A Passion for Service Leads to Career Spent Solving Puzzles

Few people discern their life’s calling by kindergarten, but Joanne Jordan, M.D., M.P.H., did. The sight on television of a malnourished African child, suffering from kwashiorkor – a protein deficiency characterized by a bloated stomach and spindly legs -- changed her way of thinking.

“I realized that there are people in this world who don’t live like we do in the United States. And some people have horrible lives! Somehow I felt like they didn’t deserve that, anymore than I deserved living a nice life in the U.S.,” she said. That experience, in combination with seeing some family members with health problems, made her realize growing up that sometimes life “really isn’t fair” and that she wanted to do something about that.

Add to that encouraging parents, a parochial school education that stressed good study habits and a strong work ethic, a passion and aptitude for science, and Jordan was on a path to medical school. At Johns Hopkins she was inspired by “giants in the field of rheumatology” and how they were able to make a real difference in people’s lives.

“Rheumatology is sort of the puzzle solver in internal medicine,” she explained. “We tend to see the people that others can’t figure out, or the patient may have some sort of autoimmune condition that no one else is quite sure about. A lot of the diseases we diagnose and treat affect multiple organ systems, so you have to know every piece of the person – you can’t just focus on one part – which was appealing to me. Also, I liked knowing that you would have long-term relationships with your patients, because these are chronic illnesses, for the most part.”

Jordan finished her residency and fellowship at Duke University a mere five days before giving birth to her oldest child. The following year she was able to put together a part-time position at UNC that enabled her to continue balancing motherhood with medicine as she added two more children to her family.

Fast forward 25 years and today Jordan directs UNC’s Thurston Arthritis Research Center, home to more than 70 researchers and physicians from 17 different departments in the UNC Schools of Medicine, Nursing, Public Health, Pharmacy and Dentistry. The center’s members collaborate and conduct both basic science and clinical research in rheumatic disease and immunologic disorders, such as osteoarthritis (OA), rheumatoid arthritis (RA), lupus, vasculitis, fibromyalgia and more.

She is also principal investigator of the Johnston County Osteoarthritis Project, a large, community-based prospective study of people age 45 and older, which she has been involved with since its inception in 1990. The study is the first of its type to include both African-Americans and Caucasians and is unique in its inclusion of radiographic, serologic, genetic and physical and functional examinations of its participants.

“At that time, in 1990, virtually nothing was known about arthritis in African-Americans in this country,” she said. So, a mission of the study is to learn about racial and ethnic disparities in OA. Also, a hallmark of the study is how deeply embedded it is within the community. Jordan and her colleagues feel strongly that it is important to give back and help the community, not just collect data and disappear. They are members of the Chamber of Commerce, employ local residents as staff and regard the relationship as reciprocal and long-lasting.

Because of the wealth of data collected thus far – and continuing to be collected and expanded upon – this study serves as the parent to a host of additional, tightly focused studies using subsets of the data. The researchers involved collect not only biomedical data, but also psychosocial data about how people cope with arthritis, whether they are employed, unemployed or depressed, and is now looking at other chronic conditions, such as osteoporosis, diabetes and heart disease.

Jordan noted that people frequently do not realize how commonly, particularly in the setting of obesity, that arthritis co-occurs with diabetes and heart disease.

“We’re really trying to change the osteoarthritis management model,” she said, to get the message out to both the public and providers about the connection between diabetes, heart disease and OA. For example, the pain from having OA may actually keep people from being active, which is necessary in the management of diabetes and heart disease.

“With childhood obesity happening at younger and younger ages, we are very much anticipating this huge increase in OA, not just from the aging of our population, but from the fact that obesity is happening at younger ages,” she added.

As she looks to the future of the Johnston County OA Project, as well as the role of the Thurston Arthritis Center, Jordan has ambitious plans.

“What we’d really like to do now is expand the operation so we can translate what we and others have learned into interventions and clinical trials in the region,” she said. “Expansion would potentially allow us to bring in pharmacologic clinical trials for arthritis, diabetes, heart disease and all sorts of chronic illnesses.”

“We’re hoping that in collaboration with other relevant entities on campus, we are able to bring in cutting edge interventions to where people live and work in the community,” she said. This would involve having a facility for collecting data and samples in Johnston county and surrounding areas. “That would be a tremendous win-win for the county, the whole area and UNC.”

“We are very conscious of the fact that we at Thurston are the Arthritis Research Center for the people of North Carolina and want that sense of service and mission to permeate the culture and everything we do here.”