Dr. Jessica Williams, Assistant Professor of Medicine, WashU Medicine Division of Rheumatology, is a dedicated rheumatologist and clinical researcher with a deep commitment to advancing our understanding of lupus, an autoimmune disease of unknown cause that disproportionately affects women, racial and ethnic minorities, and individuals from lower socioeconomic backgrounds. Her work aims to uncover the reasons behind these disparities and develop strategies to improve diagnosis, treatment, and outcomes for affected populations.
Joining WashU Medicine: A Collaborative Effort
Dr. Williams journey to WashU Medicine was influenced by a combination of professional alignment and personal connections. Her husband, a minimally invasive gastrointestinal surgeon at WashU, was finishing his fellowship and exploring new opportunities when he connected with the university. During this time, Dr. Williams connected with rheumatology leadership at WashU Medicine to discuss a potential career opportunities. With a shared interest in rural health and social determinants of health, key areas that Dr. Williams had already been focusing on, the fit with WashU Medicine Division of Rheumatology was clear. This parallel recruiting effort brought both her and her husband to WashU, where they could each pursue their professional goals.
The Path to Rheumatology and Research
When Dr. Williams first entered medical school, she envisioned a career focused solely on clinical care. However, her interest in public health and epidemiology led her to pursue a Master of Public Health (MPH) in Epidemiology, enhancing her skills in large-scale study design and population health. Her training at Harvard, a highly research-oriented institution, further exposed her to the value of integrating research into clinical practice. As her career progressed, she realized the importance of understanding the root causes of diseases like lupus, which drew her to rheumatology and specifically to lupus research.
“Lupus, in particular, attracted me because it disproportionately affects young women, many of whom are women of color. This focus on a vulnerable and underserved population made the specialty even more compelling to me, especially as research into lupus has the potential to make significant improvements in patient care.”
Jessica Williams, MD
Understanding Lupus and Its Impact
Lupus is an autoimmune disease where the immune system attacks the body’s own tissues, affecting organs like the skin, joints, kidneys, blood vessels, and even the brain. Due to the nature of the disease, patients experience cycles of flare-ups, where the disease is active, followed by periods of remission where symptoms seem to disappear. This can make diagnosis difficult, often leading to delays of up to six years between the onset of symptoms and a formal diagnosis.
Dr. Williams research is focused on understanding why lupus impacts certain populations more severely, particularly those from lower socioeconomic backgrounds. Despite lupus being more common in these populations, the reasons behind these disparities remain unclear. Williams aims to explore non-genetic risk factors, such as environmental exposures and social determinants of health, to better understand the underlying causes of these differences and improve outcomes.
Key Symptoms of Lupus
Lupus symptoms vary greatly but often include fatigue, rashes, and joint pain. Fatigue is particularly common, though it can be a symptom of many different conditions, making it hard to pinpoint lupus as the cause. As many lupus patients are young women, often of childbearing age, the symptoms can easily be dismissed as stress or hormonal changes. However, Dr. Williams emphasizes the importance of documenting symptoms—especially skin rashes by taking photographs—as they can help speed up diagnosis.
Research on Rural Health and Lupus
One of Dr. Williams current projects at WashU focuses on lupus patients living in rural areas. Rural communities in the U.S. face significant healthcare access challenges, with approximately 84% of rural areas lacking a practicing rheumatologist. Missouri, in particular, is more rural than the national average, with about a third of its population residing in rural areas.
Her research aims to assess the burden of lupus in rural Missouri, where delays in diagnosis and inadequate access to specialty care may worsen health outcomes. By examining care patterns, and risk factors for poor patient outcomes, Dr. Williams hopes to better understand the burden of lupus in rural populations in order to design future interventions to improve outcomes in this population. She is particularly interested in understanding how environmental factors, such as proximity to toxic release sites or areas with higher air pollution, may be contributing to poor lupus outcomes.
Investigating Rural Health Needs
Dr. Williams is working to reach rural communities in Missouri by connecting with the few rheumatology practices available in these areas. Her study involves surveying patients to gather information about their living conditions, environmental exposures, and social determinants of health. This data will help assess whether these factors are linked to increased risks of experiencing severe outcomes, such as kidney disease or death. The research team is particularly focused on the Bootheel region of southeastern Missouri, where poverty and limited healthcare access, are more pronounced.
Through outreach to rural healthcare providers and collaborations with WashU, Dr. Williams hopes to reach more lupus patients and improve their care, both in rural areas and within the WashU system.
Williams work continues to inspire change in the field of rheumatology and lupus research, with a strong commitment to improving the lives of patients, particularly those from underserved communities.