Kit Carson's 46-Year Legacy in Biostatistics and Health Equity at Johns Hopkins University
Johns Hopkins Center for Health Equity core faculty member, Kathryn “Kit” Carson, ScM, is retiring after an impressive 46-year career at both the Bloomberg School of Public Health and the School of Medicine.
Throughout her long and diverse Hopkins career at JHU, Carson, a skilled biostatistician, has worked in various departments and has played a pivotal role in supporting researchers in many departments on their projects. From the early days of computer punch cards to the statistical algorithms of modern biostatistics, Carson helped shape research at JHU so that researchers could build compelling studies that have broadened our understanding of health disparities.
As a young child, Carson developed a passion for math and problem-solving that would later lead to her notable career as a biostatistician.
“I played a lot of board games and card games and counted my father’s coins,” said Carson. “I also loved logic puzzles. Numbers and math came easy to me. There is such simplicity to a math or logic problem—your answer is either right or wrong. It doesn’t involve opinion and usually doesn’t involve interpretation.”
After earning her BA in Mathematics from Frostburg State College (now Frostburg State University) in 1977, Carson began her Hopkins career at the Lipid Research Clinic working on a national study that marked her entry into the world of research. In the early days, Carson programmed computers using punch cards to process scientific data.
“We never even saw the computer that was in the back,” Carson said. “You had to feed in your program and put your data tape on the shelf, and [the computer operators] would come and get the tape and mount it, and then run your analysis for you, and then put these great big green and white printouts out on the shelf. If you made a keypunch error, then you would have to re-punch your cards and start the whole process over. Just to run a simple SPSS (Statistical Package for Social Sciences) program could take you a full day.”
After seven years with the Lipid Research Center, Carson transitioned to a new position as a research program coordinator for the Alzheimer's Disease Research Center. At this time, she also entered graduate school to pursue a Master of Science (ScM) in Biostatistics from the Johns Hopkins University School of Hygiene and Public Health (now Bloomberg School of Public Health). The goal in those days was to help her team “bring in more projects and work on more grants so that [they] could keep the other people funded so they would have work to do,” she said.
Carson was also starting a family. As a young, working mother of two, Carson faced several challenges as she juggled competing priorities and responsibilities at home, work, and school.
“Being a mother always took priority,” she said. “I was working full-time, and it took me several years to complete my master's. I was home from work for a week in 1996 because of a blizzard, and that’s when I found the time to finish my thesis.”
After earning her master’s degree, Carson transitioned to a new position in oncology biostatistics, working under her thesis advisor, Steven Piantadosi, MD. In 2003, Carson transferred to the Department of Epidemiology, which would lead to a significant shift in her career.
“I went to work for Josef Coresh, MD,” said Carson, “and when I started working for him, he said, ‘there's someone I work with who could really use someone like you. Would you be willing to help her with her clinical trials?’ So that's when I started working with Lisa Cooper, MD, MPH.”
The collaboration with Cooper brought Carson into the realm of health equity research, where she has played a crucial role in designing studies, analyzing data, and contributing to publications. Since first embarking on a project with Cooper over 20 years ago, Carson has been an integral part of Cooper’s projects, contributing to significant grants and studies including the Triple P project that began their collaboration, as well as RICHE LIFE, and, most recently, the Mid-Atlantic Center for Cardiometabolic Health Equity (MACCHE).
Reflecting on their 20-year collaboration, Cooper said, “Kit joined my research program as I was just launching my first clinical trial. I’ve learned so much from her about the practical application of research methods over the past 20 years. She has been the bedrock of our research at the Center, making sure we meet our recruitment goals and that we collect, analyze, and interpret our data in a rigorous manner. Beyond that, Kit is loyal, dependable, incredibly generous, and committed to the mission of the Center, including to our training and community engagement efforts. She is an invaluable colleague and friend, and even though she is retiring, we intend to stay in touch with her and engage her as much as she is able!”
Carson’s transition to health equity research took her career in a new direction as she began to work on trials using behavioral interventions to address health disparities in hypertension.
“Most were multi-level interventions, and a few were pragmatic trials,” said Carson, whose previous work had focused on drug trials for brain tumors. Carson enjoyed her new role working with Cooper and found greater meaning in the work. “Hypertension affects many more people than brain tumors,” said Carson. “It also impacts the minority population to a greater extent than whites. If we can find a good intervention to reduce blood pressure that is feasible and sustainable it would improve people’s lives.”
Embarking on this new research venture presented Carson with a set of challenges that underscored the complexities of health equity studies.
