said his experiences at Syracuse and as a professional social worker helped him hit the ground running when he got to UB.
"With the emphasis on research being in the air, I was more productive this first semester than I would have been able to be had I stayed in Syracuse," he said.
While in Syracuse, Keefe studied the high rates of HIV infection among African-American women. At first, he said, he didn't understand why one group of women, who were all identified as HIV positive only after giving birth, had been infected—they didn't fit into any of the categories traditionally considered "high risk."
"The fathers of these children had all been incarcerated within a 24-month period," he said. But then, researchers discovered that commonality and interviewed the fathers, who denied engaging in high-risk behavior while incarcerated.
It was only after further investigation that Keefe learned all of the men had gotten tattoos in prison, but not with needles, which the initial questioning would have discovered. Instead, the ink was administered with aluminum foil, but prisoners shared the foil and body fluids mixed with the ink.
Keefe said this study demonstrated that what behavior is and isn't considered to be high risk needs to be better defined, especially in the course of HIV screening.
"The exchange of body fluids—that's really what it's all about, not do you use a needle or not, do you engage in other high-risk behaviors or not," he said.
He said that although he specializes in studying inequality in health and access to health care, he was shocked by the high rates of HIV infection among African-American women.
"We were stunned with some of the findings we had in Syracuse—where much of my research had taken place," said Keefe, who earned a bachelor's degree in sociology from Ithaca College, a master's degree in social work from Case Western Reserve University and a doctorate from the University at Albany.
Other studies he has conducted address the social impact of AIDS drugs that lengthened the lives of men who already had resigned themselves to dying, and the food choices available to residents of poor neighborhoods.
"If you go from market to market, what you'll find is a striking absence of healthy food," Keefe said of the neighborhood convenience stores that serve as a primary grocery source for many people without cars. He and other researchers visited these stores in Syracuse and took note of whether they had certain specific items, such as Cheerios; whether they accepted WIC as payment; and if expiration dates on items had expired.
"Not only do they not have healthy food, but a lot of their healthy food is outdated," he said.
Keefe also filed a Freedom of Information Act request to find out the rates of lottery ticket sales in the Syracuse area and how much of that money went to area schools.
"In Syracuse, the highest per-capita sales were in the poorest ZIP-code areas," he said, adding that those same ZIP codes also had the highest rates of diabetes, heart disease and HIV infection in women. "People are really just living on hope," he said.
Keefe is finishing a number of projects, including going through focus-group data gleaned from HIV-positive women of color, and getting to know the Buffalo area. He says he likes not only the research-oriented environment at UB, but also the collegial atmosphere and the fact that he can interact with people whose research addresses social concerns.
"I'm really thrilled with the collaborative spirit here," he said. "It's really nice to be a part of this type of organization."
The transition has not been without bumps in the road, however. When Keefe decided to take the job at UB, he and his partner had just purchased a home in the Rochester area, specifically locating in Pittsford, just east of the city, to lessen his commute to Syracuse. Now Keefe is an hour and 15 minutes from his job at UB. He decided that was a bit too much of a daily commute, and now rents an apartment in Buffalo's Elmwood Village area, where he stays a few times a week.
"Once you get to be more than an hour (away), I think that's just a bit too far," he said.