"She has been the bedrock of our research at the Center, making sure we meet our recruitment goals and that we collect, analyze, and interpret our data in a rigorous manner."
- Lisa Cooper, MD, MPH
“Because of the number of participants we needed in a study to be able to show differences in blood pressure (particularly for a comparative effectiveness trial), we had to rely on electronic medical record data for blood pressure and other clinical measures,” Carson said.
Despite implementing rigorous training protocols for health system staff to ensure standardized blood pressure measurements, they encountered substantial variability within participants. This variability was influenced by multifaceted factors such as the timing of medication intake, concurrent medications, seasonal variations, and participants’ adherence to blood pressure treatment, especially in the absence of noticeable symptoms. Carson’s candid acknowledgment of these challenges sheds light on the intricate nature of conducting research in real-world settings, emphasizing the need for innovative solutions and a nuanced understanding of participant behavior in the pursuit of meaningful health equity insights.
Beyond her role as a biostatistician, Carson has taught and mentored early-stage investigators, teaching summer intensive courses on clinical research and providing mentorship and guidance.
“I always enjoyed being able to advise [early-stage investigators] on the best way to do their analyses and to assist them with doing it or getting data ready for them to be able to do it on their own if that's what they want to do,” she said. “It has been very rewarding to see how they progress, and I've ended up continuing to consult with a couple of the people who were in my class who actually wanted to do a study and just needed help with the analysis, so they would come back to me.”
Carson has greatly enjoyed sharing her expertise in study design and data analysis, leaving a lasting impression on the next generation of researchers.
“They need to be trained in study design and data analysis in addition to other things that they're working on... to prepare for future study design and data analysis,” said Carson. She stressed that “Hopkins, as a whole, is for training” and that experienced researchers and biostatisticians should feel a deep responsibility to mentor early-career investigators.
Carson’s mentorship role was not limited to researchers. Katie Dietz, MPH, CHE’s operations director, began her career at CHE as a research program manager and remembers the significant role that Carson played in her career growth.
“Kit has made such a substantial impact on me and my career during the 15 years we have worked together at CHE. When I began working with Dr. Cooper, I was new to research program management and I was intimidated by the accomplished research team I found myself working with daily, especially Kit with her incredible attention to detail and deep understanding of all aspects of research” Deitz said. “Kit set a high bar and I was determined to meet it. Thankfully, Kit is also a wonderful teacher who invested time into my development and created space for me to ask questions and admit when I needed help. Kit has been an incredible mentor, colleague, and friend and I am so grateful I had the opportunity to work with her for the past 15 years; she is truly one of a kind!”
Reflecting on her career, Carson highlighted several milestones, including her early involvement in the Lipid Research Clinic, her comprehensive role at the Alzheimer's Disease Research Center, and the success of collaborative projects with Cooper. Carson considers her work on large grants to be particularly gratifying, as she has been able to help secure funding for important health equity research.
Praise and recognition for Carson’s contributions to research teams has shown up in some surprising places. Carson recalls, “I was reading reviewer comments in a grant proposal, and somebody specifically commented that they thought the study would do well because I was willing to devote 50% of my time to the project. And I was like, wow!”
Carson also considers her professional relationship with Cooper as a major career highlight, stating “to know someone who is so well respected internationally and has so many awards and having worked with her first clinical trial on up, that's amazing.”
“Kit set a high bar and I was determined to meet it. Thankfully, Kit is also a wonderful teacher who invested time into my development and created space for me to ask questions and admit when I needed help."
- Katie Dietz, MPH
As Carson prepares for retirement, she shares valuable advice for those entering the field, emphasizing the importance of paying attention to details, actively listening to investigators, and dedicating time and effort to personal education. Carson’s meticulous approach and commitment to her work have left an indelible mark on the research community at Hopkins, and she is eager to see future generations of biostatisticians follow in her footprints.
Carson is excited for life after retirement and has plans to travel across the USA to visit family and tour various cities and National Parks. Most importantly, Carson looks forward to spending more time with her family, particularly her four grandsons.
“It’s wild when they are together,” says Carson, “I feel very blessed that my children chose to live near me... there will be lots of babysitting after I retire!”
Carson's illustrious career, spanning nearly five decades, has been characterized by adaptability in the face of change, dedication to her work, and a passion for research. As Carson bids farewell to the institution, her legacy lives on through the countless projects she contributed to and the researchers she has mentored, leaving an enduring imprint on the field of biostatistics and health equity research. We know she will be greatly missed by faculty, trainees, Community Advisory Board members, and staff at the Center for Health Equity.